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What if alcohol were harmful, even in moderation?
While there is almost no doubt that excessive alcohol use is invariably harmful to health and communities, I believe the study cited by Dr Ladouceur in his editorial (1) , does not provide enough evidence to counter the mountain of high quality evidence that suggests drinking alcohol in moderation is overall beneficial for health as low alcohol consumption does improve all cause mortality, diabetes and cardiovascular disease despite it being a known carcinogen in higher doses (2,3,4).
Although the Whitehall II study does appear to show a correlation between moderate alcohol use and changes on neuro-imaging, the cognitive decline outcomes were not consistent. However I believe the main flaw with the paper was the fact that the MRI was only performed once during the study. This is effectively a snapshot at one moment in these patients’ lives where self-reported alcohol use was described as moderate. The authors admit that the moderate to light drinkers in the study could possibly have been heavier drinkers in the past or even at the time of the study and the Rosenthal effect (the idea that being the subject of a study makes one behave differently because one is being studied) may have decreased self-reported alcohol use. No amount of statistical wizardry can account for these subtleties of human behaviour.
The so called “J shaped mortality curve” has been discussed in the medical literature for decades...
Show MoreCompeting Interests: None declared.