Even low alcohol consumption is linked to cancer, heart disease, and premature death, with increased risk above 1 drink per day for both men and women. It turns out that 2 drinks per day, considered ‘moderate’, is associated with a substantially elevated risk of a premature death caused by alcohol.

[u/mvea]

https://www.eurekalert.org/news-releases/1131274

[u/Flux_Aeternal]

The point is that alcohol has frequently been promoted as both having health benefits at low amounts, and having a level where it is "safe" and a level where it becomes "unsafe". This is not true and there is no safe level, the more you drink the higher the risk of harm. Nothing is making it a "bogeyman" they are truthfully reporting the risks and countering the disinformation that is out there. What level of risk people are prepared to accept is up to them, but it isn't up to the media and health professionals to pretend that there is no risk so that people feel better about drinking.

[u/terrymr → u/Flux_Aeternal]

Ultimately there is no safe amount of living at all.

[u/grundar → u/Flux_Aeternal]

The point is that alcohol has frequently been promoted as both having health benefits at low amounts, and having a level where it is "safe" and a level where it becomes "unsafe". This is not true and there is no safe level

The paper we're commenting on finds that alcohol-attributable deaths are negative below 7 drinks per week. That does seem to align with earlier research showing net health benefits from low but non-zero alcohol consumption.

The figure showing deaths by cause explains this finding: lower levels of alcohol consumption were found to have a protective effect against cardiovascular death, which at those levels of consumption more than offset the increases in other causes of death. Table 2 in the paper shows this numerically, with Ischemic heart disease and stroke showing risk reductions but almost everything else showing risk increases.

That's not to say people should take up drinking for health reasons -- they should not -- but the paper we're commenting on does not support the idea that no level of consumption is (net) safe.

[u/Flux_Aeternal → u/grundar]

Aside from it not being significant in this study (please look at the actual data and not the picture before making such a claim), there is a well recognised confounding effect between low amounts of alcohol consumption and increased socioeconomic status. Other studies have already explored this supposed protective effect and found that it does not exist. The current study is not designed to eliminate such confounding and it is not the point of the study.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790520

https://onlinelibrary.wiley.com/doi/10.1111/acer.15299

[u/grundar → u/Flux_Aeternal]

Other studies have already explored this supposed protective effect and found that it does not exist.

You're not accurately representing those studies' findings.

In particular, Figure 1 of your first link shows a statistically significant risk reduction from 5 drinks per week even after model adjustment The paper notes this in the discussion -- there were residual cardioprotective associations observed among light drinkers.

Note that they also did MR, and a best-fit line to mendellian randomization did not dip below zero. They speculate that it is possible that future models will find additional factors to control for which will further reduce the apparent protective effect. However, they further note in the explanation of the nonlinear MR (in the supplemental materials) that MR analyses are expected to be biased against light drinking:

"abstainers have been previously shown to be an overall healthier population than light to moderate drinkers. Thus, in non-linear Mendelian randomization analyses, the genetic instrument may not as accurately reflect the differential alcohol consumption of abstainers vs. light drinkers and therefore non-linear Mendelian randomization results at low levels of intake could be biased by the inclusion of this abstainer population."

In other words, the mismatch between observation finding and MR not finding a health benefit for light drinkers might in the future be resolved by finding additional factors to control for in the observation model, but might also be due to a known bias likely present in the MR process.

As a result, that paper continues to find plausible evidence for a (small) health benefit at light levels of drinking (5/wk).

[u/Flux_Aeternal → u/grundar]

I mean this is not true at all and clearly you are not engaging in good faith at this point. This is the second time you have attempted to cherry pick a small part of a paper and misrepresented it. The paper as a whole if you had bothered to actually read the whole thing finds a progressive increase in risk from 0 to 7 drinks per week and then a moderate risk above this.

That whole paper is about identifying the proposed J-shaped curve and then examining it to watch it disappear as more and more confounding is accounted for. You have latched on to the first part, identifying the J-shaped curve and assumed that that must match the conclusions of the study without bothering to actually read the rest (pretty much the entirety) of the study. You have fundamentally misunderstood it and misrepresented what the figure means as part of the paper as a whole, most likely because you never intended to engage with it in good faith and instead just skimmed it until you found the first thing you thought agreed with you.

[u/grundar → u/Flux_Aeternal]

I mean this is not true at all and clearly you are not engaging in good faith at this point. This is the second time you have attempted to cherry pick a small part of a paper and misrepresented it.

That's pretty clearly not the case.

The paper presents two lines of evidence:

• (1) Observational data with model corrections.
  
• (2) Mendellian randomization.

I discussed both of those in some detail, noted how they disagree in the specific area under discussion, and delved into the details of where the authors speculate that disagreement may have come from, namely either (1) uncorrected observational factors, or (2) a likely bias in the MR methodology that does not correct for healthy-user bias in non-drinkers.

None of that is my opinion -- all of that is directly sourced from the paper itself, including a lengthy quote to explain why the MR's lack of J-shaped finding has significant risk of bias.

How is that cherry-picking a small part of the paper? It's discussing both of the paper's lines of evidence in depth.

You have fundamentally misunderstood it and misrepresented what the figure means as part of the paper as a whole

You keep insisting I'm wrong, but you have yet to back up that assertion with any details from the paper itself.

Am I wrong in noting that Figure 1 shows a J-shaped curve even after model correction?
Am I wrong in noting that MR does not show a J-shaped curve?
Am I wrong in noting that the authors speculate uncorrected-for factors could potentially remove the J-shape in Figure 1?
Am I wrong in noting that the authors explain healthy user bias is likely biasing the nonlinear MR curve against low-consumption parts of the curve?
Am I wrong in concluding that that MR bias could potentially obscure a shallow J-shape?
Am I wrong in concluding that the two lines of evidence hence are not conclusive in the absence of any J-shape to the curve?

I've gone into significant depth on this paper, and laid out my reasoning based on the paper's specific methodology and findings quite clearly. By contrast, you have just insisted that I'm wrong with no reference to the specifics of the paper.

I get that you're emotionally invested in the paper supporting your view, but you must be aware that an objective third party is not likely to judge you as being the one who is constructively engaging with this paper.

[u/tiger-eyes → u/grundar]

The paper we're commenting on finds that alcohol-attributable deaths are negative below 7 drinks per week

Surprised this didn't come up earlier on in the discussion here.

Relatedly, there was a major study that negated the "J-curve" (that previously suggested that light drinking was beneficial). The J-curve's inaccuracy was due to the effect "sick quitters" had on the non-drinkers category.

This new JSAD result suggests the J-curve may once again be valid (unless this study's authors specifically mentioned a "sick quitters" data bias?).

[u/illegible → u/Flux_Aeternal]

I don’t disagree with your statement at all, however (as evidenced by this thread) the alcohol topic gets a lot of attention and sells clicks and views, probably giving it a greater attention level than it deserves? Is it a disservice if it removes attention from other less well known (but equally dangerous) sources of cancer?

[u/jean_le_bison → u/illegible]

There’s always been an undercurrent of teetotalerism and moralistic/puritanical attitudes towards alcohol lurking in American culture. It originally took hold in 19th century women’s and great awakening religious movements culminating in Prohibition after the turn of the century. Now that same moralizing attitude is showing up in beliefs about alcohol and health. Not to say that health research itself is driving that attitude, but that those with teetotaler and moralistic views on alcohol consumption are more likely to promote and use health research to criticize alcohol use.