Even Moderate Drinking Increases Stroke Risk, Groundbreaking Genetic Study Finds
A major genetic study has concluded that there is no healthy level of alcohol consumption, at least when it comes to stroke risk.
The study, published in The Lancet Thursday, contradicts some previous research suggesting that drinking one to two glasses a day might protect against stroke, though other studies have said there is no safe level of alcohol consumption, BBC news reported. In Thursday's study, a research team from the University of Oxford, Peking University and the Chinese Academy of Medical Sciences found that even drinking one to two glasses a day increased stroke risk by 10 to 15 percent.
Moderate #alcohol consumption does not protect #against stroke: finding from a mendelian randomisation study… https://t.co/LWKqi4PcuS— The Lancet (@The Lancet)1554417300.0
"The key message here is that, at least for stroke, there is no protective effect of moderate drinking," study co-author and Oxford Nuffield Department of Population Health professor Zhengming Chen told Reuters. "The genetic evidence shows the protective effect is not real."
For heavy drinking, the effect was even more pronounced. Drinking four or more glasses a day increased stroke risk by 35 percent and raised blood pressure.
The researchers were confident in their results because they were able to use a unique genetic variant common in Asian populations to help separate the impact of alcohol on health from other factors, The Guardian explained.
In East Asian countries, around one third of people have a combination of genes that makes them flush and feel uncomfortable after drinking, leading them to drink less. However, the genes cut across status or overall health, so scientists can isolate them as a variable.
Researchers followed around 500,000 people from China for 10 years and tracked their drinking habits and incidents of stroke or heart attack. When they looked at self-reporting of alcohol consumption, they did find that drinking 100 grams of alcohol a week (one to two drinks a day) did seem to ward off stroke. However, when they looked at genetic data and location to predict the mean amount of alcohol consumed by participants, the protective effect disappeared. Stroke risk went up 38 percent for every additional 280 grams of alcohol consumed each week.
"Using genetics is a novel way ... to sort out whether moderate drinking really is protective, or whether it's slightly harmful," study author and Oxford epidemiologist Iona Millwood told Reuters. "Our genetic analyses have helped us understand the cause-and-effect relationships."
The study looked at both women and men, but very few women in China drink. While 33 percent of the male subjects consumed alcohol, only two percent of the women did. This allowed the researchers to further confirm the negative impacts of alcohol, since women with the same combination of genes did not have an increase in stroke risk.
University of Cambridge Winton Professor for the Public Understanding of Risk David Spiegelhalter, who was not involved with the research, told The Guardian he found the results persuasive:
"This is a very impressive study which shows that men who, by chance, have a combination of genes that put them off drinking alcohol have a lower risk of stroke compared with those without these genes," he said.
"The fact that this is not true for Chinese women, who tend not to drink whatever their genes, suggests this effect is due to the alcohol rather than the genes themselves. I have always been reasonably convinced that moderate alcohol consumption was protective for cardiovascular disease, but now I am having my doubts."
The study could not draw any conclusions about the impact of alcohol consumption on heart attack risk. It also focused on beer and spirits, not wine, which some say may have separate health benefits.
"It has certainly advanced what we know about the role of alcohol in some diseases but it can't be the last word," Open University Emeritus Professor of Applied Statistics Kevin McConway told BBC News. "The new study doesn't tie down exactly how alcohol works to increase stroke risk but doesn't appear to increase heart attack risk."
How #Sugar, #Alcohol and #Caffeine Affect Inflammation https://t.co/ldeDWLPmbL @HealthyChild @naturallysavvy— EcoWatch (@EcoWatch)1546898417.0
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By Melissa Hawkins
After sustained declines in the number of COVID-19 cases over recent months, restrictions are starting to ease across the United States. Numbers of new cases are falling or stable at low numbers in some states, but they are surging in many others. Overall, the U.S. is experiencing a sharp increase in the number of new cases a day, and by late June, had surpassed the peak rate of spread in early April.
Seven day rolling average of number of people confirmed to have COVID-19, per day (not including today). This chart gets updated once per day with data by Johns Hopkins. Johns Hopkins university doesn't provide reliable data for March 12 and March 13. Johns Hopkins CSSE Get the data
To Have a Second Wave, the First Wave Needs to End.<p>A wave of an infection describes a large rise and fall in the number of cases. There isn't a precise epidemiological definition of when a wave begins or ends.</p><p>But with talk of a <a href="https://www.theguardian.com/world/2020/jun/27/new-covid-19-clusters-across-world-spark-fear-of-second-wave" target="_blank">second wave in the news</a>, as an <a href="https://www.american.edu/cas/faculty/mhawkins.cfm" target="_blank">epidemiologist and public health researcher</a>, I think there are two necessary factors that must be met before we can colloquially declare a second wave.</p><p>First, the virus would have to be controlled and transmission brought down to a very low level. That would be the end of the first wave. Then, the virus would need to reappear and result in a large increase in cases and hospitalizations.</p><p>Many countries in <a href="https://doi.org/10.1038/s41562-020-0908-8" target="_blank">Europe and Asia have successfully ended the first wave</a>. <a href="https://www.theguardian.com/world/2020/jun/08/new-zealand-abandons-covid-19-restrictions-after-nation-declared-no-cases" target="_blank">New Zealand</a> and <a href="https://www.newyorker.com/magazine/2020/06/08/how-iceland-beat-the-coronavirus" target="_blank">Iceland</a> have also made it through their first waves and are now essentially coronavirus-free, with very low levels of community transmission and only a handful of active cases currently.</p>
Different States, Different Trends<p>Looking at U.S. numbers as a whole hides what is really going on. Different states are in <a href="https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html" target="_blank">vastly different situations right now</a> and when you look at states individually, four major categories emerge.</p><ol><li>Places where the first wave is ending: States in the Northeast and a few scattered elsewhere experienced large initial spikes but were able to mostly contain the virus and substantially brought down new infections. <a href="https://www.nytimes.com/interactive/2020/us/new-york-coronavirus-cases.html" target="_blank">New York</a> is a good example of this.</li><li>Places still in the first wave: Several states in the South and West – see <a href="https://www.nytimes.com/interactive/2020/us/texas-coronavirus-cases.html" target="_blank">Texas</a> and <a href="https://www.nytimes.com/interactive/2020/us/california-coronavirus-cases.html" target="_blank">California</a> – had some cases early on, but are now seeing massive surges with no sign of slowing down.</li><li>Places in between: Many states were hit early in the first wave, managed to slow it down, but are either at a plateau – like <a href="https://www.nytimes.com/interactive/2020/us/north-dakota-coronavirus-cases.html" target="_blank">North Dakota</a> – or are now seeing steep increases – like <a href="https://www.nytimes.com/interactive/2020/us/oklahoma-coronavirus-cases.html" target="_blank">Oklahoma</a>.</li><li>Places experiencing local second waves: Looking only at a state level, <a href="https://www.nytimes.com/interactive/2020/us/hawaii-coronavirus-cases.html" target="_blank">Hawaii</a>, <a href="https://www.nytimes.com/interactive/2020/us/montana-coronavirus-cases.html" target="_blank">Montana</a> and <a href="https://www.nytimes.com/interactive/2020/us/alaska-coronavirus-cases.html" target="_blank">Alaska</a> could be said to be experiencing second waves. Each state experienced relatively small initial outbreaks and was able to reduce spread to single digits of daily new confirmed cases, but are now all seeing spikes again.</li></ol><p>The trends aren't surprising based on how states have been dealing with reopening. The virus will go wherever there are susceptible people and until the U.S. stops community spread across the entire country, the first wave isn't over.</p>
What Could a Second Wave Look Like?<p>It is possible – though at this point it seems unlikely – that the U.S. could control the virus before a vaccine is developed. If that happens, it would be time to start thinking about a second wave. The question of what it might look like depends in large part on everyone's actions.</p><p>The <a href="https://dx.doi.org/10.1086%2F592454" target="_blank">1918 flu pandemic</a> was characterized by a mild first wave in the winter of 1917-1918 that went away in summer. After restrictions were lifted, people very quickly went back to pre-pandemic life. But a second, deadlier strain came back in fall of 1918 and third in spring of 1919. In total, <a href="https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/1918-pandemic-history.htm" target="_blank">more than 500 million people were infected</a> worldwide and upwards of <a href="https://theconversation.com/compare-the-flu-pandemic-of-1918-and-covid-19-with-caution-the-past-is-not-a-prediction-138895" target="_blank">50 million died</a> over the course of three waves.</p><p>It was the combination of a quick return to normal life and a mutation in the flu's genome that made it more deadly that led to the horrific second and third waves.</p><p>Thankfully, the coronavirus appears to be much more <a href="https://doi.org/10.1016/j.meegid.2020.104351" target="_blank">genetically stable</a> than the influenza virus, and thus less likely to mutate into a more deadly variant. That leaves human behavior as the main risk factor.</p><p>Until a <a href="https://theconversation.com/what-needs-to-go-right-to-get-a-coronavirus-vaccine-in-12-18-months-136816" target="_blank">vaccine or effective treatment is developed</a>, the tried-and-true public health measures of the last months – <a href="https://theconversation.com/this-simple-model-shows-the-importance-of-wearing-masks-and-social-distancing-140423" target="_blank">social distancing,</a> <a href="https://theconversation.com/masks-help-stop-the-spread-of-coronavirus-the-science-is-simple-and-im-one-of-100-experts-urging-governors-to-require-public-mask-wearing-138507" target="_blank">universal mask wearing</a>, frequent hand-washing and avoiding crowded indoor spaces – are the ways to stop the first wave and thwart a second one. And when there are surges like what is happening now in the U.S., further reopening plans need to be put on hold.</p>
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