You’re listening to breaking the bottle legacy with Molly watts, Episode 31. Hi, I’m Molly, after a lifetime living under the influence of family alcohol abuse, spending more than 30 years worrying about alcohol and my own drinking, believing I had an unbreakable daily drinking habit, I changed my relationship with alcohol forever. If you want to change your drinking habits than breaking the bottle legacy is for you. My goal is to help you create a peaceful relationship with alcohol, past, present, and future. Each week all focus on real science and using your own brain to change your relationship with alcohol. Nothing has gone wrong, you’re not broken, you’re not sick. It’s not your genes. And creating peace is possible. I’m here to help you do it. Let’s start now. Hello, and welcome or welcome back to breaking the bottle legacy with me your host, Molly watts, coming to you from an absolutely gorgeous Oregon. I know it’s July, what can I tell you, it’s just the perfect time of year here. And I really encourage you to visit because I guarantee it by October, I will not be saying how gorgeous it is here in Oregon. Today on the podcast, we are going to be talking about using science to guide your alcohol decisions. But before we get there, I want to do a little housekeeping first. So I want to encourage you if you haven’t checked it out yet to go on over to Facebook and check out my private group. Alcohol minimalists change your drinking habits that the group is awesome. It’s been very active this weekend. And I love it. Lots of people sharing their struggles sharing their wins and really just supporting each other. And I absolutely love that. It’s not all about me, but them and we’re really creating a community for people that are trying to become alcohol minimalists, right to incorporate alcohol into our lives in a minimal way that reduces harm, but still were able to enjoy it. And one of my members shared this. She said Molly, I learned about bud zero. This is not an ad, by the way from you. So therefore you are responsible for last night, which was the end of a stressful day. And therefore an excuse to drink, but had a couple zeros instead. Ha take that excuse. So you are responsible for my getting up early exercising and feeling positive about the day, I may actually get stuff done today. I firmly believe that just saying I won’t is not a plan. It’s a formula for failure. Thanks for helping me to find a thing to put in the blank space when I choose not to drink alcohol. So, again, we’d love to have you it’s a free resource. So come on over and check it out. I also want to remind you about my free ebook, alcohol truths how much is safe. It’s available over on my website www dot Molly watts.com. That’s Molly with a why watts with an S. And it’s even appropriate, especially for today. In the e book, I share that safe is actually an acronym. And it stands for s science guides your alcohol decisions. A your drinking decisions are adaptable. If your future goals align with your drinking decisions, and IE your drinking decisions make you feel empowered. So we’re going to dive into S science today and what I mean by using science to guide your alcohol decisions, so more on that in just a minute. For the others I think they are more self explanatory. But number two a your drinking decisions are adaptable may not be. What I mean by your drinking decisions are adaptable is that we don’t set ourselves in stone and decide that it’s to drinks on Friday, two drinks on Saturday and one drink on Sunday and never evaluated again. We check in with ourselves. We are aware of how we feel. We’re making plans ahead of time, but we’re willing to adapt if a different decision supports s, F and E. Our decisions have to be adaptable because number one how we metabolize alcohol is dynamic and changes. And number two how we think about alcohol is dynamic and changes. being adaptable means does not mean we get to adapt our plans from two drinks to three drinks in the moment because our impulsive toddler brain wants to it more likely means that we are moving from a plan of three to four drinks down to two, then down to one and maybe eventually down to none. We adapt based on science, our future goals, and whether or not our decisions are helping us to feel empowered. Okay, so go check it out, go grab it, if you haven’t already done so. And today, as I said, we’re gonna go a little deeper into explaining how to use science as a guide to as a guide to making alcohol decisions. If you’ve listened to this podcast, you know that I’m a self proclaimed science nerd. And I have shared a lot of science in the podcast, including a lot of neuroscience, which is super interesting to me. And it’s really important, I think, in learning how to change your drinking habits. But today, I’m going to focus on using science to help you guide your decisions and discuss some of the research on alcohol and headlines that we hear, and how trying to help understand those and the value and validity of scientific research. When it comes to alcohol. I guess I assume that we all kind of believe that we get different messages about alcohol, there are different headlines. And it seems like a new study is popping up all the time, some telling us that alcohol is good for us some telling that alcohol is bad for us. And so there’s never really a clear cut story on exactly what is true about alcohol. And so I want to talk about that a little bit more. Generally speaking, the research on alcohol falls into two camps. There’s the heart disease camp. And the research, there appears to show that moderate drinking improves cardiovascular health, we’re going to actually look at that and then and examine whether or not it’s true at all. Secondarily, there is the cancer camp. And there are the research shows links between alcohol and increased cancer risk. So we’re going to look at both of these areas of research and what we can hopefully learn from them. I say that we need to use science as a guide to guide our decisions. And as such, I want to first and foremost state that even scientists don’t necessarily agree on whether or not moderate drinking is beneficial or harmful to your overall health. And that’s because of the complexity of alcohols effect on the body, and the complexity of the people who drink it. It makes blanket recommendations about alcohol out of the question. The one recommendation that scientists do agree on is that if you don’t drink, there is no perceived health benefit, that will offset the potential harm of adding alcohol to your diet. So there is no reason to go start drinking alcohol if you don’t all ready. I’m assuming that because you’re listening to this podcast, you most likely drink already, and you’re hoping to change that relationship with alcohol. And I hope that sharing this science is going to help you do that. But the one thing is that we all agree on is there’s no reason to add alcohol to our diets. Alright, so going out and trying to drink red wine and proclaiming that you’re doing something healthy for yourself. Not really the case. All right. So do not do it do not add to your life. But we are going to make sure that we are using science to guide our decisions. Let’s look at the cardiovascular studies first. So here’s the most important thing you need to understand about studies done on alcohol in humans. They are always observational. That is because we can’t isolate humans and give them only alcohol to consume. Makes sense, right? So we have to look at people’s behaviors over time, based on what they tell us and make observations on that data. As such, there are limitations for the research there always will be. And adjusting for known confounders is not sufficient to prove causality. What did I just say there? What does that sentence even mean? It means well, first, we need to understand what a confounder is. It’s a great word, isn’t it? In science speak. confounders are factors other than the exposure slash intervention that may affect the outcome of interest, and that can be related to exposure slash intervention. For example, in a study of the effects of caffeine on pregnancy outcomes, smoking might be a confounder. If women who drank coffee were more likely more likely to be smokers than were women who did not drink coffee. With alcohol, there are always confounders because we can’t isolate alcohol consumption. And so what that first say statement says, adjusting for known confounders isn’t sufficient to prove causality. Simply put, that means that when you take out all the confounding variables and or adjust for them, there isn’t sufficient evidence to prove causality with alcohol. AKA, drinking red wine does not cause better heart health. It may help heart health in very limited amounts, but we simply cannot create a causal link. All right. Observational studies are valuable for generating hypotheses, but they are insufficient as final proof. And the number of observational studies is not an indicator of the strength of evidence for causal effect. Observational studies remain second class evidence. This is also confirmed by the many studies that give unreasonable results. One I love this one. There’s a study that showed that television viewing is associated with higher cardiovascular and total mortality, independent of physical activity, gender, age, education, smoking, alcohol, medication, diabetes, history, family history of cardiovascular disease, and cancer and body mass index. I’m sorry, what was that? So independent of all of these known confounders, physical activity, gender, age, education, smoking, alcohol, medication, diabetes, history, family history of cardiovascular disease, cancer and body mass index? Why in the world would TV viewing be more harmful, harmful than, say, for instance, book reading? Right? It’s got to be known due to some unknown health related characteristics, confounders within the group watching more TV, because all of those other confounders we know implicate a cardiovascular disease. Anyway. So that’s one of the problems with observational studies. In addition to the huge problem of identifying and covering all relevant confounders, there are classification problems when subjects are referred to drinking groups. And this was discovered when people were reviewing some of those heart beneficial red wine studies. And it’s, it’s something about the non drinking groups, right? The non drinkers that the abstainers when they’re compared to moderate drinkers, they many times include sick quitters. All right. Sick, quitters are ex drinkers who quit because of health concerns, and X drinkers have considerable excessive cardiovascular and total risk for mortality. So in these studies, the non drinkers included sick quitters. So of course, the moderate drinkers are going to compare favorably in these studies, because the non drinkers might be sick quitters. All right. And so if you take all of that, right, there’s still been a load of observational research done on cardiovascular influence for alcohol. And what the cardio what the observational research has shown is that moderate drinking up to one drink, or 12.5 grams of alcohol per day for women, and two drinks, or 25 grams of alcohol per day for men, is associated with lower rates of cardiovascular disease, but is not used uniformly productive protective for other conditions, such as cancer. Say that one more time. The observational research has shown that moderate drinking up to one drink 12.5 grams of alcohol per day for women. And two drinks or 25 grams of alcohol per day for men is associated with lower rates of cardiovascular disease, but is not uniformly protective for other conditions such as cancer. So that seems an appropriate segue to go into the research on alcohol and cancer. Stay with me here because this is going to get a little science technical. This information is from an abstract published in 2013 by Hans Olaf Farr. And here’s what it says. The issue of alcohol and cancer is more complicated. The most authoritative review is probably the large report from the World Cancer Research Fund, slash American Institute for Cancer Research on prevention and risk factors for cancer. And just so you know, this group or was a 10 year study published in 2007. And it’s it basically followed people for 10 years. The chapter on alcohol concludes the evidence that alcoholic drinks are a cause of cancers of the mouth, pharynx and larynx. OsIo figgus colo rectum, in men and breast is convincing. They are probably a cause of colorectal cancer in women and of liver cancer. Assessing this evidence the conclusion for most of these types of cancer is there is ample and consistent evidence both from cohort and case control studies. With a dose response relationship. There is robust evidence for mechanisms operating in humans. Differing, of course from the claim that moderate alcohol use prevents diseases, in addition to observational studies and plausible mechanisms is that a large number of studies have demonstrated a dose response relationship for many types of cancer. This corresponds to the general pattern for exposure to risk factors, and strengthens the case for a causal relationship. For cancer of the breast. The report states that most experimental studies in animals have shown that alcohol intake is associated with increased breast cancer risk. Thus, the evidence seems clear for breast cancer. In the evidence of animal studies on other types of cancer. The evidence for a causal relationship for these other types is more weak. However, the dose response relationships and the known biological mechanisms strengthen the evidence. So what does all of that mean? It means that there is more evidence suggesting a causal relationship between alcohol and cancer, and that it is dose dependent. The more alcohol you drink, the higher your risk of developing any of these cancers. And for women, the link to breast cancer should be considered very clear. It’s definitely why we need to pay attention to how much we’re drinking, and why the safest amount of alcohol is either none, or if you can’t, or if if you don’t, you want to include some alcohol, then you want to follow low risk limits for alcohol consumption. But again, to be clear, there is no known safe level for drinking alcohol as far as it comes to cancer. All right, so you have to balance that out. Coronary heart disease is the number one killer of people in America. Number two is cancer. So you’re gonna have to balance out the science for yourself here, folks, that’s what I want to say is that you use science to guide your decisions. So we’re not going to drink more alcohol with this idea that we’re doing better things for our heart when we need to counterbalance how much alcohol we’re drinking with respect to causing different types of cancer. So here are the guidelines for low risk limits for alcohol consumption, as defined by the National Institute on Alcohol Abuse and Alcoholism. For women. Low risk drinking is no more than three drinks on any single day, and no more than seven drinks per week. For men, it is defined as no more than four drinks on any single day, and no more than 14 drinks per week. The ni a research shows that only about two in 100. People who drink within these limits meet the criteria for alcohol use disorder. Even within these limits, people can have problems if they drink too quickly, or if they have other health issues. Moderation management, a nonprofit organization that I support has different guidelines for quote unquote moderate drinking just slightly but their name includes the word moderation. So I think it’s important that the difference is noted because I think the word moderate gets conflated and confused. The difference on the moderation.org website is that for women, the weekly total limit is nine as opposed to seven. Moderation management also includes alcohol free days and says that successful moderators should not drink on more than three or four days per week. Set another way it means multiple alcohol free days are should be included in your week. The guidelines for mmm come from the perspective of what has been successful for people who have quote unquote learned to moderate after experienced drinking problems. So this is different than the NIA a guidelines, which are based on avoiding alcohol use disorder. What’s key here is that the guidelines, neither one of them are bad based on scientific evidence for improved cardiovascular health, and they are not based on the evidence implicating alcohol for cancer risk. One of the keys I found in creating a peaceful relationship with with alcohol was to understand the science of alcohol and the truth of both the perceived benefits and known risks. There is solid evidence that light or moderate drinkers have a reduced risk of several diseases, which are influenced by lifestyle factors. Whether or not the lower risk is due to alcohol is a more complicated issue. The problem remains that we do not fully know what is implied by all relevant confounders. confounders in the case of alcohol studies include all other lifestyle factors, age education, diet, exercise, smoking, etc. This means that in practice, we are unable to find a perfect Reference Group. Today, the FDA requires randomized studies to approve new therapeutic or preventative drugs. It may be argued that such studies should be required to recommend alcohol as a protective agent. Thus, alcohols possible ability to prevent diseases should probably not be considered as an established fact. For me, using science to help inform my drinking decisions, has helped me break a daily drinking habit that passed the levels of you know, in low risk and was clearly impacting my health and putting me at risk for both cancer and cardiovascular disease. Once I understood, and the reason I say it was causing me putting me at risk for cardiovascular disease isn’t because of, you know, obviously, there’s the perceived benefit, right, but it’s the excessive calories, it’s the lack of motivation to go work out in the morning because I was had drank too much the night before. All of those things impact, right, your cardiovascular disease risk. Once I understood that it wasn’t all or nothing, and that I can enjoy alcohol in a minimal way. It helped me reduce my daily drinking, and become committed to a healthier lifestyle overall. Just like the comment for my group member I shared at the beginning of this episode, she commented on how not drinking and enjoying an NAB na beer had allowed her to be up the next morning exercising, I feel the same way. I’m happier and healthier with an alcohol minimalist lifestyle. If you want to explore more on the science of alcohol, I will link in the show notes, the research articles I use for this episode. And I would also encourage you to go listen to the science of versus podcast. It’s a great podcast I love got a brilliant Australian host and she’s got a wonderful accent. And there is an episode from March of 2019 called science versus alcohol. And I loved it I it’s one that I’ve listened to a few times and I really enjoy it. So I would encourage you to go listen to that. That is all I have this week, folks. And until next time, choose peace. Thank you for listening to breaking the bottle legacy. This podcast is dedicated to helping you change your drinking habits and to create a peaceful relationship with alcohol. Take something that 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