Plain English with Derek Thompson - What's the Truth About Alcohol, Cancer, and Your Health?

Episode Date: January 17, 2025

Today's episode has been a long time coming. For years, more scientists and health influencers have claimed that even moderate drinking does serious damage to one's health. As someone who likes being healthy and also loves a glass of wine (or scotch), Derek really wanted to understand this issue more deeply. This week, he published a long article in The Atlantic about his research on the health effects of moderate drinking—meaning one or two drinks a night. In today's episode, he breaks down his research process and conclusions, sharing audio from his interview with Canadian health researcher Tim Stockwell, who is one of the most prominent skeptics of the supposed benefits of moderate drinking. If you have questions, observations, or ideas for future episodes, email us at [e-mail]. Host: Derek Thompson Guest: Tim Stockwell Producer: Devon Baroldi Links Derek's original article in The Atlantic (free gift link!): https://www.theatlantic.com/ideas/archive/2025/01/moderate-drinking-warning-labels-cancer/681322/?gift=o6MjJQpusU9ebnFuymVdsD7vJ9S6Vd2LMCE-zROPKQs&utm_source=copy-link&utm_medium=social&utm_campaign=share "The Battle Over What to Tell Americans About Drinking" in the NYT: https://www.nytimes.com/2025/01/01/health/alcohol-dietary-guidelines.html "Alcohol and Cancer Risk 2025" The U.S. Surgeon General's Advisory https://www.hhs.gov/sites/default/files/oash-alcohol-cancer-risk.pdf A meta-analysis in The Lancet on alcohol use and burden for 195 countries and territories https://www.thelancet.com/article/S0140-6736(18)31310-2/fulltext Vinay Prasad on alcohol and the meta-analysis https://www.drvinayprasad.com/p/what-is-the-truth-about-alcohol-consumption Emily Oster on alcohol and health https://parentdata.org/alcohol-and-health/ Tim Stockwell, et al, meta-analysis on alcohol, 2023 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802963 "Associations between alcohol consumption and gray and white matter volumes in the UK Biobank" https://www.nature.com/articles/s41467-022-28735-5 Learn more about your ad choices. Visit podcastchoices.com/adchoices

What's up everybody, Chris Vernon here, and welcome to a new season of the NBA and the mismatch. And huge welcome as well to my new co-host, Dave Jacoby. I can't wait to link with you twice a week every Tuesday and Friday right here on the mismatch to break down everything that's happening in the league. Who's playing well, who we loved, who we loathed, trade rumors, team dysfunction. We've got you covered right here. So follow us, subscribe, and hit us with those five-star ratings on Spotify, or wherever you get you. your podcast. And also don't forget to follow us on social media that's at Ringer NBA and check out the full mismatch episodes with the two handsomest podcasters in the history of podcasting

read on the Ringer NBA YouTube channel. This is a show that I've wanted to do for a while. It's a deep dive into a question that I consider both common and also quite personal. Is moderate drinking okay? Is having a drink every night healthy as scientists and the media long promised us? Or is it conclusively unhealthy, as many scientists and health influencers and even members of the federal government now claim? This episode builds on an article that I wrote for the Atlantic this week, entitled, appropriately enough, is moderate drinking okay? That article is linked to the show notes, and I encourage you to read it, share it. But I wanted to spend a little bit of time in this episode, getting personal about both my own life, my reporting process for this article,

and why I came to the conclusion that I've come to. So I grew up drinking wine with my family all the time. My late dad was a lawyer in Washington, D.C., but he moonlit as the wine columnist for the Washington Post in the 1980s. He was actually one of the first journalists to go into Ronald Reagan's wine cellar, or at least this was the family lore. If you do an online search for Robert Lewis Thompson,

Ronald Reagan, Washington Post, you will find a December 1981 column that he wrote entitled, presidential wine policy, the Californians have arrived. And this is actually a funny story. So after the piece was published, Nancy Reagan actually sent to our house a life-sized cardboard cutout of herself that she signed as a thank you, which my dad kept in our little wine cellar room in the basement. For years, I thought this was my nana, right? I thought it was like normal, of course, for families to have life-size cardboard cutouts of their relatives. Only later did I

realize the far stranger reality, which was that the first lady sent things. thank-you cards in the shape of her own cardboard body, which is sort of an incredible flex when you think about it. You know, thanks for dinner. Here's a permanent reminder of what my torso looks like. Anyway, my dad loved wine, like he loved few things in this world, and he passed that love along to me. And then I took that legacy, and as children sometimes do, I amended it in various ways.

So he was pretty much exclusively a California cab guy. Personally, I love red wine, California, Argentina, Spain. I also love Scotch and American whiskey. During the pandemic, I learned to make cocktails, which I love to do when we have company over. We have a vermouth that goes really nicely with a chip of ice and a splash of lemon juice. Overall, I'd say I probably have a drink about every night or every other night, and then, let's say, you know, two on weekend nights. So this is all to say, I've been following with great interest and deep curiosity and even a little bit of alarm.

The news over the past few months and years is I've seen more and more. headlines, claiming that the scientific literature had turned hard against the old presumption that moderate drinking was good for you, right? And that even this was moving into a stronger claim that moderate drinking was actually quite bad for people. Just this month in January, the U.S. Surgeon General, Vivek Murthy, published a long paper outlining the cancer risks of light or moderate drinking, including an advice to put new scary warning labels on all alcoholic beverages to alert people to the cancer risk of even having as little as one glass of wine every evening. But here's the confusing part, and the thing that really inspired me to put

together both the article and this podcast, around the same time that the Surgeon General published a report tying even moderate alcohol to cancer, the National Academies of Science, Engineering, and Medicine published a 200-page meta-analysis of hundreds of alcohol studies and came to what sounded like the total opposite conclusion. Their finding is that moderate alcohol drinking is actually associated with longer living. Defining moderate drinking, as most researchers do, as about two drinks a day for men or less, and about one drink a day for women, this review found that, quote, moderate alcohol consumption is associated with lower all-cause mortality. So in the span of like two weeks, two different august institutions,

came to what sounded to me like two totally opposite conclusions on this all-important question of is moderate drinking okay. And that's when I decided that I really, really wanted to get to the bottom of this. So in the interest of me search is research, and because this is a topic that is, you know, both personal to me and I think deeply interesting to many, many people, I wanted to go deep. I spent hours and hours in the last few weeks researching for this episode.

I poured over studies and commentaries on those studies. meta studies, commentaries in the meta studies, I think I crashed my web browser with an oversupply of tabs like two or three times. I spoke to researchers. I consulted the scientists who disagreed with those researchers, and most importantly, for our podcasting purposes, I recorded the main interview that I conducted for this article. So I thought what I do for today's episode would be something a little bit different than I typically do. I've never really done something quite like this before, but I thought it may be a fun experiment to kick off, you know, we're still in January, experimenting with kicking off the year. I wanted to walk you through my reporting for this Atlantic

essay, explaining to you as well as I can my read of the data. And I'll let you hear firsthand from the researcher that I consulted, a researcher who I think represents a sophisticated, yet cautious view about the risks of moderate drinking, right? Someone who fundamentally disagrees with what I would hope to be true, which is, of course, that, you know, drinking wine is purely good for you. And then finally, because I think most people listening are interested in nuance and interested in science, but also fundamentally interested in just the answer to the question, is moderate drinking okay? I promise that at the end of this episode, I will come down on this topic with advice, with hopefully memorable advice, and I'll tell you how I'm folding the conclusion of this

research into my own life. I'm Derek Thompson. This is plain English. Alcohol ambivalence has been with us for almost as long as alcohol. Quote, it is hard to say whether wine does good to more people than it harms. Medical opinion is very divided. End quote. Who do you think said that. Kind of sounds like Sergeant General Vivek Murthy speaking in 2024. It was actually the Roman author Pliny the Elder writing in the first century AD, according to a very plain language translation.

400 years before Pliny the Elder, Eubilis, a Greek comic poet of the 4th century BCE, wrote that, quote, although two bowls of wine bring love and pleasure, five lead to shouting, nine lead to bile, and 10 produce outright madness in that it makes people throw things, end quote. So this is a question how much alcohol is good for us

that we've been dealing with for at least 2,400 years. In the late 20th century, however, conventional wisdom moved strongly toward the idea that moderate drinking, especially when the beverage of choice of red wine, was healthy. In 1991, morally safer, a correspondent for CBS, recorded a segment of 60 Minutes entitled The French Paradox, in which he pointed out that the French filled their stomachs

with meat and oil, butter, and fat, and yet somehow they managed to live longer lives with lower rates of cardiovascular disease than Americans or their northern European peers. There has been for years the belief by doctors in many countries that alcohol, in particular, red wine reduces the risk of heart disease. Now it's been all but confirmed. The wine apparently affects the platelets, the smallest of the blood cells.

The wine has a flushing effect. It removes platelets from the artery wall. So the answer to the riddle, the explanation of the paradox may lie in this inviting glass. Following this report, demand for wine in the U.S. surged. By some accounts, red wine purchases rose by 40% in the years following this 60-minute segment. And the idea that a glass of red wine every night was basically like taking medicine for your heart wasn't just embraced by a gullible news media. It was truly assumed as a matter of scientific fact by many researchers. Someone so far is to claim that doubting alcohol's protective effects in the heart

was akin to being a conspiracy theorist. Here's a quote from one public health researcher writing in an Australian medical journal. Quote, the evidence amassed is sufficient to bracket skeptics of alcohol's protective effects with the doubters of manned lunar landings and members of the Flat Earth Society. Who said that? That was me. That was little old me. This is Tim Stockwell,

a behavioral psychologist and a health researcher based in Canada. Basically, I was saying, why do we need more research on this? We've got hundreds of studies finding this J-shaped curve which suggests that light, moderate drinking makes you live longer. Let's just get on with it and accept it. The J-curve is a famous or infamous piece of health research.

Unfortunately, it's a graph, and this is a podcast, so now I have to do that thing where I describe a graph on a podcast, horrible radio, but this should be quick. What I want you to do is imagine an X-axis that represents the amount of drinks you've had every week, and a Y-axis that represents your risk of dying prematurely. If you were studying, say, a poison like arsenic, the graph would be very simple, very boring, just a diagonal line going up into the right since every additional drop of arsenic increases your odds of ending up in the hospital. But for alcohol, the most common graph is a little bit more interesting than that. At about one drink a day for women and two drinks a day for men, the line slopes down, suggesting a decline in all-cause mortality. And then around

four or five drinks a day, certainly six, seven, eight, nine, ten, which is, you know, getting close to two bottles of wine every night, the graph shoots up and up and up. And so when you look at the full graph, it traces the letter J, suggesting that moderate drinking reduces risk and heavy drinking increases risk. If you're not a visual thinker, or just as possibly if I'm a terrible describer of graphs on the radio, the bottom line of the J curve is very straightforward, very non-visual. Moderate drinking extends your life. But now, 25 years later, Stockwell has changed his mind. He now thinks the J-curve is wrong. The guy who once compared such thinking to being a flat-earther has joined the flat-earthers, so to speak. To understand why

the J-curve might be misleading, you have to know that it's based on averaging together a bunch of observational studies. Here's Stockwell explaining what an observational study actually is, and this might sound a little boring at first, but I promise you it's going to end up very, very important. An observational study in this context is usually one where people are observed over time. You get a random sample of people, often if it's a big study, you might have 50,000 people, and you interview them, and you get them to describe their behaviors and their background, and you assess their health status, et cetera.

Then they're followed up for maybe 5, 10, 20 years even or longer, and you see how, they fair? Observational studies can be useful, but they suffer from a common problem. Now, there's no control group. And so what that means, you might pick on one characteristic, like how much they drink, but there's a lot of uncontrolled things going on, like I just mentioned, like there are other health behaviors, exercise diet, other health risk factors, their socioeconomic status. And you can attempt to control for the those things by adjusting statistically for what happens if you are poor or rich or, you know, you're a couch potato or, you know, a triathlete. You can try and control for these things, but in

reality, it's never possible to adjust perfectly for all of this background noise. Very often, observational studies will make something appear to be true, but then we'll learn it's probably not. For example, here's the author David John, a previous plain English guest, explaining observational studies in dental care. So a good example of this is mouthwash and mouth cancer. In the epidemiology litter in the past, their event has been a correlation has turned up between mouthwash and mouth cancer, right? So this set off concerns that mouthwash was somehow causing mouth cancer. After additional explanation, people concluded that, in fact, it was the mouth cancer that was causing a mouthwash use because people were getting bad breath because of the mouth

cancer, so they were using mouthwashed. Rain and umbrellas are a correlated phenomenon. If you were an alien who knew nothing about our climate or technology, you could run an observational study and detect a striking correlation between umbrella use and rainfall. humans understand that relationship very well, right? No person ever says umbrellas cause the rain to fall. But our bodies are much more complicated, much more mysterious to us. And sometimes in biology or nutrition, when there are a ton of things that are correlated with each other, it's genuinely difficult to know for sure what's the rain and what's the umbrella.

Okay, now back to alcohol. The J-Curve suggested that moderate drinkers were healthy. than non-drinkers. But there were two big problems with this finding. First, moderate drinkers could have been healthy for a ton of reasons that had nothing to do with their alcohol intake. It appears that moderate drinkers, as you've defined, live longer and I have lower risk, particularly of cardiovascular heart conditions and events and causes of death. So, and everyone's embraced that, particularly cardiologists. You'll find stuff. a lot of in the US cardiologists. I think a majority, according to a well-placed informant of

mine, a majority of cardiologists in the US recommend people drink a little bit for their health. But the problem is comparing a moderate drinker with a current non-drinker, one of the big problems is that people change their drinking status across the life course. And a major piece is that as we age, become less healthy, more frail, using other medication, less socially active, maybe, such people will cut down or completely stop their drinking. And second, non-drinkers could be unhealthy for reasons that had nothing to do with their abstinence. For people who have given up alcohol, what we do know for sure, the former drinkers, the quitters have the worst health profiles. And that's because they became, we now know,

it's because when they become unhealthy and unwell, which of course is a predictor that they will die prematurely, they cut down and stop our cuts. It's one of the first things that they do. Timothy Namy did a classic study of this and he looked at a group of American moderate drinkers and a group of abstainers in a survey which also assessed 30 risk factors for heart disease. And for 27 of these risk factors for heart disease, abstainers, people currently abstaining were significantly at higher, their risk was significantly higher for heart disease than was the moderate drinkers. And there's just nothing to do with their drinking. It was to do with how good their dental care was, how much access to health care they had, what their income was, what their education level was, what their diet was, how much they exercised.

So 27 risk their weight. So we have this major problem of trying to compare this moderate drinking group, which is self-regulating and wealthier and more educated, with the non-drinking group of people who tend to be poorer or with disability or cancer or less health. Right. Stockwell and his fellow researchers did their best to correct for all of this. They dug into methodologies and conclusions of hundreds, even thousands of papers. They adjusted what they could adjust and threw out more than 80% of the observational studies for being hopelessly beyond repair. And after their research, they reached a startling new conclusion. The J-shaped curves disappear for heart disease, for all-cause mortality, for everything.

and there's either no benefit or there's increased risks of heart disease and various cancers when you take that approach. The J-curve was dead. It's now fair to say that Stockwell's conclusion is the new conventional wisdom. The idea that moderate drinking is good for you or protective of the heart

is considered akin to geocentrism or the miasma theory of disease, a once popular and now roundly rejected theory. The death of the J-Curb is deeply affecting not just science, but public health guidance. Take Canada, for example. In 2011, not so long ago, Canada's public health agencies said that men could safely enjoy up to three big drinks a night with two abstinent days per week, right, about 15 drinks per week.

But in 2023, the Canadian Center on Substance Use and Addiction reviewed more than 6,000 studies in line with Stockwell's approach, and it made a huge difference. New recommended guidelines for Canadians advise even moderate drinking. Anything more than two drinks a week puts your health at risk. In 10 years, the conventional wisdom among some health researchers has gone from no more than two drinks a day to no more than two drinks per week. This is the conclusion that you'll hear. If you listen to some of the most popular health, and productivity podcast in the world. Even small amounts of alcohol are bad for you.

Now, I've been hearing and listening to this new conventional wisdom for several months now, maybe even a couple of years. And I always felt like there was something about the certainty of this new dictum that bothered me quite a bit. After all, if the French paradox and the J-curve had to be thrown out because they were built on observational studies that couldn't support their weight. Why should I trust a new set of health truths based on, in some cases, the same rickety observational studies? Had the pendulum swung from overconfidence in one direction, wine equals medicine, to overconfidence in another direction.

Wine equals poison. I really wanted to get a wide range of views, as I reported this piece. So while I was reading and talking to Tim Stockwell, I was also reading and listening to the scientist and author Vene Prasad. Prasad wrote an excellent long critique of this new conventional wisdom. He pointed out that the observational research on which scientists are now basing their conclusions, right, the conclusion that moderate drinking is dangerous, these observational studies tend to suffer from a combination of, quote,

old data, shitty data, confounded data, weak definitions, measurement error, and ill, logical results, end quote. As he memorably summarized the problem, a meta-analysis is like a juicer. It only tastes as good as what you put in. And the bottom line for alcohol research seems to be just this. Any way you look at it, this is a smoothie made of rotten fruit. This brings us finally to the news of the year in this space. The U.S. Surgeon General's new report on alcohol, which recommended a more prominent warning label on all alcoholic beverages about cancer risks. I have to admit, I think the guiding motivation of this paper was honorable. About three-quarters of adults in America, drink once or more per week, and less than half of them are aware of the relationship between

alcohol and cancer risk. It's understandable, I think, to say that you want to close the gap between the use of alcohol and one's understanding of its effects. But again, many of the studies, linking alcohol to cancer risk, are bedeviled by the same confounding problems that face the observational studies. For example, there's several studies showing a relationship between alcohol use and breast cancer. But how strong is that link for moderate drinkers? Well, it's actually very hard to say, for reasons I'll let Prasad tell you.

Richer people participate in mammographic screening programs more than poorer people. White people participate more than black people. And nothing gives you more breast cancer incidents. Then mammography. This is an analysis by Welsh and colleagues in the New England Journal of Medicine that show prior to the introduction of widespread screening mammography, there's a certain incidence per 100,000 of breast cancer. After the introduction, that has gone up about 30%.

It may have even doubled in some cohorts that are heavily subject to mammography. What does that mean? That means if a rich person drinks more, but a rich person gets more mammograms, a rich person going to have more breast cancer, but it ain't the drinking, it's the mammograms that's giving you the breast cancer. Now, I'm willing to believe, even the absence of slam dunk evidence, that alcohol increases the risk of developing certain types of cancer for certain types of people. But as the Surgeon General Report points out, it's important always in this space to distinguish between absolute risk and relative risk. Right.

Owning a swimming pool dramatically increases the relative risk that somebody in the house will drown. but the absolute risk of drowning in your own backyard swimming pool is blessedly low. And in a similar way, some analyses have concluded that moderate drinking can increase a person's odds of getting mouth cancer by about 40%. That sounds pretty dramatic. But the lifetime absolute risk of developing mouth cancer is less than 1%. That means one drink per day increases the typical individual's chance of developing mouth cancer by 0.3 percentage points. Very low.

The Surgeon General Report also says that moderate drinking, say, one drink per night, increases the relative risk of a woman getting breast cancer by 10 to 20%. Again, that sounds pretty dramatic. But it only raises the absolute lifetime risk of getting breast cancer from about 11% to 13%. Assuming the math is sound, I think that's a good thing to know. But if you pass this information along to a friend,

I think it's okay if they say, sorry, I like drinking Chardonnay on Tuesdays more than I fear a two percentage point increase in my odds of getting breast cancer in 20 years, which, by the way, is a percentage point increase with a low confidence interval. Now there's one more claim about alcohol and health that I didn't have a chance to cover in my Atlantic essay,

and I want to cover here. If you're in the health and wellness and self-optimization space, you've probably heard about another finding, which is that alcohol, even small amounts of it, can cause brain degeneration. Here's the celebrity psychiatrist Dr. Daniel Amen on the Diary of a CEO podcast. Alcohol causes damage.

in the brain. Really? Even a little bit of alcohol causes damage in the brain. It disrupts something called white matter. So gray matter nerve cell bodies, white matter, nerve cell tracks. So white matter, it's the highways in your brain that transmit information and impulses. And even a little bit of alcohol has been shown to disrupt the white matter in your brain. Is this right? Does even a little bit of alcohol disrupt the white matter in your brain. Well, let's look at it. The title of the study in question is associations between alcohol consumption and gray and white matter volumes in the UK Biobank. It's a mouthful, but we'll add a link in the show notes. What the study did is it got tens of thousands of healthy middle age and older adults in the UK. It asked them how much

alcohol they drank. It gave them MRIs to look at the white and gray matter levels in their brain, and then it found the association. And what they found, in fact, was a positive association between self-reported drinking and reduced volume of white matter and gray matter even at low levels of drinking. It's a good study. It clearly shows this strong link, especially between heavy alcohol use and brain degeneration. But there's at least two problems with saying that this study proves that a glass of wine a night is killing your white and gray matter. First, The study relied on self-reports, as many of these observational studies do, and there are minimal controls for what participants define as one unit of alcohol, right? You're taking this large

group of people, some of whom are having a big martini every night, and some of whom are, like, cracking open a beer that they don't finish while they watch NBC prime time, and both those individuals might self-report, I had one drink a night, but they're consuming a wildly different amount of alcohol, which is going to muddy the final data. Second, the strongest effect size by far in this study was for folks who had more than three or four drinks a day. In one table in the paper, the authors actually did something kind of nice. They calculated the equivalent effect of brain aging in terms of additional years for an

average 50-year-old individual. So this is smart. It's kind of like, how fast is your drinking habit aging your brain? brain. And they calculated that people who have four drinks a day are increasing this one measure of brain aging by 10 years. So when they turn 50, their brain will turn 60. That's for people having four or five, six drinks a day. But what about people having one drink a day? Well, after excluding the heavy drinkers from the analysis and rerunning the regression, the authors found that one drink a day increases your brain age by four or five months.

by the time you turn 50. So I'm thinking about this for my own life, right? I was born in May. I turned 50 in 2036. My body will turn 50 that may. According to this study, my brain will turn 50 in January. Should that discovery get me to stop drinking wine forever? I think it's fine to be crystal clear about the health effects of moderate drinking,

but if my brain's going to turn 50, the same year my body turns 50, but just like a few months earlier, that is a much more acceptable risk to me than some of the fear-mongering that I hear among health influencers for anybody who has a glass of wine at night. So to sum up, because this has been a lot of information, there was an old conventional wisdom represented by the J-Curb that moderate drinking was clearly good for you.

But this was based in observational studies that had a ton of problems, especially in that moderate drinkers were healthier for reasons that had nothing to do with their drinking, and non-drinkers are often less healthy for reasons that had nothing to do with their abstinence. And when you failed to control for this, well, then, of course, the moderate drinkers looked healthier. But when the J-Cerve died, when it went away,

It was replaced by a new, emerging conventional wisdom that now is telling us that moderate drinking is dangerous. And I think that conventional wisdom is also overconfident. And it includes frequent warnings about the effects of moderate drinking on cancer rates and brain health that I think are worth noting, but I think also misrepresent in the media the effect size of moderate drinking on cancer mortality and brain disease, and effect size, which is often very, very low. So where does this leave us?

Well, for Tim Stockwell, the upshot is pretty simple. The safest thing to do now is just to assume there's some slight risks if you drink a little bit, and it's up to you whether you take those risks. Look, I think that's fair. But I also think that life isn't, or at least it should not be, about avoiding every single activity that has the tiniest amount of risk. right cookies have risk going out into the sun going to the beach has risk trying to bench your body weight when you have a bad shoulder has risk getting in a car to go hang out with a friend all of these

involve a real possibility of risk and injury so i pressed tim to define his most cautious conclusions in a memorable way a way that i could remember after our conversation even if i felt he might be overconfident in his caution. One drink a day for men or women will reduce your life expectancy on average by about three months. Another way I think of saying that, if I have the math right, is that every drink reduces your expected longevity by about five minutes. Does that seem about accurate? Yeah, that's if you, yeah, that's the same as just saying the same thing in a different way. You look at all the minutes that you might live, the average person lives, and all the drinks they might consume over a life course.

And so at a low level of drinking, we calculate about five minutes of life lost every time you take a drink. If you drink at a heavier level, you know, two or three drinks a day, that goes up to like 10, 15, 20 minutes per drink, not per drinking day, but per drink. Every drink takes five minutes off your life. It's hard to forget that one. Every drink takes five minutes off your life. Now, maybe the thought scares you, but personally and honestly, I find comfort in it, even as I think it probably suffers

from the same flaws of overconfidence that plagued this entire field. Several months ago, I had the Stanford University scientist, you and Ashley, on this podcast. He studies the cellular effects of exercise. And if you recall, Ewan told me that according to the observational data that he consulted,

one minute of exercise adds five minutes to your expected lifespan. This data is based on a population of more than half a million people, so that's pretty big, who were followed for over 10 years. And then we basically, not me, this is not my work, I'm reporting the work of others, but those investigators basically looked at the amount of exercise that was done, It was generally moderate to higher intensity exercise, but a brisk walk plus and looked at the number of minutes every day that those people exercised and then looked at how long they lived. And there was a very clear correlation.

And when you looked at how much that exercise bought you in terms of extra life, it did indeed map that one minute of exercise at a brisk walking sort of pace would buy you five minutes. In fact, if you exercise at a higher intensity, you could get seven or eight minutes of extra life. So check this out. When you put these two statistics together, Tim Stockwell, you and Ashley, you get the following lovely bit of longevity math. For moderate drinkers, every drink reduces your life by the same five minutes that one minute of exercise can add back to your life. Right? Now, there's a motto for healthy moderation. Have a drink. drink, have a jog. But I think even this kind of arithmetic can absolutely miss a bigger point and a deeper point.

And I want to end here by quoting the article that I wrote for The Atlantic because I tried very, very hard to capture in words something more profound about this whole exercise that we're going through. To reduce our existence to a mere game of minutes gained and lost is to squeeze the life out of life. Alcohol is not a vitamin or a pill that we swiftly consume in the solitude of our bathrooms, which could be straightforwardly evaluated in a controlled lab setting. At best, moderate alcohol consumption is enmeshed in activities that we share with other people.

Cooking, dinners, parties, happy hours, celebrations, rituals, get-togethers. Life! It is pleasure, and it is people. A social mortar for our age of social isolation. An underrated aspect of the Surgeon General's report is that it is following, rather than trailblazing, a national shift away from alcohol. As recently as 2005, Americans were more likely to say alcohol was good for them than bad. Last year, they were five times more likely to say it was bad than good. In the first seven months of 2024, alcohol sales declined for beer, wine, and spirits, and the decline seems especially pronounced among young people.

To the extent that alcohol carries a serious risk of excess and addiction, less booze in America seems purely positive. But healthy drinking is social drinking. And the decline of alcohol seems related to the fact that Americans now spend less time in face-to-face socializing than in any period in modern history. That some Americans are trading the blurry haze of intoxication for the crystal clarity of sobriety might be a blessing for their minds or their guts, but in some cases, they may be trading an ancient drug of socialization

for the novel intoxicants of isolation. Thank you for listening. We'll talk to you next week.