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Moderate Drinking Linked to Brain Changes and Cognitive Decline

Consumption of seven or more units of alcohol per week is associated with higher iron levels in the brain, according to a study of almost 21,000 people publishing in the open access journal PLOS Medicine. Iron accumulation in the brain has been linked with Alzheimer’s and Parkinson’s diseases and is a potential mechanism for alcohol-related cognitive decline.

There is growing evidence that even moderate alcohol consumption can adversely impact brain health. Anya Topiwala of the University of Oxford, United Kingdom, and colleagues explored relationships between alcohol consumption and brain iron levels. Their 20,965 participants from the UK Biobank reported their own alcohol consumption, and their brains were scanned using magnetic resonance imaging (MRI). Almost 7,000 also had their livers imaged using MRI to assess levels of systemic iron. All individuals completed a series of simple tests to assess cognitive and motor function.

Participants’ mean age was 55 years old and 48.6% were female. Although 2.7% classed themselves as non-drinkers, average intake was around 18 units per week, which translates to about 7½ cans of beer or 6 large glasses of wine. The team found that alcohol consumption above seven units per week was associated with markers of higher iron in the basal ganglia, a group of brain regions associated with control of motor movements, procedural learning, eye movement, cognition, emotion and more. Iron accumulation in some brain regions was associated with worse cognitive function.

This is the largest study to date of moderate alcohol consumption and iron accumulation. Although drinking was self-reported and could be underestimated, this was considered the only feasible method to establish such a large cohort’s intake. A limitation of the work is that MRI-derived measures are indirect representations of brain iron, and could conflate other brain changes observed with alcohol consumption with changes in iron levels.

Given the prevalence of moderate drinking, even small associations can have substantial impact across whole populations, and there could be benefits in interventions to reduce consumption in the general population.

Topiwala adds, “In the largest study to date, we found drinking greater than 7 units of alcohol weekly associated with iron accumulation in the brain. Higher brain iron in turn linked to poorer cognitive performance. Iron accumulation could underlie alcohol-related cognitive decline.”

Source: Science Daily

Alcohol May be More Risky to the Heart Than Previously Thought

Levels of alcohol consumption currently considered safe by some countries are linked with development of heart failure, according to research presented at Heart Failure 2022, a scientific congress of the European Society of Cardiology (ESC).

“This study adds to the body of evidence that a more cautious approach to alcohol consumption is needed,” said study author Dr. Bethany Wong of St. Vincent’s University Hospital, Dublin, Ireland. “To minimise the risk of alcohol causing harm to the heart, if you don’t drink, don’t start. If you do drink, limit your weekly consumption to less than one bottle of wine or less than three-and-a-half 500 ml cans of 4.5% beer.”

According to the World Health Organization, the European Union is the heaviest-drinking region in the world.2 While it is well recognised that long-term heavy alcohol use can cause a type of heart failure called alcoholic cardiomyopathy,3 evidence from Asian populations suggests that lower amounts may also be detrimental.4,5 “As there are genetic and environmental differences between Asian and European populations this study investigated if there was a similar relationship between alcohol and cardiac changes in Europeans at risk of heart failure or with pre-heart failure,” said Dr. Wong. “The mainstay of treatment for this group is management of risk factors such as alcohol, so knowledge about safe levels is crucial.”

This was a secondary analysis of the STOP-HF trial.6 The study included 744 adults over 40 years of age either at risk of developing heart failure due to risk factors (e.g. high blood pressure, diabetes, obesity) or with pre-heart failure (risk factors and heart abnormalities but no symptoms).7 The average age was 66.5 years and 53% were women. The study excluded former drinkers and heart failure patients with symptoms (e.g. shortness of breath, tiredness, reduced ability to exercise, swollen ankles). Heart function was measured with echocardiography at baseline and follow up.

The study used the Irish definition of one standard drink (i.e. one unit), which is 10 grams of alcohol.8 Participants were categorised according to their weekly alcohol intake: 1) none; 2) low (less than seven units; up to one 750 ml bottle of 12.5% wine or three-and-a-half 500 ml cans of 4.5% beer); 3) moderate (7-14 units; up to two bottles of 12.5% wine or seven 500 mL cans of 4.5% beer); 4) high (above 14 units; more than two bottles of 12.5% wine or seven 500 ml cans of 4.5% beer).

The researchers analysed the association between alcohol use and heart health over a median of 5.4 years. The results were reported separately for the at-risk and pre-heart failure groups. In the at-risk group, worsening heart health was defined as progression to pre-heart failure or to symptomatic heart failure. For the pre-heart failure group, worsening heart health was defined as deterioration in the squeezing or relaxation functions of the heart or progression to symptomatic heart failure. The analyses were adjusted for factors that can affect heart structure including age, gender, obesity, high blood pressure, diabetes, and vascular disease.

A total of 201 (27%) patients reported no alcohol usage, while 356 (48%) were low users and 187 (25%) had moderate or high intake. Compared to the low intake group, those with moderate or high use were younger, more likely to be male, and had a higher body mass index.

In the pre-heart failure group, compared with no alcohol use, moderate or high intake was associated with a 4.5-fold increased risk of worsening heart health. The relationship was also observed when moderate and high levels were analysed separately. In the at-risk group, there was no association between moderate or high alcohol use with progression to pre-heart failure or to symptomatic heart failure. No protective associations were found for low alcohol intake.

Dr. Wong said: “Our study suggests that drinking more than 70 g of alcohol per week is associated with worsening pre-heart failure or progression to symptomatic heart failure in Europeans. We did not observe any benefits of low alcohol usage. Our results indicate that countries should advocate lower limits of safe alcohol intake in pre-heart failure patients. In Ireland, for example, those at risk of heart failure or with pre-heart failure are advised to restrict weekly alcohol intake to 11 units for women and 17 units for men. This limit for men is more than twice the amount we found to be safe. More research is needed in Caucasian populations to align results and reduce the mixed messages that clinicians, patients and the public are currently getting.”

Source: European Society of Cardiology

Will a Little Drinking Help Your Heart? Maybe Not

If you believe an occasional tipple is good for your heart, a new study may make you reconsider the notion.

Some previous research has suggested that light drinking may benefit the heart, but this large study concluded that any amount of drinking is associated with a higher risk of heart disease, and that any supposed benefits of alcohol may actually be due to healthy lifestyle habits practiced among light and moderate drinkers.

“The findings affirm that alcohol intake should not be recommended to improve cardiovascular health; rather, that reducing alcohol intake will likely reduce cardiovascular risk in all individuals, albeit to different extents based on one’s current level of consumption,” study senior author Dr. Krishna Aragam said in a Massachusetts General Hospital news release. He’s a cardiologist at the hospital and an associate scientist at MIT’s Broad Institute.

In the study, the researchers analyzed data from more than 371,000 British adults who had an average of nine drinks a week.

As in previous studies, this new paper found that light to moderate drinkers had the lowest heart disease risk, followed by people who did not drink. People who drank heavily had the highest risk.

However, light to moderate drinkers tended to have healthier lifestyles than those who didn’t drink, including more physical activity, more vegetables in their diet and less smoking.

Taking just a few healthy lifestyle factors into account made any benefit associated with alcohol less significant, according to the study published in the journal JAMA Network Open.

The researchers also conducted a genetic analysis of samples from study participants and discovered substantial differences in heart risk from drinking, with minimal increases in risk when going from zero to seven drinks per week, much higher increases when going from seven to 14 drinks per week, and especially high risk with 21 or more drinks per week.

Significantly, the findings suggested a rise in heart risk even at levels of drinking considered “low risk” by the U.S. Department of Agriculture (less than two drinks per day for men and one drink per day for women), the study authors noted.

The finding that the connection between heart risk and drinking is an exponential one rather than a linear one was supported by an additional analysis of data from more than 30,000 U.S. participants in the Mass General Brigham Biobank.

That means that reducing drinking can benefit even people who have just one alcoholic beverage per day, but the health benefits of cutting back may be more substantial in those who drink more, according to the researchers.

Source: HealthDay

One Alcoholic Drink a Day Linked with Reduced Brain Size

Katherine Unger Baillie wrote . . . . . . . . .

The science on heavy drinking and the brain is clear: The two don’t have a healthy relationship. People who drink heavily have alterations in brain structure and size that are associated with cognitive impairments.

But according to a new study, alcohol consumption even at levels most would consider modest—a few beers or glasses of wine a week—may also carry risks to the brain. An analysis of data from more than 36,000 adults, led by a team from the University of Pennsylvania, found that light-to-moderate alcohol consumption was associated with reductions in overall brain volume.

The link grew stronger the greater the level of alcohol consumption, the researchers showed. As an example, in 50-year-olds, as average drinking among individuals increases from one alcohol unit (about half a beer) a day to two units (a pint of beer or a glass of wine) there are associated changes in the brain equivalent to aging two years. Going from two to three alcohol units at the same age was like aging three and a half years. The team reported their findings in the journal Nature Communications.

“The fact that we have such a large sample size allows us to find subtle patterns, even between drinking the equivalent of half a beer and one beer a day,” says Gideon Nave, a corresponding author on the study and faculty member at Penn’s Wharton School. He collaborated with former postdoc and co-corresponding author Remi Daviet, now at the University of Wisconsin-Madison, and Perelman School of Medicine colleagues Reagan Wetherill—also a corresponding author on the study—and Henry Kranzler, as well as other researchers.

“These findings contrast with scientific and governmental guidelines on safe drinking limits,” says Kranzler, who directs the Penn Center for Studies of Addiction. “For example, although the National Institute on Alcohol Abuse and Alcoholism recommends that women consume an average of no more than one drink per day, recommended limits for men are twice that, an amount that exceeds the consumption level associated in the study with decreased brain volume.”

Ample research has examined the link between drinking and brain health, with ambiguous results. While strong evidence exists that heavy drinking causes changes in brain structure, including strong reductions in gray and white matter across the brain, other studies have suggested that moderate levels of alcohol consumption may not have an impact, or even that light drinking could benefit the brain in older adults.

These earlier investigations, however, lacked the power of large datasets. Probing massive quantities of data for patterns is the specialty of Nave, Daviet, and colleagues, who have conducted previous studies using the UK Biobank, a dataset with genetic and medical information from half a million British middle-aged and older adults. They employed biomedical data from this resource in the current study, specifically looking at brain MRIs from more than 36,000 adults in the Biobank, which can be used to calculate white and gray matter volume in different regions of the brain.

“Having this dataset is like having a microscope or a telescope with a more powerful lens,” Nave says. “You get a better resolution and start seeing patterns and associations you couldn’t before.”

To gain an understanding of possible connections between drinking and the brain, it was critical to control for confounding variables that could cloud the relationship. The team controlled for age, height, handedness, sex, BMI, smoking status, socioeconomic status, genetic ancestry, and county of residence. They also corrected the brain-volume data for overall head size.

The volunteer participants in the Biobank had responded to survey questions about their alcohol consumption levels, from complete abstention to an average of four or more alcohol units a day. When the researchers grouped the participants by average-consumption levels, a small but apparent pattern emerged: The gray and white matter volume that might otherwise be predicted by the individual’s other characteristics was reduced.

Going from zero to one alcohol units didn’t make much of a difference in brain volume, but going from one to two or two to three units a day was associated with reductions in both gray and white matter.

“It’s not linear,” says Daviet. “It gets worse the more you drink.”

Even removing the heavy drinkers from the analyses, the associations remained. The lower brain volume was not localized to any one brain region, the scientists found.

To give a sense of the impact, the researchers compared the reductions in brain size linked with drinking to those that occur with aging. Based on their modeling, each additional alcohol unit consumed per day was reflected in a greater aging effect in the brain. While going from zero to a daily average of one alcohol unit was associated with the equivalent of a half a year of aging, the difference between zero and four drinks was more than 10 years of aging.

In future work, the authors hope to tap the UK Biobank and other large datasets to help answer additional questions related to alcohol use. “This study looked at average consumption, but we’re curious whether drinking one beer a day is better than drinking none during the week and then seven on the weekend,” Nave says. “There’s some evidence that binge drinking is worse for the brain, but we haven’t looked closely at that yet.”

They’d also like to be able to more definitively pin down causation rather than correlation, which may be possible with new longitudinal biomedical datasets that are following young people as they age.

“We may be able to look at these effects over time and, along with genetics, tease apart causal relationships,” Nave says.

And while the researchers underscore that their study looked only at correlations, they say the findings may prompt drinkers to reconsider how much they imbibe.

“There is some evidence that the effect of drinking on the brain is exponential,” says Daviet. “So, one additional drink in a day could have more of an impact than any of the previous drinks that day. That means that cutting back on that final drink of the night might have a big effect in terms of brain aging.”

In other words, Nave says, “the people who can benefit the most from drinking less are the people who are already drinking the most.”

Source: University of Pennsylvania

Social Media Is Attention Alcohol

Derek Thompson wrote . . . . . . . . .

Last year, researchers at Instagram published disturbing findings from an internal study on the app’s effect on young women. “Thirty-two percent of teen girls said that when they felt bad about their bodies, Instagram made them feel worse,” the authors wrote in a presentation obtained by The Wall Street Journal. “They often feel ‘addicted’ and know that what they’re seeing is bad for their mental health but feel unable to stop themselves.”

This was not a new revelation. For years, Facebook, which owns Instagram, has investigated the app’s effects on its users, and it kept getting the same result. “We make body image issues worse for one in three teen girls,” said one slide from a 2019 presentation. “Teens who struggle with mental health say Instagram makes it worse.”

The findings weren’t all negative. Although many teenagers reported that Instagram was compulsive but depressing, most teenagers who acknowledged this dark side said they still thought the app was enjoyable and useful.

So a fair summary of Instagram according to Instagram might go like this: Here is a fun product that millions of people seem to love; that is unwholesome in large doses; that makes a sizable minority feel more anxious, more depressed, and worse about their bodies; and that many people struggle to use in moderation.

What does that sound like to you? To me, it sounds like alcohol—a social lubricant that can be delightful but also depressing, a popular experience that blends short-term euphoria with long-term regret, a product that leads to painful and even addictive behavior among a significant minority. Like booze, social media seems to offer an intoxicating cocktail of dopamine, disorientation, and, for some, dependency. Call it “attention alcohol.”

I personally don’t spend much time on Instagram, but on reflection I love Twitter quite like the way I love wine and whiskey. Other analogies fall short; some people liken social media to junk food, but ultra-processed snacks have few redeemable health qualities compared with just about every natural alternative. I have a more complicated relationship with Twitter. It makes my life better and more interesting. It connects me with writers and thinkers whom I would never otherwise reach. But some days, my attention will get caught in the slipstream of gotchas, dunks, and nonsense controversies, and I’ll feel deeply regretful about the way I spent my time … only to open the app again, several minutes later, when the pinch of regret has relaxed and my thumb reaches, without thought, toward a familiar blue icon on my phone.

For the past decade, writers have been trying to jam Facebook into various analogical boxes. Facebook is like a global railroad; or, no, it’s like a town square; or, perhaps, it’s like a transnational government; or, rather, it’s an electric grid, or a newspaper, or cable TV.

Each of these gets at something real. Facebook’s ability to connect previously unconnected groups of people to information and commerce really does make it like a 21st-century railroad. The fact that hundreds of millions of people get their news from Facebook makes it very much like a global newspaper. But none of these metaphors completely captures the full berserk mosaic of Facebook or other social-media platforms. In particular, none of them touches on what social media does to the minds of the young people who use it the most.

“People compare social media to nicotine,” Andrew Bosworth, a longtime Facebook executive, wrote in an extensive 2019 memo on the company’s internal network. “I find that wildly offensive, not to me but to addicts.” He went on:

I have seen family members struggle with alcoholism and classmates struggle with opioids. I know there is a battle for the terminology of addiction but I side firmly with the neuroscientists. Still, while Facebook may not be nicotine I think it is probably like sugar. Sugar is delicious and for most of us there is a special place for it in our lives. But like all things it benefits from moderation.

But in 2020, Facebook critics weren’t the ones comparing its offerings to addiction-forming chemicals. The company’s own users told its research team that its products were akin to a mildly addictive depressant.

If you disbelieve these self-reports, perhaps you’ll be persuaded by the prodigious amounts of outside research suggesting the same conclusion. In June, researchers from NYU, Stanford, and Microsoft published a paper with a title that made their position on the matter unambiguous: “Digital Addiction.” In closing, they reported that “self-control problems cause 31 percent of social media use.” Think about that: About one in three minutes spent on social media is time we neither hoped to use beforehand nor feel good about in retrospect.

Facebook acknowledges these problems. In a response to the Wall Street Journal exposé published on Tuesday, Karina Newton, the head of public policy at Instagram, stood by the company’s research. “Many find it helpful one day, and problematic the next,” she wrote. “Many said Instagram makes things better or has no effect, but some, particularly those who were already feeling down, said Instagram may make things worse.” But this self-knowledge hasn’t translated into sufficient reform.

Thinking of social media as attention alcohol can guide reform efforts. We have a kind of social infrastructure around alcohol, which we don’t have yet for social media. The need to limit consumption is evident in our marketing: Beer ads encourage people to drink responsibly. It’s in our institutions: Established organizations such as Alcoholics Anonymous are devoted to fighting addiction and abuse. It’s in our regulatory and economic policy: Alcohol is taxed at higher rates than other food and drink, and its interstate distribution has separate rules. There is also a legal age limit. (Instagram requires its users to be 13 years old, although, as it goes with buying alcohol, many users of the photo-sharing app are surely lying about their age.)

Perhaps most important, people have developed a common vocabulary around alcohol use: “Who’s driving tonight?”; “He needs to be cut off”; “She needs some water”; “I went too hard this weekend”; “I might need help.” These phrases are so familiar that it can take a second to recognize that they communicate actual knowledge about what alcohol is and what it does to our bodies. We’ve been consuming booze for several thousand years and have studied the compound’s specific chemical effects on the liver and bloodstream. Social media, by contrast, has been around for less than two decades, and we’re still trying to understand exactly what it’s doing, to whom, and by what mechanism.

We might be getting closer to an answer. A 124-page literature review compiled by Jonathan Haidt, an NYU professor, and Jean Twenge, a San Diego State University professor, finds that the negative effects of social media are highly concentrated among young people, and teen girls in particular. Development research tells us that teenagers are exquisitely sensitive to social influence, or to the opinions of other teens. One thing that social media might do is hijack this keen peer sensitivity and drive obsessive thinking about body image, status, and popularity. Instagram seems to create, for some teenage girls, a suffocating prestige economy that pays people in kudos for their appearance and presentation. The negative externality is dangerously high rates of anxiety.

How do we fix it? We should learn from alcohol, which is studied, labeled, taxed, and restricted. Similar strictures would discourage social-media abuse among teenagers. We should continue to study exactly how and for whom these apps are psychologically ruinous and respond directly to the consensus reached by that research. Governments should urge or require companies to build more in-app tools to discourage overuse. Instagram and other app makers should strongly consider raising their minimum age for getting an account and preventing young users from presenting fake birthdates. Finally, and most broadly, parents, teens, and the press should continue to build a common vocabulary and set of rules around the dangers of excess social media for its most vulnerable users.

Digital sabbaths are currently the subject of columns and confessionals. That’s a good start, but this stuff should be sewn into our everyday language: “No apps this weekend”; “I need to be cut off”; “I love you, but I think you need to take a break”; “Can you help me stay offline?” These reforms should begin with Facebook. But with social media, as with every other legal, compulsive product, the responsibility of moderation ends with the users.

Source : The Atlantic

Study: Alcohol Can Cause Immediate Risk of Atrial Fibrillation

Elizabeth Fernandez wrote . . . . . . . . .

A single glass of wine can quickly – significantly – raise the drinker’s risk for atrial fibrillation, according to new research by UC San Francisco.

The study provides the first evidence that alcohol consumption substantially increases the chance of the heart rhythm condition occurring within a few hours. The findings might run counter to a prevailing perception that alcohol can be “cardioprotective,” say the authors, suggesting that reducing or avoiding alcohol might help mitigate harmful effects.

The paper is published in Annals of Internal Medicine.

“Contrary to a common belief that atrial fibrillation is associated with heavy alcohol consumption, it appears that even one alcohol drink may be enough to increase the risk,” said Gregory Marcus, MD, MAS, professor of medicine in the Division of Cardiology at UCSF.

“Our results show that the occurrence of atrial fibrillation might be neither random nor unpredictable,” he said. “Instead, there may be identifiable and modifiable ways of preventing an acute heart arrhythmia episode.”

Atrial fibrillation (AF) is the most common heart arrhythmia seen clinically, but until now research has largely focused on risk factors for developing the disease and therapies to treat it, rather than factors that determine when and where an episode might occur. AF can lead to loss of quality of life, significant health care costs, stroke and death.

Large studies have shown that chronic alcohol consumption can be a predictor of the condition, and Marcus and other scientists have demonstrated that it is linked to heightened risks of a first diagnosis of atrial arrhythmias.

The research centered on 100 patients with documented AF who consumed at least one alcoholic drink a month. The patients were recruited from the general cardiology and cardiac electrophysiology outpatient clinics at UCSF. People with a history of alcohol or substance use disorder were excluded, as were those with certain allergies, or who were changing treatment for their heart condition.

Each wore an electrocardiogram (ECG) monitor for approximately four weeks, pressing a button whenever they had a standard-size alcoholic drink. They were also all fitted with a continuously recording alcohol sensor. Blood tests reflecting alcohol consumption over the previous weeks were periodically administered. Participants consumed a median of one drink per day throughout the study period.

Researchers found that an AF episode was associated with two-fold higher odds with one alcoholic drink, and three-fold higher odds with two or more drinks within the preceding four hours. AF episodes were also associated with an increased blood alcohol concentration.

The authors note study limitations, including that patients might have forgotten to press their monitor buttons or that they minimized the number of button presses due to embarrassment, although these considerations would not have affected alcohol sensor readings. Additionally, the study was limited to those with established AF, not to the general population.

“The effects seem to be fairly linear: the more alcohol consumed, the higher the risk of an acute AF event,” said Marcus. “These observations mirror what has been reported by patients for decades, but this is the first objective, measurable evidence that a modifiable exposure may acutely influence the chance that an AF episode will occur.”

Source: UCSF

Less than Half of Americans Know that Alcohol is a Carcinogen

Jessica Fu wrote . . . . . . . . .

The alcohol industry regularly spreads misinformation to obscure booze’s cancer link. Public health groups are demanding label warnings to give consumers clarity.

In retrospect, researchers Erin Hobin and Timothy Stockwell shouldn’t have been surprised that their first-of-its-kind experiment placing cancer warnings on 47,000 bottles of booze—funded by the Canadian government to the tune of $1 million (CDN)—got yanked.

Designed to assess the impact of eye-catching labels, researchers set out to affix bright yellow stickers bearing health messages onto nearly every alcoholic drink for sale at the sole liquor store in the city of Whitehorse, Yukon, for eight months. “It was a rare and unique opportunity,” said Hobin, a public health scientist for the province of Ontario, in a recent interview. But as soon as the experiment began in late November 2017, disgruntled emails from the heads of Canada’s beer, liquor, and wine lobby groups began to roll in. They demanded the Yukon government halt the study, according to public records the researchers later obtained—by Christmas, it was suspended.

Big Booze’s interference in what would have been an unprecedented study on alcohol cancer warnings is only one instance in a long history of efforts the industry has taken to sow doubt about drinking’s health effects. Other recent hits include the funding of flattering research and campaigns against policies that encourage drinking less. These actions muddy the general public’s understanding of how much it’s safe to drink—and in the cases of certain types of cancer, whether it’s safe to drink at all.

There is a frustratingly stubborn gulf between what experts know about alcohol’s cancer risk and the awareness of everyday drinkers.

Alcohol’s cancer link is irrefutable: In 1988, the World Health Organization (WHO) concluded that there is a causal relationship between ethanol—the specific type of alcohol in booze—and throat, liver, breast, and colon cancers. This link has since been acknowledged both by the Centers for Disease Control and Prevention—which advises that “for some conditions, such as certain types of cancer [for example, breast cancer] and liver disease, there is no known safe level of alcohol consumption”—as well as the U.S. Surgeon General, who has written that, “[for] breast cancer, studies have shown that even moderate drinking may increase the risk.” A public health analysis published last year estimated that the cancer risk posed by drinking one bottle of wine a week was comparable to smoking five cigarettes for men and 10 for women in the same time span.

In late October, eight organizations led by the Consumer Federation of America filed a petition to the Department of the Treasury’s Alcohol and Tobacco Tax and Trade Bureau (TTB), calling on the agency to set the record straight for consumers once and for all, by making explicit on all booze the fact that alcohol is a carcinogen. Since WHO’s declaration in 1988, our understanding of alcohol’s cancer risk has only become more clear, says Nigel Brockton, vice president of research at the American Institute for Cancer Research (AICR), one of the groups involved in the petition.

“Although the link between cancer and alcohol has been [noted] for 30 years, we see it in much finer resolution than we were able to before,” he said. But here’s the catch: Despite the scientific consensus, less than half of the general public knows that alcohol is a carcinogen.

“The tobacco industry pioneered this by manipulating the science on heart disease and cancer, by hiring researchers who pretty much get on their payroll and then create doubt about the linkages.”

Part of this, Brockton suspects, may be due to the myth that moderate drinking can be heart-healthy—an association that has long been debunked as a conclusion of shoddy analysis. Nonetheless, there’s a pervasive sense among the general drinking public that the science remains unsettled. That climate of doubt is no accident: A 2017 analysis found that industry-affiliated groups regularly spread misinformation online to cast uncertainty around alcohol’s cancer link. Companies also sometimes engage in a practice dubbed “pinkwashing,” which involves branding alcoholic products with ribbons denoting breast cancer awareness to obscure ethanol’s carcinogenicity. (In 2018, Mother Jones published a detailed investigation examining the efforts that the alcohol industry has taken to mislead the public about alcohol’s cancer link.)

As a result, public health advocates say, there is a frustratingly stubborn gulf between what experts know about alcohol’s cancer risk and the awareness of everyday drinkers. Cancer warnings are essential to closing that gap, said Thomas Gremillion, director of food policy at the Consumer Federation of America. Just take the impact of such labels on tobacco as an indication: Researchers have found that mandatory health messages are associated with increased knowledge about smoking’s risks, and that graphic warnings illustrative of particular risks like brain damage and cancer may increase interest in quitting.

“On the one hand, you have this huge contribution of alcohol to cancer and the public health burden, and on the other hand, you’ve got a majority of Americans for whom alcohol as a cancer risk is not on their radar,” Gremillion said in an interview. “They don’t put two and two together.”

That’s where cancer warnings can play a role, he added. Since November 1989, federal law has required every bottle of booze sold in the United States to bear a health message that warns pregnant women against drinking, and states that alcohol “may cause health problems.” However, the petition argues, this message hasn’t been updated in three decades and needs to be brought up to speed with the latest science. Gremillion says that the petition was inspired in part by Hobin and Stockwell’s study and it proposes a cancer warning identical to the one they used in Yukon. (In California, retailers must present alcohol cancer warnings to consumers at points of sale online and in stores, as required by Prop. 65. However, these are not required on products themselves, as such labeling falls under TTB oversight.)

The process to make those labels a mandated national reality, however, will require multiple steps. First, TTB has to recommend any proposed label changes to Congress. Lawmakers will then have to approve them. “That’s a big lift,” Gremillion admitted. And if the interruption of the Yukon experiment is any indication, alcohol lobby groups will likely pull out all the stops to prevent it from happening.

“I was surprised we were able to run it for [a month], honestly, before we got stopped,” said Stockwell, director of the Canadian Institute for Substance Use Research and professor of psychology at the University of Victoria. “I was thinking that that was only because it was in the Yukon, out in the middle of nowhere. Nobody quite knew what was going on until the launch—that’s why we got away with it.”

“On their own, well-designed labels can increase consumer knowledge of national drinking guidelines and serious, largely unknown alcohol-related health risks, such as cancer, as well as reduce per capita alcohol consumption.”

Despite the interruption, the team was able to pull a handful of telling findings from the cancer label’s four weeks in action: Shoppers in Whitehorse were significantly more likely to know about alcohol’s cancer risk than control groups. Researchers also found that total alcohol sales decreased by more than six percent. These findings were published in the Journal of Studies on Alcohol and Drugs in May.

“On their own, well-designed labels can increase consumer knowledge of national drinking guidelines and serious, largely unknown alcohol-related health risks, such as cancer, as well as reduce per capita alcohol consumption,” Hobin wrote in a email.

The U.S. petitioners will likely face tremendous pushback from the industry. Recently, for example, after a scientific advisory committee suggested in July that the next iteration of the Dietary Guidelines (DGA) lower its moderate drinking limit for men from two drinks per day to one—industry groups, their representatives, and lawmakers to whom the groups had poured hundreds of thousands in campaign contributions raised furor over the recommendation. They challenged its scientific basis, and in statements to the media, resuscitated the discredited idea that drinking can have health benefits.

“The alcohol industry is not doing anything different. They really see science as a threat to their viability.”

These marketing and lobbying efforts have been frequently compared to Big Tobacco’s old playbook on staving off public health regulations.

“The tobacco industry pioneered this by manipulating the science on heart disease and cancer, by hiring researchers who pretty much get on their payroll and then create doubt about the linkages,” said Thomas Babor, a professor of public health science at the University of Connecticut and the editor-in-chief of the Journal of Studies on Alcohol and Drugs. “The alcohol industry is not doing anything different. They really see science as a threat to their viability.”

And much like in the case of tobacco, public health advocates don’t expect the general public’s attitudes toward alcohol to shift overnight.

“[Alcohol] is a big part of our culture and of our society,” Hobin said. “Alcohol is present when we’re celebrating birthdays, weddings, anniversaries, in religious ceremonies. And because alcohol has been so prominent in our culture—that in and of itself creates a barrier because it’s been so normalized. In order to really start to rethink alcohol, it will take time and it will be gradual.”

“Those who know alcohol can cause cancer are 1.6 times more likely to support health warning labels relative to those who do not know.”

Right now, just two countries, South Korea and Ireland, have laws on the books requiring cancer warnings on booze. Gremillion’s hope for the Consumer Federation petition is that it also raises awareness of the alcohol-cancer link among the general public.

“A warning—and even short of that—just drawing attention to this could have a real, significant public health impact,” he said.

Down the line, widespread recognition may even result in greater pressure from drinkers themselves for cancer warnings. That might seem implausible, but Hobin and Stockwell’s study found that awareness is in fact linked to higher support for such messaging: “Those who know alcohol can cause cancer are 1.6 times more likely to support health warning labels relative to those who do not know,” the authors wrote.

Any industry pushback—and there undoubtedly will be industry pushback—might even incidentally serve the campaign’s interests. Just look at what happened with Hobin and Stockwell: When the industry pressured the Yukon government to halt their work, the move sparked vocal outrage and widespread coverage in both the domestic and international press. High-profile health columnist André Picard covered it, as did The New York Times and The Wall Street Journal. It wasn’t exactly the kind of exposure that researchers had expected, and it came with an unfamiliar degree of public esteem.

“I’m used to being unpopular talking about alcohol, because we all love our drink, and anyone who moans about how it’s bad for you, and that it should be restricted and so on can be very unpopular,” Stockwell said. “I got so much support.”

Source : The Counter