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September 1st, 2010:

Drink Hard, Live Longer

Judging by the number of times I’ve seen links to it online yesterday and today, the liveliest Web story in recent memory is an item suggesting that heavy drinkers live longer than nondrinkers. The curve isn’t linear; moderate drinkers live longer than both heavy drinkers and nondrinkers. The WTF moment lies entirely in the correlation between nondrinking and shorter lifespans.

The science looks good here: The sample size was big enough to be trustable, and the researchers controlled for a lot of factors, including socioeconomic class, physical activity, social isolation, and so on. So we can’t write it off out of hand. But what in tarnation is going on? Is a little alcohol really good for you?

I think it may be. But let’s not get completely hung up on the alcohol. I have an intuition that what we’re seeing are not the effects of the alcohol itself, but consequences of the psychology of people who won’t touch the stuff.

I’m talking about scruples. That word is generally seen as religious jargon today, so I might better characterize it as “lifestyle panic.” There is a psychology that constantly walks on eggs, fretting at a very deep level that one false move in some direction (or many, or a multitude) will lead to early death or eternal damnation. This can be an inculcated attitude (the priests of my youth tried very hard to make us panic over “impure thoughts,” and often succeeded) but I think the underlying psychology is inborn. My mother basically died of scruples, and I’ve been fighting the tendency most of my life. If I’m “soft” on sex and divine judgment, that’s certainly a big part of the reason.

The New York Times published an article about food scruples some months back, quoting a researcher who said that “…all of these women I kept meeting…were scared to death if they didn’t eat a cup of blueberries a day they would drop dead.” This is of a piece with “fat panic,” which I see all the time. That pugnacious scientific fraud Ancel Keys has convinced hundreds of millions of people that fat will kill them, when more and more science is pointing in the other direction. Fatty acids are essential. Not eating enough fat will probably kill you a lot quicker.

My thought is this: People prone to lifestyle panic are the least likely to drink–but the most likely to live lives that are cortisol thrill rides, keeping their arteries in a continuous state of inflammation. That’ll kill you fersure if it goes on long enough.

So there’s a type of selection going on here that isn’t being adequately addressed. Some people worry constantly that they’re doing the wrong thing, no matter what it is that they’re actually doing, nor how virtuous their lives objectively are. The effect seems inborn and may not be curable. I’m not sure I buy the obvious objection, which is that alcohol makes you worry less. One reason I drink very little is that when I drink I worry that drinking will disrupt my sleep or give me headaches. It sounds weird, but becoming less inhibited does not mean worrying less. (That’s certainly been the case with me.) Inhibition and worry are two different (if perhaps related) things.

Moderate drinkers are people who are not panicked enough to avoid alcohol entirely, but still careful enough to know that too much will do permanent damage. In other words, they’re fundamentally sane. If they live the longest, well, that doesn’t surprise me at all.