Truth the experts won’t admit: Drink PREVENTS dementia
It’s the OPPOSITE of what we’re told. But a top science writer says the evidence shows alcohol doesn’t harm your brain — it protects it
THERE I was in my local newsagent last Wednesday morning, buying my Daily Mail, when my bleary-eyed brain was assaulted by a huge front-page headline on another paper — ‘Give up all drink or risk dementia.’ A terrifying message to every drinker in Britain — i.e. most of the adult population.
But I was certain there was something seriously wrong with it. That’s because I keep my ear very close to the ground for the latest research findings on alcohol and health, and I’d not picked up a hint of such a draconian claim.
The headline arose not from some hot-offthe-newswires research, but from the National Institute for Health and Care Excellence (NICE) publicising its Guideline On Delaying Dementia, Disability And Frailty In Later Life.
In fact, as the author of a recent book on alcohol and health, with a whole chapter devoted to mental functioning, I knew that the headline completely contradicts the entire medical evidence about alcohol and dementia.
It was about as wrong as saying ‘smoking does not cause lung cancer’.
The evidence is very clear — I would even say overwhelming — that not only does everyday drinking (i.e. in moderation) not cause dementia, it actually prevents it.
That’s not a misprint. Alcohol really does reduce the risk of dementia.
This is an astonishing statement, I agree, which I didn’t believe when first encountering it — until I looked in detail at the research findings, all of it published in mainstream medical journals.
THE ASTOUNDING STUDY RESULTS
WITH access to 150 years’ worth of medical journals stored in the Royal Society of Medicine’s (RSM) magnificent library in London, I found that one of the earliest studies looking at the effect of moderate alcohol intake on dementia had been done in the Nineties.
In this study, U.S. researchers kept tabs on 6,000 women aged over 65 living in care homes, some of whom had been (and still were) regular drinkers. The women, who were all of sound mind at the start, were tracked for more than six years; their alcohol intake was noted, plus the date of the first diagnosis of dementia.
The results couldn’t have been clearer: in terms of who got dementia first, in pole position were the non-drinkers.
The women who drank up to 14 grams of alcohol a day (the equivalent of a large-ish glass of wine) obtained some protection against dementia, but those who drank more than that halved their risk of dementia compared to the non-drinkers.
Published the same year was another U.S. paper with almost identical results, but it was a German one in 2011 that knocked my socks off. In a three-year study, mental health experts in Mannheim observed 3,200 people over the age of 75, roughly half of whom were regular drinkers. Once again, the teetotallers had a much higher risk of dementia than drinkers.
Even fairly heavy drinkers (downing more than 40g of alcohol a day — half a bottle of wine) halved their risk of dementia compared to non-drinkers.
However, the most astounding benefit occurred with those who drank a little less than that — between 20g to 29g of alcohol a day. These people reduced their chances of getting ‘overall dementia’ (i.e. all types) by two-thirds, and Alzheimer’s specifically to almost zero.
Truly amazing. There’s not a pharmaceutical drug, herb, vitamin supplement, diet or other lifestyle change that can get anywhere near achieving that level of protection.
HOW WINE CUTS ALZHEIMER’S RISK
IT SOON became clear that these weren’t isolated cases. In fact, the RSM library houses a multitude of these so-called ‘population studies’ exploring the connection between alcohol and dementia. As you’d expect, many show that alcoholics and heavy binge drinkers are at serious risk of brain damage, which can sometimes lead to dementia.
But those are the only research findings the public ever hears about. What’s rarely publicised are the many studies exploring the effects of ordinary alcohol intake — the amounts most normal people drink.
To date, there have been more than 140 such studies. Not all of them have come up with identical results to the three I’ve mentioned, but that’s not unusual in medical research.
When there’s a large body of slightly differing findings, scientists often pool the data together in what’s called a meta-analysis. In the past seven years, three metaanalyses have been done by different groups of experts, all working independently of each other.
Researchers at Imperial College London published the first metaanalysis in 2008. Their conclusion? ‘Low to moderate alcohol use in earlier adult life is associated with a 38 per cent reduced risk of unspecified incident dementia.’
Interestingly, they noted that wine, at an intake of up to half a litre a day, significantly reduces the risk of Alzheimer’s in particular. A year later, an Australian group’s meta-analysis found that ‘compared with nondrinkers, drinkers had a 34 per cent reduced risk of Alzheimer’s disease and a 47 per cent reduction of any dementia type’.
Heavy drinkers didn’t benefit, but they were found to be at no greater risk of dementia than non-drinkers. In 2011, a meta-analysis by U.S. researchers concluded that there is ‘a real and beneficial effect of light to moderate drinking that reduces the risk of dementia, cognitive impairment, and cognitive decline in older adults by 20 to 25 per cent’.
But population study data such as this can never provide ultimate proof. So in 2001, Harvard University neurologists decided to use MRI
1m The number of people in Britain expected to have dementia by 2025
scanners to examine the inside of drinkers’ and non-drinkers’ skulls.
The results were stunning. Completely in line with the population studies, ‘moderate drinkers’ had healthier-looking brains than non- drinkers, with ‘a lower prevalence of infarcts [damage from mini-strokes] . . . and white matter abnormalities [defects in the tissue that transmits messages between brain cells]’ — two classic precursors of dementia.
You can now understand my shock at that headline claiming that any amount of alcohol intake will cause dementia — it could not have been more wrong-headed. Mind you, almost the whole of what used to be called Fleet Street plugged the same line.
But who can blame them? It was the message many were bound to take from the dementia ‘guidelines’ published by NICE last week.
NHS RULES BASED ON SCANT EVIDENCE
THIS was a document purporting to give the public evidence-based advice on simple lifestyle changes to reduce their risk of dementia.
However, nowhere does it say drinking alcohol in moderation will help. Quite the reverse.
These are the kinds of statements that litter the whole document: ‘alcohol is an avoidable risk factor for dementia’, ‘alcohol can increase the risk of dementia’ and ‘there is no safe level of alcohol consumption’.
How did NICE come up with all this? I emailed its press office, which was completely open about what
had been done. I was astonished. I’d imagined that an organisation whose title includes the word ‘excellence’ and which costs the taxpayer more than £1 million a week would have had enough in-house researchers to perform the kind of medical ferreting exercise I’d done.
Apparently not. NICE told me it had asked an outside ‘expert’.
I was duly sent the expert’s report. Only a page long, it took less than a minute to read.
A quick and easy way to assess the quality of a scientific report is to go straight to the references the author has used to arrive at the final verdict.
SHOCK NUMBER ONE: The expert had referenced just one solitary scientific paper. The lowliest undergraduate knows that scientific reviews need at least 50 ‘refs’.
I was hoping to read something really interesting, but this lonely reference chosen by the expert was a total letdown. Yes, it was an up-todate survey of the research on alcohol and dementia, but it was mainly about the hazardous effects of binge-drinking and alcoholism on the brain.
Nothing wrong with that, of course, but blindingly obvious.
The referenced paper did mention some of the studies I’ve told you about, but that section was brief and buried away.
Furthermore, the paper failed to explore the implications of the evidence showing the role of moderate alcohol intake in dementia prevention. In fact, the whole issue was totally ignored in the summary.
SHOCK NUMBER TWO: The expert that NICE had consulted was Professor Ian Gilmore.
I was puzzled. I’d never seen his name anywhere in dementia literature. That’s hardly surprising, as Professor Gilmore is a gastroenterologist, which means he specialises in stomachs and intestines.
He is no doubt a VIP in his field, but he is unlikely to have expertise in people’s brains. But, give him the benefit of the doubt, I thought. So I read the ‘expert summary testimony’ he had sent to NICE.
SHOCK NUMBER THREE: Moderate alcohol intake and dementia is a complex area which I needed more than 1,500 words to cover in my book. Professor Gilmore’s word count was 92.
That’s an exaggeration, of course — his testimony was longer than that. But it largely consisted of generalities about alcohol and health, and policy concerns about ‘cheap supermarket alcohol’, ‘alcohol marketing’ and ‘pricing’. So there wasn’t much room for dementia, hence the 92 words.
It was his raising of policy concerns that led me to . . .
SHOCK NUMBER FOUR: The good professor is also an anti-alcohol campaigner. He is president of Alcohol Concern, a lobbying organisation whose website makes it very clear that it believes alcohol is what churchmen used to call the ‘demon drink’.
A spokesperson for NICE said the guideline did not focus solely on alcohol, and looked at a number of lifestyle changes that can help lower dementia risk, adding: ‘ Our public health guidelines are developed by a standing committee made up of an independent panel of experts. Professor Gilmore was joined by topic specialists for other areas.’
Even so, Alcohol Concern must have been delighted by the headlines generated by its president, particularly ‘Give up all drink or risk dementia’.
Funnily enough, a mere two letters in that statement are wrong. As you now know, it should not have said ‘or’ but ‘and’. I’m certain my article will raise suspicions that I’m a closet alcoholic or in the pay of the drinks industry. I hope I’m not the former (I enjoy a few glasses of red wine with dinner) and I assure you I’m not the latter. As a medical journalist, I see it as part of my job to give people evidence-based information to help them live long and healthy lives. Dementia is a cruel disease that will destroy any hope of that, so surely society should grasp hold of anything that might help prevent it.
As I’ve said, there is currently no dementia medicine to match the protective power of alcohol — taken in relatively small doses, of course.
The fact that alcohol can also do the complete opposite in high doses is a huge paradox which science can’t yet explain. In other words, we don’t know why a little may be good, but more is bad.
Don’t get me wrong, though. NICE is right that drinking to excess may cause not only dementia, but other terrible diseases such as liver problems and some cancers, and I wholeheartedly support its general efforts to warn people off unhealthy drinking — but not with distortions about healthy, moderate drinking.
21% Proportion of adults in the UK who are
teetotal