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Researchers concerned new U.S. dietary guidelines will overlook harms of alcohol

LEILA FADEL, HOST:

How much is OK to drink? The federal government is updating its dietary guidelines, which it does every five years. NPR's Will Stone reports there are concerns some of the evidence about alcohol will be overlooked.

WILL STONE, BYLINE: No more than two drinks per day for a man and one for a woman - that's the current guidance. Several years ago, health officials in the Biden administration enlisted a handful of researchers to review the evidence in case that advice needed to change.

KATHERINE KEYES: We worked for many, many months.

STONE: Katherine Keyes is an epidemiologist at Columbia University. She says their study looked at lots of things - motor vehicle accidents, cancer, cardiovascular disease, stroke.

KEYES: We showed in that paper that the risks begin to increase even at relatively low levels of alcohol consumption.

STONE: And they modeled how the harms grow with each drink.

KEYES: Your risk of dying of an alcohol-related cause at two drinks a day is greater than 1 in 1,000. So that's pretty substantial.

STONE: All of that was in their draft report released at the end of last year. The alcohol industry criticized the findings and called for the study to be disregarded. And now it seems that's happened.

KEYES: We were told in August that the final report was not going to the packet of materials that would be considered for the dietary guidelines.

STONE: The Department of Health and Human Services did not explain the decision. The Trump administration may instead rely on another report - this one ordered by Congress and done by the National Academies of Sciences, Engineering, and Medicine. That concluded with moderate certainty that moderate drinking is associated with a lower risk of dying, including from cardiovascular disease.

Dr. Ned Calonge at the Colorado School of Public Health led that effort. He acknowledges they only went back to 2010 in their review, and they excluded studies with what's known as abstainer bias. This is when former drinkers who stopped drinking are included, which makes the control group look sicker.

NED CALONGE: And so we end up with a study that I feel confident in the moderate levels.

STONE: Now, Calonge says he doesn't think their findings actually support recommending drinking for health, but he rejects claims that bias tainted their work. One of the researchers on the committee received funding in the past from the alcohol industry.

CALONGE: I looked at every research paper that we both included and excluded. I was in on the meetings when we were drafting the report. There was no influence of industry.

STONE: Some advocacy groups worry the Trump administration, citing this report, will soften the guidelines on alcohol. Tim Stockwell, who's at the Canadian Institute for Substance Use Research, is very critical of the National Academies report, in part because they excluded relevant studies showing the harms of alcohol, including links to cancer. He says there are many pitfalls when you analyze data on alcohol, and he once believed that moderate drinking was good for you.

TIM STOCKWELL: Twenty-five years ago, I published a study basically saying you're crazy to doubt the protective effects.

STONE: Now, thanks to more rigorous studies, he doubts there are benefits.

STOCKWELL: Most of the literature - serious bodies like the World Health Organization, recently the European Heart Network - have all come out saying there's no safe level, you know, there's no protective effects. So the way the field - expert opinion - is shifting is towards skepticism.

STONE: In fact, the Canadian guidelines say two drinks a week or less is considered low risk. But it's possible the U.S. may go in the opposite direction, even with a president and health secretary who do not drink.

Will Stone, NPR News.

(SOUNDBITE OF ARMS AND SLEEPERS' "WHEN THE BODY") Transcript provided by NPR, Copyright NPR.

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Will Stone
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