Is Moderate Drinking Protective Against Heart Disease? The Science, Politics and History of a Public Health Conundrum.

Title
Is Moderate Drinking Protective Against Heart Disease? The Science, Politics and History of a Public Health Conundrum.
Publication type
Journal Article
Year of Publication
2019
Journal
Milbank Quarterly
Date published
2019 Dec 05
ISSN
1468-0009
Abstract

Policy Points For more than 40 years, most research by epidemiologists, social scientists, and alcohol policy experts found that moderate alcohol consumption was cardioprotective. In the early 2000s, that consensus was shaken by new critics who subjected the previous research to vigorous methodological and empirical analysis, precipitating a bitter controversy, seemingly unresolvable despite numerous observational epidemiological studies. The effort to finally put that debate to rest through a large, multiyear randomized controlled trial under the aegis of the National Institute on Alcohol Abuse and Alcoholism, generated external criticism and adverse newspaper coverage, particularly because the trial was largely funded by the alcohol industry, forcing National Institutes of Health leadership to abruptly terminate the study shortly after it started. In the absence of definitive evidence and given the contentious debate over the risks and benefits of moderate alcohol consumption, those who formulate health policy have a responsibility to clearly acknowledge to the public the existence of evidentiary uncertainty when making recommendations.