No booze is good booze
Seeing a lot of discussion about Canada’s stern new directives on alcohol consumption: two drinks max per week, better to have none. Even the BBC asks why the rapid drop from the previous guideline of ten drinks a week for women and 15 for men.
jeather 12:06 on 2023-01-18 Permalink
I don’t drink two drinks per month but even for me that sounds incredibly low. And honestly, something like 90% of people drink on average less than 1 drink a day, 10% average less than 2 drinks a day, and the remaining 10% who drink 10 a day (IIRC these are American stats which I assume are similar to Canadian ones) aren’t the ones who are going to be convinced..
Kevin 12:24 on 2023-01-18 Permalink
One takeaway is that in previous research, the group of non-drinkers has included a lot of people who are ex-drinkers because they’ve already suffered a lot of damage. These new guidelines exclude those sick people — which makes it a bit clearer how much damage alcohol causes.
carswell 12:46 on 2023-01-18 Permalink
Neoprohibitionism on the march!
Kate 12:46 on 2023-01-18 Permalink
i was wondering whether there are statistics showing that lifelong non-drinkers – observant Muslims and any others – suffer less morbidity than people who drink even a llittle, socially.
On the other side of the coin, I’ve wondered whether the whole thing about wine in the Mediterranean diet being healthy wasn’t really more about the social connections that come with it than anything in the wine itself.
Kate 12:48 on 2023-01-18 Permalink
carswell, I’ve seen comments attempting to link this new directive with Ontario’s swerve to privatizing health care – setting up a scenario where patients could be blamed for their ills, which would then not be covered by insurance.
carswell 13:01 on 2023-01-18 Permalink
@Kate I also wondered about the drinking habits of the study subjects. How many of them drank but never touched the hard stuff? How many drank but only when eating? How many limited their consumption to minimally processed, low-alcohol beverages (e.g. “natural” wines)?
Wine is currently being stripped of several popular myths. For example, contrary to earlier claims, reservatrol is increasingly thought to have little or no positive impact on heart health.
Uatu 13:06 on 2023-01-18 Permalink
@kate I read an article that cancer rates in the middle East were lower than NA and that was attributed to no alcohol according to the article.
DeWolf 13:24 on 2023-01-18 Permalink
I wonder if these new guidelines won’t do more harm than good. The old guidelines, versions of which are still in place in most countries, felt like a reasonable goal. You could in theory follow them while still being able to have a drink with dinner or join your friends for a 5 à 7. But these new ones are so severe people are likely to ignore them completely. They’re basically saying we should all be teetotallers.
That doesn’t even begin to touch on the irony of the government telling us not to drink while also running a liquor monopoly with a big marketing budget.
shawn 13:39 on 2023-01-18 Permalink
Well, as someone who is basically a teetotaller with little interest in drinking, I do think that should be encouraged. It’s a Level 1 carcinogen. If it’s any small consolation we’ve seen a similar shift for processed meats. In the past they were lumped with red meats but now they’ve been split off and guidelines are saying basically zero consumption to avoid increased cancer rates?
Kate 14:28 on 2023-01-18 Permalink
shawn, that’s so depressing. One of my personal treat rewards is a “petit ménage” from Les Cochons Tout Ronds and a glass of red.
Kevin 14:30 on 2023-01-18 Permalink
I don’t think we’re at the level of California, where everything is a known carcinogen — but I do think it’s an honest attempt at opening a discussion about risk factors.
There is risk in everything — my preferred mode of transport is an engine with two wheels strapped to it — but we should be adult enough to accept it with eyes wide open.
shawn 14:40 on 2023-01-18 Permalink
Well, Kate, and just as much a treat for me is the occasional bit of bacon or a pepperoni pizza!
Blork 15:49 on 2023-01-18 Permalink
I don’t think this is a “directive” from the government, although some alarmist media like to present it that way. At this point it is a change in the GUIDELINES published by the government. (Maybe splitting hairs here, but in English a “directive” is essentially an order from an authority whereas a “guideline” is a suggestion, or the presentation of data to allow for your own informed decision making.)
I’ve heard a number of health experts speak on this, and most of them, when asked directly, say something along the lines of “this is to inform people that our perception of the risks has changed, and to use that information to make your own decisions.”
That said, drinking culture is definitely shifting away from its former state of being fully integrated with all aspects of “society.” Not only are people on average drinking less (I don’t have those stats on hand, but I’ve seen it reported many times in the past few years) but there are more low alcohol and even zero-alcohol alternatives on the market than ever before. I haven’t tried any, but there are zero-alcohol sprits (gin, and even whiskeys) available, and not just in niche markets. My local Provigo stocks quite a few, along with zero-alcohol craft beers.
Personally, I have largely shifted to “session” beers over the past year or so, although they’re not easy to find at pubs and whatnot. But the beer stores have a lot of craft-brewed session beers and even “nano” beers, such as Vagabond Hop (a 2.5% IPA that is actually pretty good). Boreal makes both a nano-IPA and a session IPA, and they are essentially my house beers now.
Read a novel set in the 1950s or 1960s and you can barely go two pages without someone getting a drink. Drinks were ubiquitous. All conversations started with a drink. All evenings ended with a drink. All moments of personal reflection took place over a lowball glass.
We’re very far from that now. Drinking as a ubiquitous cultural phenomenon is receding, not unlike smoking has over the past couple of decades. (Does anyone remember the DOOM SAYERS who all claimed that every bar and pub in the city would be out of business within six months once they banned indoor smoking? Ha!)
Side note: the bit about connecting this to the privatization of healthcare is right out of “Conspiracy Theory Theatre” and is just silly.
(For the uninitiated, “session” beers take their name from the lower alcohol beers that people would sometimes choose in the UK and Ireland when they were at the pub with their friends for a drinking session but they didn’t want to get drunk. They knew they’d knock back six or eight pints before the night was over, and if they wanted to stay relatively sober they’d drink a lower alcohol “session” beer, which in Ireland also had the advantage of being less expensive because the taxes on beer were related to their alcohol content. In recent years the “session” moniker has been picked up by craft brewers for lower alcohol brews, typically about 3.5% alcohol.)
shawn 16:39 on 2023-01-18 Permalink
Yes there’s lots of articles and opinions about the “Prop 65” warnings, courtesy of the state of California and the litigious legal system. It slaps labels on things that you may not ingest at all.
H. John 21:38 on 2023-01-18 Permalink
I’m struck by the difference in tone between the Radio-Canada article, and the one by CBC:
https://www.cbc.ca/news/health/alcohol-cancer-risk-warning-1.6715769
From the Canadian Centre on Substance Use and Addiction’s web post:
“CCSA proudly led the initiative to update Canada’s Low-Risk Alcohol Drinking Guidelines (LRDGs). The project, funded by Health Canada, began in July 2020. The two-and-a-half-year process culminated in the creation of Canada’s Guidance on Alcohol and Health, which replaces the LRDGs.
Canada’s Guidance on Alcohol and Health provides people living in Canada with the information they need to make well-informed and responsible decisions about their alcohol consumption.”
It is not based on a single study:
“Paradis says the panel spent the last two years combing through nearly 6,000 peer-reviewed studies,…”
Their report:
https://ccsa.ca/canadas-guidance-alcohol-and-health
H. John 21:45 on 2023-01-18 Permalink
The CCSA web site explains who they are:
“An Act of Parliament created the Canadian Centre on Substance Use and Addiction (CCSA) in 1988 as a non-governmental organization to provide national leadership on substance use and to advance solutions to address alcohol- and other drug-related harms.”
Blork 21:50 on 2023-01-18 Permalink
I wish it were easier to get a clear sense of what those risks are. For example, if you take two drinks per week and you have a one-in-a-million chance of getting cancer from it, or you take 10 drinks per week and you have a two-in-a-million chance of getting cancer from it, then OMG YOUR CHANCES OF GETTING CANCER HAVE DOUBLED but it’s still pretty darn low.
I’m not saying the numbers are like that. I’m saying nobody is discussing the actual numbers so we don’t know if they’re like that or not. All we have are subjective words like “increased” and whatnot. Show us the numbers!
H. John 22:17 on 2023-01-18 Permalink
Another take by CBC:
https://www.cbc.ca/news/canada/alcohol-risks-cancer-questions-answered-research-canada-1.6718211
jeather 23:14 on 2023-01-18 Permalink
“Increased” is not subjective. It doesn’t give a lot of detail, as you note, but it is in fact objective.
MarcG 10:16 on 2023-01-19 Permalink
@Blork: The closest the report comes to your request seems to be in the “Risk Associated with Weekly Levels of Alcohol Use” section: 2 drinks per week = 1 in 1,000 risk of premature death, 3 to 6 drinks per week = 1 in 100 risk of premature death.
PatrickC 10:34 on 2023-01-19 Permalink
@Kevin and Shawn, a belated note about California and carcinogens. Last year, LL Bean wouldn’t ship me some mocassins with rubber-like soles, similar to older ones I had used for years, because some component in them violated California rules. had to get them wen I traveled to another state.
Blork 10:36 on 2023-01-19 Permalink
Thanks @MarcG. That is a significant difference!
shawn 10:57 on 2023-01-19 Permalink
PatrickC, that’s funny. I’ve never been sure about the ethical stance of LL Bean – or maybe it’s just fear of litigation. Don’t eat your shoe soles!
Meezly 11:12 on 2023-01-19 Permalink
I agree with Blork about the cultural shift in attitudes re: alcohol consumption is similar to the public campaign against smoking and that the CCSA updates are merely guidelines, not directives. I also agree with John H. that the CCSA guidelines are only recommendations based on hundreds of studies done by other entities. There has definitely been a surge of new research on the effects of moderate alcohol use on health, which is a good thing, but it’s also a very complex area to draw clear evidence-based guidelines from.
I believe that the CCSA is using a lowest common denominator approach with the goal of minimizing health loss across all alcohol-attributable outcomes in a population. Thresholds exist for different purposes; in terms of injury prevention, several countries have moved to a zero-tolerance threshold that is consistent with evidence of the entirely harmful effect of alcohol consumption on injuries, as well as triggers for domestic violence and abuse.
I find it interesting that the CCSA guidelines didn’t seem to consider key recommendations from the Lancet study last year that looked at alcohol consumption on a global scale (funded by the Gates Foundation so they had tons of money): https://www.healthdata.org/news-release/lancet-alcohol-consumption-carries-significant-health-risks-and-no-benefits-young
The findings of this study suggested that guidelines should not incorporate sex-specific recommendations, given the absence of data by sex across geographies and locations, but instead should focus on age and region. An example is that the majority of the world’s population consuming harmful amounts of alcohol are young adults and predominantly young males, so in order to minimize health loss due to alcohol consumption it is important to prioritize interventions targeted at these demographic groups. Another example is that alcohol use poses a greater risk to population health in areas with a high prevalence of tuberculosis than in areas with low prevalence.
The CCSA guidelines don’t seem to be considering these factors. But as the Lancet study states: “countries navigate the epidemiological transition and their background rates of disease evolve from infectious diseases and injuries to non-communicable diseases, policy recommendations will need to evolve as well.”
I remember the scare-mongering articles from a couple of years ago about a study that showed evidence that alcohol consumption can cause cancer. I found the study to read for myself and learned that they only looked at individuals who lacked the enzyme needed to break down the ethanol, because it’s much easier to see the direct causal relation of how alcohol as a potential carcinogen can impact a healthy human body. But they didn’t look at how alcohol could affect people that had the enzyme.
Obvs, alcohol is a legal, regulated drug that’s quite easily accessible, so that’s another reason for the lowest common denominator approach of these guidelines. The positives of the CCSA guidelines is that it’s educating the public. And obvs, if you have a family history of cancer, then definitely try to follow the guidelines and try to cut down on drinking if you’ve been well above the guidelines.
GC 13:31 on 2023-01-19 Permalink
Thanks for quantifying that, MarcG. That is a big difference!
shawn 13:42 on 2023-01-19 Permalink
I don’t know about that, Meezly. When we drink alcohol, our body breaks it down into a chemical called acetaldehyde. Acetaldehyde damages DNA. But yes: there is a recent study that suggests that some who lack an “ALDH2 enzyme” would be even more susceptible to DNA damage.
Meezly 14:09 on 2023-01-19 Permalink
There are apparently two distinct mechanisms in our bodies that can repair this type DNA damage, according to a 2020 study: https://www.nature.com/articles/s41586-020-2059-5.
Obvs, alcohol abuse will result in an accumulation of ICL damage that may lead to cell death and cancer.
“The first line of defense against ICLs caused by acetaldehyde is the ALDH2 enzyme, that largely breaks down acetaldehyde before it causes any harm. However, not everyone profits from this enzyme – about half of the Asian population, more than 2 billion people worldwide, possess a mutation in the gene coding for this enzyme. Because they are not able to break down acetaldehyde, they are more prone to develop alcohol-related cancer…. the second line of defense against alcohol-induced ICLs: mechanisms that remove the damage from the DNA. The investigators studied these mechanisms using protein extracts made from the eggs of the clawed frog (Xenopus laevis), an animal model commonly used in biology research. By using these extracts to repair an ICL formed by acetaldehyde, they discovered the existence of two mechanisms that repair ICL damage: the previously known Fanconi anemia (FA) pathway and a novel, faster route. These two mechanisms differ from each other: in the FA pathway the DNA is cut to remove the ICL, whereas the enzymes in the newly discovered route cut the crosslink itself.”