[pekk]

IIRC, someone else with more expertise may show up, but the studies showing that drinking is helpful for heart disease say that this is about drinking one. Not "way too much" - mortality increases dramatically if you drink way too much, over what it would be if you didn't drink at all. The advantage of drinking is completely erased by drinking too much.

The message isn't as mixed as you think.

[carbocation]

This is essentially correct as far as I understand things. There is epidemiological evidence that <=2 drinks per day for men and <=1 drink per day for women is associated with a reduced risk of mortality. However, keep in mind that it is pretty difficult to isolate someone's drinking habits from the rest of their lifestyle. Although controlling for various features of lifestyle is attempted, this is a fundamental limitation of an observational study.

As a physician I tell my patients that there may be a benefit from such very carefully controlled, modest drinking, but there is almost certainly a benefit from abstaining rather than over-drinking.

Alcohol overuse makes you look old (yes I will appeal to vanity); it suppresses your bone marrow and makes you anemic; it causes dilated cardiomyopathy; it destroys the liver in time and will make you gut dump fluid into your belly, causing you pain until you develop liver cancer or bleed into your throat and die; it causes its own form of brain wasting; etc. It is an extraordinarily dirty drug.

Most of these effects come from sustained heavy drinking, but many people can sustain this level of drinking and still be productive, so that is not a useful gauge of how heavy your drinking is.

[conroe64]

What do you think of the study mentioned in this article that indicates that heavy drinkers outlive abstainers?

http://content.time.com/time/magazine/article/0,9171,2017200...

Here is the study itself:

http://courses.ttu.edu/jkoch/ETOH/Readings/Late_life_alcohol...

[mike_esspe]

Looks like confounding factors are the reason.

http://www.ncbi.nlm.nih.gov/pubmed/22152665

CONCLUSIONS: Among older adults who are moderate drinkers, the apparent unique effects of wine on longevity may be explained by confounding factors correlated with wine consumption.

[conroe64]

I don't understand what you are trying to show with this study. It compares moderate drinkers among themselves according to the type of alcohol consumed. It doesn't compare drinkers vs non drinkers

[logicchains]

Interestingly, one study has found that the reasons for abstaining actually determine whether or not it results in slightly worse health outcomes than light drinking:

http://www.colorado.edu/ibs/pubs/pop/pop2012-0006.pdf

"Mortality risk is low for light drinkers and many individua ls who abstain from drinking—including those who abstain for religious and moral reasons, have a responsibility to family, were brought up not to drink, and are not social; it is higher among former, infrequent, and moderate drinkers, and individuals who abstain because they do not like the taste of alcohol, are concerned that they will lose control, or are concerned about adverse consequences. Unsurprisingly, mortality risk is by far the highest for heavy drinkers. We reveal that reasons for abstention capture heterogeneity in the risk of death among lifetime abstainers. "

[carbocation]

The covariates for which one is able to control are necessarily limited, so we're left to speculate. I will speculate that if you could add a covariate such as "Used to drink lightly but stopped entirely because of a health problem" you will find the answer.

This study did create a variable which is the number of health problems and symptoms a person has. However, people can have one bad health problem/symptom (e.g., COPD on 3L home O2) which affects them more than 10 minor health problems might affect someone else.

As an aside, it is curious that this study did not replicate the repeatedly-observed finding of an association between obesity and mortality (OR = 1.00 in this study).

I will also add that this study is looking at older adults (aged 55-65 at the outset of a 20-year study, so they ended up dead or 75-85), which is different from the people discussed in the original thread (working age adults).

[hunvreus]

Same opinion here. Many possible interpretations.

For example: social interaction seems related to mortality as well, and social interaction leads to the very popular activity of consuming alcohol. Moreover, alcohol acts as a social lubricant, helping to fuel back these interactions.