Thursday, 18 June 2020

Should we be reducing our alcohol consumption?

It's the 3rd Thursday of the month again, the day on which we should be at Falmouth's Chain Locker pub enjoying a few drinks with mining friends from Cornwall and visitors from around the world. But not to be of course, and I, like many others, will be partaking in a glass or two of wine at home until the pandemic is over.
As pubs and restaurants have shut, there has been an increase in alcohol purchases in shops; sales have risen by more than 30% in off-licenses and one-in-five people are believed to be drinking more often, which is not too surprising. And it would appear that those in the mining industry drink more than most, which is also not that surprising.
Source @CruxInvestor
If lockdown has not been bad enough, the prophets of gloom have been reminding us of the pitfalls of the demon drink and the report of a couple of years ago that there is no safe limit to alcohol consumption. The current UK guidelines advise limiting alcohol intake to 14 units per week, equivalent to drinking no more than 7 medium-sized glasses of wine, but I have never been able to find any scientific evidence for this, believing maybe that these are just figures plucked from the air. 
Should we frown on those who enjoy an occasional glass of wine?
However, an article in The Lancet in August 2018, in which the Global Burden of Disease study looked at levels of alcohol use and its health effects in 195 countries between 1990 and 2016, was the first major, and massive, study on the effect of alcohol on premature death, cancer, and cardiovascular problems. The huge team of collaborators compared people who did not drink at all with those who had one or more alcoholic drinks per day.
The media, including the BBC National News, immediately reported the findings with the scary headline that drinking half a bottle of wine a day increases your risk of contracting an alcohol related illness, or injury, by up to 40%, worrying to say the least as this was my (roughly) daily alcohol consumption, which might have increased slightly over the past few months.
As The Lancet is a reputable Elsevier journal, and the article had obviously been rigorously peer-reviewed, I had no doubts about the research, but maybe the media were exaggerating the statistics, so I had a good look at the manuscript.
A massive population was surveyed and the researchers found that out of 100,000 non-drinkers, 914 would develop an alcohol-related health problem such as cancer, heart disease, or suffer an injury. But an extra four people would be affected if they drank one alcoholic drink a day. For people who had two alcoholic drinks a day, 63 more developed a condition within a year and for those who consumed five drinks every day, there was an increase of 338 people who developed a health problem. One alcoholic drink was defined as the equivalent of a 100ml glass of red wine.
One of the study authors, Prof Sonia Saxena, a researcher at Imperial College London and a practising GP, said: "One drink a day does represent a small increased risk, but adjust that to the UK population as a whole and it represents a far bigger number, and most people are not drinking just one drink a day." "The health risks associated with alcohol are massive," said Dr. Emmanuela Gakidou of the Institute for Health Metrics and Evaluation at the University of Washington and the senior author of the study. "Our findings are consistent with other recent research, which found clear and convincing correlations between drinking and health, and that zero alcohol consumption minimizes the overall risk of health loss."
These figures are obviously of great significance to a national health service, but how worried should you be as an individual? Everything we do in life involves a risk and enjoying a few glasses of wine or beer is just another risk.  The research shows that if I did not drink at all, I would statistically have a 0.9 chance in a 100 of cancer, cardiovascular problems etc, which would increase to 1.3 in 100 by drinking just over a half bottle of wine per day, an increase in around 40%, as reported in the media.
These odds would seem an acceptable risk for many but what do you think? Do we have a moral obligation to reduce our alcohol intake? Do you feel that alcohol enhances our overall quality of life, or would we be better without it? Should we at MEI conferences curb our policy of letting the wine flow freely at sundowners and dinners, where delegates relax at the end of a long day?
A controversial topic, I know what my views are, but what are yours?

14 comments:

  1. Maybe its time to look at the mental health issues of working long term in the mining industry?

    Is it a cause of the drinking?

    Just a thought?

    David

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    1. I completely agree. Excessive drinking normally has a reason behind it.

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  2. Anything more than moderation is not good for health.Some say that red wine is good for heart. However, this information in the Blog is of interest--

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  3. Hi Barry, The Battersby family motto - "Omnia debet moderate". What is the Wills family motto? Regards Mike

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  4. Which language is this--hope not a secret code

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    1. Bad schoolboy Latin. Should be vinum!

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  5. I've also noticed that most social/networking events in the mining industry revolve around drinking. Why is that? I don't mind it but have noted that friends and colleagues who don't drink can find these events tricky to navigate. Perhaps we should offer more options- different settings (i.e. not always the pub) and alcohol free beverages?

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  6. Hello unknown. Of course social events include drinks, but don't "revolve around drinking". All the conferences we attend, including MEI conferences, supply non-alcoholic as well as alcoholic drinks, and pubs, of course, do the same. It would be difficult to organise social events without food and drinks. If you get back, please leave your name

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  7. I always found that an informal meet after a heavy working meeting is more productive and free when we meet for a dinner where both those who drink and do not are very comfortable.
    Whether drinking alcohol is good or bad for health is different subject--

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  8. Dear Barry. Please do not change your policy. Beer and wine are very effective social lubricants, I had several very interesting chats at the sundowners and dinners. And there is no point in deciding what is best for others, it would be patronizing, I guess no one likes that!
    Cheers
    Reiner Neumann (Rio de Janeiro, Brazil)

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    1. Perfectly put Reiner. We have no intention of changing our policy, and soft drinks and fruit juice are always readily available

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  9. Kudos to Barry Wills for taking on this health and social issue in such a thoughtful way at the time of Covid when alcohol sales are going up in many countries. I’ve been meaning to post a comment for weeks, but competing activities have kept me from doing so until now. I post this as a retired medical epidemiologist (obviously with an interest in the minerals industry, and as a follower of the MEI Blog).
    The relationship between alcohol and health effects is a difficult area for the interpretation of population health studies, most of which actually show a J-shaped distribution with an apparent benefit (lowest risk) for light social drinking, with a higher risk of morbidity and mortality for non-drinkers, and increasingly higher risks for those drinking further up the scale.
    That said, the design and analysis of such studies is challenging due to the nature of multiple competing considerations, ranging from people avoid alcohol as they are already in poor health (and therefore may experience a higher morbidity and mortality) to the time honoured role of alcohol as a facilitator for social interactions which are themselves often (not always) conducive to positive health outcomes. Controlling for confounding variables is challenging, the end result of which the evidence for both risks and benefits of alcohol use in moderation will remain controversial for the foreseeable future.
    Almost all studies rely on patient recall and truthful reporting of their ingestion over the years, which is virtually impossible to verify. The challenge then is to attempt to sort out causality from association. Alcohol and health status (positive, negative or neutral across the spectrum) may be associated, but the relationship may not be causal e.g., adults in good health may engage in more social activities and enjoy alcohol in moderation, but this may have nothing to do with making them healthier.
    It is of relevance that humans (and other mammalian species) have evolved enzymes such as alcohol dehydrogenase, testimony to our evolution along with the ingestion of foods that quite naturally include the products of fermentation, not to put aside the fermentation that also takes place in our gut as part of the digestive process. If the body had no mechanism for breaking down alcohols, these would accumulate in the body and become toxic. Humans are thus able to process alcohol in moderation, although variability also predicts that this capacity will vary across human groups and individuals.
    It may be helpful to conclude this brief synopsis with reference to a systematic review (2011) that indicates that favourable changes in several cardiovascular biomarkers (including high density lipoprotein or HDL, the so-called “good cholesterol”) thereby providing indirect pathophysiological support for a protective effect of moderate alcohol use on coronary heart disease. () Once again however, the interpretation of this evidence in remains controversial.
    Searching for consensus on this side of the Atlantic, the following Mayo Clinic statement may be helpful:
    “Any potential benefits of alcohol are relatively small and may not apply to all individuals. In fact, the latest dietary guidelines make it clear that no one should begin drinking alcohol or drink more often on the basis of potential health benefits. For many people, the possible benefits don't outweigh the risks and avoiding alcohol is the best course… On the other hand, if you're a light to moderate drinker and you're healthy, you can probably continue to drink alcohol as long as you do so responsibly.”
    Selected References (abbreviated):
    Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies. BMJ 2011 doi: 10.1136/bmj.d636

    Alcohol use: Weighing risks and benefits. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/alcohol/art-20044551 Retrieved July 9, 2020.

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    1. Thanks for your thoughtful comments Franklin. It's a complex subject and it is obvious that, as with most things in life, moderation is the key

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