VP. Points well taken, yet I sometimes feel that not every question is answered by what can only be an imperfect study. You ask doctors and scientists to stay out of the debate, yet you place yourself smack in the middle of it. As a doctor I’m entitled to my opinion based on the data I see plus my individual observations. Your approach should also include tobacco. The health hazards of smoking did not reveal themselves from a randomized study, yet one can also conclude that many people enjoy smoking and do not get sick or live less. Finally, the missing piece in your proposed study is individual genetic variance in how we metabolize alcohol, likely a defining factor for how our diets affect us.
I remember many studies pointing to evidence that treating chronic pain with opioids would not lead to addiction (porter and jick letter appeared as a scientific source 800+ times!). And we see where that led.
Been on them for ~ 5 years. No increase to speak of over that time. They help when needed. OTOH, I titrate the minimal amount to suit the current state. I must cut pills to arrive at my dosage. Not clear why others aren't told that the entire pill may be too much particularly for we seniors.
If I have a few glasses of a Glenfiddich with friends, I get funnier, some say wittier. For sure I get better looking. My points on literature and art and music and films become more insightful, my personal stories much deeper and lucid. My friends, and any women in the room want to know more about me. A few whiskies with ice in a proper crystal tumbler are the perfect social lubricant.
Now about that study on drinking. What are you trying to uncover? I'm sorry, your point is?
I agree. So many of our recommendations do not factor in the quality of life component. Most patients do better, I think, with a more nuanced approach that doesn’t shame them into compliance.
Thank you for your wise perspective. A good life is better than a long life but, I suspect that chances are, a long life will often be the result of a good one.
What about alcohol impact on HRV and RHR. Huge on Whoop. Does it impact ability to exercise the next day? May be short-term, but could have cumulative impacts. Or are those measure not significant?
Everything in moderation and until you experience an issue that is directly pointed at and proven to you, it’s all just opinion in my opinion. If something by makes you feel bad then do not do it or consume it. There are things that are straight up bad in my books but perhaps not in other people’s views. Alcohol is a personal choice and if you have a tendency towards abuse of alcohol then there are bigger issues here. There are too many broad sweeping statements which conflict and cancel each other out. Use your gut and common sense here.
Hi Vinay as a doctor who is also a fourth generation vintner I like the idea behind your proposed study. A great study is happening right now in Spain as part of PREDIMED where people who drink in moderation while following the Mediterranean diet are being randomized to continue drinking or not, and their alcohol consumption is being measured in hair/urine. It's a 5 year study.
One comment I'd like to make about your post is that despite potential improprieties by NIH officials in the MACH trial that was planned to include the USA, Europe and Africa, there was no wrong doing found for the scientists and half the funding was being provided by the alcohol industry through NIH foundation in a transparent way. If we are going to criticize this kind of funding we should also criticize all pharmaceutical funding. I obviously have a conflict of interest as part of the alcohol industry, but I think this topic is worth discussing.
Here is the info on the cancellation of the MACH (Moderate Alcohol and Cardiovascular Health) trial - I think this randomized controlled study on alcohol and health would have been really helpful to understand how to approach legislation and medical advice for patients with diverse backgrounds who drink in moderation.
Here’s the key quote “Additionally, a preliminary report from the NIH Office of Management Assessment (OMA) determined that a small number of NIAAA employees violated NIH policies in soliciting gift funding and circumvented standard operating procedures designed to ensure a fair competition for NIH funding. These policy violations were committed by NIAAA employees prior to the involvement of the Foundation for the National Institutes of Health (FNIH), and the review found that the FNIH conducted its role appropriately.“
Years ago we watched the Marlboro Man, Joe Camel, etc. And then people, I don't know who, decided advertising cigarettes is not good for children or adults because it looks like cigarettes are being promoted. Later on the 'people' decided advertising alcohol isn't bad (lobbyists?) but drinking it is. So they decided to reduce its influence by showing people not actually drinking it. Not sure who thought that idea was beneficial. I have noticed lately on TV shows and movies and books that the-go-to-thing is wine. Olivia on Law & Order SVU drinks at least one, sometimes 3 glasses of wine at night. Game of Thrones. Walking Dead. The Simpsons. The list is endless. I don't know what the effect was taking smoking commercials off and I don't know that taking alcohol out of commercials and TV series and movies would help. Does this information require an RCT?
VP. Points well taken, yet I sometimes feel that not every question is answered by what can only be an imperfect study. You ask doctors and scientists to stay out of the debate, yet you place yourself smack in the middle of it. As a doctor I’m entitled to my opinion based on the data I see plus my individual observations. Your approach should also include tobacco. The health hazards of smoking did not reveal themselves from a randomized study, yet one can also conclude that many people enjoy smoking and do not get sick or live less. Finally, the missing piece in your proposed study is individual genetic variance in how we metabolize alcohol, likely a defining factor for how our diets affect us.
I think he means the debate on "what should our blanket recommendation be for the public?", not what we'd recommend for individual patients.
I remember many studies pointing to evidence that treating chronic pain with opioids would not lead to addiction (porter and jick letter appeared as a scientific source 800+ times!). And we see where that led.
Been on them for ~ 5 years. No increase to speak of over that time. They help when needed. OTOH, I titrate the minimal amount to suit the current state. I must cut pills to arrive at my dosage. Not clear why others aren't told that the entire pill may be too much particularly for we seniors.
If I have a few glasses of a Glenfiddich with friends, I get funnier, some say wittier. For sure I get better looking. My points on literature and art and music and films become more insightful, my personal stories much deeper and lucid. My friends, and any women in the room want to know more about me. A few whiskies with ice in a proper crystal tumbler are the perfect social lubricant.
Now about that study on drinking. What are you trying to uncover? I'm sorry, your point is?
I agree. So many of our recommendations do not factor in the quality of life component. Most patients do better, I think, with a more nuanced approach that doesn’t shame them into compliance.
Thank you for your wise perspective. A good life is better than a long life but, I suspect that chances are, a long life will often be the result of a good one.
What about alcohol impact on HRV and RHR. Huge on Whoop. Does it impact ability to exercise the next day? May be short-term, but could have cumulative impacts. Or are those measure not significant?
Using a FitBit to monitor my sleep, drinking after 3 pm has material negative effect on my sleep quality.
As Samuel Clemons said, to paraphrase, if you can’t get to 70 by a pleasant route, don’t go.
Evidence based gutter…I laughed aloud.
This is the most sensible thing I’ve read on this subject in a long time (possibly ever)
Everything in moderation and until you experience an issue that is directly pointed at and proven to you, it’s all just opinion in my opinion. If something by makes you feel bad then do not do it or consume it. There are things that are straight up bad in my books but perhaps not in other people’s views. Alcohol is a personal choice and if you have a tendency towards abuse of alcohol then there are bigger issues here. There are too many broad sweeping statements which conflict and cancel each other out. Use your gut and common sense here.
Hi Vinay as a doctor who is also a fourth generation vintner I like the idea behind your proposed study. A great study is happening right now in Spain as part of PREDIMED where people who drink in moderation while following the Mediterranean diet are being randomized to continue drinking or not, and their alcohol consumption is being measured in hair/urine. It's a 5 year study.
One comment I'd like to make about your post is that despite potential improprieties by NIH officials in the MACH trial that was planned to include the USA, Europe and Africa, there was no wrong doing found for the scientists and half the funding was being provided by the alcohol industry through NIH foundation in a transparent way. If we are going to criticize this kind of funding we should also criticize all pharmaceutical funding. I obviously have a conflict of interest as part of the alcohol industry, but I think this topic is worth discussing.
Here is the info on the cancellation of the MACH (Moderate Alcohol and Cardiovascular Health) trial - I think this randomized controlled study on alcohol and health would have been really helpful to understand how to approach legislation and medical advice for patients with diverse backgrounds who drink in moderation.
https://www.nih.gov/news-events/news-releases/nih-end-funding-moderate-alcohol-cardiovascular-health-trial
Here’s the key quote “Additionally, a preliminary report from the NIH Office of Management Assessment (OMA) determined that a small number of NIAAA employees violated NIH policies in soliciting gift funding and circumvented standard operating procedures designed to ensure a fair competition for NIH funding. These policy violations were committed by NIAAA employees prior to the involvement of the Foundation for the National Institutes of Health (FNIH), and the review found that the FNIH conducted its role appropriately.“
Years ago we watched the Marlboro Man, Joe Camel, etc. And then people, I don't know who, decided advertising cigarettes is not good for children or adults because it looks like cigarettes are being promoted. Later on the 'people' decided advertising alcohol isn't bad (lobbyists?) but drinking it is. So they decided to reduce its influence by showing people not actually drinking it. Not sure who thought that idea was beneficial. I have noticed lately on TV shows and movies and books that the-go-to-thing is wine. Olivia on Law & Order SVU drinks at least one, sometimes 3 glasses of wine at night. Game of Thrones. Walking Dead. The Simpsons. The list is endless. I don't know what the effect was taking smoking commercials off and I don't know that taking alcohol out of commercials and TV series and movies would help. Does this information require an RCT?