Comments on Moderate Alcohol Consumption and Mortality

Barrett‐Connor, Elizabeth; Gaetano, Giovanni de; Djoussé, Luc; Ellison, R. Curtis; Estruch, Ramón; Finkel, Harvey E.; Goldfinger, Tedd M.; Keil, Ulrich; Lanzmann‐Petithory, Dominique; Mattivi, Fulvio; Skovenborg, Erik; Stockley, Creina S.; Svilaas, Arne; Teissèdre, Pierre-Louis; Thelle, Dag S.; Ursini, Fulvio; Waterhouse, Andrew L.

doi:10.15288/jsad.2016.77.834

Cited by 7 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…35 Seventeen members of the International Scientific Forum on Alcohol, which describes itself as a volunteer organization of 46 practitioners and scientists, accused Stockwell and his colleagues of promulgating "misinformation in the name of scientific method," and asserted that their failure to acknowledge evidence challenging their critique did "a major disservice to the scientific community." 36 In reply, Stockwell and his colleagues turned the charge of scientific irresponsibility back onto their opponents. They argued that given the "extensive list" of potential conflicts of interest involving the alcohol industry, "who [is] really guilty here of promulgating misinformation?"…”

Section: Point-counterpoint: the Hardening Of Scientific Campsmentioning

confidence: 99%

“…The tone of mutual mistrust that had come to characterize the epistemological divide between supporters of the protective effects of moderate drinking and those who had emerged as the most persistent critics of what they viewed as bad science was revealed in an exchange of letters in 2016 in the Journal of Studies on Alcohol and Drugs in response to a report by Stockwell and his colleagues . Seventeen members of the International Scientific Forum on Alcohol, which describes itself as a volunteer organization of 46 practitioners and scientists, accused Stockwell and his colleagues of promulgating “misinformation in the name of scientific method,” and asserted that their failure to acknowledge evidence challenging their critique did “a major disservice to the scientific community.” In reply, Stockwell and his colleagues turned the charge of scientific irresponsibility back onto their opponents. They argued that given the “extensive list” of potential conflicts of interest involving the alcohol industry, “who [is] really guilty here of promulgating misinformation?” In the end, “only rigorous, independent and impartial science” that was free of commercial vested interests could definitively resolve the issues at hand …”

Section: The Consensus Challengedmentioning

confidence: 99%

See 1 more Smart Citation

Is Moderate Drinking Protective Against Heart Disease? The Science, Politics and History of a Public Health Conundrum

Oppenheimer

Bayer

2019

Milbank Quarterly

View full text Add to dashboard Cite

For more than 40 years, most research by epidemiologists, social scientists, and alcohol policy experts found that moderate alcohol consumption was cardioprotective. In the early 2000s, that consensus was shaken by new critics who subjected the previous research to vigorous methodological and empirical analysis, precipitating a bitter controversy, seemingly unresolvable despite numerous observational epidemiological studies. The effort to finally put that debate to rest through a large, multiyear randomized controlled trial under the aegis of the National Institute on Alcohol Abuse and Alcoholism, generated external criticism and adverse newspaper coverage, particularly because the trial was largely funded by the alcohol industry, forcing National Institutes of Health leadership to abruptly terminate the study shortly after it started. In the absence of definitive evidence and given the contentious debate over the risks and benefits of moderate alcohol consumption, those who formulate health policy have a responsibility to clearly acknowledge to the public the existence of evidentiary uncertainty when making recommendations.

show abstract

Section: Point-counterpoint: the Hardening Of Scientific Campsmentioning

confidence: 99%

Section: The Consensus Challengedmentioning

confidence: 99%

Is Moderate Drinking Protective Against Heart Disease? The Science, Politics and History of a Public Health Conundrum

Oppenheimer

Bayer

2019

Milbank Quarterly

View full text Add to dashboard Cite

show abstract

“…To take simultaneously into account positive and negative effects of drinking, the association of different volumes with all-cause mortality needs to be analyzed, taking into account all the open issues mentioned above [11,12,[23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Alcohol intake and total mortality in 142 960 individuals from the MORGAM Project: a population‐based study

et al. 2021

Self Cite

View full text Add to dashboard Cite

Aim To test the association of alcohol consumption with total and cause-specific mortality risk. Design Prospective observational multi-centre population-based study. Setting Sixteen cohorts (15 from Europe) in the MOnica Risk, Genetics, Archiving and Monograph (MORGAM) Project. Participants A total of 142 960 individuals (mean age 50 ± 13 years, 53.9% men). Measurements Average alcohol intake by food frequency questionnaire, total and cause-specific mortality. Findings In comparison with life-time abstainers, consumption of alcohol less than 10 g/day was associated with an average 11% [95% confidence interval (CI) = 7-14%] reduction in the risk of total mortality, while intake > 20 g/day was associated with a 13% (95% CI = 7-20%) increase in the risk of total mortality. Comparable findings were observed for cardiovascular (CV) deaths. With regard to cancer, drinking up to 10 g/day was not associated with either mortality risk reduction or increase, while alcohol intake > 20 g/day was associated with a 22% (95% CI = 10-35%) increased risk of mortality. The association of alcohol with fatal outcomes was similar in men and women, differed somewhat between countries and was more apparent in individuals preferring wine, suggesting that benefits may not be due to ethanol but other ingredients. Mediation analysis showed that high-density lipoprotein cholesterol explained 2.9 and 18.7% of the association between low alcohol intake and total as well as CV mortality, respectively. Conclusions In comparison with life-time abstainers, consuming less than one drink per day (nadir at 5 g/day) was associated with a reduced risk of total, cardiovascular and other causes mortality, except cancer. Intake of more than two drinks per day was associated with an increased risk of total, cardiovascular and especially cancer mortality.

show abstract

“…If the results of that analysis were valid you might drink up to just below 65 grams of alcohol a day and still have the same mortality risk as a nondrinkera conclusion that is hardly plausible. Stockwell et al used the same selection criteria as Fillmore et al, demonstrated earlier to be invalid and did not acknowledge that the "errors" that had been proposed in 2006 have been adjusted for in most recent reputable investigations without changing overall results (Barrett-Connor et al, 2016). Stockwell et al had identified 2,575 studies on the subject and analyzed only 87; however, even so they found reasons to exclude almost all of these 87 studies and reached the conclusion of no significant protection for lowvolume drinkers based on a very small number of publications.…”

Section: Systematic Misclassification Of Abstainersmentioning

confidence: 99%

The J-shaped curve-conceptual and methodological challenges

Grønbæk

Ellison

Skovenborg³

2021

DAT

Self Cite

View full text Add to dashboard Cite

Purpose The purpose of this paper is to review the conceptual and methodological challenges of a J-shaped association between alcohol consumption (AC), coronary heart disease (CHD) and all-cause mortality. In associated papers in this journal, Skovenborg et al., 2021 reviews the evidence for the J-shaped curve, and Ellison et al., 2021 examines the advantages and drawbacks of Mendelian randomization studies of the J-shaped curve. Design/methodology/approach A number of methodological problems are common in observational research in general, and some of the methodological problems suggested for the J-shaped alcohol-CHD-associations are discussed. The extent of the methodological problems in studies of the J-shaped curve is reviewed, and the possibility that the J-shaped curve is an artifact created by reverse causality and residual confounding is discussed. Further, the issue of interaction with drinking pattern and type of alcohol is discussed. Findings Imprecise categorization of alcohol intake information seems to have had little effect on the J-shaped alcohol-CHD-associations, nor has it affected the ability of these studies to show increasing mortality from a range of causes with increasing AC. The problem of “sick quitters” has been resolved by large studies using lifelong abstainers or infrequent drinkers as reference group. Many studies lack information on drinking patterns with regard to regular, moderate consumption versus binge drinking. Stratified analyses by important risk factors for CHD have not significantly changed the J-shaped association observed in most epidemiologic studies. Originality/value Potential biases and residual confounding probably do not overcome the J-shaped alcohol-CDH-association observed in most epidemiologic studies; however, the existence of a J-shaped curve is challenged by some degree of uncertainty. The actual review together with the associated papers by Skovenborg et al., 2021 and Ellison et al., 2021 offers a possibility to “update your priors” and achieve greater certainty when giving your patients information on the pros and cons of alcohol intake.

show abstract

Comments on Moderate Alcohol Consumption and Mortality

Cited by 7 publications

References 5 publications

Is Moderate Drinking Protective Against Heart Disease? The Science, Politics and History of a Public Health Conundrum

Is Moderate Drinking Protective Against Heart Disease? The Science, Politics and History of a Public Health Conundrum

Alcohol intake and total mortality in 142 960 individuals from the MORGAM Project: a population‐based study

The J-shaped curve-conceptual and methodological challenges

Contact Info

Product

Resources

About