Anti-alcohol academics smoked out

An attempt to rig the US's drinking guidelines has failed spectacularly

The USA’s House Committee on Oversight and Government Reform has released a scathing report about a study produced by six anti-alcohol academics which was intended to influence the Dietary Guidelines for Americans 2025-30 (which were also published this week). The US Dietary Guidelines have traditionally included recommendations on safe drinking limits and have become a battleground for the neo-temperance lobby. An attempt to halve them (from 2 drinks a day for men to 1 drink a day) failed in 2020.

In preparation for the 2025-30 edition, Congress authorised the National Academies of Sciences, Engineering, and Medicine (NASEM) to carry out a review of the evidence on alcohol and health. However, the Biden administration also commissioned the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD) to carry out essentially the same review.

These two organisaions were always likely to come to different conclusions. NASEM is “a large group of doctors, medical professionals, and scientists with specialized expertise to evaluate data” whereas the ICCPUD panel consisted of six activist-academics who claim that there is no safe level of alcohol consumption. The Interagency Coordinating Committee on the Prevention of Underage Drinking is supposed to focused on underage drinking, but as I said last January:

Stuffed with anti-alcohol academics, don’t be surprised if it goes beyond its remit and spouts “no safe level” dogma.

The ICCPUD report was published a week later and that’s exactly what it did. A month earlier, NASEM had published its own 230 page report which concluded that “compared with never consuming alcohol, moderate alcohol consumption is associated with lower all-cause mortality”, but that was soon followed by the news that the Surgeon General wanted cigarette-style health warnings on alcohol.

Confused? You were supposed to be. The campaign to downplay and dismiss the benefits of moderate drinking is being fought via the media - and surveys show that the merchants of doubt are winning.

The ICCPUD panel was assembled to give credibility to an extreme and poorly evidenced point of view, dismissing decades of evidence showing health benefits from moderate drinking and placing a disproportionate emphasis on cancer risk.

For those who are familiar with the alcohol research community, the presence of Tim Naimi on the panel was the big giveaway. Naimi is an advocate of neo-temperance policies and a close collaborator of Tim Stockwell. The two Tims have spent the last 20 years downplaying the benefits of moderate drinking and clogging up the academic literature (and search engines) with contrarian meta-analyses that attempt to erase those benefits (if you ask AI about it, you will usually get their take). Naimi was instrumental in the Canadian evidence review which led to the risible recommendation that people should drink no more than two alcoholic beverages per week, and the plan seems to have been to do the same thing in the USA.

Naimi has admitted that the evidence about whether national drinking guidelines influence alcohol consumption is “inconclusive” but says that such guidelines are “an important touchstone by which to inform public, scientific or industry-sponsored debate about alcohol consumption and the means or intensity by which to regulate it”. If you’re wondering why anti-alcohol academics get so hot and bothered about mere guidelines, there is your answer.

In Canada, they sidelined the epidemiological and biological evidence and replaced it with opaque modelling. The ICCPUD review - the Alcohol Intake and Health Study - did much the same, creating risk curves out of thin air to claim that there are people dying as a result of drinking one drink per week.

In the Canadian report, Naimi is listed alongside Stockwell and another author as being “a member of an independent group of academics sponsored by Movendi International”. As I mentioned in a Telegraph article last year, Movendi is the new name for the Independent Order of Good Templars, a formerly prohibitionist outfit that preaches the gospel of total abstinence from alcohol. This was not considered to be a significant conflict of interest because Naimi was not benefiting financially from the relationship but it nevertheless gave a sign of where his sympathies lie. Despite, or perhaps because of, this he was invited to be one of the six authors of the ICCPUD report, alongside Kevin Shield who also worked on the Canadian report and “leads an advisory panel on addiction at the WHO, which in 2023 updated its stance to recommend that there is ‘no safe level of alcohol consumption.’”

The ICCPUD study received a great deal of media coverage and the authors followed it up with attacks on the NASEM report. One of the ICCPUD authors, Priscilla Martinez, told the press: “Using flawed research to inform the public about alcohol sends mixed messages about its risks. The best available science simply doesn’t support the idea that a nightly drink is good for you.” The essence of their critique was that NASEM had focused on all-cause mortality and that there are all sorts of confounding factors for that. This was highly misleading. The NASEM report had looked in depth at cardiovascular disease, cancer and other conditions to make its conclusion and, unlike the ICCPUD authors, had assessed the biological plausibility of their findings.

Here, for example, is what they say about cardiovascular disease:

Several biologic mechanisms potentially explain how moderate alcohol consumption plays a role in reducing the risk of CVD, including the ability of alcohol to (1) increase high density lipoprotein (HDL) cholesterol and apolipoprotein A-1 (Camargo et al., 1985; Chiva-Blanch et al., 2015; Gepner et al., 2015; Masarei et al., 1986); (2) inhibit platelet aggregation (Umar et al., 2005; Zhang et al., 2000) and inflammation (Chiva-Blanch et al., 2015; Fragopoulou et al., 2021; Sierksma et al., 2002); (3) reduce fibrinogen (Chiva-Blanch et al., 2015; Sierksma et al., 2002; Stote et al., 2016) and increase plasminogen activator inhibiting factor 1 (Stote et al., 2016); and (4) favorably affect markers of glycemic control (Gepner et al., 2015), all of which are risk factors for MACE-3.

These biological mechanisms, which were originally proposed in observational studies, have also been confirmed in dozens of short-term RCTs over the past 40 years. For example, systematic reviews of RCT data have demonstrated that moderate drinking favorably affects HDL cholesterol, low density lipoprotein (LDL) cholesterol, and apolipoprotein A-1 (Brien et al., 2011; Huang et al., 2017; Spaggiari et al., 2020); fibrinogen (Brien et al., 2011; Huang et al., 2017); interleukin-6 (Huang et al., 2017); and glucose control (Schrieks et al., 2015). While each of these established effects is likely to contribute to observed reductions in risk of MI and ischemic stroke with alcohol consumption, some changes in biologic pathways (e.g., decreased clotting) also help explain how alcohol consumption may increase risk of hemorrhagic stroke.

Movendi-aligned academics have no answer to this kind of stuff because it is too sciency for them. The NASEM report is such a rigorous and definitive piece of research that it is laughable to mention the ICCPUD study in the same breath. The latter is no longer available online because ICCPUD has been closed down, but it is really just a series of assertions (you can read a full critique here).

The House Committee on Oversight and Government Reform does not pull its punches. Its report - A Study Fraught with Bias - concludes that ICCPUD’s Alcohol Intake and Health (AIH) study was a politically motivated waste of money that violated federal law.

The Committee’s investigation uncovered evidence that the Biden Administration’s ICCPUD AIH study was conducted in a manner inconsistent with federal law and was wastefully duplicative, raising outcome bias concerns, as Congress had already allocated $1.3 million for the NASEM to study the relationship between alcohol consumption and negative health outcomes to inform the 2025-2030 Dietary Guidelines.

… All six study group members are anti-alcohol advocates who had conducted previous research linking negative health outcomes with alcohol. The evidence points to the AIH study group having a pre-determined goal—to publish a biased study that parroted a “Canadian model” conclusion that no amount of alcohol consumption is safe. The AIH study group then took active steps to conceal their study from Congress and the public.

… The Committee concludes that the ICCPUD AIH study is irretrievably flawed and should not be considered in the 2025-2030 Dietary Guidelines.

The report notes that the six authors were selected by “Alicia Sparks, a long-time anti-alcohol activist and board member of the anti-alcohol U.S. Alcohol Policy Alliance” and provides evidence of anti-alcohol bias among at least five of them.

The “experts” chosen to serve on the Scientific Review Panel to conduct the AIH study were all anti-alcohol advocates, half of whom reside outside of the United States.

… Congress made clear in the 2016 Appropriations Act that NASEM must include “a balanced representation of individuals with broad experiences and viewpoints regarding nutritional and dietary information” in the study to inform the Dietary Guidelines. Here, the ICCPUD AIH group included three individuals from Canada whose research backgrounds show a dedication to eliminating the use of alcohol through dietary guidelines and a belief that no amount of alcohol consumption is safe. The other three ICCPUD group members from the United States are academics who have strong anti-alcohol beliefs, as evidenced by their research, publications and published statements.

… It is clear that the Biden Administration’s goal for the ICCPUD AIH study was to conclude under the “Canadian model” that no amount of alcohol consumption is safe. Therefore, the Biden Administration recruited two researchers who directly developed the “Canadian model” and one whose previous research was a substantial source in creating the “Canadian model” for the ICCPUD AIH study.

Not only did the plan not work but it backfired badly. In the new edition of the Dietary Guidelines for Americans, there is no specific guideline for how much you should drink. It just lists a few groups of people who shouldn’t drink at all and sends a vague message about drinking less for better health.

And in the scientific report for the guidelines is a note making it very clear that NASEM was the only trusted source for the alcohol section.

ICCPUD was defunded last September and no longer exists. The US no longer has drinking guidelines, the authors of the ICCPUD report have been named and shamed in a government report, and there may yet be legal proceedings. Way to go, Tim!

Update

A tear-stained article in the Washington Times gives us the reaction from Tim Naimi.

Naimi said he had hoped that guidelines would be tighter, calling for no more than a few drinks per week, or no more than one per day for men and women.

You don’t say!

But Naimi said he appreciated that the guidelines still espouse limiting alcohol for better health. “I think that’s what the public now understands — when it comes to alcohol, the less is better,” said Naimi, director of the University of Victoria’s Canadian Institute for Substance Use Research.

Cope harder, sir.