Booze Isn't All Bad

While we have discussed the dangerous effects of alcohol abuse and misuse, that doesn't mean it's always bad. Besides being part of many complex and delicious beverages, there are any number of studies which show that alcohol is linked to health benefits.

That doesn't mean it's all good news, either, or that the evidence is a slam dunk. There's certainly enough, though, to warrant a thorough review. That's the topic of this week's Healthcare Triage.

John Green -- Executive Producer
Stan Muller -- Director, Producer
Aaron Carroll -- Writer
Mark Olsen -- Graphics

And the housekeeping:

[legna]

Hi, in the video at 4:35 there seems to be dissonance between what Aaron says and what is written. It's written:
"..beverages reduce the levels of HDL..."
but he says :
"..beverages increase the levels of HDL..".
So which one is correct?(was to lazy to check the literature but wanted to point it out.)

[Skip]

I am by no means an expert, but it seems like the key to a lot of dietary concerns is "moderation"

[olivergalgut]

did we define low, moderate and heavy alcohol consumption? are these definitions consistently applied between studies?

[lollsazz]

What if we add these two factors into the discussion?:
- people might not drink if they know their health isn't that great
- people stress over being the ones that don't think it's fun to drink. Stress --> heart disease
- those who have a lot to do = more stressede, might drink less. You don't usually have time to drink much if you work a lot
- some health-consious people might stress more in general
- drinking is considered a social activity. Being social reduces stress. But what about being social in other ways?

I see the associations, but I don't think there's a simple explanation, like "eat fruit, and you'll get lots of vitamins". It would be interesting to look at drinking people in the general population (where non-drinkers are almost considered outcasts) vs for example people from Christian, non-drinking communities, where not drinking is quite normal. Would one see the same differences after controlling for that religion might be protective against diseass for some people (I'm non-religious)?

[nolanthiessen]

Free wine for 2 years? Where do I sign up for the study?

[brendansully]

At 4:35 the text says "beverages reduced levels" but Dr. Carroll says increased.

[SparrowFae]

FINALLY! Ever since your video on how daily milk has no evidence of improving health I was wondering about the research on alcohol. Officially replacing my morning milk with whiskey.

[thomasagrusti]

Question: when the studies state "an average of one drink per day, " are they controlling for binge drinking? There should be a marked difference between someone who has wine with dinner every night and someone who drinks a six pack every Friday.

[patrickvachino]

please do an episode on the long term effects of behavior altering drugs like depression medication and anxiety medication. The effects are very serious and not many people know about them.

[Thinkingnamesishard]

I began watching this episode and drinking water. I finished this episode by drinking wine.

Thanks, HT

[HyperSpify]

If you're taking ANY meds at all, including OTC ones, run your meds through a drug interaction checker and add ethanol to the list of meds. You'd be shocked at how many meds interact with alcohol. That's one of the big problems with alcohol.

[shadebug]

Have we had an episode on RCTs about health benefits of other recreational drugs?

[mattkeysme]

I'd love to see an update to this video in light of the WHO report this January suggesting there is NO level of alcohol consumption that is 'safe'. Is this just another study cherry picking diseases that have a negative association with alcohol, and ignoring other beneficial effects? Or have the past 7 years of research since this video was released changed minds?

[syddlinden]

Yeah, as someone with general anxiety disorder, I have to avoid alcohol or it can set off bad anxiety attacks. I can maybe have one drink, slowly and I've got to be in a good mood already. Otherwise, I'll end up in an anxious fit over nothing, which sets off my depression... and it's all downhill from there. It's hard to think about health benefits when drinking one too many drinks can make you suicidal.
Thus, I'm glad you guys pointed out that people with certain disorders can't drink. Being one of those, these updates on the benefits of stuff I still can't enjoy on that regular basis are kind of a downer.

[TakeWalker]

I'm interested in this designation of slow vs fast ethanol metabolism. I've always felt like I process alcohol quickly, but it could just be my habits. (Drink one beer, drink water like a fish for the rest of the night.)

[robertpaulton]

Just what do we mean by light, moderate and heavy drinking? It would be very helpful is there was some guidance such as alcohol units / week or something like that.

Oh, and what about no alcohol days to allow the liver the rest?

[andrewandrew]

I appreciate you looking at randomized controlled trials. Most people don't bother and take headlines as truth.

[nathanhamer]

+Healthcare Triage there is a typo on the slide at 4:30.

[audiodan]

FYI at 4:40, you mention that the meta-analysis increased levels of HDL, but your visual says decreased.

[JenteKramer]

Im sad that i never hear "Thanks Cameron and Qadeem" anymore. It always sounded so cheerful when you said it