When public health and science clash

Scientific evidence is an important cornerstone for effective alcohol policy and alcohol policy advocacy. As advocacy organisation we aim to rely on evidence based measures and we rally for these interventions that are proven to be most effective. And there is no question that we do have all the evidence we need. Effective and cost-effective alcohol policies and interventions are known and repeatedly proven.

But there is another side to science which unfortunately works (or is used) against public health goals. Whether we call it a junk-science or there is a kind of a communication error between dedicated scientists and click-hungry media, the problem is real.

Example: Danish study on alcohol and diabetes
Researchers at the National Institute of Public Health of the University of Southern Denmark analyzed data from 70,551 Danish adults who participated in their country’s Health Examination Survey (DAHNES) during 2007-2008.
What ever the study actually claimed or was able to state as an outcome, the headlines in media globally had a field day.
“You now have a good reason to drink six beers next week.” – Men´s Health
„Want to keep diabetes at bay? Drinking alcohol might just help” – The Economic Times
“Regular alcohol consumption could cut diabetes risk” – The Guardian
etc, etc, etc.
And the clear and simple message that these articles spread to their readers was: „Drinking a moderate amount of certain drinks such as wine three to four times a week reduced diabetes risk by about 30%.“
Those who search for arguments to justify their alcohol consumption and possible health benefits rejoiced together with various alcohol industry representatives. As someone once put it (can´t remember who) people tend to persist in trawling the shark-infested waters of the definite evidence showing the dangers of alcohol in search of one sardine’s worth of positive, healthful evidence in favor of alcohol use.
We can be thankful to Great Britain’s National Health Service’s website “Behind the Headlines” which published an analysis showing various weaknesses „which means it cannot conclusively show that drinking frequently and moderately protects against diabetes. For example, people were only asked about their drinking habits and other lifestyle choices at a single time point. Also, the study doesn’t tell us whether those habits changed over the period in which people were monitored for diabetes.“

The article sums up following limitations:
People were only asked about their drinking habits and other risk factors at a single time point.
– The study doesn’t tell us whether those habits changed over the period in which people were monitored for diabetes. – Most studies related to alcohol consumption also run the risk that people are not always completely accurate when describing what and how much they drink.
– The way diabetes cases were recorded for the study did not distinguish between type 1 and type 2 diabetes, even though these conditions have different causes and treatments.
– The study only followed people up for an average of just under five years, whereas a condition like diabetes may develop due to risk factors experienced over a longer period.
– The information collected on diet may have been too simplistic to properly allow an understanding of how nutrition may also affect the diabetes risk of the people in the study.
– Although the researchers excluded people from the study if they already had a diagnosis of diabetes at baseline, they didn’t exclude people if they had other chronic health conditions, some of which may contribute to diabetes risk. The only other condition that was considered in the analysis was high blood pressure.

These limitations were also reported by some of the online magazines and news portals but obviously not close as many as those that wrote that alcohol is now a good prevention measure for diabetes.

When it comes to the relationship between science and media, the problem is that news agencies tend to shout news where there is none. I don´t want to claim that scientists (also in that case) are working to prove something they want to believe in. They are investigating sometimes minor details which scientifically are important and interesting but which conclude usually with a common statement „more research is needed“. But media takes parts of that single study and creates a powerful headlines. Headlines that attract attention and are newsworthy.

I do think that scientists do bear the responsibility of explaining the limits and implications of their work as most journalists and wider public is not capable to understand these. And at the same time journalists should do their investigative work while reporting new scientific evidence as well. By asking for instance where is the money coming from and are there any links to business interests.

For instance the leading author of this study, Prof Janne Tolstrup from the University of Southern Denmark, has received a grant for 2015/2016 from The European Foundation for Alcohol Research which is supported by The Brewers of Europe, the voice of the brewing industry in Europe, whose members are the national brewing trade associations, representing more than 90% of European beer production.

Link to industry funding does´nt automatically mean that this study or scientist is biased. Of course not. But it is curious that big part of alcohol-friendly evidence comes from studies and scientists which do have some links with the alcohol companies.

A pattern: Danish studies
Another interesting thing that I have noticed over the years is that these studies showing the health effect or harmlessness of alcohol are coming quite often from Denmark. In addition to this alcohol and diabetes study, few others are coming to my mind. Almost exactly a year ago Danish researchers from the Department of Clinical Epidemiology at the University Hospital of Aarhus stormed the international media with a finding that fertility is ‘unaffected’ by moderate alcohol consumption.

British Medical Journal published an editorial claiming then that “abstinence is unnecessary”. The study did conclude that moderate alcohol use does´nt seem to influence women’s fertility. But that isn’t an end goal. Right? Having a child is. Becoming a parent is. Having a healthy child is. And for that abstinence from alcohol is needed. The study created odd and I would think unintended messages. But that is not rare and scientists should be aware of that possibility.

And then there is 2012 study by scientists from Aarhus University and University of Copenhagen that found „Moderate drinking in early pregnancy branded ‘safe’“ which understandably uproared most of the global FASD community and worked against difficult task convincing people that safest choice is total abstinence during pregnancy. As other studies show drinking during pregnancy is unfortunately very common problem.

These are just some of the studies that have been getting a huge media attention with different interpretations and I would think (and hope) that at least part of it has been unexpected by the authors of these studies as well. Or maybe not.

Lauri Beekmann
Executive director, NordAN