Booze Isn’t Good For You?

There are more old drunks than there are old doctors.

booze alcohol whisky
Photo by Jeff Drongowski under CC BY 2.0 license

Washington Post food columnist Tamar Haspel asks, “Is moderate drinking good for you?” Avoiding Betteridge’s law, the headline immediately answers itself: “Despite what you’ve read, probably not.”

As a moderate drinker, I desperately want to believe that moderate drinking is good for you. January, when a lot of us (including me) cut back on alcohol, seems like a good time to see if it actually is.

For a while there, it was looking good. The idea that some alcohol improved some health outcomes was widely accepted for quite some time. A meta-analysis published in the BMJ a decade ago is typical: “Light to moderate alcohol consumption is associated with a reduced risk of multiple cardiovascular outcomes,” it concludes.

The association is remarkably consistent across studies and populations. People who drink moderately (the definition varies; it’s usually one to two drinks per day) have better health outcomes than either people who don’t drink at all or who drink a lot. Graph that, and the curve looks like a J.

Lately, though, scientists and researchers are beginning to doubt. So am I, for two reasons.

First, there are questions about the reliability of all that evidence, most of which is observational.

Second, there’s a new way to study this, and it’s not looking good.

Let’s look at the observational evidence first. Because alcohol is addictive, and undoubtedly unhealthy in large quantities, running trials in which you give it to people is problematic. There have been some trials, but most of the evidence we have comes from asking people how much they drink and then seeing what happens to them.

But in 2013, a Norwegian psychologist named Hans Olav Fekjaer, who studies addiction and substance abuse, widened the lens. He published an overview of many things whose risks were said to be decreased by moderate drinking, and it was a very long list.

Lots of the items on his list jibe with the ideas at the time: cardiovascular health, cancer mortality, stroke. But then there’s hearing loss. Asthma. Gallstones. The common cold, really? Although I have a friend who asserts that tequila does indeed ward off colds, the rest of us probably balk at the idea that a glass of wine with dinner is protective.

This is a clue that maybe those associations aren’t about the alcohol. They’re about the lifestyle of people who have a drink or two.

There’s a whole lot more to the piece, mostly expounding on that “clue.” But most of us have presumed that correlation was not causation here.

My drinking is on the high side of moderate. Some might say higher. I do enjoy a good pre-dinner cocktail. And a glass of wine or two while cooking and consuming dinner. And, if someone offers me a postprandial cognac or whisky, who am I to refuse?

But, never once, did I say to myself, “James, this is making you live longer. You owe it to your future self to have another.”

Yes, booze is the “water of life” in many languages. Whether aqua vitae, eau de vie, akvavit, or, my personal favorite, uisce beatha (whisky), it’s been part of the human experience since time immemorial. Most of those people are dead now.

FILED UNDER: Entertainment, Health
James Joyner
About James Joyner
James Joyner is Professor and Department Head of Security Studies at Marine Corps University's Command and Staff College and a nonresident senior fellow at the Scowcroft Center for Strategy and Security at the Atlantic Council. He's a former Army officer and Desert Storm vet. Views expressed here are his own. Follow James on Twitter @DrJJoyner.

Comments

  1. Sleeping Dog says:

    Sooner or later, something is going to get you and when you look at how much longer the supposed life expectancy is, I’d rather enjoy a cold one.

    Cheers!

    3
  2. CSK says:

    My father had a quintuple bypass in 1998. Several doctors advised him to have one glass of red wine with dinner. He had that, and also a pre-dinner vodka martini. Never more than that, never less.

    He lived happily and heathily till he was well past 94.

    2
  3. Kathy says:

    In ancient times, it was healthier to drink wine or beer because the alcohol helped kill off bacteria in drinking water. the Romans watered down their wine, for instance. Beer also served as a way to preserve wheat for weeks or months (ancient beer was more like juice with pulp than the clear brew we know today).

    So, the ancients probably saw a correlation between drinking alcohol and relatively good health, which would also lead to a longer life (on average), and deemed wine and beer to be good. Also, pretty much all ancient civilizations had some sort of alcoholic drink made from what was locally available, just as all had some form of vegetable oil as well.

    1
  4. OzarkHillbilly says:

    Ah, fill the cup.
    What boots it to repeat
    how time is slipping beneath our feet.
    Unborn tomorrow and dead yesterday
    What matter they if today be sweet?

    -the Rhubaiyat of Omar Khayyam

    4
  5. Scott says:

    @Kathy: Whiskey is also how Kentuckians got their corn to market back in the day. Grapes and other fruit were preserved for the same reason. Stretching out calories year round.

    1
  6. Stormy Dragon says:

    @OzarkHillbilly:

    Also Omar Khayyam:

    I wonder what the vintners buy / one half so precious as the stuff they sell.

  7. MarkedMan says:

    @Scott: It can throw you off when you read revolutionary war era descriptions of meetings and they “take a pause to pass the corn around”.

    1
  8. just nutha says:

    There are more old drunks than there are old doctors.

    True. But only because there are more drunks to begin with. 😉

    1
  9. just nutha says:

    Beyond the observation above, good for you, bad for you, helpful, harmful are all just words mostly being taken out of context in these discussions. Alcohol is a substance that carries known and measured risks. So are ephedra, epinephrine, theophylline, and prednisone–all of which I took in copious quantities for 25 or so years until the next generation of asthma medicines came along. Of course, my situation was different in that I took those things with the understanding that the risks were outweighed by the benefit of being able to breathe and not be bedridden. But the health problems that I have now are attributable to the risks I had to assume then. It’s the same with alcohol except that it doesn’t have the reputation of being a necessary theraputic.

    Drink. Abstain. Moderate. The choice is yours. Same with tobacco [collective gasp from the audience]. There’s a joke my doctor told me years ago about asthma that goes that most asthmatics die from emphysema or complications with having contracted pneumonia–and the rest die in airplane crashes. I’m working on the dying in an airplane crash one, but Covid-19 really got in the way of that.

  10. Gustopher says:

    As a moderate drinker, I desperately want…

    Maybe not so moderate. Sounds like he might be a chocoholic, but for booze.

  11. Andy says:

    My drinking is on the high side of moderate. Some might say higher. I do enjoy a good pre-dinner cocktail. And a glass of wine or two while cooking and consuming dinner. And, if someone offers me a postprandial cognac or whisky, who am I to refuse?

    That was me a year ago. Medical testing showed pretty conclusively that was not healthy for me, despite my enjoyment. I could keep it up for another five or ten years, but after that time I’d have serious liver damage and the growing fatty organ tissue would also be a serious problem.

    It sucks, because I really enjoyed my evening routine. My doctors have told me I should stop drinking completely, but I haven’t been able to do that yet. I have cut way, way down though.

  12. James Joyner says:

    @Andy: I suspect a physician might offer me similar advice were I to seek it. I came to enjoy drinking late in life but really appreciate it at this point. But it’s hard to stop at two.

    2
  13. CSK says:

    There are people who separate humanity into two groups: teetotalers and alcoholics. I’ve known one or two (happily, there aren’t many) like this. According to them, everyone commenting on this thread, including the author of the piece, James Joyner, is a hopeless lush.

  14. flat earth luddite says:

    I’m descended from a long line of functional(?) alcoholics and substance abusers. That being said, I never really had a problem with controlling my intake, because I hate being out of control.

    As a Stage IV cancer survivor, one of the ugliest cancer treatments and follow-up was the surgery to remove a 2+cm tumor from my liver. Shorter duration but way uglier than the 3+ years of bi-weekly chemotherapy. I remember sitting in the spa (chemo room) a couple of months after the liver resection and commenting to the nurse that “Christ, I really need a drink.” She came back 10 minutes later and told me that the doctor said moderate alcohol usage was fine, as my liver showed no signs of serious damage, and I was nicely recovered from the liver surgery.

    So, like many here, I’m going to continue the behaviors that will likely kill me. Of course, the last time I checked, I’m going to go anyway, but I figure I’m still playing on the house’s $$$. Not everyone can drink rationally, and I’m happy for those who can recognize this.

    5
  15. Andy says:

    @James Joyner:

    It is hard. And on the days I do drink (1-2 times a week now), I don’t stop at two but maintain my usual 3-4.

  16. Daryl and his brother Darryl says:

    @James Joyner:

    But it’s hard to stop at two.

    Everything in moderation. Including moderation.

    4
  17. gVOR08 says:

    The only think I feel sure of about this and similar topics is that popular press articles about diet, nutrition, and health are essentially useless.

    1
  18. Andy says:

    @Daryl and his brother Darryl:

    Everything in moderation. Including moderation.

    I’m stealing that!

  19. CSK says:

    @gVOR08:
    I’ve had several doctors and dentists tell me that they hate, hate, hate what passes for medical reporting.

    2
  20. Flat Earth Luddite says:

    @Daryl and his brother Darryl:
    Which brings to mind a (no doubt) misremembered quote from an early Heinlein novel, “Moderation is for Monks!”

  21. Lynn says:

    @CSK: He lived happily and heathily till he was well past 94.Y

    He should have smoked –my mother smoked 4-5 packs a day for many years, and died just short of 96.

  22. CSK says:

    @Lynn:
    He did actually smoke till he was in his early sixties. I tip my hat to your mother; she sounds like one tough broad. And I say that with admiration.

  23. Dude Kembro says:

    Nope. Definitely gonna do my own research on this one. These woke elitist experts are out of control!

    2
  24. Lynn says:

    @CSK: one tough broad

    More a damn fool, imo.

  25. CSK says:

    @Lynn:
    Hey, she made it to almost 96.

    1
  26. Liberal Capitalist says:

    So…

    30+ years ago, I was $30,000+ in debt, had no home, and had a string of drinking related legal “issues” that took a lot of time an income, both domestically and internationally. (Canada had stated strongly that they would like me to leave and not return).

    In short, it’s expensive time-consuming hard work to be a more-than-moderate drinker.

    30 years later, I have multiple homes (paid), a dumb number of cars & toys, a high six figure income that I absolutely don’t deserve, and a net worth that says that I could have retired 5 years ago.

    Because I quit drinking. In total.

    I can’t tell you what to do, nor would I ever on this subject.

    But there is one test that seems to resonate… and this can usually tell you what side of the line you are:

    Every time I drink, I don’t get in trouble… but every time I’ve been in trouble, I have been drinking.

    You define what “trouble” means… Some folks really have to keep going until trouble becomes unbearable. I know that I did.

    2
  27. Stormy Dragon says:

    @Liberal Capitalist:

    Every time I drink, I don’t get in trouble… but every time I’ve been in trouble, I have been drinking.

    Every time I’ve been in trouble, I’ve been completely sober, so maybe I need to drink more?