In the last 2 years, two studies have thrown a large bucket of ice water on the notion that a drink, whether beer, wine, or spirits, a day will really help you live longer. The problem these researchers confronted was the sick abstainer bias. Essentially, there are many reasons for a person to not drink. Voluntarily abstaining from alcohol is only one of those reasons. Others include having a medical condition that makes alcohol consumption unsafe or being a former alcoholic. These non-voluntary reasons to abstain from alcohol are also significant risk factors for early death, but in most studies, the unhealthy non-drinkers are collected into the same group as the healthy non-drinkers, which potentially introduces bias into the study (It is usually unwise to have sick participants in control groups). By reviewing a large body of scientific literature and accounting for this sick abstainer bias, the benefits of moderate drinking (aka 1 drink a day) disappear. Sadly, a drink a day won’t help you (It probably won’t harm you though).
At this point, it is important to note that these studies were funded by the National Institutes of Health (NIH) and, specifically, by the National Institute for Alcohol Abuse and Alcoholism (NIAAA). Both are US government entities with the executive brand, and NIH/NIAAA funding is largely seen as unbiased, by which I mean NIH/NIAAA does not expect any specific outcome of the research. Instead, they want to know if your hypothesis is true or false because proving a hypothesis false can be as important as proving a hypothesis true (and a necessary possibility in experimental research).
It’s also important to note that the alcohol industry was not supportive of the conclusion that moderate drinking isn’t healthy for you, unsurprisingly. The International Scientific Forum on Alcohol Research (ISFAR), which consists of approximately 50 researchers who are financially supported or sympathetic to the alcohol industry, issued a scathing critique of the study within days of publication (A little off track but how do 50 researchers read and reach consensus on a study critique within days? It takes me weeks to get a single researcher to review a paper.). The President of the Distilled Spirits Council of the US, an alcohol industry trade association, called the paper an “attack.”
So independent researchers concluded that alcohol use is probably not healthy for you (a pretty logical conclusion), and the alcohol industry didn’t like the findings (an expected response).
What happens now?
The alcohol industry throws a bunch of money at the problem.
But not just any money. Money that in essence gets laundered so it looks clean on the other side.
Anheuser-Busch InBev, Heineken, Diageo, Pernod Ricard and Carlsberg, the largest alcohol producers in the world, have pledged nearly $68 million (so far) to the NIH Foundation in support of a study to determine the health consequences of 1 drink of alcohol per day. The entire study is expected to cost $100 million.
If you haven’t heard of the NIH Foundation, you are not alone. I didn’t know it existed until learning about this controversy. It exists as a 501(c)3 non-profit organization as a way to raise private funds to support NIH research. Its donors include several pharmaceutical companies, the Gates Foundation, the National Football League (which is also the subject of controversy), and now the alcohol industry.
By donating this large sum of money to the NIH Foundation, the alcohol industry is intending to build a wall between itself and the research outcomes. If the study produces positive results, the industry needs the ability to say the study was done independent of industry influence. The problem is that by providing the money to fund the study, the alcohol industry is at least indirectly influencing the results. As Dr. Thomas Babor, from the University of Connecticut School of Medicine, said in an article on Wine Spector “there is the potential for people to subtly or not-so-subtly change their findings or interpretations based on the expectation of the funder.” In sum, the alcohol industry may not be directing the research, but there are ways to influence the process.
Funding the study through the NIH Foundation is even more insidious than at first glance because the researcher’s do not need to disclose that the alcohol industry funded the project when the time comes to publish the findings. Instead, they only need to disclose that the funding the provided by the NIH Foundation, which on paper looks like a pretty benign funding source.
This has been done before.
For some, gambling is an addiction, and heavy gamblers risk serious negative social and health consequences due to their addiction. In a not so deceptive effort to influence the direction of gambling research, the gaming industry has been funding gambling research through the National Center for Responsible Gaming (NCRG). The NCRG was started by a gaming company, and the NCRG remains fully funded by the gaming industry. This firewall allows researchers who accept such money to truthfully state they were not directly funded by industry dollars, and allows gambling industry members to fund researchers who will most likely support their positions.
Frankly, the NIH Foundation is being used by the alcohol industry as the NCRG is used by the gambling industry.
What can be done? What is the purpose of discussing this?
First, research needs to be fully independent with no expectations of results placed on the investigators. I support government funded research for this very specific reasons. Once investigators expect a certain result before a study has even begun, they will make decisions, small and large, to ensure that such a result is achieved. These decisions can be as large as what criteria to use to include or exclude potential participations or as small as whose data to include or exclude in the final analysis. Maybe the intervention group gets a little more attention than the control group or maybe the results are downplayed or even withheld from the public if they are unfavorable to the funder. Moreover, these decisions may be made consciously or unconsciously, and no one is immune to this influence. I cannot honestly say I would be unaffected by a funders intentions, and I feel like I have a pretty good grasp of the problem.
Second, follow the money when it comes to research. Just like political donations, research “funded” by foundations and other non-governmental groups may actually be funded by for-profit industries that stand to benefit from favorable results or suffer from unfavorable results. The investigators who will publish the NIAAA-alcohol use study will claim the study is funded by the NIH Foundation, which is technically correct, but the study actually has the finger prints of numerous transnational alcohol producers.
The take home message: One drink a day may not be healthy after all, and the NIH/NIAAA is accepting a large amount of money from the alcohol industry to study this exact problem. Beware the final results of this project. It will likely be influenced by the alcohol industry itself. For a more critical analysis of the study methods, please read: http://tobaccoanalysis.blogspot.com/2017/07/niaaa-prostitutes-its-scientific.html.