Safety of Alcohol Consumption
I have in previous blogs and newsletters discussed the health benefits of alcohol, which, based on scientific research, can be summarized as, “moderate drinkers outlive non-drinkers”.
Previous research has always supported the idea that moderate drinking (1 - 2 drinks per day for women; 2 - 4 drinks per day for men) offered more health benefits than totally abstaining from alcohol. But, alcohol consumption in excess of those moderate limits resulted in (dose-dependent) increases in the risks of certain cancers, cirrhosis of the liver, and death.
This belief, held in the scientific community, was called into question, not long ago, by a report in The Lancet medical journal (2018). In that report, researchers concluded there is no healthy level of alcohol consumption, a point emphasized in headlines around the world. “Our results show that the safest level of drinking is none,” concluded the researchers.
Now, however, that conclusion has been called into question by new research. In a recently published article (JAMA Internal Medicine), researchers re-examined the data used in The Lancet study.
In The Lancet study, researchers gauged alcohol consumption by looking at sales of alcohol in 195 countries around the world (controlling for alcohol consumption by tourists, and other unrecorded consumption). As well as sales data (and this is the key point) their estimates of individual consumption was also based on self-reported data from drinkers.
What the JAMA researchers discovered was that heavy drinkers underreport their actual levels of alcohol consumption by from 40 to 65%. Since the Lancet study didn’t take this underreporting into account, their results “may have resulted in an overestimate of the risk of adverse health outcomes from a low amount of alcohol consumption”, pointed out JAMA researchers.
Here is how they explained it: “If 30% of at-risk drinkers under-report their drinking by 1 to 2 drinks per day and if 30% of heavy drinkers try to hide their drinking by saying they only drink 1 to 2 drinks per day, this underreporting could lead to biased study findings that misrepresent a reality in which 1 drink per day reduces the risk of adverse health outcomes by 5% and 2 drinks per day result in no net harm. The bottom line is, the more that heavy drinkers underreport their drinking, the more that the risks associated with low levels of alcohol use will be overestimated."
The authors of the JAMA study did not set out to find an appropriate amount of alcohol that is safe to consume: “Our intent was to show a potential problem with reported risk estimates, not to generate new risk estimates that can reliably be used in real-world settings,” they wrote.
Given that the Lancet study has this flaw based on under-reporting by actual drinkers, perhaps we can safely go back to trusting the decades of research showing that moderate alcohol consumption is both safe and beneficial.
“Given the pleasure presumably associated with moderate drinking, claiming there is no ‘safe’ level does not seem an argument for abstention,” said David Spiegelhalter, PhD, Winton Professor for the Public Understanding of Risk, University of Cambridge, Cambridge, UK.
“There is no safe level of driving, but the government does not recommend that people avoid driving,” he added. “Come to think of it, there is no safe level of living, but nobody would recommend abstention.”
Vitamin D and Neuropathic Pain
A new study (Jan, 2020) sought to examine “the effect of vitamin D replacement therapy on neuropathic symptoms, and balance, in patients with diabetic neuropathic pain and low vitamin D levels”.
In this randomized, placebo-controlled study, patients were assessed for symptoms of neuropathic pain, and polyneuropathy (peripheral neuropathy), as well as determining any issues with balance.
After being examined, patients in the treatment group were injected with 300,000 IU vitamin D, while those in the placebo group were injected with a saline solution placebo. After 12 weeks they were reassessed for the same symptoms previously tested.
Results indicated those patients receiving vitamin D had a significant decrease in symptoms of neuropathic pain and polyneuropathy, as well as a marked improvement in balance.
The study concluded that, “In patients with diabetic neuropathic pain, vitamin D levels should be measured and vitamin D replacement therapy should be administered as required to resolve neuropathic symptoms and to improve balance.” (Source)
Of note here is the high amount of vitamin D given with one injection: 300,000 IU. While conventional medicine is warning us about taking too much vitamin D, the scientific community has for decades been using the approach of one high dose of vitamin D, which the patient is assumed to utilize over a long period of time (usually throughout the winter).
Certainly regular use of high amounts of vitamin D (in my opinion, over 25,000 IU per week), will require cofactors (vitamin K2, and to a lesser degree, vitamin A), but, clearly these subjects received much benefit, and no signs of toxicity, from an extremely high dose of vitamin D. Which indicates to me that vitamin D is something which can be experimented with, at high doses, relatively safely.