- A lot of us are drinking too much, and on Tuesday the Centers for Disease Control and Prevention called us on it.
More than eight drinks a week for women and 15 drinks a week for men can get you into trouble, the CDC warned.
But that doesn't seem to jibe with other studies that found that drinking alcohol makes for better heart health, several Shots commenters noted. Shana Cuddy wrote:
"Interestingly, in another NPR article they say that moderate drinkers are healthier overall than folks who don't drink at all, and they define 'moderate drinker' as someone who has 3 or less drinks per day. This would be 21 drinks per week for women, which this story claims is well over twice the safe limit."
So can someone follow along with me to see what I'm missing:
NPR: 8 drinks a week for women
Why?
NPR: "To find out how the CDC came up with them, we talked with Lela McKnight-Eily, a health scientist at the CDC who is the lead author on the new study."
New study:
- CDC analyzed Behavioral Risk Factor Surveillance System (BRFSS) data from a question added to surveys in 44 states and the District of Columbia (DC) from August 1 to December 31, 2011, about patient-reported communication with a health professional about alcohol. Elements of ASBI are traditionally delivered via conversation. Weighted state-level prevalence estimates of this communication were generated for 166,753 U.S. adults aged ≥18 years by selected demographic characteristics and drinking behaviors.
- Results: The prevalence of ever discussing alcohol use with a health professional was 15.7% among U.S. adults overall, 17.4% among current drinkers, and 25.4% among binge drinkers. It was most prevalent among those aged 18–24 years (27.9%). However, only 13.4% of binge drinkers reported discussing alcohol use with a health professional in the past year, and only 34.9% of those who reported binge drinking ≥10 times in the past month had ever discussed alcohol with a health professional. State-level estimates of communication about alcohol ranged from 8.7% in Kansas to 25.5% in DC.
So… NPR says "two drinks a day are too many" because the CDC added 1 (one) question to an intake form for 5 (five) months in 2011 and came to the conclusion 1 in 4 "binge drinkers" talk about alcohol with their doctors, 1 in 6 "regular drinkers" and about 1 in 7 "non drinkers."
First thing: Okay….
Next thing: This isn't what we're supposedly talking about.
- The findings in this report are subject to at least five limitations. First, BRFSS data are based on self-report and dependent on respondent recall of dialogue with a health professional, which can vary based on the time since the patient's last visit or other factors that could have affected patient recall, thus resulting in underreporting. Second, respondents were asked to report only whether they "talked with" a health professional about their alcohol consumption, not whether they reported their alcohol consumption in some other manner (e.g., on a patient history form) or if they were actually screened or received an intervention.
So, li'l story. Back in 2000 or so I went to see a doctor for a check up. First time I'd been in years, figured it was a good idea. Strange asian man, part of the UW health network, done in a strip mall next to Costco. And it was the damndest thing:
"Raise arm… don't do drug."
"Turn head, cough: always wear seat belt."
"Say aaah: always wear condom for sex. Don't get AIDS."
A couple years later I was going through records and mentioned this bizarre visit with my girlfriend, who had been a high-up software architect in the insurance industry. She laughed at me.
"Well, of course he did. Every single one of those PSAs is a box his secretary can check off on the form they're sending your insurance company. He's probably making thirty bucks for telling you to use a condom."
So you'll excuse me if I'm skeptical of this study's intended results, let alone NPR's projected results. For one thing, if their question isn't even granular enough for "did your doctor bilk your insurance company out of $30 by telling you not to drink too much" I'm unconvinced it's granular enough to be useful. One question on one form for five months? Puhhhleaze.
But to then extrapolate it out to "hey, we found a study that contraindicates every other study we've been trumpeting for the past ten years"?
Yeah, not buyin' it.
I talked a little about my views on the CDC and its limits here. I believe that its weekly limits and definition of binge-drinking, especially for women, are ludicrous. If I have 4 drinks over the course of 6 hours, according to this table AND being skimpy on my weight, I would not even have a BAC over the legal limit to drive. Therefore I find it ludicrous to consider that "binge drinking." If you never get legally inebriated can that be a "binge"?
It is not uncommon for me to have 8 drinks in a day, perhaps once every week or two. (For what it's worth I generally drink doubles; I'm not slamming eight shots back.) I have a favorite bar and it is also not uncommon for me to spend six hours there once every week or two (on a weekend; start at brunch, end in the afternoon/evening). I run into a lot of friends at this bar, which is what keeps me from leaving - not the fact that I'm there to get drunk.
I don't trust the government to ascribe what is most healthy for you correctly. I trust them to have views that are influenced by puritans and by lobbyists.
- I don't trust the government to ascribe what is most healthy for you correctly. I trust them to have views that are influenced by puritans and by lobbyists.
I'll go through phases, right now I'm in a beer phase. I was just on a whiskey kick and prior to that it was gin. Prior to gin I was drinking wine a lot. I think it's time to start the cycle again and go back to wine :)
I typically have a couple of drinks most evenings. On Mondays when we have our Hubski team call I'm most likely to have more than a few drinks... those calls can be a lot of fun.
- I don't trust the government to ascribe what is most healthy for you correctly. I trust them to have views that are influenced by puritans and by lobbyists.
Yeah but you have to read what academics write and what the government or your family doctor says very differently. An academic study is going to look at the hard numbers and tell it like it is. Those studies are usually meant to be read by other academics. What your doctor tells you--or in this case, the CDC--is influenced by human nature. Your doctor knows the study about how having three drinks isn't unhealthy. But if she tells her patients that it's OK to have three drinks per day, many of them are going to think, "Well six drinks must be really good then!" So they go the puritan route. It's not out of malice or judgement; it's purely hedging against knuckleheads. One of my good buddies who's an ER physician told me once that in his profession when you ask patients how often have sex (men especially), you divide the number by three, and when you ask how much they drink, you multiply!