The overall conclusion of the study is "We observe negative relationships between alcohol intake and global gray and white matter measures". But if you look at Figure 3, it is consistent with a J-shaped risk curve with risk equal to nondrinkers around 16 grams ethanol per day, like the 16.9 number found for 40-64 year old males in https://www.thelancet.com/journals/lancet/article/PIIS0140-6.... So I would say this study adds another reason to not overdrink, and confirms that current drinking expectations are too high, but isn't a reason to abstain entirely.
Did they correct for individuals who currently intake no alcohol but have a past history of alcohol consumption? My understanding is this is one of the ways past studies have skewed the results, because some people quit cold turkey but then live with the consequences of moderate or heavy drinking for years (or an entire lifetime) after that.
(I skimmed to the introductory paragraph where they talk about confounders, but don't see alcohol history listed as a confounder.)
In the summary section they talk briefly about this:
"It is reasonable to expect that the relationship we observe would differ in younger individuals who have not experienced the chronic effects of alcohol on the brain. An additional limitation stems from the self-reported alcohol intake measures in the UK Biobank, which cover only the year prior to participation. Such estimates may not adequately reflect drinking prior to the past year and are susceptible to reporting and recall bias.
Further, our analyses do not account for individuals with a past diagnosis of AUD. Earlier studies have shown that the brain shows some recovery with the cessation of drinking in individuals with AUD, but this varies with age and sex, and recovery might be incomplete. Thus, a past diagnosis of AUD would likely influence our results. We hope future studies will shed light on how a history of AUD with prolonged recovery is associated with brain structure in middle-aged and older adults."
Some version of their code is listed here[1] and it doesn't look like former alcohol consumption was accounted for. (Interestingly they have code to toggle inclusion/exclusion of people based on former alcohol consumption.) I didn't see it mentioned in the main text or the supplement either.
>> Alcohol intake explains 1% of the variance in global GMV and 0.3% of the variance in global WMV across individuals beyond all other control variables (both p < 10−16).
Definitely shows there is some grey and white matter reduction... but the impact doesn't seem drastic? Do I use that 1%? Do other activities reduce my brain of 1%? I don't know the scale of volume they use. I could be wrong.
And looking at figure 2[1], age is also a major factor for change in white/grey volume (which they normalize).
You have to admit the same argument in other contexts is a little funny. Like if you were exposed to an industrial pollutant that was shown to reduce your brain mass by 1% I don't think many people would be saying 'do I really need that brain material?' Obviously this is more than a little influenced by enjoying the effects of a drug.
The old mantra of people only use X% of their brain has been found to be hogwash. We use all of our brain, so I’d be very worried about a poison that even takes 1%.
> The notion that a person uses only 10 percent of their brain is a myth. fMRI scans show that even simple activities require almost all of the brain to be active.
Did they control for all of the comorbidities associated with non-drinkers?
A lot of people who don't drink are not abstaining for some health augmentation or lifestyle choice, but because drinking any amount of alcohol would send them into a very early grave.
It seems like these hidden confounding factors are more plausible of an explanation that the "0 drinks per day" group has higher morbidity, compared to "alcohol is healthy in moderate amounts" explanation for the bottom of the J curve.
Yeah. And it's a daily average, so you can have 3 standard drinks every Saturday for example (aiming for the TMREL of 6g). I'm not sure about the maximum per day; there was a heart disease study that defined heavy drinking as 60g in a day,but I haven't seen any studies specifically on drinking patterns at this low intake.
Personally I'm far more more interested in questions about how correlated brain matter volumes are with real world outcomes and overall quality of life.
I'm vaguely familiar with the term "synaptic plasticity" to roughly mean the way the brain processes information and how it changes over time with varying life experiences.
It seems to me that one's risk-taking behavior may reduce brain matter volume, yet still improve quality of life because experience itself (literally the way the brain is wired) is worth far more. Some experiences are practically impossible without alcohol due to its social and cultural significance.
To make a dumb metaphor, consider the fact that the raw number of pixels contained in an image isn't necessarily correlated with its success. What is a life, but a meme?
The article mentions that the effects are particularly strong in the frontal lobe. This is the part of your brain that's involved with planning and self-control, amongst others.
So if chronic drinking damages that part of your brain most, the visible long term effects would be problems with planning and being less able to control your impulses and emotions.
I have to say that this matches my (few) experiences with chronic drinkers quite well. I've seen them become less inhibited and less self-aware and become more selfish over a couple of decades, even when they're sober.
My own experience with the so called "high functioning alcoholics" is they probably managed to both find the right level of moderation to slow this loss to a rate that they can handle and developed the coping strategy of keeping routines they cannot break.
It's like they become robots. While it's definitely bad for health, I'm not sure broader society really cares because good health isn't necessarily correlated with success in life past a certain point.
My somewhat more positive counterexamples roughly fall into the dichotomy of introverts and extroverts (yeah yeah I know).
On the introvert side, I've seen hard drinking make people into creatures of habit. Not necessarily "bad" habits, but habits nonetheless such as overworking themselves in a narrow field, deep hobbies, etc. "drunken masters" so to speak.
On the extrovert side, I've seen hard drinking train people to optimize for high charisma, handling crowds, and deep knowledge of conflict resolution to the detriment of being able to learn any other skills or really appreciate the world in any other way. The "life of the party" while being just as dead inside as the introverted example above.
They get trapped into a certain way of life from the brain damage. I'm definitely not advocating alcohol abuse just sharing my perspective. I'm pretty sure more people drink than abstain so this isn't a topic that can be dismissed as just purely bad.
If anyone knows of research on this kind of topic that would be amazing. Too often this is only discussed via movies, ads, and personal stories which are all strongly biased.
Could it not also be that people who happen to have less grey matter in those "self-control" areas, will (statistically) tend to be prone to drink more alcohol? That is, the causality could run the other way. It takes some self-control and restraint to moderate one's consumption, after all.
"It seems to me that one's risk-taking behavior may reduce brain matter volume, yet still improve quality of life because experience itself (literally the way the brain is wired) is worth far more. Some experiences are practically impossible without alcohol due to its social and cultural significance"
Yes, sadly that might be. In my youth heavy drinking was the norm, all the cool kids and pretty girls did it and to connect to them, you had to do it, too. Those who did not, were the depressed loosers.
So to socialize, you had to poison yourself.
From an individual point of view that makes sense, but overal I believe it makes more sense, to change that culture around alcohol.
And luckily since then, I met people who can have crazy wild parties, without being wasted. I love dancing, but I hate to avoid uncoordinated drunk idiots on the dancefloor.
I mean, I still do like a beer or a coctail occasionally and I see nothing wrong with it. But needing alcohol to socialize or party is not healthy at all and I would like to see the obligatory drunkness to go away.
Not just because of drunk parties, but also because this culture gets people hooked into alcoholism and then families get destroyed.
I decided as a 14 year old to never drink. It’s been an interesting experiment in particular regarding peer pressure, group dynamics and societal norms.
Same here, though I grew up as a Mormon so it wasn't as much my own personal choice as it was a religious conviction. I'm an atheist now, so it is a personal choice now. I find it can be really enjoyable to be "the sober friend" at group outings—being the only one with my wits about me while my friends get super relaxed, outgoing, and nonsensical all of a sudden is pretty funny.
I don't think there's anything evil about drinking, I've just gotten this far in my life without it and figure "heck, might as well go for broke" at this point. I do believe that alcohol advertisements on TV and radio should be banned like tobacco ads were, though. The fact that I have been conditioned by ads since I was a kid to think that beer is delicious and harmless is unnerving to me.
Ideally, drinking ought to be a personal choice to exchange risk for pleasure. This only holds true when drinking is done responsibly, though. Irresponsible drinking can ruin lives, relationships, and hurt or kill people. Budweiser and Heineken may be required to say "drink responsibly" at the end of all their ads, but it's extremely obvious they don't actually care. At the end of the day, they make more money off alcoholics than responsible drinkers, so they and their marketing cannot be trusted. The incentives are too misaligned.
Well, I think it helped me strengthen my will power, that’s for sure.
Also watching people around you get drunk a couple of times early on was quite the turn off. It’s actually rather sad.
Often I am considered to ‘have excellent memory’ compared to my peers (I am 44 now).
There was no religious motivation to start and even though I was Buddhist for a few years I consider myself Atheist now. It was just an early aversion towards the taste and then a heightened sense of peer pressure that didn’t sit well with me. After that it became a game of ‘let’s see how long I can keep it up’. Now it’s second nature - but I do notice there is a deep seated aversion towards alcohol and probably a side effect of conditioning myself against it. That probably goes with all drugs (I don’t take any)
And finally yes, society is very hostile towards sobriety. Less so in the US. People always feel embarrassed and defensive, interestingly enough.
It also turns out to be a great example to people who struggle with alcohol and children, so I am rather happy having stayed away from the rat poison ;-)
If you really don’t want to explain, fill a beer bottle with water and drink that all night. I frequently have one or two beers then do this for the rest of a party, and feel great the next day.
Don’t mind that at all. It’s fascinating to see how people react to one’s explanation. Very polite people will actually ask if I am okay if they drink around me which of course is no issue whatsoever.
On the plus side, per-capita alcohol consumption does seem to be on the decline in many countries over the past few decades [1]. So hopefully in the future it will be less difficult for others to make a similar choice.
As in general with associative studies, it is hard to make a distinct conclusion on causation.
Do we know if alcohol decreases gray and white matter volumes? Could the causation run in the reverse direction? Bi-directionally? Or could there be some common cause (e.g., proneness to "risky" behavior) that leads to both?
Every study that comes through here somebody invariably trots out the old "correlation does not equal causation" argument. You're not wrong, but you know, sometimes it is causation.
Rather than disregard every study, I just sort of internally give it a 50% weight and move on. Maybe it's bogus, maybe it's not, but surely some of them are correctly identifying causation.
Indeed, we'd need an interventional study.
Forcing a random study group to drink for decades seems unethical and expensive, but I wish we had the results.
This seems to have been known for decades with respect to heavy users, now it's being found it lighter users. For background:
> "Partial recovery of brain function with abstinence suggests that a proportion of the deÆcits must be neurochemical in origin while neuronal loss from selected brain regions indicates permanent and irreversible damage. The factors influencing these two components are unknown..."
Kril, J. J., & Halliday, G. M. (1999). Brain shrinkage in alcoholics: a decade on and what have we learned? Progress in Neurobiology, 58(4), 381–387.
> "Various mechanisms underlie ethanol-induced cell death, with oxidative stress and endoplasmic reticulum (ER) stress being the main pro-apoptotic mechanisms in alcohol abuse and FASD. Oxidative and ER stresses are induced by thiamine deficiency, especially in alcohol abuse, and are exacerbated by neuroinflammation, particularly in fetal ethanol exposure."
Yes, psychedelics and cannabis are safer recreational drugs than alcohol is, and maybe opiates and cocaine are not really any worse. Revising drug laws to account for such realities is long overdue - although banning marketing and promoting public health campaigns on risks and side effects are also good ideas.
> maybe opiates and cocaine are not really any worse
The negative health effects from moderate use of these are really not that bad, but it's very hard to moderately use them, they're a bit moreish.
Although alcohol is pretty moreish too, and the withdrawals can be really bad. (Your body develops a chemical dependence to the point that stopping cold turkey can actually kill you)
> Here, we show that the negative associations between alcohol intake and brain macrostructure and microstructure are already apparent in individuals consuming an average of only one to two DAUs (daily alcohol units), and become stronger as alcohol intake increases.
It should be noted that a single 'weak' 5% beer is 1.65 DAUs.
Does anyone know the same-person variance in gray and white matter volume, and if it has any measurable dependence on other biological factors (hydration and/or electrolyte balance come to mind as plausible)? And if any temporary[0] same-person effects are directly attributable to alcohol and its short term effects, e.g. hangover?[1]
[0]I presume if permanent single-person shrinkage was observed it would have been a big enough headline to have been noticed.
[1]Unless accounted for in sampling, drinkers would be statistically more likely to be experiencing transiently smaller brains from alcohol consumption or accompanying dehydration - if an effect exists.
I gave up alcohol years ago after reading a few of these studies. I wasn't drinking often anyways, but does it ever feel good to never feel that morning after headache. I found even one pint in the evening could disrupt my sleep.
Saving on the restaurant, and eliminating the liquor store, bills was gravy.
I poured a 3/4 full bottle of scotch that I'd been gifted down the drain the other day. If there's booze in the house I'll have a drink several nights a week; I now routinely get a headache the next day with "just" two glasses of scotch, so it really isn't worth the damage it's doing to my body. My current plan is to have a beer or two when I'm out, but to completely cut out drinking at home.
Hm, I still have a fancy bottle of scotch I got as a gift, buried somewhere forgotten in the cupboards. That is it though. I brought the rest of my liquor cabinet to the office. The free booze was appreciated by the takers, although I admit I had mixed feelings about giving away what I deemed poison :). It was probably $600-700 worth.
Readit News
(I skimmed to the introductory paragraph where they talk about confounders, but don't see alcohol history listed as a confounder.)
"It is reasonable to expect that the relationship we observe would differ in younger individuals who have not experienced the chronic effects of alcohol on the brain. An additional limitation stems from the self-reported alcohol intake measures in the UK Biobank, which cover only the year prior to participation. Such estimates may not adequately reflect drinking prior to the past year and are susceptible to reporting and recall bias.
Further, our analyses do not account for individuals with a past diagnosis of AUD. Earlier studies have shown that the brain shows some recovery with the cessation of drinking in individuals with AUD, but this varies with age and sex, and recovery might be incomplete. Thus, a past diagnosis of AUD would likely influence our results. We hope future studies will shed light on how a history of AUD with prolonged recovery is associated with brain structure in middle-aged and older adults."
1 = https://osf.io/chgbv
Definitely shows there is some grey and white matter reduction... but the impact doesn't seem drastic? Do I use that 1%? Do other activities reduce my brain of 1%? I don't know the scale of volume they use. I could be wrong.
And looking at figure 2[1], age is also a major factor for change in white/grey volume (which they normalize).
[1] https://www.nature.com/articles/s41467-022-28735-5/figures/2
> The notion that a person uses only 10 percent of their brain is a myth. fMRI scans show that even simple activities require almost all of the brain to be active.
https://www.medicalnewstoday.com/articles/321060#takeaway
A lot of people who don't drink are not abstaining for some health augmentation or lifestyle choice, but because drinking any amount of alcohol would send them into a very early grave.
It seems like these hidden confounding factors are more plausible of an explanation that the "0 drinks per day" group has higher morbidity, compared to "alcohol is healthy in moderate amounts" explanation for the bottom of the J curve.
I used to drink socially when I was young, and I usually had more than that.
I'm vaguely familiar with the term "synaptic plasticity" to roughly mean the way the brain processes information and how it changes over time with varying life experiences.
It seems to me that one's risk-taking behavior may reduce brain matter volume, yet still improve quality of life because experience itself (literally the way the brain is wired) is worth far more. Some experiences are practically impossible without alcohol due to its social and cultural significance.
To make a dumb metaphor, consider the fact that the raw number of pixels contained in an image isn't necessarily correlated with its success. What is a life, but a meme?
Disclosure: I'm buzzed right now btw :p
I have to say that this matches my (few) experiences with chronic drinkers quite well. I've seen them become less inhibited and less self-aware and become more selfish over a couple of decades, even when they're sober.
It's like they become robots. While it's definitely bad for health, I'm not sure broader society really cares because good health isn't necessarily correlated with success in life past a certain point.
My somewhat more positive counterexamples roughly fall into the dichotomy of introverts and extroverts (yeah yeah I know).
On the introvert side, I've seen hard drinking make people into creatures of habit. Not necessarily "bad" habits, but habits nonetheless such as overworking themselves in a narrow field, deep hobbies, etc. "drunken masters" so to speak.
On the extrovert side, I've seen hard drinking train people to optimize for high charisma, handling crowds, and deep knowledge of conflict resolution to the detriment of being able to learn any other skills or really appreciate the world in any other way. The "life of the party" while being just as dead inside as the introverted example above.
They get trapped into a certain way of life from the brain damage. I'm definitely not advocating alcohol abuse just sharing my perspective. I'm pretty sure more people drink than abstain so this isn't a topic that can be dismissed as just purely bad.
If anyone knows of research on this kind of topic that would be amazing. Too often this is only discussed via movies, ads, and personal stories which are all strongly biased.
Yes, sadly that might be. In my youth heavy drinking was the norm, all the cool kids and pretty girls did it and to connect to them, you had to do it, too. Those who did not, were the depressed loosers.
So to socialize, you had to poison yourself.
From an individual point of view that makes sense, but overal I believe it makes more sense, to change that culture around alcohol.
And luckily since then, I met people who can have crazy wild parties, without being wasted. I love dancing, but I hate to avoid uncoordinated drunk idiots on the dancefloor.
I mean, I still do like a beer or a coctail occasionally and I see nothing wrong with it. But needing alcohol to socialize or party is not healthy at all and I would like to see the obligatory drunkness to go away.
Not just because of drunk parties, but also because this culture gets people hooked into alcoholism and then families get destroyed.
I don't think there's anything evil about drinking, I've just gotten this far in my life without it and figure "heck, might as well go for broke" at this point. I do believe that alcohol advertisements on TV and radio should be banned like tobacco ads were, though. The fact that I have been conditioned by ads since I was a kid to think that beer is delicious and harmless is unnerving to me.
Ideally, drinking ought to be a personal choice to exchange risk for pleasure. This only holds true when drinking is done responsibly, though. Irresponsible drinking can ruin lives, relationships, and hurt or kill people. Budweiser and Heineken may be required to say "drink responsibly" at the end of all their ads, but it's extremely obvious they don't actually care. At the end of the day, they make more money off alcoholics than responsible drinkers, so they and their marketing cannot be trusted. The incentives are too misaligned.
My mistake was avoiding parties and socialization in college along with drinking.
Also watching people around you get drunk a couple of times early on was quite the turn off. It’s actually rather sad.
Often I am considered to ‘have excellent memory’ compared to my peers (I am 44 now).
There was no religious motivation to start and even though I was Buddhist for a few years I consider myself Atheist now. It was just an early aversion towards the taste and then a heightened sense of peer pressure that didn’t sit well with me. After that it became a game of ‘let’s see how long I can keep it up’. Now it’s second nature - but I do notice there is a deep seated aversion towards alcohol and probably a side effect of conditioning myself against it. That probably goes with all drugs (I don’t take any)
And finally yes, society is very hostile towards sobriety. Less so in the US. People always feel embarrassed and defensive, interestingly enough.
It also turns out to be a great example to people who struggle with alcohol and children, so I am rather happy having stayed away from the rat poison ;-)
that's how it looks to me when non-drinkers have to explain every time themselves
Deleted Comment
[1] https://ourworldindata.org/grapher/per-capita-alcohol-1890?t...
Do we know if alcohol decreases gray and white matter volumes? Could the causation run in the reverse direction? Bi-directionally? Or could there be some common cause (e.g., proneness to "risky" behavior) that leads to both?
https://en.wikipedia.org/wiki/Correlation_does_not_imply_cau...
Rather than disregard every study, I just sort of internally give it a 50% weight and move on. Maybe it's bogus, maybe it's not, but surely some of them are correctly identifying causation.
Life is too short to quibble about this crap.
Well, it's still true, and still applicable.
> You're not wrong, but you know, sometimes it is causation.
No, I don't know, and neither do you. That's... kind of the problem.
Yup, so have a drink when you want, or don't. We will all die eventually.
Then why bother doing science at all?
There are ways to determine the correlation vs causation problem, but yes it takes more effort - possibly redesigning studies, follow up studies etc.
But that's just the price of knowledge. And knowledge is worth quibbling over.
> "Partial recovery of brain function with abstinence suggests that a proportion of the deÆcits must be neurochemical in origin while neuronal loss from selected brain regions indicates permanent and irreversible damage. The factors influencing these two components are unknown..."
Kril, J. J., & Halliday, G. M. (1999). Brain shrinkage in alcoholics: a decade on and what have we learned? Progress in Neurobiology, 58(4), 381–387.
https://sci-hub.se/10.1016/s0301-0082(98)00091-4
Here's something on mechanisms from 2021:
> "Various mechanisms underlie ethanol-induced cell death, with oxidative stress and endoplasmic reticulum (ER) stress being the main pro-apoptotic mechanisms in alcohol abuse and FASD. Oxidative and ER stresses are induced by thiamine deficiency, especially in alcohol abuse, and are exacerbated by neuroinflammation, particularly in fetal ethanol exposure."
https://www.mdpi.com/1660-4601/18/16/8678
Yes, psychedelics and cannabis are safer recreational drugs than alcohol is, and maybe opiates and cocaine are not really any worse. Revising drug laws to account for such realities is long overdue - although banning marketing and promoting public health campaigns on risks and side effects are also good ideas.
The negative health effects from moderate use of these are really not that bad, but it's very hard to moderately use them, they're a bit moreish.
Although alcohol is pretty moreish too, and the withdrawals can be really bad. (Your body develops a chemical dependence to the point that stopping cold turkey can actually kill you)
It should be noted that a single 'weak' 5% beer is 1.65 DAUs.
Seriously though, why doesn't the unit of 1 DAU correspond with any existing commercial form factors?
A single 12oz 5% beer would be a more helpful starting point.
[0]I presume if permanent single-person shrinkage was observed it would have been a big enough headline to have been noticed. [1]Unless accounted for in sampling, drinkers would be statistically more likely to be experiencing transiently smaller brains from alcohol consumption or accompanying dehydration - if an effect exists.
Saving on the restaurant, and eliminating the liquor store, bills was gravy.
Company xmas party is coming up, I'll have a couple to drink there because its free but I'll be super lightweight so only a couple will do anyway.