Is Moderate Drinking Protective Against Heart Disease? The Science, Politics and History of a Public Health Conundrum

Abstract

For more than 40 years, most research by epidemiologists, social scientists, and alcohol policy experts found that moderate alcohol consumption was cardioprotective. In the early 2000s, that consensus was shaken by new critics who subjected the previous research to vigorous methodological and empirical analysis, precipitating a bitter controversy, seemingly unresolvable despite numerous observational epidemiological studies. The effort to finally put that debate to rest through a large, multiyear randomized controlled trial under the aegis of the National Institute on Alcohol Abuse and Alcoholism, generated external criticism and adverse newspaper coverage, particularly because the trial was largely funded by the alcohol industry, forcing National Institutes of Health leadership to abruptly terminate the study shortly after it started. In the absence of definitive evidence and given the contentious debate over the risks and benefits of moderate alcohol consumption, those who formulate health policy have a responsibility to clearly acknowledge to the public the existence of evidentiary uncertainty when making recommendations.

Health Disparities and Cardiovascular Disease

“…There are conflicting studies about the effects of drinking on CVD/MI. Some studies have shown an effect of drinking on CVD/MI [25], while others have found no such association [26]. This study's findings support no relationship between drinking and CVD/MI.…”

Health Disparities and Cardiovascular Disease

“…There are conflicting studies about the effects of drinking on CVD/MI. Some studies have shown an effect on drinking on CVD/MI [26], while others have found no such association [27]. This study's findings support no relationship between drinking and CVD/MI.…”

A safe level of alcohol consumption: the right answer demands the right question

“…After millennia of use, it is disturbing indeed that no such randomized trial has been conducted. The major obstacle to such a trial appears to be an asymmetric fear of what it might show, restricted to those who favour complete abstention and/or prohibition [46]. Without a trial, the evidence base on which to judge a safe level of alcohol consumption is relegated to be substandard and inconclusive and, worst of all, intentionally engineered that way.…”