EP #111

Alcohol & the Global Burden of Disease

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In this episode of the “Alcohol Minimalist” podcast, host Molly Watts discusses the complexities of alcohol consumption and the challenges in interpreting scientific research. Broadcasting from snowy Oregon, Watts explores the nuances of recent studies and guidelines, particularly focusing on a controversial Canadian report, dissecting the impact of alcohol on social connections, mental health, and overall well-being. Watts and her guest, Monica, emphasize the importance of considering individual differences in interpreting research findings, encouraging listeners to critically analyze reports and make informed decisions about their alcohol consumption. Throughout the episode, Watts promotes the idea of minimizing alcohol intake, reassessing perceived benefits, and taking charge of one’s relationship with alcohol to align with their well-being and peace of mind.

Hey, it’s Molly from alcohol minimalist. What do you do in this October? I would love to have you join me in my more sober October challenge. What do I mean by more sober October, it simply means that we’re going to add in more alcohol free days than you currently been doing, whether that’s one or two or 31. It’s up to you, you get to set your own goal and that’s why it’s more sober October. You can check it out and learn more at get got sunnyside.co/molly It’s totally free. I’ve got grises I’m going to be going live every week to announce the prize winners. And it’s just going to be an awesome event. So I would love to have you join me. You can learn more at get.sunnyside.co/molly and you can get registered today. Welcome to the alcohol minimalist podcast. I’m your host Molly watts. If you want to change your drinking habits and create a peaceful relationship with alcohol, you’re in the right place. This podcast explores the strategies I use to overcome a lifetime of family alcohol abuse, more than 30 years of anxiety and worry about my own drinking and what felt like an unbreakable daily drinking habit. Becoming an alcohol minimalist means removing excess alcohol from your life. So it doesn’t remove you from life. It means being able to take alcohol or leave it without feeling deprived. It means to live peacefully, being able to enjoy a glass of wine without feeling guilty and without needing to finish the bottle. With Science on our side will shatter your past patterns and eliminate your excuses. Changing your relationship with alcohol is possible. I’m here to help you do it. Let’s start now. Well hello and welcome or welcome back to the alcohol minimalist podcast with me your host Molly Watts coming to you from it’s a snowy Oregon this morning. Just a little bit a dusting of snow here in the hilltops. And but I mean last week, we had like a 60 degree day a couple really warm sunny days. And now it’s snowing. Not for long, but wow. Just the the difference in just a few days. What a difference a few days can make. It’s winter. It’s still February. I don’t hold out much hope for anything but rain coming. And that’s okay. I’m gonna stick I’m gonna stay here anyway. I have a prize winner this week. If you would like to be entered into the prize drawing for some alcohol, minimalist swag. All you got to do is leave a review of this podcast wherever you listen to podcasts, or leave a review of my book breaking the bottle legacy. wherever you happen to pick that up. I will find you you will get entered into the drawing and this week’s winner is en Marino 912 N Marino 912. If that is you. You can email me Molly at Molly watts.com. Let me know that you heard your name and you were the prize winter. The review was this coming at you from a somewhat sunny Hartford Connecticut. I need to ask y’all is this podcast a clown in a sewer? Seriously, because it’s seriously it? I can’t tell you how many times I’ve really listened to these episodes. Each one gives me a kernel of truth that I hold close every week. It feels good to be seen in the podcast world. Thank you, Molly, for your research and compassion. Can’t wait to read your book. Well, and Marino I hope you did read the book. And thank you for your kind review. I think it’s a kind review. I wasn’t even sure what a podcast decline in the store. I don’t know what that means. I love the fact that you left a five star review and thank you for your kind words. on to this week’s show. I am joined again by friend of the show and my friend Monica Ryan Akel. Monica is a licensed nutritionist. She has a Master’s of Science in Human Nutrition. And she’s also a trained opera singer if you didn’t know, which is why she hosts a very long standing podcast called The nutrition diva podcast. And I listened to nutrition diva all the time. And recently, very recently, Monica had an episode on alcohol. It was actually inspired by a listener question for her. And so it was she kind of did a deep dive into a recent recent report that came out in the end of 2022. And so I wanted to have her back on the show so that we could talk about that and talk about the really great work that she did for her episode. I’m going to link everything in the show notes so that you can find out Everything that we talk about, as with all of our conversations, you know, I don’t know that there’s anybody else that I have the same kind of rapport with in terms of having a guest on the show. It’s more like two people, you’re kind of dropping into a friend’s nerdy conversation about some of the things that Monica and I both see eye to eye on, and sometimes, you know, have a friendly disagreement or not disagreement, but we challenge each other’s views on things. So you kind of get to be a part of that when we turn on the microphones and chat. Here is my conversation with my latest conversation with Monica. Rai Nagel. Hey, Monica, thank you so much for coming back on the alcohol minimalist podcast, I am super excited to have this conversation. I wanted to share your brilliant episode. I think it’s brilliant, because it’s talking all about things that are near and dear to my heart. But it was really a great episode, this recent episode on nutrition diva, and we’ll talk about that a little bit. But you kind of had somebody come to you and ask you about the questions that I get all the time about whether or not alcohol is good for you, bad for you. And what’s the current thinking there? And so that kind of took you down a rabbit hole, and I want to talk about that. So welcome back to the show. Miss, it’s always it’s always great to be with you, Molly. Hi, alcohol. minimalists. Good to see you again. Yeah, absolutely. So okay, so tell me about the genesis for your the episode that you did on nutrition data? Well, we had this new study come out right at the end of 2022. That was part of the Global Burden of Disease Study Group. This is a consortium an international consortium of researchers that it’s not just one study, it’s an ongoing study, a rolling study that they’re constantly adding to and updating. And they released a new analysis of the impact of alcohol consumption on mortality risk. And it seemed to sort of reverse direction from the report that this very same group brought out in 2018, which in and of itself seemed to be a reverse of direction. I think whenever people see this kind of whiplash going on, about whether you know, it’s safe, it’s not safe, how much safe there’s a lot of confusion comes up. So I wanted to just kind of explain why we’re seeing what seem to be big changes in the science. It’s not actually big changes in the science and we can we can get into that yet. I just thought it was worth kind of digging into. Thank you for saying that you loved this episode, because it is very, it’s very nutrition. nerdy, you know, we really get wonky. Well, you and I are you and I line on our science nerdiness? Well, right. And I have to give my audience a lot of credit and your audience for a lot of credit for will being willing to go there with us. And yeah, settle for the headline, right? There’s always so much more to say, than that neatly packaged up bromide that that ends up at the top of the page. Yeah. Oh, bromide, big word. You know, that’s, again, that’s kind of another reason that I wanted to have this conversation with you now, because I just talked about on my podcast episode, this last week, the report that came out in Canada just this month, that is going to be impacting or is meant to inform the Canadian government’s new guidelines on low risk drinking guidelines. That’s what they call them up there low risk LRDG low risk drinking guidelines. And the report that came out was very strong, very dire. It sounds very, and the way that the news was presented, basically made it sound that if you drink anything more than two standard drinks per week, you’re you’re pretty much just, you know, cascading down a hill of associated risk, just get out the shovel and start digging. Right. Right. Right. And so, you know, and there’s a whole bunch of considerations up there. The fact I think I you know, I mentioned to you it’s, you’ve got the the report coming out, you’ve got the Canadian government now going to be making diet dietary guidelines that are supposed to align with people’s overall health risks. And then you’ve also got the Canadian provinces who actually are the ones that regulate and sell alcohol. The provinces themselves are like, Huh, interesting. We’ve got this report out there that basically tells everybody not to drink any alcohol ever, and or to be very minimal about it right to drinks or less, or you’re going to have associated high risk or associated risk issues. And we’re the ones that are selling alcohol and we counted a lot of alcohol sales to keep our provinces going. This could be problematic. Well, you know, when a provinces port standpoint, well, right but you know, in a Perfect World, revenue from product sales would not be influencing public health guidelines. But of course, we don’t live in a perfect world, we live in a political world. And even among the groups of scientists who huddle to come up with these recommendations, there is not perfect agreement on what that final recommendation should be. They are making decisions about what to include in their consideration what to exclude for various reasons how to balance factors that may not be directly waivable against one another. They’ve got to make some judgment calls, you know, how big a consideration do we want to how much do we want to take this factoring to consideration versus that factor? So even among the scientists before it gets escalated to that level of politics and government? Right, there’s not perfect agreement. And I think that for people outside the sciences, there is this idea that scientists will sit down with a data set and a question and turn a crank, and come up with an answer that they all 100% agree with. And that is incontrovertible fact. And that’s not really the way science works, especially like a messy, wet science, like human health and biology, you know, where you have so much variation and so many, you know, confounding factors. So so we should probably just start by saying that even when a scientific advisory committee hands up a report, you can bet there were some people on that committee who weren’t happy with where they landed. Yeah, yeah. And as you mentioned, confounding, right confounding things, they the the things that go into anything that’s going to make science messy, right, so we’re looking for this answer, and I talk all about all the time about this idea is any amount of alcohol safe, right? Well, scientifically speaking, the baseline answer is no, there is zero amount that can be physically determined, safe, right? But well, actually, I’ll just put that right there. Because up until 2018, which was when the previous Global Burden of Disease study came out, the generally accepted wisdom, which is still what is reflected in the United States dietary guidelines was that moderate consumption of alcohol by which they get here in the US anyway, they mean, one drink, no more than one drink per day per women to ferment was considered harmless and there was even flirtations with this idea that it might actually be kind of good for you, you know, good for your heart. It really was only in 2018, that this idea that no amount can be considered safe, started to be bandied about. And that came out of that 2018 Global Burden study. And now, in this 2022 iteration, they’ve come back and said, well, actually, for certain groups of people, a low amount of alcohol is essentially equivalent to not drinking at all in terms of your disease risk. But we should talk a little bit more about what they mean by risk and what they mean by certain groups and all of that. So if you’re having if anyone listening is having trouble keeping track of where we’ve painted this tail on this donkey, it’s certainly not their fault. I mean, it has been a moving target. Right? I would still say that the from a, just a sheer toxin known toxin and the what, than all alcohol is to our systems, right? So I’m not talking about global burden of proof. I’m just talking about the idea of ingesting something that is a known toxin, right. So if we look at it just from that strict chemical outline, right, there is no safe amount of toxin that you’re going to want to take into your body period that that side. But yeah, I see her she’s raising her finger looking at me like Wait, what am I wait a minute? Well, I mean, of course, the first rule of toxicology is the dose makes the poison dose, we have to just acknowledge there are several ways they’re not only harmless at lower amounts and toxic at higher amounts, but there are also substances which are beneficial in lower amounts, and higher at toxic amounts. And up until recently, that was the category that alcohol was basically put into. But I also think I’m sorry, I haven’t let you finish a single sentence. So by the way, welcome to modernize world, folks. This is the kind of conversations that we tend to have. That’s right. It’s just been one long conversation for the last two years. Yeah. Every once in a while we turn on the microphone and record a little bit for you guys, but it goes on behind the scenes. But no, you I think you were making the point like okay, let’s just be clear. This is a toxic substance. It’s been rated as a class one carcinogen. So we’re really just talking about balancing benefits and risks would that be fair to say? Yes, and I think that the that the the thing that I would say is there has been, it’s been pretty well scientifically proven now that there’s no benefit to adding alcohol into your life, if you’re not already consuming it, right? So there’s no, there’s no protective benefits from it, it is. So in any way, shape or form, we need to be looking at ways to minimize it in our lives as a if that’s the case, then we have to assume that there’s some associated risk with it. That’s my, I guess, my global take on on ingesting alcohol? Sure, sure. Not, and so then take that out of the equation. And so then there’s Yes, there is, then you have to balance out your own personal risk, which is going to be based on and I say this all the time. Every time you’re your own independent experience with alcohol, right is really your own personal petri dish, because we all have a different makeup and are in everything that comes into play with how we metabolize alcohol is going to impact. So our age, our weight, our gender, our how much sleep we’ve gotten, how stressed out we are all of these things, how much food we’ve had, that’s all going to go into that independent and how much Oh, on an ongoing basis, how much alcohol we consume, all of this goes into each each time that we drink alcohol and and how it impacts us independently. Okay, but let me just introduce this idea that there are some effects that we can observe. So we can run this little experiment on our own little petri dish, and we can take notes and we can keep track, how do I feel after two glasses of wine versus one glass? How am I sleeping? How does my skin look, whatever, we can observe those effects, and we can make decisions based on them. I would also argue there are other effects that alcohol may be having in our system that is harder to observe the where risks may be accumulating over time, we cannot necessarily see or even feel the fact that our liver is beginning to accumulate little fatty deposits, because it’s having trouble processing the alcohol plus the food that we’re eating. And so as a as a backstop, it’s just going to go ahead and store some fat there in the liver. We can’t see that happening. Right. We’re feeling that that’s symptomless. And of course, eventually, that can progress to the point where we start to have Fatty Fatty liver or other you know, kind of important consequences. So, and that’s just one example. There are some effects of long term consumption of alcohol that might be harder for us to see. And that’s why I think people are looking at these risk estimates. Like, tell me what happens after 10 years, 20 years, 30 years, is my current consumption pattern safe? I don’t want to find out when it’s too late, that these consequences were accumulating, and I wasn’t aware of it. Right. Okay. Yeah. Fair enough. And I think that, you know, that’s the difference between news that’s reported about alcohol and us trying to break down everything, you know, all of the information. And you and I definitely, we agree that giving people a more neutral and scientific and expansive idea of where this information comes from, and what it really truly looks like, and global risk assessment. So let’s talk about that, because it’s a little bit also, I just want to say this straight up, folks, what is what is true on a global basis does not necessarily mean that it’s true for you, right? And I think you were kind of saying that Monica, but you have to, I mean, we want to take in all this information, we want to use it to inform our choices, but we can’t just automatically assume that that’s exactly what’s going to be our outcome it is just doesn’t work that way in life. And with really anything you’re ingesting, will write or with any risk assessment, because any risk is a probability. It’s not a prediction of what is going to happen. But what happened in this latest iteration of the Global Burden of Disease study was that they did get a little bit more granular instead of just lumping every person in the entire globe into one big risk pool, and seeing how alcohol consumption correlated to all cause mortality risks. And that means your risk of dying of anything at all, in a given time period, usually in a given year. They put everybody in one big risk pool, and and back in 2018, they saw like, yeah, actually, there’s no level that is not associated with some increased risk of mortality. Okay, what they did this time, though, is instead of putting everybody into one giant risk pool, they broke it out by region of the globe, by age by sex, and they started calculating the risk for these different groups and a much different picture emerged. And you can imagine why you know how different the consumption of alcohol plays out depending on the background culture and your age, and you know, the everything else that goes into your lifestyle, and that is invisible in a global risk pool. So when they did that, they could see that the amount of alcohol that was equivalent to not drinking anything at all, varied from zero, up to, you know, two, or in some cases, in some rare cases, you know, three drinks a day, those populations still had the same risk as people who didn’t drink at all. That’s a much different story, isn’t it? And then, of course, your question is, Okay, where am I on that chart? It’s a, it’s a chart that you’re going to really take some time looking at, folks, let me tell you that, yeah, we’ll give you the link, you can look yourself up and see what amount is correlated with your sort of what would they call non drinker equivalents? And I think that’s what we’re looking for, right? What amount I could I feel safer, safer, consuming. And you’ll see, it’s, it really depends on how old you are, what sex you are, and what part of the globe you live in. And that’s just reflecting all of those different background variables. But the the real, the punchline of the whole thing was that for younger people, there really is no amount of drinking that has zero impact on their risk or risk, right, all cause mortality, the older you get, the more likely you are to be able to justify maybe use that word. one drink a day, you know, as as being relatively low risk. Right? Just it’s just what did you take away from that? It’s just line and it’s in line with other risks? That’s I think is the is the key is that it’s like, right, it’s not, I think that we are looking for ways to frame it, or people are wanting ways to frame it that because it’s a it’s a risk that you take, you choose, right? What does that conflict with? They call it discretionary or voluntary? So there’s, yeah, I mean, it’s voluntary risk, right? So you’re making the decision, right? So there’s voluntary risks. There’s other things like air pollution, like we can’t really do anything about like we can’t control, right. So there’s voluntary risks versus non Vult, voluntary risks. So. So yeah, I was not surprised by the global burden of risk disease, I share in my ebook from Dr. David Nutt, and it’s kind of along those same lines, it’s like, what I think is most important, and the thing that irritates me about the candidate thing and about, about what I really wish the message was, because I think it’s so much more important is the significant benefit that people would get from reducing their intake from 35 to, you know, from 25 to 40 standard units per week, if they got down to the two to 10. area, they would actually see a huge decrease in their risk profile, a huge increase in the benefits to them. And that part is where I think that, you know, that Canada has kind of missed the boat, and this particular study does, it really does a good job of helping people quit that global risk into perspective, I still think we could do a better job in really letting people understand the and you talk a little bit about it in that episode about the J curve, right. So it’s a dose dependent, and about how the biggest benefit that people really will see is if they would reduce from taking those higher risk levels that are absolutely associated with increased mortality risks. You know, it’s a great point, you know, here we are obsessing over whether it’s point eight or point nine or 1.2, you know, drinks per day, that might constitute or be defined as low risk or no risk, is really not addressing the problem, that problem is at the upper end of the curve, and the and the potential benefit in terms of lives saved and person years is, you know, spared is in moving the people at the highest end of the curve, anywhere lower down that curve, even one step lower down that curve has a much more profound impact on global burden of disease, and more importantly on that person, that individual’s health and well being and longevity than us, you know, trying to decide where to put that decimal point, you know, on the on the zero risk end of it. And the other thing that I really appreciate that David Nutt brings to this discussion and I loved your your interview with him, it’s been over a year now I think that he’s been on that it was one of my favorite episodes, like almost two years. I think now, you know, one of my favorite episode still think about it. And one of the things I really appreciate that he acknowledges, and I’m sure there are people who push back on this, but he acknowledges like we get as social animals hate Right, we get some benefit from alcohol. It’s Is it essential? Absolutely not. Is it available to us? Obviously, it is. And we do get some some benefits from it. If we are not willing to acknowledge the fact that some people do I receive those benefits, then I feel like we’re tilting at windmills, windmills, you know, because we’re trying to balance these risks against benefits that we’re not willing to acknowledge. And how do we, you know, what kind of arithmetic can we do there? What kind of algebra can we do if we’re if we’re unwilling to even like name the denominator? So, so I so I appreciate that he brings that acknowledgement that like, Yeah, is it the is it good for you? No, but does it might it make your life a little bit warmer, a little bit more sociable, a little bit more enjoyable? And could that be reconciled with a low risk approach? He and you and I believe yes. Just a quick break to talk with you about Sunnyside. You hear me talk about it on the podcast and truthfully, I have so many students and group members that share with me how Sunnyside is their preferred tool. It helps them build their healthier drinking habits and really create that peaceful relationship with alcohol. It’s a tool that I feel very confident in recommending. And the Sunnyside team has recently in September launched a new iOS app. And that iOS app is going to just enhance the existing text message experience. It makes it easier to build healthier drinking habits for anyone looking to cut back or simply drink more mindfully. The new Sunnyside community is also available only in the new iOS app. And it gives you access to an engaged community of like minded people who are also on a journey to cut back on drinking and build healthier drinking habits. It’s a safe private space. And you’ll get access to inspiration and advice from Sunnyside members as well as coaches. I encourage you to go check out Sunnyside go to www.sunnyside.co/molly to get started on a free 15 day trial. That’s www.sunnyside.co/molly. I’ve read and shared a little bit of information from somebody a professor up in Canada that’s that actually is a historian on the regulations of alcohol and things like that. And his take on this whole Canada thing was the same it was like there has been studies on the the positive benefits for longevity on connectiveness. Right on on forgoing social isolation. Okay, so let’s just extrapolate that isolation. They they say it was they they said it in the United States was like the equivalent of smoking two packs of cigarettes a day, right on the impact on morbidity, isolation and loneliness. So if you look at it that way, there are people that that count on going to their local local pub across the world and making connections with people. Now. That connection now, of course, over drinking in excess of drinking is not going it’s not an answer, it’s going to offset any any positive impact, right? But you cannot on a global basis on a cultural basis on a historical basis. Ignore the role of alcohol in terms of social connectedness, and that in and of itself, again, social connectedness, increases longevity. So right, it’s kind of right. I mean, we should say you don’t have to go to a pub define social connectedness or go to church choir rehearsal instead. No, but but but it is. exist. Right? It exists, right. So I think the thing that I, that I, again, get get frustrated by is, is the messaging that comes out when these reports come out a lot of it and certainly happened in Canada, they created this color coded chart, right, and low risk look, you know, green and then But then you get to yellow when you’re in the moderate risk. And then high risk was, you know, purple and red. And it’s like, very alarming and very dire and the the words that they used, were very they just did not paint a true picture of what they were really talking about. Like they they just very generically said that if you drink three to six, or you know anything, yeah, three to six drinks per week that you had an increasing risk of cancer and heart disease. Now, if you go into the body of the report, that increasing risk was they even say like, in very big red letters, increasing risk 100 times increase, increased risk for larynx cancer. All right? Well, larynx cancer is got one of the lowest incidence of overall cancer rate in, you know, at all, and it’s mostly smokers who had happens to, and your your increased risk for cancer went from like 0.00197 to 0.197. You know what I mean? It was like that. And it’s so it’s like, so people are gonna get this message that, oh my God, I’ve got an increased risk of cancer if I drink three drinks per week instead. And so what I fear is that mindset of well, I’m screwed anyway. Can’t do it. So what’s the point? Well, yeah, I am thinking about what the desired impact of this messaging and these regulations in these guidelines are and whether they are achieving it. I mean, for all of the the press that goes on and and does it actually change behavior? Do people actually make decisions based on those guidelines? Maybe they worry a little bit more, maybe they they joke more, you know, maybe there’s a little bit more gallows humor that’s associated with it. But does it actually impact the decision making? And if not, how might we impact the decision making? And I noticed from my study of behavior science, that when you make a change, unreachable, unattainable, you really demotivate people to take any action whatsoever. You know, if I don’t believe that, I’m able to do what you’re asking me to do. I’m not going to try, I’m not going to be motivated to do it. I know for a fact, I have a coaching candidate, I mean, a coaching client in Canada, who I had a session with, after this report came out, she’s been working with me for six months, she’s done. Fabulous work has gone from drinking that, you know, 35 to 40, drinks a week, down to six to 10. And that report came out and she was like, Oh, my God, well, I’m an English teacher. Yeah, I’ve exactly what’s her exact thought I have accomplished? Absolutely nothing. All this stuff that I was feeling so good about everything that I was doing. And now I just it feels like it’s all for naught all because this report came out it came out on the news, right? So her, her the, her takeaway was, Oh, my God, they’re telling me that I’m that I have, because I can never imagine. I still can’t imagine only having two drinks. I’m just, you know, it’s, it’s terrible. And we went, of course, we weren’t we worked all through that not only did I you know, send her the report, because I wanted her to read it so that you because, again, if you get down into the nitty gritty of it, and I’m not saying please do not hear me in any other in any other way, there are the association between increased alcohol and alcohol use, and cancer is something that you got to take into it, you know, account, that it depends on who you are, and what you’re drinking and how much you’re drinking, whether you’re a woman, all of that matters. And so to just make a generic comment, that three to six standard drinks increases your risk for cancer and heart disease, makes it sound really frightening to people when it when the when the data may just be that. Yeah. Okay. Are you really at risk for developing larynx cancer? Probably not. Right, I think the question isn’t so much is that a true statement or not? But you know, is it motivating? Or is it helpful? You know, and if not, is there another statement, that could be just as true, but that would be more helpful, more motivating, and actually helping those people who would benefit most from reducing their consumption? Do that. And when we were talking before about the most benefit could be from the people who are at the very top end of the curve moving down a little bit? How do they feel when they hear those guidelines? Right? Is there any point in their doing anything at all, and I see the same thing in the world a little bit closer to my domain of weight management, there is so much messaging about how bad for your health it is to be overweight? You know, God forbid, obese and the stigma attached to that blame and shame attached to that. And it’s all based around this, this idea of a healthy way to normal weight. If I’m somebody who, who doesn’t feel like it’s ever going to be possible for me to attain to attain what the authorities have designated for me as a healthy weight or a normal rate. Is there any point in me trying? Yes, there absolutely is a huge benefit. Even if you are still quite overweight, reducing your weight by 5% of your body weight, no matter what weight class you end up in at the end of that, that trajectory. You You will have significantly impacted all of the health conditions that we are most worried about being negatively affected by overweight and obesity, ya know, heart disease risk and cancer risk and blood sugar regulation, you do that with a 5% reduction in body weight. But for people that are all they’re hearing is you need to lose 150 pounds in order to be considered healthy or normal. It’s demotivating. And it’s not true that that that’s what they need to do in order to reduce their risk, and bring themselves into like really quite a manageable risk category. Right. And I think that’s the whole thing with with, you know, that we’re saying about alcohol, if you are consuming at those higher risk levels, right now, if you’re consuming alcohol, and you may not have even known they were high risk levels, right, because that’s, again, a lot of times we haven’t really people in when they’re just coming to my work, they aren’t even aware that how much they’re drinking is really associated with being high risk, right, or being on that on that, that that excessive alcohol use, I talk about low risk. And I said this in my last week episodes, the low risk guidelines that I talk about are based on not developing alcohol use disorder, they are not about avoiding alcohol related consequences when it comes to disease state because quite honestly, as we’ve just very, you know, at length discussed, it’s, it’s hard to get a number beyond zero, that’s going to be that’s going to actually be accurate for everybody, it just probably doesn’t exist. And we are missing numbers one to 1.2. What I can tell you is excessive amounts of alcohol, it is dose dependent, as Monica pointed out earlier, any toxin that’s going to be the case, the more you ingest, the worse off, the worse your body is going to the worse consequences for your body. And some of these consequences, we really don’t know over time could be building up, we can’t, you know, open up everybody and check and see what’s going on, in our insides to know what risks we may be, may be experiencing. And that’s why it’s always good to balance what you hear on the news, try to take in information from trusted sources and get to the bottom of it. But at the end of the day, you’ve got to look at your own self and at your own life in at your own risk factors and decide how much risk tolerance you have for anything that you are going to be you know that is voluntary risk. Well, so yeah. What else can I What are you What else? Anything else? Any parting thoughts? Again, this is just another episode of Molly and Monica is conversations, folks, you can see we almost you know, we we appreciate one another’s perspectives. And so the science of alcohol is a little bit tricky for me, I, one of the things that I want to make sure people hear as well. The science on alcohol is not like the science that Monica says like in terms of nutrition, a lot of the things that we know and can learn about nutrition, because we cannot isolate people and only have them drink alcohol, there are no double, no double blind placebo controlled studies in humans, for alcohol. So everything that we talk about from from alcohol is always associative. And it’s always observational. These are not the gold standards in science, right? They’re not the gold standard and how we understand things about science. And so that’s another whole piece of this puzzle, even in these meta analysis that were a part of the global disease, none of the science comes is is pure science. It’s always associative, right. So that the even the results that they’re analyzing, yeah, it’s not experimental. And, and the all of those analyses that we were talking about today, were again on all cause more mortality, they were not breaking things out by various causes of death, whether which could include everything from automobile accidents, to suicide, to breast cancer to heart disease. And of course, when you look at the relationships between alcohol consumption reported alcohol consumption, we should say, right, right. That’s the other part of it. Right? We just have to take their word for it. Right. And people generally under report, right? If we were to look at the the relationships between reported alcohol intake and all of the all of the different ways unfortunately, that human life can come to an end, we would also see much different pictures and associations. So this is really just kind of a summing it up at the at the most general possible level. I guess you asked if there was anything else that I wanted to add, and, you know, we’ve talked a lot about how we assess risk and how important it is to understand I love that you brought up we need to understand our risk tolerance. It’s not just our risk factors, which may include our age and our genetic history and our own history of disease and other aspects of our lifestyle, all of those are going to interplay with the with the risks of consuming alcohol. But we have to assess our risk tolerance, that’s something that definitely cannot be summed up in anybody’s meta analysis. Right? Right. And then we’ve implied this, but maybe it’s worth just stating a little bit more overtly, we’re weighing those against the benefits. So maybe we could just take a second and talk a little bit about the benefits and the perceived benefits. And the value of actually looking at those and making sure that what you are perceiving as a benefit or believing as a benefit, or listing to yourself as a benefit is a benefit? Because I think sometimes there’s a little bit of unpacking to do there as well. Oh, 100%. I mean, I think that’s where people start with me is, I had at least that’s where I started myself, right? I had a lot of beliefs about alcohol, that were just fundamentally not true. I believed that it helped me unwind and de stress. And I did not understand the neural chemistry that was at play, in terms of actually creating a rebound anxiety. Yeah, I think a lot of people believe that alcohol helps them create more intimate connections to other human beings. And there’s a degree to which that may be true at that very, very low level, there is kind of an expansiveness, and, and a, you know, a willingness to, to connect socially, just one of the values that that alcohol has played in our in our evolution as human beings. But it doesn’t take very long before, before alcohol consumption starts to be more isolating than connecting. And yet, even people who have been isolated by overuse of alcohol or have isolated themselves in order to maybe cover up their their use of alcohol, still believe that it is important, because it makes them feel connected or right, you know, to their partner, or, you know, to their friends or something. So, yeah, there’s, there’s a lot that can be looked at and assessed and investigated, which is what you do so well, Molly, in terms of what we put on the benefit side of those scales, when we’re weighing benefits and risks. So really, we talked today about being a little bit more discerning about how we’re going to assess risk and, and, you know, getting the best possible information that we have. But yeah, that other side of the scale also deserves some, some investigation. Yes, well said. I am going to link Monica is much more I think Monica is episode on Nutricia diva was just brilliant. On this whole she was if you haven’t noticed already, folks, Monica is more more concise than I am more succinct than I am. And she’s she gets down to it. And it’s very informative. The nutrition diva episodes, if you’re not familiar with them are very short, sweet, and I get so much out of them. So thank you for them. That is Yeah, and so I really highly recommend listening to it and getting it’s it’s such great science most and, and, of course, I love it. But this particular one on alcohol, of course, was very was great for those of us that are interested in keeping informed and understanding. And I will link in my show notes, not only the chart that that Monica, the study that we were talking about the 2022 global risk assessment meta analysis of that, I’m also going to link that Canada report because I want you to look at it and read it folks, I want you to really dig into it and and see where the science really came out on it. And also remember that it was a meta analysis of many different studies, and you can actually in the body of it, you can link to and see all of the studies that were included. It’s pretty interesting, when you look at that, the numbers on you know, they had studies that had 25 people, they had studies that had, you know, zero to 18 year olds. Interesting. Interesting. So, I mean, it’s what I mean, it’s just very, it’s worth exploring. At the end of the day, I would come down on the side that minimizing alcohol in your life is is a good way to go because there are benefits that you probably think you’re getting that aren’t actually true. And there are associated risks with higher x with higher drinking levels. And when we can bring those down, you’re going to you’re going to see benefits both I think in your in the acute short term of your life and really in the in the longevity as well. Yeah, and you know, it occurs to me that low risk drinking guidelines are in that same category with horseshoes and hand grenades were close to audibly counts. It is close does count. It does count. It should count counts. You know, certainly sure she’s important. Yeah. Thank you for coming on again and for putting up with my, you know, the well, I don’t know what it how would I generalize or, or characterize our conversations? I was just thinking I don’t have these kinds of conversations on anybody else’s podcast but I think it’s because we are, you know, kind of having this conversation all the time in the background. When we turn on the microphones, we just, we forget that they’re on. Yeah, so excellent. Thank you for being here and everybody. I will link everything in the show notes including a link to nutrition diva as well. Thank you Miss Monica. Right Nagle. Thanks, Molly. Bye, everybody. Thank you for listening to the alcohol minimalist podcast. This podcast is dedicated to helping you change your drinking habits and to create a peaceful relationship with alcohol. Use something you learned in today’s episode and apply it to your life this week. Transformation is possible. You have the power to change your relationship with alcohol now, for more information, please visit me at www dot Molly watts.com