cover of episode Revisited: just how bad is alcohol for us?

Revisited: just how bad is alcohol for us?

2024/12/31
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Tim Stockwell
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Madeleine Finlay: 本期节目探讨了长期以来关于酒精对健康影响的争议。一方面,大量研究表明适度饮酒与较低的死亡率相关,呈现出所谓的“J曲线”现象;另一方面,也有研究指出,酒精有害健康,甚至具有致癌性。 Tim Stockwell博士对大量研究进行了系统性回顾和荟萃分析,发现早期研究中存在偏差,例如将因健康问题而戒酒的人群与继续饮酒的人群进行比较,导致结果失真。 Stockwell博士指出,适度饮酒的益处可能被夸大了,其研究结果表明,即使是少量饮酒也存在一定的健康风险,与吸烟的风险相当。 节目中还讨论了公众对酒精益处的认知,以及如何更科学地理解酒精的风险。 Tim Stockwell: 我长期以来相信适度饮酒有益健康,这基于大量流行病学研究,这些研究显示适度饮酒者死亡率低于禁酒者,呈现出“J曲线”的图形。 然而,我和同事对这些研究进行了重新审视,发现其中存在严重的偏差。许多研究使用了食物频率问卷,只关注受试者过去一年的饮酒习惯,忽略了其终生饮酒习惯。此外,这些研究往往将因健康问题而戒酒的人群与继续饮酒的人群进行比较,这导致结果失真。 我们的荟萃分析结果表明,高质量的研究并没有发现适度饮酒有益健康。相反,即使少量饮酒也存在一定的健康风险,与吸烟的风险相当。每天一杯酒会使平均寿命缩短三个月。 我认为,酒精的益处被夸大了,这可能是因为酒精是人们喜爱的休闲饮品,并且长期以来受到行业和政府的保护。我们需要更准确地告知公众酒精的风险,例如在酒类产品上贴上警示标签。

Deep Dive

Key Insights

Why did scientists initially believe that moderate alcohol consumption could be beneficial?

Scientists initially believed moderate alcohol consumption could be beneficial due to studies showing a J-curve relationship, where moderate drinkers had a lower risk of death compared to abstainers. This was supported by theories like the Mediterranean diet and the French paradox, which suggested red wine could reduce heart disease risks.

What flaws were found in the studies that suggested moderate drinking was beneficial?

The studies were flawed because they compared moderate drinkers to abstainers who had already quit drinking due to health issues. This created a bias, making moderate drinkers appear healthier when they were simply a healthier group to begin with, not because of alcohol consumption.

How does the mortality risk of one alcoholic drink compare to one cigarette?

The mortality risk of one alcoholic drink is equivalent to that of one cigarette. This risk increases with higher alcohol consumption, where two to four drinks a day can equate to 10 to 15 cigarettes a day in terms of mortality risk.

What is the estimated impact of one drink a day on life expectancy?

One drink a day is estimated to reduce life expectancy by an average of three months for the general population, according to Canadian guideline estimates.

Why has the belief that moderate alcohol consumption is beneficial persisted despite evidence to the contrary?

The belief has persisted because alcohol is a widely enjoyed recreational drug, and the idea of its benefits is appealing. Additionally, mixed messages and divided opinions in public discourse have contributed to its continued acceptance.

What changes have been observed in public opinion regarding the health effects of alcohol?

Public opinion has shifted significantly, with a decline in the belief that moderate alcohol consumption is beneficial. While 40% of people once believed it was good for you, that number has dropped to about 10%, and more people are now aware of the small health risks associated with low-volume drinking.

What does Tim Stockwell suggest governments should do regarding alcohol consumption?

Tim Stockwell suggests that governments should publicly acknowledge the risks of alcohol and implement health warning labels on alcohol containers to inform consumers about its carcinogenic effects and other health risks.

Chapters
This chapter explores the long history of alcohol consumption, from its ancient origins in the Middle East to its use in various cultures for rituals, celebrations, and even as a form of payment. It also touches upon the early awareness of alcohol's dangers and its dual nature as both beneficial and harmful.
  • 7,000-year-old evidence of beer-making in Syria
  • Alcohol's use in rituals, antiseptic purposes, and ancient payment
  • Early accounts of alcohol addiction and health issues in Egypt
  • Ancient Greek medical opinion divided on alcohol's benefits versus harms

Shownotes Transcript

For the regular drinker, the studies that say a daily tipple is better for a longer life than avoiding alcohol completely are a source of great comfort. But a new analysis challenges that thinking and says it was based on flawed research that compares drinkers with people who are sick and sober. In this episode from August, Madeleine Finlay hears from the study’s lead author, Tim Stockwell, a scientist at the Canadian Institute for Substance Use Research at the University of Victoria, to find out why scientists (including him) were so convinced, and what the actual risks of alcohol are. Help support our independent journalism at theguardian.com/sciencepod)