When the National Institute on Alcohol Abuse and Alcoholism (NIAAA) received a grant from the National Institutes of Health (NIH) to do an extensive study on the effects of moderate alcohol consumption and heart disease, that sounded like a smart idea. After all, we've all read studies hinting at the health benefits of moderate drinking. The new study, which launched in January, was intended to dig deeper than previous studies. For six years, half of the 7,800 participants in several countries wouldn't drink at all, and the other half would drink one alcoholic beverage a day for the duration.
The goal was to answer a simple question: Can drinking one alcoholic beverage a day be heart-healthy?
But how the study was funded is coming under scrutiny, and it raises questions about when and how industry officials can be involved in government-funded studies.
Those are just some of the issues raised by an investigative story in The New York Times, which questions the validity of a current government trial that's being funded by the NIH and five of the world's largest alcohol producers: Anheuser-Busch InBev, Heineken, Diageo, Pernod Ricard and Carlsberg. The five companies contributed $67.7 million of the study's $100 million funding.
The NYT article goes into depth about how Dr. Kenneth J. Mukamal, an associate professor of medicine at Harvard Medical School, and Dr. John Krystal, a Yale University neuroscientist (who is now the lead investigator of the study), told the industry representatives at working lunches and meetings with trade groups that a "long-term randomized controlled trial could dispel lingering doubts about the benefits of moderate daily drinking."
In response, the NIH is now doing an investigation of its own, looking into how (and if) NIH officials solicited the beverage companies' involvement, according to Science magazine:
The newspaper described emails, other documents, and interviews indicating that two NIAAA officials met with alcohol industry executives in late 2013 and early 2014 to urge them to support the study, with one noting that it probably would not happen otherwise. That appears to violate a policy prohibiting employees from soliciting contributions to NIH.
Looking for a particular outcome from research isn't uncommon with industry-backed studies. When the sugar industry supported studies in the 1960s, they paid scientists to say the studies found that sugar was not linked to health issues like heart disease; they also had scientists shift the blame for negative outcomes to fat.
Not all industry-backed studies are dishonest, but when an industry helps fund a study, it raises questions about bias.
In the case of this current alcohol study, Krystal showed a slide during a meeting with alcohol industry representatives that said, "A definitive clinical trial represents a unique opportunity to show that moderate alcohol consumption is safe and lowers risk of common diseases. That level of evidence is necessary if alcohol is to be recommended as part of a healthy diet." That wording makes it seem there was a bias before the study even began.
These meetings took place before the researchers applied for the NIH funding grant, so the researchers believe they did nothing wrong as far as NIH rules go. After the investigative article was published, the NIH said it would "examine whether health officials violated federal policy against soliciting donations when they met with alcohol companies to discuss funding a study of the benefits of moderate drinking," according to a separate piece in The New York Times that ran a few days after the original article.
Research or marketing?
There's some question as to whether this type of study is public health research or if it's marketing.
In order to qualify to participate in the research, subjects can't have a "history of addiction, psychiatric, liver, or kidney problems, certain cancers or a family history of breast cancer." Those are the people who may be at risk of complications from drinking, so the results will only be relevant to those without those issues. But, if the results are reported as "moderate drinking is part of a healthy diet," the public may not understand the exemptions. And, those who drink might be more likely to be attracted to headlines that tout alcohol's health benefits.
Whether the outcome of this study is unbiased or not, the conditions of the study could help answer the big question about the potential health benefits of moderate drinking. There has never been a study this detailed and asked people to drink every day.
The studies about alcohol that we tend to get excited about — those that find that red wine may aid in weight loss or beer may be good for your brain — have not been long-term studies and may not have even included human subjects. The study that showed red wine might help with weight loss wasn't tested on people, for example. When positive results such as these are reported, it's never the alcohol in the wine, beer or spirit that brings about the good results. For the weight loss study, the positive results were due to a beneficial compound called ellagic acid, an antioxidant found in wine grapes, but also found in many other fruits and vegetables.
So if and when the results of the NIH-funded study are released, and they say that moderate alcohol consumption is hearth-healthy, it would be wise to put those results in perspective. In fact, it's smart to put the results of all studies about alcohol into perspective. It's good to fully understand a study that says beer may be good for your bones and what that really means. Remember, moderation is one, maybe two beers at the most. Ordering a third pint and saying, "I'm doing it for my bone health," is just an excuse to have a third beer.