Is Moderate Drinking Really Healthier than Teetotalling?

A recent study reported that even moderate consumption of alcohol delivered zero health benefits to those under 40, but was allegedly associated with better health in those over 40.

The findings of this study (funded by the dubious Bill and Melinda Gates Foundation) have been presented as something of a revelation, but fellow veterans of the perennially bemusing health news-cycle know this is not a new finding. Numerous studies over the years have claimed a linear dose-response relationship between alcohol and health harms in younger folks, but a J-shaped relationship in older people.

The age delineation was ignored for a long time, with the media pimping the J-shaped curve seen in older folks as if it applied to everyone. If we were to believe the media and take the epidemiology at face value (never a good idea), total abstinence from alcohol actually conferred a higher health and mortality risk than moderate drinking.

It was just what everyone wanted to hear. Actually, in Australia, what a lot of people really wanted to hear was getting blind drunk every weekend was good for your health, but even the sleazy mainstream media couldn't bring themselves to spin the research that much.

But the claim that some drinking was more healthful than none was widely and readily accepted. Deep down inside, we all knew it was bollocks, but it was a feel-good research finding that everyone who drank alcohol could use to justify their habit.

Wishful Thinking Versus Reality

When I published The Great Cholesterol Con way back in 2006, the "moderate drinking is healthier than abstinence" paradigm was at the height of its popularity. Being the contrarian I am, I felt obliged to note the science behind this paradigm was pretty damn sketchy, and that the famed J-shaped curve did not apply to those under 50.

This new study, which factored in 22 health outcomes, sets the bar at 40 years of age.

So if we're to take the epidemiology at face value (again, never a good idea), it would mean alcohol is damaging to young bodies even in small amounts, but somehow healthful to older bodies at those same small amounts.

Before I explain why this is a crock, a quick disclaimer: I'm not a teetotaller. I am a moderate drinker, but I don't kid myself that my moderate alcohol consumption will somehow boost my health or extend my lifespan. I drink for no other reason than enjoyment. Like many folks of Mediterranean descent, I find a bit of red wine a nice compliment to dinner, and a touch of anisette a nice digestif after a meal.

And a couple of Estrellas sure go down nicely after a hard ride on a warm day.

So having got that out of the way, let me explain the different risk profiles seen between old vs young folks, and why the J-shaped curve is a J-shaped mirage.

The difference between younger and older folks in their health risk from alcohol is not a physiological phenomenon but a statistical artifact. There is no benefit from alcohol that the human body suddenly and magically starts responding to the day you turn 40 or 50 or 55 (depending on what study you're reading).

In their introduction, the Gates-funded researchers (writing under the auspices of the "Global Burden of Disease 2020 Alcohol Collaborators") claim "The relationship between moderate alcohol use and health is complex, as shown in multiple previous studies."

It's not that complex at all. Of course, researchers need us to believe issues like this are complex, so they can keep sucking up grant money in order to fuel their often-useless careers (just like government, the bloated research community is way overdue for a massive haircut. Most of what passes for 'science' nowadays is just useless and redundant hogwash designed to keep the grant money flowing for researchers and their institutions and/or to bolster the anti-scientific agendas of government and industry).

The J-shaped curve in older folks, that suggests moderate consumption confers health benefits compared to abstinence, can easily be explained by employing a little commonsense. The problem with commonsense, of course, is that it's not very common at all.

And from what I've observed to date, it's pretty much non-existent among Gates-sponsored researchers.

Young Fools versus Old Farts

Young people, because they are far less advanced along the aging timeline, suffer lower rates of chronic diseases such as heart disease, cancer, kidney failure, and diabetes. Not surprisingly, they are far less likely to die from these ailments than older folks.

Young people, however, are more susceptible to violent injury and death, for a number of reasons including greater risk-taking behaviour, immaturity, impulsiveness and peer pressure. Young people are also more impressionable and susceptible to emulating the dipshitted, self-destructive and anti-social behaviours of social media influencers, actors, musicians and other celebrities, not realizing this crowd are largely a bunch of clueless degenerates.

And that's before you bring alcohol into the picture.

Alcohol increases the risk of violent injury and death, because it makes people do really stupid things, like pick fights in bars, walk along the edge of high-rise balconies, and jump behind the steering wheel of vehicles they are wholly unfit to commandeer. Alcohol turns seemingly normal people into complete idiots, and it makes those who are already idiots act like even bigger twats. It makes slurring, staggering idiots of the male variety think they can fight like Mike Tyson, and makes idiots of the female variety get stupidly drunk and become isolated with sleazy predators or, even worse, drunken football players and government staffers.

Alcohol greatly impairs your judgement and dulls your reflexes, a true lose-lose situation. Alcohol makes you more likely to get into hairy situations, and less able to effectively talk, flee, or fight your way out of those situations.

To put it bluntly, getting fucked up is a great way to get fucked up.

On top of all that, regular consumption of alcohol in excessive amounts, be it on a daily or weekend "binge" basis, is a toxic activity that can lead to degenerative health conditions later in life.

The Truth Behind the J-Curve Stares the GBD Researchers in the Face

Sure enough, the GBD 2020 Alcohol researchers found in all global regions, among individuals aged 15–39 years, injuries accounted for the majority of alcohol-related "disability-adjusted life-years" (DALYs) in 2020. DALYs is a a time-based measure that combines years of life lost due to premature mortality and years of life lost due to time lived in a state of compromised health.

Globally, in the 15–39 age range, injuries accounted for 66% of alcohol-related DALYs for males and 48% of alcohol-related DALYs for females.

Transport injuries comprised 25·9% of alcohol-related DALYs among males and 12·7% among females in this age group.

Self-harm comprised 11·7% of alcohol-related DALYs among males and 12·3% among females, and interpersonal violence comprised 12·4% of alcohol-related DALYs among males and 6·70% among females.

Time Wounds all Heels

As people get older, they do things like mature or marry and start a family. Some people even do both.

Unless they're one of those creepy couples who are into the whole "sharing is caring" thing, married people are much less likely to go to bars and clubs and get plastered in the hope of hooking up with a similarly inebriated loser. Reading bedtime stories to kids and getting up early to open the store relegate such behaviour to the sewerage heap of history, as adult responsibilities push aside youthful indiscretions. Sure, some people suffer relapses during mid-life, especially after divorce. Women way past their prime start grooming themselves like Love Island contestants, and men with beer guts and grey, balding hair buy Harley Davidsons and wardrobes full of True Religion. But by and large, age tends to mellow the average person's behaviour and risk-taking tendencies.

But while alcohol-fueled violent injury and death become less of a threat as one gets older, morbidity and mortality from chronic degenerative diseases become far more common. And as people age and fall ill, they often drastically reduce or even completely cease drinking. In some reasons this may be because their previous excessive alcohol consumption directly contributed to the disease. In other cases, teetotalling is employed as a precautionary measure, in the hope of preventing a pre-existing condition from becoming worse.

So in epidemiological studies examining alcohol and health risk that find a J-curve, the so-called 'teetotaller' group in fact includes people who formerly drank alcohol, in some cases excessively. In some studies, anyone who claimed not to have consumed alcohol in the last 30 days was considered an "abstainer"!

So the mythical J-curve is skewed by participants who are not true teetotallers. Some are in fact heavy former drinkers whose past indiscretions have now caught up with them, even though they no longer drink.

The moderate drinkers, meanwhile, are not enjoying any protective effect of alcohol, but simply the ongoing benefits of their non-addictive, non-extreme approach to drinking and life in general.

When researchers bother to factor this into their analyses, the mythical J-shaped curve disappears. In 2016, for example, a collaboration of US, Canadian and Australian researchers found that, without adjustment, meta-analysis of 87 studies replicated the classic J-shaped curve, with low-volume drinkers (1.3–24.9 g ethanol per day) and occasional drinkers (<1.3 g per day) having reduced mortality risk (RR = 0.86).

However, after adjustment for abstainer biases and quality-related study characteristics, no significant reduction in mortality risk was observed for low-volume drinkers (RR = 0.97). Analyses of higher-quality bias-free studies also failed to find reduced mortality risk for low-volume alcohol drinkers. The risk estimates for occasional drinkers were similar to those for low- and medium-volume drinkers.

The researchers concluded:

"Estimates of mortality risk from alcohol are significantly altered by study design and characteristics. Meta-analyses adjusting for these factors find that low-volume alcohol consumption has no net mortality benefit compared with lifetime abstention or occasional drinking."

So, if you can control your drinking (something a lot of people cannot seem to do) and keep it at a low and temperate level, or a zero level when driving, and don't consume alcohol at bars, parties or other venues conducive to dickhead behaviour, then alcohol statistically poses little health or mortality risk. But don't kid yourself that you are consuming a health elixir when you down a serving of alcohol, because you're not.

Which means, if you don't already consume alcohol, or consume it very rarely, there's no compelling health reason to change your ways.

Remember how the GBD researchers found injury to be the main cause of alcohol-related morbidity and mortality in those 39 and under? Their own analysis showed in "individuals aged 40–64 years, the health outcomes contributing to the alcohol-related burden shifted to chronic health conditions, including cardiovascular disease and cancer."

So the answer to the J-shaped curve conundrum is staring them in the face, but they'd prefer to believe it's a "complex" issue, requiring more grant money from the plentiful coffers of the Bill and Melinda Gates Foundation.

The alcohol J-curve exists, not because the body contains a genetic switch that magically flips on at age 40, but because of statistical artifact and the different lifestyles of young versus older people.

When you are driving and/or in situations where you are surrounded by strangers, in an environment rife with trouble-makers and predators, you need to have your wits about you. These are the exact conditions young people find themselves in every weekend as they pile into their cars and hit the bars, clubs and parties to a degree not seen in older folks.

But instead of navigating these shady environments with a full compliment of mental acuity, they often engage in a socially-acceptable form of self-harm known as inebriation. A substantial volume of research on the effect of alcohol on driving confirms that impairment in one's reflexes and judgement begins as soon as blood alcohol concentration departs from zero.

Young people. therefore, often expose themselves to the worst of both worlds - environments with an elevated risk of violence and predation, and intoxication with a substance that impairs their reflexes and judgement at a time when they need these qualities the most. The end result is a linear relationship between alcohol consumption and morbidity and mortality in younger people.

If you took a group of over-40s and routinely placed them in the same set of circumstances, alcohol would very likely show a similar relationship with morbidity and mortality. Instead, older folks tend to live more settled lives, with chronic degenerative diseases collectively forming their number one genuine health concern (mythical viruses that have not been isolated using anything resembling non-absurd methods do not constitute a genuine health concern). In this group, alcohol is often avoided in order to compensate for health conditions of varying severity. The result is a misleading J-shaped curve that has been irresponsibly promoted as proof that moderate alcohol consumption confers health and mortality advantages over teetotalling.

In a subsequent article, I'll discuss Australia's highly dysfunctional relationship with alcohol, why young women should avoid the living daylights out of inebriation, and why the anti-feminine abomination that is modern 'feminism' is a sex predator's best friend.

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