Author Archives: Bix

Alcohol: No More Than 5 Drinks A Week Says New Lancet Study

Here’s the big, new Lancet study on alcohol that is now over a week old so the National Institutes of Health (NIH) can go on promoting drinking too much alcohol which makes the alcohol industry happy.

Risk Thresholds For Alcohol Consumption: Combined Analysis Of Individual-Participant Data For 599,912 Current Drinkers In 83 Prospective Studies, The Lancet, 14 April 2018

They were looking for a threshold, an amount you could drink that wouldn’t cause harm:

Background: Low-risk limits recommended for alcohol consumption vary substantially across different national guidelines. To define thresholds associated with lowest risk for all-cause mortality and cardiovascular disease, we studied individual-participant data from 599 912 current drinkers without previous cardiovascular disease.

They found that there was no threshold. Alcohol, at any and all intakes, increased risk for disease:

Interpretation: In current drinkers of alcohol in high-income countries, the threshold for lowest risk of all-cause mortality was about 100 g/week. For cardiovascular disease subtypes other than myocardial infarction, there were no clear risk thresholds below which lower alcohol consumption stopped being associated with lower disease risk. These data support limits for alcohol consumption that are lower than those recommended in most current guidelines.

They said if you wanted to drink alcohol, the lowest risk (not non-risk) was had from about 100 grams a week or less.

What is 100 grams of alcohol?

  • 5 ounces of wine at 12% alcohol is 0.6 ounces or about 17 grams ethanol.
  • 12 ounces of beer at 6% alcohol is 0.72 ounces or about 20 grams ethanol.

100 grams of alcohol works out to about 6, 5-ounce servings of wine a week (about a half cup each, see photo), or 5 glasses of beer a week (12 ounces each).

From the Washington Post:

A sweeping international study of alcohol consumption has found no overall health benefits from moderate drinking and calls into question the U.S. guidelines that say men can safely drink twice as much as women.

Alcohol consumption, even at that allegedly moderate level, is also associated with a suite of cardiovascular problems, including stroke, aortic aneurysm, fatal hypertensive disease and heart failure.

Alcohol consumption is also associated with higher risks of several types of cancer, including breast cancer. The new study confirmed an association between drinking and cancers of the digestive system.

From The Guardian:

Tim Chico, professor of cardiovascular medicine at the University of Sheffield said, “This study makes clear that on balance there are no health benefits from drinking alcohol, which is usually the case when things sound too good to be true.”

Prof Jeremy Pearson, associate medical director at the British Heart Foundation, which part-funded the study, called it “a serious wakeup call for many countries.”

In a commentary in the Lancet, Profs Jason Connor and Wayne Hall from the University of Queensland Centre for Youth Substance Abuse Research in Australia, anticipated that the suggestion of lowering recommended drinking limits will come up against opposition.

“The drinking levels recommended in this study will no doubt be described as implausible and impracticable by the alcohol industry and other opponents of public health warnings on alcohol. Nonetheless, the findings ought to be widely disseminated and they should provoke informed public and professional debate.”

Given the significant association of alcohol to breast cancer (“There is no level of alcohol use that is completely safe in terms of breast cancer.”) and dementia, I’m beginning to see the alcohol industry’s advice to consume their product “in moderation” as misogynistic and ageist. Actually, it’s misandristic too since current US guidelines state that men can drink twice the amount as women. This study found that was not the case. The UK has already changed their guidelines.

If you drink, it’s a good idea to take a “liver holiday” 2 or 3 times a week. Those are days you don’t consume any alcohol at all. That gives your liver and the cells that line your throat, esophagus, and stomach time to heal. It’s also fewer days they are exposed to acetaldehyde, a byproduct of alcohol metabolism that’s thought to promote cancer. (See also: “Liver Holiday” May Do Drinkers Some Good“)

No doctor worth their certification should be failing to assess their patient’s alcohol intake.

Study: Drinking Alcohol Every Day Can Shorten Life (Repost)

I’m reposting this from 2014 because I’m reading that new Lancet study which has the new recommendations down to 5 drinks a week, with several days of abstinence between.

___________

JapaneseMenDrinking3

The source for this photo, GlobalVoicesOnline.org, says that in Japan, drinking can be a social obligation.

Here’s another study that addresses, not just amount of alcohol consumed, but frequency … how many days a week one drinks at all. It’s much bigger than the one I just posted. It analyzed data from 88,746 men and women from Japan and found the same thing, that drinking alcohol every day can shorten life:

Patterns Of Alcohol Drinking And All-Cause Mortality: Results From A Large-Scale Population-Based Cohort Study In Japan, American Journal of Epidemiology, May 2007

The deleterious effects of alcohol seem to be mitigated by abstaining for a few days a week. The Japanese call this a “liver holiday,” which “is considered important for general health and for maintaining the metabolic function of the liver.”

This study defined a heavy drinker as someone who consumed more than 300 grams of ethanol a week. I had to run the numbers to understand that:

  • 5 ounces of wine at 12% alcohol is 0.6 ounces or about 17 grams ethanol.
  • 12 ounces of beer at 6% alcohol is 0.72 ounces or about 20 grams ethanol.

300 grams works out to 2.5 glasses of wine a day (a small glass: 5 ounces) or 2 glasses of beer a day (12 ounces). If you drank this amount or more, you were considered a heavy drinker.

However, in the US, a heavy drinker (from the US Cancer Prevention Study) was someone who consumed more than 30 g of alcohol per day, so more than 9 ounces of wine (a little less than 2 glasses) or 1.5 beers.

“The highest hazard ratios [were] observed among those consuming ≥450 g of alcohol 5–7 days per week.”

That about 3.5 small (5oz) glasses of wine or 3 (12oz) beers a day. That was the riskiest.

“The increased risk of all-cause mortality associated with frequency of alcohol intake was seen among heavy drinkers only (≥300 g alcohol/week).”

That’s telling. It says that if you drank less than 2 drinks a day, you didn’t experience increased risk, in this study at least.

This following bit is interesting … The researchers found that most of these alcohol-related deaths were from cancer. What’s the mechanism? The NIH says that the body first…

“… metabolizes alcohol to acetaldehyde, a highly toxic substance and known carcinogen. Then, in a second step, acetaldehyde is further metabolized down to another, less active byproduct called acetate, which then is broken down into water and carbon dioxide for easy elimination.”

So, the more you drink, and the more often you drink, the more you expose your tissues (especially liver, pancreas, and brain) to acetaldehyde, “a known carcinogen.”

I imagine that future guidelines for alcohol consumption in the US will address frequency as well as amount, incorporating “three alcohol-free days a week” into the “1 drink for women and 2 drinks for men” advice. … As long as the wine, beer, and spirits lobbies don’t nip it.

The Pleasure Rationale

Barbara Ehrenreich has a new book, Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer. I haven’t read it. I think I would like it. While scanning through it on Amazon I saw this.

On page 207 Ehrenreich writes:

I pretty much eat what I want and indulge my vices, from butter to wine. Life is too short to forgo these pleasures, and would be far too long without them.

I hear this a lot. The pleasure rationale. Is life too short to forgo the pleasure of cigarettes with coffee? Of driving a motorcycle or car without a helmet or seat belt? Unprotected sex? A rave without pot and pills? Sugar Pops and whole milk for breakfast? Or maybe an Egg McMuffin? Bacon? Life’s too short!

Maybe this has an age component to it. Ehrenreich is 76. Should we be encouraging young people to indulge their vices?

I agree with her that life is too short not to experience pleasure. But as long as we are able to chose our pleasures, why not chose those that heal instead of those that harm?

Heritage Loaf

This is a 100% whole grain, no-knead bread that I adapted from Mark Bittman’s recipe. The consistency is more crumbly, like a quick bread. It doesn’t rise much because the lower-gluten rye and corn flours, and all the bran and germ, get in the way of gluten formation. Not much oven spring. But a great-tasting, whole-grain loaf with a bit more character than whole wheat bread. No white flour, no oil. Great toasted.

Ingredients:

2 cups whole wheat flour
½ cup whole rye flour
½ cup coarse cornmeal
1 teaspoon instant yeast
1 ½ teaspoons salt
1 ½ water
2 tablespoons maple syrup

Directions:

Combine flours, cornmeal, yeast and salt in a large bowl. Stir maple syrup and vinegar into water, add to flour mixture, stir until blended. Cover bowl with plastic wrap. Let rest about 4 hours at room temperature, about 70 degrees.

Nudge dough onto a lightly floured surface. With lightly floured hands and a pastry scraper, roll dough around a bit, or knead gently, until it forms a ball. This will happen very quickly, 4 or 5 kneads, don’t overdo it. Place ball onto a piece of parchment, drape with plastic wrap, let rest about 1 hour.

Before the hour is up, place a large, heavy, covered pot (dutch oven) into oven. Preheat oven and pot to 350 degrees. Score the bread. Gently lower bread into hot pot, holding it by the parchment (parchment cooks with bread in pot), and cover. Bake 45 minutes, remove lid, bake another 15 minutes. Remove bread from pot. After a few minutes gently peel away parchment. Cool on a rack.

Dietary Fat Contributes To Inflammation

Dietary fat, especially saturated fat found in foods such as cheese, butter, and red meat, induce an immediate and prolonged immune response. Chronic, low-level systemic inflammation is at the root of metabolic diseases like diabetes and heart disease, and depression.

People are like, wait, what? Saturated fat causes inflammation? (Which I said on this post: The Link Between Inflammation And Depression.) It does. I learned about it several years ago, in relation to diabetes. You don’t have to have diabetes for dietary fat to cause inflammation, but if you do, it’s worse.

High Fat Intake Leads to Acute Postprandial Exposure to Circulating Endotoxin in Type 2 Diabetic Subjects, Diabetes Care, February 2012

One way dietary fat contributes to inflammation is by increasing absorption of endotoxins, to which we launch an inflammatory response. Endotoxins are bits of bacterial membrane that are absorbed along with the fat we eat, especially saturated fat to which endotoxins have an affinity. They’re thought to derive from bacteria (dead or alive) introduced to the intestines from food, primarily meat, eggs, dairy, or fermented food, all of which carry relatively higher levels of microorganisms. The bacteria that colonize our colon are  too far along the digestive tract for absorption to take place in any significant quantity.

These studies have highlighted that exposure to a high-fat meal elevates circulating endotoxin irrespective of metabolic state, as early as 1 h after a meal [up to 4 hours after a meal]. However, this increase is substantial in IGT* and type 2 diabetic subjects, suggesting that metabolic endotoxinemia is exacerbated after high-fat intake.

Endotoxin, which is considered a potential mediator of chronic low-grade inflammation, is considerably higher in the state of type 2 diabetes.

A person eating three high-SFA [saturated fat] meals each day may encounter endotoxin levels that remain perpetually high.

While the most obvious solution to metabolic endotoxinemia appears to be to reduce saturated fat intake, the Western diet is not conducive to this mode of action, and it is difficult for patients to comply with this request.

*IGT is impaired glucose tolerance, usually a prediabetes state.

People with diabetes typically have a constant low-grade inflammation and this study was trying to figure out why.

Here’s another study that links dietary fat, specifically saturated fat, to inflammation, and it has nothing to do with endotoxins:

Acute And Chronic Saturated Fatty Acid Treatment As A Key Instigator Of The TLR-mediated Inflammatory Response In Human Adipose Tissue, Journal of Nutritional Biochemistry, January 2012

They exposed adipose cells (fat cells) to saturated fat and it invoked an immune response in the fat cell. The fat cell, they said, has its own immune response.

The identification of innate immune receptors- toll-like receptors (TLRs) — on human and murine adipocytes — and their activation by bacterial and fungal pathogens supports the theory that adipocytes have an innate immune capacity.

Studies have also observed that free fatty acids have the potential to activate the innate immune signalling pathways, indicating a causative role for both glucose and saturated fatty acids (SFAs) in the pathogenesis of T2DM [type 2 diabetes], via the initiation of these inflammatory processes [9–11].

They found that fat in the diet was worse than glucose:

[Our] data highlights the potential risk of a continued high fat diet on inducing an inflammatory response, as it appears to be more pronounced than the glucose induced response. This would also appear to align with clinical studies that suggest hyperlipidaemia may impact more significantly over time than hyperglycaemia in the pathogenesis of metabolic disease [e.g. diabetes].

This study implicates elevated SFAs [saturated fatty acids] as a key instigator of the inflammatory response in both adipose tissue and adipocytes”

Saturated fat, found mostly in animal food, is the most problematic type of fat.

These studies have been out for years and I’ve posted them. But for some reason, “butter is back.” I’m afraid the social psyche has been irreparably damaged.

In Order To Prove How The Illness Was Caused, A Scientist Purposely Gave Himself?

In order to prove how the illness was caused, a scientist purposely gave himself?

1. Measles
2. Bladder cancer
3. HIV
4. Stomach ulcers

From How-To Geek:

For the longest time, the standing theory about peptic ulcers (more commonly called stomach ulcers) was that they were caused by stress and spicy food. Patients stricken with ulcers were commonly urged to engage in calming activities and even switch away from high stress occupations.

In the early 1980s, two Australian doctors, Barry Marshall and Robin Warren, began exploring a completely different hypothesis: that ulcers were caused by bacteria. Their interest in the matter, research, and eventual hypothesis that ulcers were caused by the spiral bacteria H. pylori were widely mocked in the greater scientific and medical communities since it was believed that no bacteria could survive the harsh conditions of the stomach.

Eventually, after numerous frustrations in their research (H. pylori grows slowly and the first 30 out of 100 early samples were ruined when lab assistants disposed of the culture samples too soon) and poor reception of their work in scientific journals, Barry Marshall took matters into his own hands. In 1984, Marshall had his stomach cultured via endoscopy to establish that he was free from H. pylori, then he drank a broth laced with a culture of the bacteria. He anticipated that he would fall ill with an ulcer within a year or more of ingesting the broth, but was shocked to find out that within a matter of days, he was symptomatic. Eight days after ingesting the laced broth, he had another endoscopy which revealed that his stomach was severely inflamed and the bacteria had completely colonized it, and after a course of antibiotics starting on the fourteenth day, he was cured.

Today, as a result of the research carried out by the duo and by Marshall’s willingness to be a guinea pig, we now know that H. pylori is one of the major causative factors of stomach ulcers (NSAID pain relievers like ibuprofen are the major causative factor of non-bacterial cases). In the end though, a few weeks of stomach problems aside, Marshall had the last laugh. Not only was their research immediately validated, both eventually won the Nobel Prize in Physiology or Medicine for their work.

So, stomach ulcers were once thought to be caused by stress or certain foods. It ended up being a microorganism. Do you think this may shine a light on the cause of irritable bowel?

Depression Is No More Prevalent Today Than In The Past

In answer to Dr. Gibson’s question, “Why is there such a dramatic rise in anxiety and depression in the United States?” Dr. Frances replied:

Allen Frances literally wrote the manual used to diagnose mental illness in this country. He’s top of his field and a force to be reckoned with:

Frances was the founding editor of two well-known journals: the Journal of Personality Disorders and the Journal of Psychiatric Practice.

Frances chaired the task force that produced the fourth revision of Diagnostic and Statistical Manual (DSM-IV) and became critical of the current version, DSM-5. He warned that the expanding boundary of psychiatry is causing a diagnostic inflation that is swallowing up normality and that the over-treatment of the “worried well” is distracting attention from the core mission of treating the more severely ill.

One of his recent books, “Saving Normal”, I covered here. He says that drugs prevent us from experiencing our “natural resiliency”.