Commentary on Roerecke & Rehm (2012): The state of the science on moderate drinking and health—a case of heterogeneity in and heterogeneity out?

On the Evidence of a Cardioprotective Effect of Alcohol Consumption

“…While we consider the epidemiological evidence for a beneficial effect as strong, we also consider the evidence against it to be weak. Coincidently, the two studies cited by Stockwell [5] as fulfilling his criteria [6,7] fit well into the current theory regarding the effect of average alcohol intake and drinking pattern on ischaemic heart disease as described in our paper [2, see also 8]. However, many categories of bs_bs_banner drinking in those two studies had very low numbers of cases, so we wouldn't give them much weight.…”

What is Best Evidence in Epidemiology? A Reply to Stockwell (2012)

“…I am grateful for the opportunity for further debate and to reiterate my view that (i) Roerecke & Rehm [1] conducted a technically excellent meta-analysis on a largely poor literature and (ii) that plausible arguments remain against there being health benefits from moderate drinking. Given the fundamental significance of the issue for alcohol policy, I suggest that it is important to keep the shortcomings of this literature in clear view-as well as some other awkward findings for the health benefit hypothesis.…”

“…Dr Stockwell [1] questioned the evidence base for a beneficial effect of average alcohol consumption on heart disease that we reported in our meta-analysis of (as we arguably classify them) high-quality epidemiological studies [2]. Epidemiology is mostly an observational science [3] and, for many topics (including heart disease), experimental designs are difficult, or impossible, to conduct.…”

At the heart of the problem - A person-centred, developmental perspective on the link between alcohol consumption and cardio-vascular events

“…The harmful effects of chronic heavy alcohol exposure and associated cardiomyopathy are well documented [9][10][11]. It is the beneficial effect of AC, in particular, that has aroused controversy [12][13][14][15], even though research on biological mechanisms underlying the cardio-protection is available. Several pathways have been proposed, and the current consensus is that different mechanisms may be operative.…”