Understanding Risk Through Numbers

Disclaimer: we are not medical professionals and the information outlined below should be considered as thought-provoking rather than instructional.

This is the second blog in our Beer and Health series. Our first piece, Beer and Health Part I: How to look after your body at a Beer Festival! can be found here

Humanity has a long and rich history with beer, going back thousands of years. From ancient Mesopotamia to European monasteries, from the Industrial Revolution to tribal Africa – beer has played an important role in many cultures across the entire world. Its use in ceremonies, during periods of fasting, as a social lubricant, and even for its health benefits has been well-documented for millennia.

But beer is often vilified around this time of year, following a period of indulgence across the December holidays which many feel they should rectify with healthy living. The beginning of the year is a time of reflection, when we tend to consider our health more acutely. It is important then that as brewers (and consumers) we look at both the risks involved in, as well as the facts surrounding, beer consumption and what that looks like for our health throughout our lives. This is information that could inform our health-oriented decision-making around alcohol not only in January, but for the other 11 months of the year.

Regularly consuming excessive units of alcohol is dangerous, this we know. But it is interesting to look at what exactly constitutes “excessive” and how this risk compares to that of other lifestyle choices, such as diet and exercise. To draw focus to these comparisons, we looked at Sir David Spiegelhalter’s work on micro-lives as a unit of life expectancy as well as data on liver disease and its alcohol and non-alcohol causes.

Micro-lives and how they are affected by lifestyle choices:

Essentially a “micro-life” should be considered as a 30-minute fragment of life expectancy. So, an increase of 1 micro-life is an increase of 30 minutes to your life, and a decrease of 1 micro-life is a loss of 30 minutes.

Spiegelhalter applies this concept to determine the risks associated with certain behaviours and their impact on an average life expectancy. Below is a table outlining the impact certain common lifestyle choices have on the average person’s micro-lives based on data he collated.

Interestingly you will notice that 7 units of alcohol per week (3 pints of average strength beer) increases daily micro-lives by 1 and adds 1.2 years on average to a lifetime. This suggests that complete abstinence from alcohol is ultimately less beneficial to health than drinking up to 7 units a week, because of hormesis and social factors. But this is far from the end of the story when it comes to alcohol consumption.

It is important to note that we can see health risks associated with drinking increase exponentially when consuming more than 14 units per week, for example drinking 14 units per week decreases micro-lives by 0.16 per day and 21 units per week by 0.4. By the time you get to 140 units of alcohol per week (2 bottles of wine per day) the daily decrease is 8.84 micro-lives and those that regularly consume this amount live on average 21 years less.

The table also helps us to compare drinking alcohol with other risky lifestyle choices. For example, drinking a bottle of wine a day has a similar risk level – according to this research -- to smoking 20 cigarettes a day. The table above also shows that 20 minutes of daily exercise and a diet rich in fruit and vegetables will aid longevity. These aren’t necessarily revolutionary insights, but the precise figures can make for sharper comparisons among lifestyle choices.

Similar ideas are confirmed by the bar chart below showing the percentage of disability adjusted life years due to different risk factors.

This data suggests that smoking (10.5%), high blood pressure (10%), obesity (9%) and inactivity (5%) all contribute a higher risk percentage to major diseases than alcohol use (4.5%).

The Liver Disease Epidemic: Lifestyle Choices and Liver Disease

New analysis from Liver disease UK shows that over the next few years it will overtake heart disease as the biggest cause of premature death in the UK. This increase is considered a national health epidemic. The graph below shows that deaths from Liver Disease in the UK have increased by 400% since 1970, the fastest-growing of any major disease in the nation.

While beer consumption has fallen in recent years, the kinds of beer, and other things we drink has also changed.

Alongside the rise of liver disease deaths, the consumption of wine, spirits, and ready-to-drinks (RTDs) -- alcopops, canned cocktails, hard seltzers – has also significantly increased. These drinks regularly contain extra or added sugar (fructose) and have been through pasteurisation, making them more dangerous to the liver. Within the beer world – specifically craft beer – there has been a parallel change in the styles we regularly drink. These days you are likely to find a large percentage of high ABV pale ales and Double IPAs alongside fruited sours and adjunct-heavy imperial stouts in bars and on supermarket shelves. It goes without saying that these beers contain high carbohydrate levels, including fructose, and cause a bigger risk to liver health when drunk regularly.

Fructose deserves a special mention here as it is only processed by the liver. From evolution it was important to help us easily store energy from seasonal fruit as fat to get us through the leaner months. Unfortunately, it also has a similar metabolic pathway to alcohol, being broken down in the liver and described as “alcohol without the buzz” as it causes inflammation and, in excess, is linked to fatty liver disease.

Although ARLD (Alcohol-related Liver Disease) is currently the biggest contributor to liver disease in the UK, data shows that NAFLD (Non-alcoholic Fatty Liver Disease) is set to overtake ARLD in the next few years. Much of this data links an increase in the consumption of highly processed foods (including RTDs), inflammatory seed oils, and obesity. It is important to note that there are links between obesity, ARLD and NAFLD and that being overweight can medically make people more prone to both.

Given this information, are there simple lifestyle changes you could make to improve your health, or negate some of the negative aspects of drinking alcohol? Are there other toxic substances we should try to avoid? We will explore this in our next blog post…