Well, with Thanksgiving right around the corner here, and the start of the endless stream of Holiday parties, I need to address an issue that arose about a week ago:
THE DANGERS OF DEMON ALCOHOL!
Now, I know what you're all thinking.
"Dr. Joe, why did you wait so long to write about this very important topic?"
Well, it's because when it came out, I was on my way to Miami for a wedding.
And, I drank a lot of alcohol.
So, I didn't want to talk about it.
But, now the binge is over, time to face the music.
The organization the American Society of Clinical Oncology (ASCO) has decided to come out with a position statement about alcohol.
To be fair, I'm pretty sure no one asked them to do this, and I think doing this now is pretty shitty.
In summary, it says that alcohol is bad.
However, I think it is important to delve into this a little deeper to get a better idea of what they mean.
First, I need to briefly explain a medical concept of linear versus threshold effect.
(Stop rolling your eyes, and pay attention!)
When a person is exposed to something, anything really, there are two possible ways it can affect that person.
The first theory is the threshold theory. That says that you need a certain amount of that substance before it can affect you (for good or bad).
An example of this is the EPA measures of water quality. There are certain components that in very small amounts (usually parts per million or billion) where they are felt to be harmless. (See the chart here)
So, copper, as an example, can be present in concentrations of up to 1.3 mg/L.
Lead has to be zero.
The list is pretty interesting in terms of some chemicals that are allowed. The rationale being, that in small enough quantities, they are harmless. Meaning they have to reach a threshold dose.
On the other hand, something like lead is bad at any quantity. This is a linear model, where any is bad for you.
Radiation exposure is also assumed to be linear, however, there are those who say our constant exposure to radiation in our environment (cosmic rays, naturally occurring radioactive isotopes in the soil, etc.) has given us the ability to tolerate some dose.
But, to be safe, we recommend no excess radiation exposure if possible, unless you want to risk turning into the Incredible Hulk.
(Just kidding, radiation isn't that cool.)
So, now let's get back to alcohol, my old friend.
There has always been debate as to whether there are any truly beneficial effects from alcohol.
Things like reducing your risk of heart disease, stroke and diabetes. Sounds good, right?
Well the Killjoys at ASCO are saying that they believe alcohol should be looked at as a drug where ZERO amounts should be considered the ideal.
Now, here's the interesting part.
They estimate that about 3.5% of all cancer deaths are alcohol related.
OK, says I, that means 96.5% are not.
They also go on to define "binge drinking" (4 drinks for gals, 5 for guys on a single occasion, like the wedding I was just at) and "heavy drinking" (8 drinks a week for gals, 15 for guys).
I suspect the higher totals for men may help to explain why we are constantly saying and doing stupid shit.
However, the real question is that if you do not engage in this type of behavior, then you must be a Mormon!
No, seriously, if you do try to drink more moderately, then perhaps the benefits would outweigh the risks, however, these researchers explicitly state that they think the cardiac benefits have been overstated.
So, in summary, they say all danger, probably no benefit.
But here is the questions I'd like to see answered:
Do any of the researchers or their family members drink?
Do any of these researchers have friends?
Any of those friends actually fun to be with?
Let me conclude this on a serious note.
Everything we do, every single day, involves risk. We try to minimize those risks, when we can, but sometimes you have no real control over them.
Like driving on the expressway. Like flying in a plane. Like zip lining, or skiing or...well, you get the picture.
To me, having a wonderful, rich chardonnay at dinner with my wife at the end of a long week, is worth every real or imaginary risk.
Or sipping on a bourbon on a miserably cold day, like today.
The best we can do is to balance the risks life throws at us with the enjoyment some of those risks bring.
So, this holiday season, drink responsibly, in particular if you're driving, but don't hesitate to raise a glass and toast your friends and families and happiness being together brings.
And if some jerk tries to tell you not to drink-STAY SKEPTICAL!
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Filed under: Health Care