A recent study in The Lancet concluded that the only safe level of alcohol consumption is: none. As the principal investigator said: “Alcohol poses dire ramifications for future population health in the absence of policy action today.” This finding generated myriad sensational headlines such as:
“No amount of alcohol is safe, health experts warn” (CNBC),
“No amount of alcohol Is good for your health, global study says” (NPR),
“No level of alcohol consumption is healthy, scientists say.” (FOX News).
The conclusion generating those headlines:
Alcohol is a leading risk factor for death and disease worldwide, and is associated with nearly one in 10 deaths in people aged 15-49 years old...
Based on their analysis, the authors suggest that there is no safe level of alcohol as any health benefits of alcohol are outweighed by its adverse effects on other aspects of health, particularly cancers.
But don’t encourage your employees to stop drinking alcohol altogether just yet. The good news is, as with many seemingly scary healthcare conclusions (such as the “need” to screen younger employees for colon cancer), the study self-invalidates upon Quizzify’s close examination. Our recommendation? Employees can still enjoy 7 or so ounces of alcohol over the course of a week, even a bit more, without guilt or harm. (Just not all in one day...but that’s not news.)
How did we arrive at this conclusion?
(1) The study confuses absolute risk with relative risk. We don’t.
The study identifies bad outcomes (like car accidents and certain illnesses) associated with alcohol use. It finds that even one drink a day increases the relative risk of these bad outcomes — but by only 0.5%. That’s fairly trivial to begin with, but the absolute change per 100,000 people is from 914 to 918 such events. That means that, despite the alarming headline, 100,000 light-drinkers would have only 4 more unfortunate events in an entire year compared to the same amount of non-drinkers.
Even two drinks a day increases absolute risk by only 60 events a year for every 100,000. (Once you get beyond two drinks a day, the chance of harm accelerates exponentially…but that’s not news.)
Takeaway: Based on our calculations, the risks of adverse effects from light alcohol use are very, very low. There are other higher-risk population health concerns that can benefit more from your attention.
(2) The study misattributes hazards of heavy drinking to light drinking. We don’t.
Recall that the authors say:
Alcohol is a leading risk factor for death and disease worldwide, and is associated with nearly one in 10 deaths in people aged 15-49 years old…
We make two observations about that comment. First, very few U.S. employees die between those ages, so “nearly” 10% of that trivial number would be a much more trivial number still. Second, virtually all alcohol-related deaths in that cohort stem from acute or chronic alcohol abuse, not the one-drink-a-day indulgence the authors are trying to stigmatize.
Takeaway: Again, it is very unlikely that light drinking will harm your employees.
(3) Encouraging less (or no) alcohol consumption does not result in healthier consumption habits.
A classic fallacy in health risk assessments (HRAs) is the assumption (for example) that telling employees to “avoid” or “limit” salty snacks means they will substitute broccoli instead. No, they will substitute sugary snacks.
And when HRAs tell employees to eat lowfat or nonfat yogurt, as the popular one below does, they neglect to mention that many lowfat or nonfat yogurts contain more sugar than a Twinkie. Hardly a healthy piece of advice.
Likewise, people who pass on alcoholic beverages are quite likely to substitute sugar-sweetened beverages. (Ask yourself: what do you drink when you are the designated driver?) And one sugar-sweetened beverage a day may, over time, create a higher health risk than one lower-carb alcoholic beverage would.
Takeaway: The study does not take into account the risk of substitute beverages, which is likely comparable — and equally trivial in small quantities — to the risk of light alcohol consumption. One more reason to ignore light consumption of alcohol and focus on more addictive behaviors, whether they involve alcohol, opioids or even sugars.
Critical Thinking as a Health Literacy Skill
One of Quizzify’s goals in health literacy education is to teach employees how to think critically about healthcare, especially when it comes to sensational headlines and scary-sounding pronouncements. Some, such as the hazards of added sugars, should be believed. However, there are many phony hazards disguised as real ones. The trick is knowing how to distinguish them.
The media won’t do it for you. Critical thinking is a skill lacking not just amongst employees but apparently amongst the media as well — only The Incidental Economist (the New York Times’ economists, who have written extensively on wellness) identified one obvious invalidator of this study. And even so, we identified 2 more.
Keep in mind that our findings are not the result of a level of critical thinking that we would expect employees to achieve, but rather the level that you should expect your wellness vendors to achieve.
Bottom line: Don’t ask employees to change too many health habits. That will overwhelm them, and they probably won’t change any. In particular, don’t ask them to make changes that will lead them to inadvertently substitute more sugar — since reducing sugar intake is the one health habit that will benefit almost everyone.
And even more importantly, don’t give wellness advice based on screaming headlines without estimating the actual risk, identifying overlooked factors, or considering the even riskier alternatives employees might turn to instead. (If in doubt, you can simply check with us by filling out the contact form below or emailing firstname.lastname@example.org)