The latest set of headlines pronouncing the health benefits of moderate drinking have followed the publication of a new BMJ study examining the association of alcohol consumption and dementia risk.
The latest study found as expected, dementia risk was increased amongst those regularly drinking above the recommended guidelines of 14 units per week, but also amongst abstainers. Notably, the increased risk was only shown for those who abstained from wine, though as some noted, wine may act a proxy for uncontrolled socio-economic status.
Whilst a BMJ commentary states the findings raise the question 'of a possible protective effect from moderate alcohol consumption', the study however cannot confirm this owing to the potential mediating role of cardiovascular disease and crucially, why people were abstainers. As the NHS Choices analysis highlights, abstainers include those who may have drank heavily in the past, a known risk factor for cognitive impairment, or may abstain owing to other health issues.
The BMJ note that whilst there is a potential beneficial mechanism of moderate drinking to dementia risk, 'alcohol choices must take into account all associated risks, including liver disease and cancer.' Indeed health researchers are often at pains to point out that abstainers should not consider taking up moderate drinking for any physical health benefits, particularly given the proven and more significant benefits that can be accrued from other lifestyle changes such as increasing physical activity.
Some media headlines of course appealed to the oft-repeated notion of the 'health benefits' of moderate drinking, with Sky news claiming 'not drinking increases dementia risk' amongst the middle aged and even the Guardian leading with a questionable headline. Others appeared more responsible, including the BBC's Alcohol and Dementia - is moderate drinking safe?, which referenced potentially conflicting research on the mooted benefits of moderate drinking and other evidence of alcohol's potential damaging effect on the brain. A 'what the research really says' piece in the Conversation by Dr Tony Rao explores the study and all important questions over confounders.
Media and public thinking
Regular readers may feel tired of the repetition of mooted but causally unproven 'j-curve' benefits to moderate alcohol consumption. However the relish with which such studies attract media attention is likely to at least partially reflect the appeal such stories have by allaying concerns about reader's health. Reaction to the downward revision of the recommended guidelines in 2016 certainly created significant degrees of public backlash, even aside those who may be considered to have vested interests in doing so. Indeed antipathy to the guidelines tends to be highest amongst those who drink above them, and it may be basic psychology that people do not want to feel that their behaviours are not 'healthy' or 'normal'.
As such, researchers will continue to hope for what they would see as more accurate reporting and public discussion of such studies. Namely that any moderate drinking 'benefits' are most relevant in social terms, whilst any potential physical health benefits - while important to seek to establish - do not qualify for the public attention they get. Regardless, public health groups will continue to see those drinking at levels unequivocally linked to such as harms as the priority for action, and indeed how to foster approaches that may lead to reductions in the risk of a far wider range of health and social impacts.
Study found alcohol consumption >14 units/week increased the risk of dementia in a linear fashion @epiageing https://t.co/Nnk5rTJSqr pic.twitter.com/rRKIbzfjS1
— The BMJ (@bmj_latest) August 2, 2018
Comments