Science Vs - Alcohol: Time to Put a Cork in It?

Episode Date: March 30, 2023

For decades we’ve been yanked around over alcohol: one day it’s actually good for us, the next day it’s a killer. And recently there’ve been reports that even a little bit of booze is bad for you overall. We first looked into this back in 2019, and since then the research has evolved faster than a nanobrewery’s tap list. So today we’re diving back into the science to find out: is just a bit of alcohol dangerous? We talk to epidemiologist and nutritionist Prof. Eric Rimm, psychologist Prof. Tim Stockwell, cancer researcher Dr. Susan Gapstur, and substance use disorder researcher Dr. Peter Butt. Find our transcript here: https://bit.ly/AlcoholCorkinItScienceVsTranscript  In this episode, we cover:  (00:00) The debate over alcohol (03:26) Why alcohol might be good for us (10:10) Why alcohol might be bad for us (16:30) Why are experts recommending even less alcohol now? (19:30) Alcohol and cancer risk (25:32) Our conclusion on alcohol Credits:  This episode was produced by Meryl Horn with help from R.E. Natowicz, Wendy Zukerman as well as Disha Bhagat, Rose Rimler, Michelle Dang, Joel Werner, and Kaitlyn Sawrey. We’re edited by Blythe Terrell. Editing help from Caitlin Kenney. Gimlet’s managing director is Nicole Beemsterboer. Fact checking by Erica Akiko Howard, Michelle Harris and Michelle Dang. Mix and sound design by Catherine Anderson, Bobby Lord and Peter Leonard. Music by Peter Leonard, Bumi Hidaka, Emma Munger and Bobby Lord. A huge thanks to all the researchers we got in touch with for this episode including Dr. Arthur Klatsky, Dr. Krishna Aragam, Dr. William Kerr, Dr. Tim Niami, Professor William Ghali, Dr. Wendy Chen, Max Griswold and many others. Recording help from Andrew Stelzer, Susanna Capelouto, Katie Sage, and Joseph Fridman. Also thanks to Lynn Levy, the Zukerman Family and Joseph Lavelle Wilson. Science Vs is a Spotify Original Podcast and a Gimlet production. Follow Science Vs on Spotify, and if you wanna receive notifications every time we put out a new episode, tap the bell icon! Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hi, I'm Wendy Zuckerman and you're listening to Science Versus from Gimlet. Today we're pitting facts against old fashions. As we look at alcohol. Should we put a cork in it? It feels like we've been yanked around for years about whether drinking a little alcohol is OK or not. Like several years ago, there was news that drinking a glass or two was practically a health food. There is groundbreaking new research on the benefits of drinking alcohol moderately. Many studies have shown that drinking a moderate amount of red wine can help the fight against heart disease, Alzheimer's, and some cancers.

One to two glasses of something a day, that might actually be pretty good for you. But then earlier this year, it felt like public health wonks from Canada pissed in everyone's beer by saying the healthiest thing to do here, think about taking it easy on those daily drinks. New guidance out this week on drinking alcohol.

Experts recommending no more than two drinks a week. Other reports seem to take things even further. We hate to be the ones to break some sobering news to you, but a major new study says no amount of alcohol is good for your overall health. Even that one glass of wine at dinner does more harm than good. No amount of alcohol is good for you, not even a little bit. Is this thing that a lot of us love doing after a stressful day at work really killing us?

Well, it turns out that what we thought was a fairly simple question took us down this rabbit hole, where things just got curiouser and curiouser, until it became almost impossible to know what to think. So might as well give up, eh? Never. Here at Science Versus, there is no question too confusing, no research quagmire too sticky.

Strap on your beer goggles and get yourself ready for a peer-reviewed adventure to find out once and for all, is alcohol good for us or not? When it comes to alcohol, there's a lot of opinions. But then there's science. Science versus alcohol is coming up just after the break. Cheers.

It's really not important to me to have a lot of things to show off, fancy cars, you know, a giant home. Those things are just not part of who I am. But I've been coached and I've learned through my advisor that it's not one size fits all. Everyone has their own preferences. Everything that I do with Edward Jones is tailored to who I am. Edward Jones.

We do money differently. Visit edwardjones.ca slash different. Bumble knows it's hard to start conversations. Hey. No, too basic. Hi there. Still no. What about hello, handsome?

Who knew you could give yourself the ick? That's why Bumble is changing how you start conversations. You can now make the first move or not. With opening moves, you simply choose a question to be automatically sent to your matches. Then sit back and let your matches start the chat. Download Bumble and try it for yourself. Welcome back. Today, we are finding out if a little giggle juice is killing us.

We first looked into this question back in 2019. So we're going to start by playing some of that episode as it originally aired. And then we're going to look and see whether the science has changed in the last few years. Okay, so here's me back in 2019. Whoops, went back too far. Okay, so here is me from 2019. We all know that drinking a lot, like four drinks a day, can be bad for us. It increases our risk for all kinds of diseases, like liver disease, and it makes it more likely that we'll get into serious accidents. But where it's confusing is when it comes to drinking in moderation.

You know, cracking open a cold one or two. Because it seems like every day we hear something different. Some say it's good for you, some say it's bad for you, and all I want to know is can I have a beer? To start our journey in answering this question, we wanted to take you to a time where basically no-one was seriously arguing that alcohol was good for you. Alcohol is a violent narcotic, almost as if its aim in life was to transform man back into an animal.

This is a PSA from 1952. All it takes is five drops of alcohol for every thousand drops of blood and, brother, you're a dead duck. All it takes is five drops of alcohol for every thousand drops of blood. And brother, you're a dead duck. Things changed for alcohol in the 1970s though. That was when a very curious study came out showing that alcohol might actually be good for you. It found that people who drank had far fewer heart attacks than those who didn't drink.

And it caused a huge stir. Heart disease kills hundreds of thousands of Americans each year. It's the biggest killer around. And if this finding was true, no longer were drinkers dead ducks, but they might be majestic eagles soaring to health. Other scientists immediately bellied up to the bar and wanted to find out, could this be true? Could alcohol really be good for you?

I was surprised that there was something that seemed so simplistic. It really was, gee, just really having a couple glasses of wine with dinner can have that strong of an impact. Eric Rimm is a professor of epidemiology and nutrition at Harvard, and one of his first big studies was checking to see if that 1970s paper was right. After all, the idea that alcohol could help your heart? It sounded too good to be true. Yeah, I think people were skeptical. Anecdotally, alcohol was bad. People who showed up in hospitals had too much. And therefore, if too much was bad, then, you, and he also asked the men what they ate,

to see if maybe it wasn't the alcohol, but something the drinkers happened to be eating that was protecting their heart. Maybe we can sift out, is it the alcohol or is it the diet? So we had four pages where we asked them about their diet, and it was a list of about 130 foods. So you'd go through and tell us how many sweet potatoes you ate on average over the last year, how much red meat you ate. To make sure that Eric could trust that people were accurately filling out his survey, Eric's team later made sure that what people said they ate lined up with what was actually in their bodies. So they'd look for specific chemicals found in certain foods. So if you eat a lot of carrots, that means you should have a lot of beta-carotene in your blood.

And sure enough, people that reported more carrots had much higher levels of beta-carotene. And people that reported more tuna had more mercury in their toenails, which we'd expect because there's mercury in tuna. So... You actually went and measured the mercury in people's toenails to make sure that they were reporting their tuna consumption correctly? Yeah. We have one of the world's largest collections of toenails. Yeah, I don't like to brag about that, but that comes up at parties. Yeah, sounds like a real rager.

Okay, back to Eric's study. So, as the late 1980s were rolling into the 90s, Eric starts plugging all this info about what people drank and ate and whether they got a heart attack into a computer, which was very fancy for the time. You hit the enter key. In this case, you know, I had to wait eight hours for it to churn through because the computers were pretty slow at that time. And when the results popped up, Eric found that alcohol really was good for the men's hearts. Any amount of alcohol lowered their risk of heart diseases. And generally speaking, the more they drank, the stronger the effect. And the benefit from booze was huge. Like men who drank three glasses a day, they had a 35% lower risk of getting a heart attack

than those who drank nothing. And this was after you considered what they ate. And I looked at the result going, no, it can't be that strong. It can't be that strong that there really is a 35% reduction. Eric's like, hardly anything you do makes that big of a difference. So the absolute risk reduction is very similar to exercising regularly. Wow. Eric found that drinking booze

lowered the men's risk of a heart attack as much as exercising regularly, which is bonkers. And if you're into liquor, the news for booze was about to get even better. It didn't make a difference what you drank. That if you liked vodka or if you liked beer or if you liked white wine, you had the same benefit as red wine. Other studies have come out backing this up too. Beer, gin, whiskey, tequila, all of them were found to be good for your heart. And while Eric's first study was only in men,

other researchers found that it worked for women too. Their risk of coronary heart disease dropped if they only had one or two glasses a day. And as all this research on alcohol came out, scientists immediately started wondering why. When researchers did some digging, they found a few things going on that might explain this. For example, alcohol may raise your good cholesterol, keeping plaque from building up in your arteries. It also might prevent blood clots.

All good stuff for preventing future heart attacks. It seemed like case of wine closed. I dare say there is a few people at my institution who have toasted me for 30 years since my initial publication. Yeah, it is not just my friends. It is my colleagues. It is the dean of our school. So, drinks all round.

I'm cracking open a cold one. And I'm taking a sip. Well, before I down this, you should know that not everyone is toasting this idea that alcohol is good for your heart. Hang on a minute. This is so flawed. This is so fundamentally flawed. This is Tim Stockwell. He's a professor of psychology at the University of Victoria in Canada. And Tim, he is battling team booze. He's part of team booze. That's going to get confusing. So before we jump to the conclusion, it's the alcohol, which is such a nice conclusion. It's no, it's more complicated than that. Scientists in Tim's camp, they were the ones who threw a wrench into all this intoxicating booze research.

But Tim wasn't always a party pooper. In fact, he used to think that alcohol was good for your heart. Then he met a sociologist called Kay Fillmore. It was really when I met Kay Fillmore and got to know her and her work that I began to seriously question the scientific evidence. Tell me about Kay. She was quite a, oh, she was one feisty woman. She was about five foot nothing, heavy smoker. She liked her scotch.

And oh, my God, she would give it to anybody in large public meetings. And Kay was about to start giving it to scientists like Eric. She died several years ago. But Tim told us that Kay started thinking there was something fishy about all these alcohol studies. So she phoned Tim. And yeah, I get this call, this gravelly voice. She was smoking away, puffing on a cigarette. And Tim, can you help me? Tim said yes.

So Kay's like, all right. All these studies are showing that those who drink have less heart disease than those who don't. Well, have you ever thought, who are these non-drinkers in these studies? Like, what kind of person doesn't drink anything? It might seem like people who don't drink would be these healthy types, you know, my body is a temple. But Kay suspected that wasn't true.

She started looking into the studies that have been done on people who don't drink and found something kind of shocking. Generally speaking, they were more likely to be unhealthy. Many of them used to drink but then had to stop for some medical reason. And so the team figured, well, if you want to know if alcohol is good for you, then it's a bad idea to be comparing drinkers to these sick teetotalers. You know, they're unhealthy, so they make the moderate drinkers look good by comparison. The people who did drink and then stopped, well, some scientists call them sick quitters.

And it sounds like a bad burn, but it basically means they didn't stop drinking because they were running a triathlon, but because they weren't well. So Tim and Kay thought, let's only look at the studies that we trust, like those that don't have this problem with sick quitters. And when they did that and ran the numbers, then all of a sudden, alcohol wasn't good for your heart anymore. Tim remembers the moment that the team figured it out. I remember being stuck in there in the snowstorm and talking with her on the phone and working over the data.

And yeah, it was pretty clear that the significance fell away. Significance fell away. That's the dorky way of saying that his paper couldn't find evidence that beer is good for my heart. Are you someone that people want to invite to parties based on your research? Ooh, ooh. I was invited around to dinner at Friends last night, so I'm not a complete pariah. I do occasionally leave my house. And when Tim and Kay published their study in 2006,

it got a lot of media attention, making headlines across the US saying that alcohol might not be good for us anymore. And it really set the stage for the confusion that's been mixing us up today. Even that one glass of wine at dinner does more harm than good. One day it'll kill you, the next it'll save your life. For Eric, Tim's research was like a shot of vodka across the bow. Eric says he's taken these sick quitters into account in his studies and he still finds that alcohol is good for our heart. But Tim has other problems with this research and it basically centres around this idea that it's just really hard to account for everything

that might be different about people who drink and those who don't. And so if you're finding that drinkers have lower rates of heart disease, it's hard to know that alcohol is the reason why. This is a very complex issue. These are hugely complicated things to resolve. And so the two sides have gone round and round on this, with no end in sight. Ultimately, where did we land?

Well, last year, two big reviews came out, pulling together work from this entire field. And these newer studies tend to show that Eric is right. Alcohol seems to be good for your heart. But there are a couple of caveats. Now that more studies are being more careful with things like the sick-quitter effect, they're finding some things that are different to what Eric found.

For one, men and women get a benefit to their heart after just about one drink a day. It's not the more you drink, the stronger the effect. Also, more sobering news. Alcohol isn't as good at protecting your heart as that early research had found. So, bottom line, I'm taking a sip of my beer, but I'm a little less excited about it. Okay, Wendy here from 2023.

So that is where we landed in 2019 on whether alcohol is good for your heart. But since then, it's felt like the tide against alcohol has gotten even stronger, much like the latest double IPA on tap. Because now we're hearing about these reports, like that one out of Canada, which suggested that maybe I should put down my beer. It basically said that you can't have more than two drinks a week without some kind of health consequences. So we wanted to know, why did they make that call? Like, what's changed in the science? So we called up one of the guys who headed up that Canadian report.

His name is Dr. Peter Butt. He's an associate professor at the University of Saskatchewan College of Medicine. And he says that he gets a bit of guff for his work. People saying, enough, enough. You're taking away everything that I have derived pleasure from in life. Get off my back. Here's why these Canadians are taking everything that we've derived pleasure from in life. So to create this report, these boffins did a big review of all the science in this space. And when it came to the heart, he said that there have been more and better quality studies coming

out, doing things like not lumping in the sick quitters, but also including more diverse groups into their analyses. And they're finding that for a whole host of heart and cardiovascular conditions, high blood pressure, hemorrhagic stroke, atrial fibrillation and flutter, alcohol is not good and in fact just makes things worse. There's been more and more evidence that the impact of alcohol on the heart is not beneficial. So it's really not good medicine. And it's not just the Canadians that are switching to mocktails. Back in 2019, to see where the consensus was at here,

we asked dozens of cardiologists and epidemiologists whether light drinking was protective against coronary heart disease or not. Back then, about half thought it was. We recently redid this survey and things had changed. Now, only one in five thought it was good. I know, if you like your cheeky beers, this is all kind of heartbreaking news. After the break, a surprising soldier in the war against alcohol

takes centre stage. Now when I go home and I go to take a beer from the fridge, I'm now going to be thinking of what you just said. Good. Not for me. Coming up. Welcome back. Okay, we just found out that after decades of shouting over beers on whether alcohol is good for your heart, it's now looking like it's

probably not. But the thing is, this whole time that the heart has been hogging the spotlight, kind of like a Negroni spagliato this summer, something else has been bobbing under the surface like an olive at the bottom of a martini glass. And it's this thing that might overshadow any of the argy-bargy around alcohol and your heart. And it's cancer. Let's look at where the science stood on cancer back in 2019. Susan Gapster at the American Cancer Society is looking into this. Of course, you get the original, oh my gosh, don't show her my drink.

Really? But, you know, then people are curious. They want to know. Yeah, and we wanted to know. So when it comes to cancer, how much alcohol is safe to drink? So the most recent evidence has shown that when it comes to cancer, there is no safe amount. No safe amount. What Susan is saying here is that even that cheeky glass or two of wine every day is bad news when it comes to many

different types of cancers. Even at low amounts of consumption, drinking alcohol increases the risk of mouth and throat cancers, cancers of the esophagus, which is that tube in the body just beyond your throat. Another big one for women is breast cancer. Light drinking bumps up your chances of getting it. The research suggests it's even riskier if you binge. And the news gets worse the more you drink. Then your risk of getting all kinds of cancers go up. So how is alcohol doing this?

How is it causing cancer? Well, here's one way it can happen. Susan told us that after you have one drink, the alcohol is broken down into something called acetaldehyde. Acetaldehyde reacts with DNA and with proteins to basically glob onto them. Acetaldehyde sticks to our DNA and it can squish itself right in the middle of the double helix, getting all up in the DNA's business.

And all this can trigger mutations in our DNA, leading to cancer cells. And that's just one mechanism. There are others. Acetaldehyde can prevent those cells that are damaged from dying. This is a problem because our body has a way to clean up damaged cells so they don't stick around and grow into tumors. But acetaldehyde mucks this up too.

And when those dud cells with messed up DNA don't die, we can get cancer. We want damaged cells to die and acetylcholine can help inhibit that death. I mean, I'm imagining myself now when I go home and I go to take a beer from the fridge, which I know is currently sitting in the fridge. I'm now going to be thinking of what you just said. Good. Not for me.

So, alcohol increases our risk of getting cancer. But I mean, doesn't basically everything give us cancer? What we wanted to know is how bad is it? Like, is alcohol a liquid cigarette? Well, we all know that when it comes to cancer, ciggies are the worst. About 19% of cancers in the population can be attributed to smoking. And Susan told us that almost 6% of cancers in the US are caused by alcohol. 6%.

So not as bad as ciggies, but still not great. And if you've got a cold one sitting next to you, what does all this mean? Like how much will that drink increase your risk of getting cancer? Well, to give you an example, one of the cancers that you're most likely to get from having a drink each day is actually breast cancer. That's for a woman anyway. So let's zoom in on this. Susan told us that the average woman's lifetime risk of getting breast cancer is a little more than 12%. But if she's drinking about five drinks a week,

her risk jumps up to a little more than 13%. And it can be hard to know what to feel about a stat like that. So here's how Susan thinks about it. This is something you can do if you're worried about your cancer risk. If you are a woman and you are worried about your breast cancer risk, you know, minimizing your consumption, if you are a two-drink-a-day drinker, you know, starting to reduce that is something you can do. Hey, Wendy here from 2023 again. Okay, so all this research into alcohol and cancer, it's held up. In fact, we just have even more studies that are backing it up.

We asked Peter Butt, our Canadian boffin, about this. You know, even during all of that focus and attention and promoting alcohol for the heart, people were forgetting that it was a class one carcinogen. People were silent on that. When you drink, you cannot direct the alcohol to a particular organ. It affects the whole body. So you can't ignore the fact that it might be causing breast cancer. Pretty sobering, isn't it? So, when it comes to alcohol, should we raise a glass?

One, does alcohol help our heart? Back in 2019, we thought the science was suggesting that it might help a little, but now it's looking like the tide is turning and it probably doesn't. Two, does alcohol increase our risk of cancer? Yes, even if you don't drink very much. And the more you drink, the greater your risk. Now, most of the experts that we spoke to for this episode had not cut out alcohol entirely from their lives. But when you look at the science, it does look like team booze is winning. And as for that beer I opened back in 2019, well, it's gone pretty flat by now. And I'm not really in the mood for another.

That's Science Versus. If you want to see our survey results where we interviewed all those cardiologists and epidemiologists about their thoughts on alcohol and how that's changed between 2019 and now, check out our Instagram. It's at scienceverses, that's science underscore VS. And by the way, since our original episode aired, Susan has moved on and is now a consultant working with the International Agency for Research on Cancer. Hey, Meryl Horne, producer at Science Verses. Oh, wait, senior producer at science versus oh wait senior producer at science versus yes i demand that you always call me senior producer at science versus now what about senior producer dr meryl horn phd i don't know if it's a doctor senior producer or a senior producer doctor what's the proper oh it's true it's true um well dr senior producer

dr merrill hall phd um how many citations are in this week's episode there 80 citations 80 citations and if people want to see them all in all of their glory, learn more about the perils of alcohol, where should they go? Just go to the show notes and follow the links to the transcripts. Excellent. And next week, we have a little episode on hangovers, just in case people weren't listening closely enough to this episode. I mean, I am interviewing the expert in a pub holding a beer,

so no judgment on my part. Yep. Thanks, Meryl. Thanks, Wendy. This episode was produced by Meryl Horne, with help from Ari Natarvich, Wendy Zuckerman, me, as well as Disha Bhagat, Rose Rimler, Michelle Dang, Joel Werner and Caitlin Sorey.

We're edited by Blythe Terrell. Editing help from Caitlin Kenney. Gimlet's Managing Director is Nicole Beamster-Baw. Fact-checking by Erica Akiko Howard, Michelle Harris and Michelle Dang. Mix and sound design by Catherine Anderson, Bobby Lord and Peter Leonard. Music by Peter Leonard, Bumi Hidaka, Emma Munger and Bobby Lord. A huge thanks to all the researchers that we got in touch with for this episode, including Dr Arthur Klatsky, Dr Krishna Aragam, Dr William Kerr, Dr Tim Nyami,

Professor William Garley, Dr Wendy Chen, Max Griswold and many others. Thank you. Follow Science Versus on Spotify. And if you want to receive notifications every time we put out a new episode, which you do because it just makes it really easy to be like, yay, Science Versus is out. So if you want to get notifications on Spotify, then tap on the bell. There's a little bell icon. Tap on that bell and you'll get notifications. All right. I'm Wendy Zuckerman.

Back to you next time.