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How much is too much? A methodological investigation of the literature on alcohol consumption

Author

Listed:
  • Stefano Castriota
  • Paolo Frumento
  • Francesco Suppressa

Abstract

Until a few years ago, moderate alcohol consumption was thought to have (mild) beneficial effects on health. However, some recent studies have suggested that "there is no safe level" of alcohol intake. Consequently, public health institutions have responded by advising against any level of alcohol use and suggesting governments a number of policies to reduce the overall alcohol consumption. Nonetheless, medical studies suffer from a variety of methodological issues that could undermine the reliability of the findings, especially when focusing on low-intake levels. We apply a search algorithm to extract 19,981 Confidence Intervals (CIs) from 6,763 medical abstracts, and show the existence of a clear publication bias which appears to have even increased and not decreased, in recent years. Further, we assess the quality of a sample of articles, showing the presence of several limitations such as omitted variable bias, miscalculation of alcohol intake, use of linear in place of non-linear models, and lack of validation of Mendelian Randomization (MR) assumptions. We conclude that the methodological limitations of the literature preclude us from claiming that "there is no safe level" of alcohol intake.

Suggested Citation

  • Stefano Castriota & Paolo Frumento & Francesco Suppressa, 2023. "How much is too much? A methodological investigation of the literature on alcohol consumption," Discussion Papers 2023/297, Dipartimento di Economia e Management (DEM), University of Pisa, Pisa, Italy.
    • Handle: RePEc:pie:dsedps:2023/297
    Note: ISSN 2039-1854
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    File URL: https://www.ec.unipi.it/documents/Ricerca/papers/2023-297.pdf
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    References listed on IDEAS

    as
    1. Erik W. van Zwet & Eric A. Cator, 2021. "The significance filter, the winner's curse and the need to shrink," Statistica Neerlandica, Netherlands Society for Statistics and Operations Research, vol. 75(4), pages 437-452, November.
    2. Shiu Lun Au Yeung & Chaoqiang Jiang & Kar Keung Cheng & Benjamin J Cowling & Bin Liu & Weisen Zhang & Tai Hing Lam & Gabriel M Leung & C Mary Schooling, 2013. "Moderate Alcohol Use and Cardiovascular Disease from Mendelian Randomization," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-9, July.
    3. Yon Ho Jee & Sun Ju Lee & Keum Ji Jung & Sun Ha Jee, 2016. "Alcohol Intake and Serum Glucose Levels from the Perspective of a Mendelian Randomization Design: The KCPS-II Biobank," PLOS ONE, Public Library of Science, vol. 11(9), pages 1-9, September.
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    More about this item

    Keywords

    Alcohol; health; safe level; publication bias; statistical bias;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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