Alcohol Consumption and Health-Related Quality of Life

Introduction: Feinstein's Paper on the Menace of Everyday Lifestyle Factors on Health

In 1988, Feinstein wrote a paper on the 'Scientific Standards in Epidemiologic Studies of the Menace of Daily Life.' It tacked the issue of the effect of everyday lifestyle factors on detrimental health. He studies Tobacco, Sugar, Coffee, and alcohol trying to understand if the adverse effect is authentic or is due to chance, additional risks not considered, coincidence or bad science. He states that the field of epidemiology should rely less on the statistical methods used but rather on the quality of the evidence. The randomized trials carried out in the methodology should lead to the formation of new approaches, paradigms, and concepts that aim at the achievement of scientific standards. This has brought the debate on whether alcohol is a menace to the life of the user and if the threat warrants the formation of a public health program.

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Early Studies on Alcohol and Health Implications: Archie Cochrane's Research

Studies suggesting that one or two glass of alcohol is beneficial to the health of the user are usually received with much enthusiasm by the general public and the media. It is a complex task to determine if there is any implication of the use of alcohol on the health of the user (Bell, & Britton, 2015).

The first study on alcohol and health implications was carried out by Archie Cochrane (the father of evidence-based medicine) in 1979. He was trying to understand the main cause of the increased rate of heart diseases in 18 developed countries including Australia, UK, and the US. The study showed that there is a significant link between alcohol consumption, specifically wine, and heart diseases caused by the decreased rate of the Ischaemic heart. It contradicted earlier studies on the same topic that associated reduced death from heart attack to increased consumption of alcohol. He hypothesized that the aromatic compounds found in alcohol, such as plant-based polyphenols, act as antioxidants to be beneficial to human health rather than the alcohol itself (Bentzen, & Smith, 2013).

To try and make the experiment more evidence-based, they tried an experimental approach where the subjects were plied with alcohol. It was highly unlikely to reveal the kind of chronic disease that they speculate alcohol caused. This led to studies being done on this topic to be long-term and with a huge population base (Feinstein, 1988).

In 1986, another study was done with more than 50,000 male doctors being used as the subject to identify US drinking and eating habits, and their medical history over the last two years. The study found that despite the dietary habits, increased alcohol consumption reduced the chances of developing coronary artery diseases (Imtiaz, et. al., 2017).

Investigating the Health Benefits of Moderate Alcohol Consumption: Studies on Male Doctors

Another study in 2000 on male doctors on the relationship between moderate alcohol consumption and death showed that individuals who took a standard one drink a day were less likely to die than those who drank more than one drink a day. It proved that there is a huge difference between consumption of too much and too little alcohol that balanced the risk of cardiovascular diseases and health imbalance that caused death. This thought brought the question of whether it is the alcohol that brought out the health benefits or alcohol consumption is a marker for other healthy behaviors. Are the individuals who drink moderately the same individuals who eat a balanced diet, exercise regularly and look after themselves (Kazeem, Car, & Pappas, 2015).

Criticisms and Flaws in Research: The Misclassification of Abstainers

This sweet spot effect of alcohol consumption on death and Ischemic stroke has been the cause of study for numerous research but does this prove that alcohol consumption is safe. Research in 2006 done to analyze the design of these studies showed that there was a huge flaw in their meta-analysis of an abstainer. In these studies, abstainers were individuals who had stopped alcohol consumption due to health issues or age. This biases the abstainers as individuals who are far unhealthy than the normal population. Studies that lacked this misclassification didn't find the rate of deaths being reduced by alcohol consumption.

These studies clearly show that the threat is not supported, but rather more research should be carried out on the topic. It also necessitates a health program for the public to educate them on the potential threat associated with alcohol consumption. Public health programs have proved to be quite effective in mitigating the potential harm caused by alcohol consumption (Kelly-Weeder, Phillips, & Shannon, 2011). They have been seen to reduce the number of alcohol consumers, change the minimum legal age for alcohol consumption and reduce the legal limit for alcohol consumption while handling heavy machinery.

The Need for More Research and Public Health Programs: Mitigating Potential Harm

It is important to carry out more research on the potential threat that is associated with alcohol consumption. This is because there are different results that have been associated with alcohol consumption. While some researchers state that alcohol doesn't have an adverse effect on the health of the user, other research shows that the use of alcohol has health benefits like reducing the rate of death and heart attack. Experiments done on this topic should be conceptual and involve a large population to be able to get the best results.

References

Bell, S., & Britton, A. (2015). Reliability of a retrospective decade-based life-course alcohol consumption questionnaire administered in later life. Addiction, 110(10), 1563-1573. doi:10.1111/add.13012

Bentzen, J., & Smith, V. (2013). Life Satisfaction and Alcohol Consumption: An Empirical Analysis of Self-Reported Life Satisfaction and Alcohol Consumption in OECD Countries. Wine Economics, 11-27. doi:10.1057/9781137289520_2

Feinstein, A. (1988). Scientific standards in epidemiologic studies of the menace of daily life. Science, 242(4883), 1257-1263. doi:10.1126/science.3057627

Imtiaz, S., Loheswaran, G., Foll, B. L., & Rehm, J. (2017). Longitudinal alcohol consumption patterns and health-related quality of life: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug and Alcohol Review, 37(1), 48-55. doi:10.1111/dar.12503

Kazeem, A., Car, J., & Pappas, Y. (2015). Telephone consultations for the management of alcohol-related disorders. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.cd009267.pub2

Ortola, R., Garcia-Esquinas, E., Galan, I., & Rodriguez-Artalejo, F. (2016). Patterns of alcohol consumption and health-related quality of life in older adults. Drug and Alcohol Dependence, 159, 166-173. doi:10.1016/j.drugalcdep.2015.12.012

Perreira, K. M., & Sloan, F. A. (2001). Life events and alcohol consumption among mature adults: a longitudinal analysis. Journal of Studies on Alcohol, 62(4), 501-508. doi:10.15288/jsa.2001.62.501

Poikolainen, K. (2000). Alcohol Intake, Drinking Habits, and Coronary Heart Disease. Moderate Alcohol Consumption and Cardiovascular Disease Medical Science Symposia Series, 81-87. doi:10.1007/978-94-011-4307-3_10

Trends in alcohol consumption. (2009). doi:10.1787/health_glance-2009-graph2_6_3-en