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Government Drinking Guidelines


#41

@Ghost-of-Mr-Tallis, if I am reading all 3 graphs correctly, and also the base data on consumption levels, I understand that:

If you drink regularly (> 2 days per week), exclusively or predominantly wine, and you rarely if ever ‘binge drink’, then you probably need a baseline consumption of somewhere at or over twice the 100g limit -i.e. you need to be above the US limit, and miles above the limit recently foisted on us by the chief health fascist of the nanny state known as UK, for there to be any statistically measurable (not even significant) difference to expected outcomes?

Or am I wrong? I do think that someone needs to give that CMO person a good slap though :slight_smile:


#42

Having just read through all 3 graphs, I think @MarkC has pretty much got it right. 100g of pure alcohol is equivalent to a 750ml bottle at just under 13.5%. So, around 2.5 - 3 bottles of wine per week (depending on strength), with no extra spirits or beer and spread over 5 or 6 days elevates your risk by 20% (1.2 ratio where 1 is no additional risk - I think that’s how the Y axis works?).

Obviously all 3 graphs also show that increased frequency of drinking and increased volumes has a negative impact, but it would appear that drinking large amounts in one go (equivalent of 2 - 3 bottles of wine) and spirits or beer of a similar alcohol volume appear to be much riskier.

Life is a risk and for me, moderate wine consumption (albeit more than the Government guidelines), is a pleasure that outweighs the increased risk.


#43

Crikey, that’s harsh. I’m sure they’re just doing their best.

When enough people fail to act responsibly, and the rest of society repeatedly has to pick up the tab, someone has to step in on our behalf.


#44

Read about her here. She is an admirable woman.

Having to pronounce on behalf of government re alcohol consumption is a thankless task.


#45

Indeed. I wouldn’t wish it on anyone.


#46

I would take a slightly different tack here.

First point - 1 unit of alcohol in UK usage = 10ml ethanol. That’s 8 grams. owing to the density difference compared with water. That needs to be borne in mind as the alcohol content on the back of your bottle is “by volume”, i.e. v/v (volume in volume), whereas a lot of the scientific papers address weight of alcohol consumed.

Take a look at this graphic -

(Incidentally, this is the data on drinkers - non-drinkers have been removed from the data set). I think it is a reasonable interpretation to say that there appears to be no evidence of adverse effect until you reach somewhere between 100 and 150 g/week. After that there is an effect proportionate to intake over that limit.

Or in other words, you can draw a graph using two straight lines, and the point where they intersect is the highest weekly intake where the population shows no adverse effects on mortality, statistically. It does seem reasonable to draw the line where the intersection point occurs around 110g/week. Which is 140ml per week (14 units), which is the new guideline. So I do think it is justifiable from a government point of view.

HOWEVER - these are comments on entire populations - it is inadmissible to assume that individuals will follow the population data. It always is in statistics! But what you can do is to try to find a more specific subset that describes your circumstances more closely, in the hope that you can learn more about how alcohol may affect your risk of added mortality. And finally this is only about mortality. In a way that is a sort of aggregation of all the potentially life-threatening conditions that may come with alcohol. You could still suffer some chronic side-effects, but if they are not life-threatening they won’t show up here.

Right - that’s all I wanted to say on the 14 units a week business.


#47

@Herbster ‘doing their best’ in many areas seems to involve setting the bar at a level that involves no comeback to them, which tends to mean overreaction in my view.

I don’t disagree that some guidance should be given, but we seem well out of line with many other countries who don’t appear to have the same problem that certain segments of the UK population do. Maybe the bit about the rest of us picking up the tab is the part that needs looked at…

I am perhaps influenced by living in Scotland where the Government has a tendency to be even more nanny like at times…


#48

@Ghost-of-Mr-Tallis , but that doesn’t take account of the combined impact of the other three graphs which you highlighted showing the estimated impacts of:

  • regular v intermittent drinking
  • wine/spirits/beer
  • moderate v binge drinking.

I have to say I was a bit surprised by the first one, but in practice it probably interacts with the third one, where someone doesn’t drink Sunday- Thursday but goes out and gets hammered every Friday and Saturday night.

Taking all three together suggests that for regular but moderate wine drinkers, it would not be unreasonable to conclude that 25ish units a week is ok for many people - clearly not Mr Chiles though…


#49

She may well be in many ways but not this one.

Don’t doubt it, but getting it right might be helpful. The comment about ‘no safe level of alcohol consumption’ looks particularly questionable.

A bigger risk according to the Wiki article might be being married to her :wink:


#50

Oh, I completely agree with that. The post of mine you cite was intended to be the first of two. The intention was then to look at the weaknesses inherent in the “one size fits all” approach, but you beat me to it!

Whilst on the subject, I might also add that I consider removing non-drinkers from the data set is pretty contentious. The excuse is that it includes those who probably gave up for health reasons and whose health is thereby already compromised. Fair enough, but even when you exclude the “gave up” category, you are left with the “never touched the stuff” remainder, who also show a higher risk of mortality than the modest drinkers. Excluding them also gives you a data set that is already biased. And if you are going to exclude people who gave up drinking because of their poor health, you should surely also exclude those who drink because of their poor health.

On the “no safe level of alcohol consumption” issue, I think there is a somewhat different complaint to make. The statement is probably correct in the technical sense that there are certain effects of alcohol that show show no “zero effect” levels. But in talking about mortality statistics we need to stick with the integrative approach. There are quite clearly other beneficial effects of alcohol at lower levels which offset the added risk. This is the same sort of misuse of statistics that the Daily Mail regularly gets pilloried for.


#51

Agree re ‘no safe level’ comments, and hence my comment about it being questionable if taken in isolation. It is concerning that the CMO either makes or endorses pronouncements which would look dodgy in the Daily Mail :slight_smile: !


#52

Here, here!

The State is not perfect. How could it be, it’s composed of humans. It would, of course, be nice if everyone could be relied upon to drink moderately, and/or ensure that the consequences of their immoderate drink/substance misuse don’t leave an impact on the rest of us- but that is not the reality.
As long as one believes in the concept of society and the importance of social responsibility - the ‘state’, love it or hate it, has to act as some sort of a guide. We can disagree with the guidelines and have a healthy debate- which is what we’re doing. But we can’t pretend that we can be free to do as we wish without the state (i.e. us) picking up the tab.


#53

I don’t think it’s unreasonable for someone in her position to err on the side of caution, especially when it comes to a complex issue which as we have seen in this thread involves a huge number of different factors, some of which are easier to measure than others, and which interact in ways nigh on impossible to predict. And all this in a country with a somewhat dysfunctional relationship with alcohol anyway.

Exactly. We need more guidance. Hands up if you know someone who is chronically ill or deceased because - unambiguously - of alcohol.

Goodness no. Our healthcare is universal and free at the point of need. Let’s keep it that way.


#54

Mistaken quite probably. She is a haematologist so undoubtedly relied on others for the evidence, interpretation and advice. But that doesn’t make her a fascist, health or otherwise. Name calling isnt helpful in this debate, though I can see has provoked some passionate responses and I’m sure you don’t actually think she is a fascist :slightly_smiling_face:


#55

Entirely correct, as usual, in the detail of your analysis. It’s been interesting to see where the evidence for the 14 unit level came from and I think you’ve succinctly arrived at the answer.

Perhaps if the government were able to communicate what they meant by this limit in the same way you have, then it might be more respected by the drinking public.


#56

@Herbster but do you really think that many of the problem segments of the population will listen?

Also, I think that the concept of free healthcare at point of need unconditionally will come under increasing challenge as unlimited demand will be unsustainable. By that I mean that there will come a point where if people are unwilling to help themselves then some lines may have to be drawn - would you give a liver transplant to an unreformed alcoholic? Universal and free at point of need is great, but I wonder how sustainable? Anyway, that is verging on another debate, not for here…:slight_smile:


#57

Twas tongue in cheek about her personally of course, but I think we need to be careful that the interface with the State does not tilt too far. Particularly, as we have seen before, where previous advice has been ambiguous or wrong.


#58

Some will, some won’t, but the overall trend looks good.

How many people used to smoke in the 1950s? I’m proud of what the nanny state has done since then to save innumerable lives which would have needlessly been lost to COPD, ischaemic heart disease, lung cancer and so on. It takes time, but attitudes change.

Here’s hoping that, thanks to the changing habits of younger people, we’ll have fewer people in intensive care with pancreatitis, cirrhosis and what have you, in the coming decades :crossed_fingers:

I’m not 100% sure, but I’m pretty confident there are already pretty strict criteria in place for people on the waiting list. They don’t just hand out livers to any old Oliver Reed.

As sustainable as we want it to be. We’re a rich country, the money’s there somewhere, it’s all about what we choose to do with it - where our priorities lie. Underfunding the NHS is a political choice, not a necessity. But yes, that is indeed another debate altogether!


#59

I hope you are right, however smoking was and is an unequivocal Bad Thing (apologies to 1066 and all that!), whilst the case for (or is that against?) alcohol is much more nuanced.

Still, if you get another corked bottle of burgundy, you might be put off for life too :slight_smile: ! It is a bummer that, and I empathised with your description of willing it not to smell and taste like damp cardboard. I spent an hour or two last Christmas Day doing the same with a CNdP with about the same level of success…fortunately there was a reserve on standby.


#60

Very true. On reflection, that was a slightly tangential example of mine and not the same as the guidelines we’re talking about here.

Ha ha! At least it wasn’t the Morey-St-Denis - then I might have cried! :scream:

Oh no! That sinking feeling when you realise that it’s not going to get better…we all know it.