Monday, 19 November 2018

Teetotallers still dying too young

In April, the Lancet published one of those 'no safe level' studies about alcohol. It was garbage but it got the kind of media coverage its authors doubtless anticipated, with the Guardian declaring that ‘Drinking is as harmful as smoking’ and the BBC asserting that ‘One drink a day “can shorten life”‘. Interestingly, the BBC headline has since been changed to the more credible 'Regular excess drinking can take years off your life' but the damage has been done.

It's all part of the drip-drip campaign to erase the health benefits of alcohol consumption. Lies like this travel the world while the truth is getting its shoes on. Last week, I mentioned the article by Alexandra Freeman and David Spiegelhalter criticising a similar study that was published in August. It did not receive the same level of interest from the media as the original, to put it mildly.

Nor did the letters in Friday's Lancet criticising the April study so I will flag them up here. The trick employed in that study was fiendishly simple. The authors simply removed non-drinkers from the analysis, leaving graphs that imply no health benefits from moderate drinking...


If you put the never-drinkers and ex-drinkers in, the usual J-Curve emerges. Drinkers have to consume quite a lot of booze before their health risks exceed those of teetotallers.


I don't know why it has taken seven months for a rebuttal to this deeply misleading study be published in the Lancet, but two have now come along at once. As the first letter says:

Taking out the non-drinkers as a reference group is the only novelty in this study compared with existing scientific literature, and causes the complete elimination of the left rising arm of the J curve (as shown in the figure and in the Article's appendix, p 31). This is also not the first time a study has suggested that the mortality curve bends at a drink per day or less. By removing the non-drinkers, Wood and colleagues make it difficult to establish whether any amount of moderate alcohol consumption has a different effect to abstaining. Thus, we believe that the study has little to add to existing scientific literature and cannot contribute to public health advice.

The second letter makes a similar point...

Over the past decades, observational studies have taught us a lot about the relation between alcohol consumption and health. The effects of alcohol on health are now understood to differ depending on the amount of alcohol consumed, the age and gender of the consumer,1 and the various endpoints studied. Most studies find that individuals who abstain entirely from alcohol consumption might be worse off than moderate drinkers, and virtually none have reported a beneficial effect of abstention on mortality compared with moderate consumption.

.. By disregarding ex-drinkers and never-drinkers and the differing effects patterns of alcohol consumption had on mortality, the main message emerged that less alcohol consumption was better. A more informative message based on the findings hidden in the appendix could have been that the study added further evidence to support a beneficial effect of moderate alcohol consumption (especially wine) on mortality. The headlines might have then resembled those of just a year ago: “A glass of wine or pint of beer a day can help people to live longer, according to new research”.

The authors have replied to these criticisms but are unable to credibly defend the decision to exclude non-drinkers - who are, after all, the only relevant control group if you're going to encourage total abstinence. They don't deny that non-drinkers have higher rates of mortality than moderate drinkers, nor do they deny controlling for every conceivable confounding factors. Instead they make vague assertions about non-drinkers possibly being unhealthy for reasons nobody can think of.

...never-drinkers might differ systematically from drinkers in ways that are difficult to measure, but might be relevant to disease causation.

Well, they might. Just as heavy drinkers might be more likely to get liver cirrhosis for reasons that have nothing do with drinking, but since every alternative explanation has been studied and found wanting, we would reject this notion as desperate straw-clutching. Same rules apply.

NB. I wrote about this study at the time for Spectator Health.

Friday, 16 November 2018

Fall? Did we say fall? We meant rise!

The arse-covering has already begun at the Sheffield University Alcohol Research Group (SARG). Having bet the farm on minimum pricing reducing alcohol consumption in its first year, it's having to deal with the news that consumption has risen in the first six months.

Their worthless model made some very specific predictions about Scotland's first year under MUP:


Alas, consumption has gone up by four per cent (year on year) since the policy was implemented in May - this, against a backdrop of falling consumption over the long-term.

Sensing that the wheels could be falling off already, the Sheffield team are trying to move the goalposts...


The emerging narrative is that the rise in consumption would have been even higher if minimum pricing had not been introduced. This theory has the convenient benefit of being impossible to prove either way and it allows for even more meaningless modelling in the future.

In an interview with the Herald, Sheffield's Colin Angus said:

"A more relevant comparison is to look at alcohol consumption over the same period in England, where MUP is not currently in place.

"Alcohol sales in England rose by substantially more over the same period, suggesting that in the absence of MUP we might have seen a bigger rise in drinking in Scotland.

As tempting as it is to look for immediate impacts of the policy, this volatility means that the real test of MUP will be in how drinking in Scotland changes over the next few years."

Suddenly those predictions for the first year, which were such a big part of the campaign for this regressive policy, are being shoved down the memory hole. "Did we say alcohol consumption would fall? No, no, no! We meant to say it would rise, just a bit more slowly than in England." It's hard to believe than even the SNP would have proceeded with minimum pricing if that was the prospectus.

It's still too early to say what will happen to alcohol consumption, let alone alcohol-related deaths, in the first year. A big decline in the second half of the period is still possible. I have always said that trying to predict the effect of the policy is a fool's errand, other than to say that a shift to spirits is highly likely. But the response from SARG shows that it doesn't matter how far off the mark their predictions turn out to be, they will always find a way to claim minimum pricing 'worked'. 

And yes, it was an unusually hot summer (even in Scotland) and there was a World Cup on (which Scotland wasn't in). Both may have been factors in alcohol consumption rising, although there is an international football tournament every two years so that really should have been accounted for in the model. But we were told that minimum pricing is 'the most effective of a range of policy options' (Scottish Government) and 'a highly effective tool' (every self-proclaimed alcohol expert). It was seen as such a powerful weapon against excessive drinking that the Scottish Government went to court to defend it - and commissioned research from (you guessed it) SARG which concluded that minimum pricing was the single most effective anti-alcohol policy available.

You'd think that a game-changing policy of such potent efficacy would be able to overcome the effects of a few weeks of sunshine and a bit of football on the telly, wouldn't you? 

But apparently not. In the space of six months, the rhetoric around minimum pricing has gone from it being 'the most potent and evidence-based approach to reducing the population’s consumption of alcohol' to 'er, well, it could be worse.'

If minimum pricing continues to have so little effect on alcohol consumption, a rectally sourced regression model will be the only way to spare the campaigners' blushes. We have seen it all before with the Mexican sugar tax, plain packaging and various smoking bans. In each case, the targeted outcome either failed to decline or declined at the same rate as it usually did after the 'game-changing' intervention. And yet, thanks to opaque modelling that can never be tested or replicated, campaigners claimed success - take a look at this study by Jill Pell to see the lengths to which activist-academics go to conjure a positive finding out of nothing.

This is one of many ways in which 'public health' differs from public health. Real public health interventions deliver observable improvements in health. If rates of disease stay the same or rise after a vaccine is introduced, for example, we would rightly conclude that the vaccine doesn't work. But when the intervention works, the results are obvious and immediate. They do not require statistical models to (supposedly) filter out the other factors - though other factors undoubtedly exist. We can see the effects with our own eyes because they do what they are supposed to do. They actually work.

Wednesday, 14 November 2018

Who is to blame for junk science? Junk scientists.

Remember the junk study published earlier this year which claimed that there's no safe level of alcohol consumption? No, not that one, or that one. This one. It was reported like this...

No alcohol safe to drink, global study confirms

Bad news for those who enjoy what they think is a healthy glass of wine a day. 

A large new global study published in the Lancet has confirmed previous research which has shown that there is no safe level of alcohol consumption.

The researchers admit moderate drinking may protect against heart disease but found that the risk of cancer and other diseases outweighs these protections.

Note the use of the word 'confirms' in the headline and the implication that most previous research came to the same conclusion when, in fact, almost all research shows health benefits from moderate drinking.

The study was flim flam from start to finish. It involved no new research and instead relied on opaque modelling of crude national data. It contradicted virtually all epidemiological evidence and relied on an implausible large association between drinking and tuberculosis - which is irrelevant in most developed countries in any case - to reach its preordained conclusion. Even after all this, the findings didn't actually support the claim that there is no safe level of alcohol consumption.

Who is to blame when such fake news stories appear - the media, the journal, or the researchers? In a article published yesterday in BMC Medicine, Alexandra Freeman and David Spiegelhalter point the finger at the latter. Using the alcohol study and a study about adrenaline/brain damage as examples of poorly communicated scientific evidence, they write...

The path from research findings to media headlines is often a tortuous one, fraught with various hazards; nevertheless, in the two cases presented above, it is possible to backtrack along the decision-making pathway. Journalists were initially alerted to these two stories by press releases. The alcohol risk study press release included the sub-headline “The authors suggest there is no safe level of alcohol, on which the press chose to focus. The adrenaline study press release stated that “Using adrenaline in cardiac arrests results in less than 1% more people leaving hospital alive – but nearly doubles the survivors’ risk of severe brain damage, with journalists choosing to literally reproduce the press release. Therefore, should the press officers be held accountable? Did they misinterpret the numbers to ‘spin’ the story? No – the press releases actually quoted the researchers verbatim, with the authors’ own interpretations of the numbers being reported.

These two examples illustrate a seemingly continuing pattern, wherein journalists’ reports are fairly accurately reproduced from the press releases they are given and press officers work hard to clearly and accurately represent their authors’ views. Therefore, much of the responsibility lies with the researchers themselves, perhaps feeling under pressure to maximise the ‘publishability’ of studies.

I'm not sure the alcohol study was about 'publishability'. It was no coincidence that it was published in the most political medical journal (the Lancet) a few weeks before the big WHO conference on non-communicable diseases in New York. In the growing war on alcohol, it is important for the 'public health' lobby to erase the health benefits of alcohol. That can only be done with junk science and it will continue.

Tuesday, 13 November 2018

Action on Milkshakes

Freakshakes
Action on Sugar's shtick is reading the labels on food and drink to see how much sugar is in them and then slapping the figures - always in 'teaspoons' - on a press release with some outraged quotes about how 'shocking' it is. They have been doing this for several years but the media still lap it up.

This week it's the turn of milkshakes. Milkshakes generally consist of around 10 per cent sugar, so a 400ml serving will have about 40 grams of sugar. They tend to have around 60-70 calories per 100ml. They're obviously not a health food but they are very tasty.

Public Health England, in its madness, wants to cap calories in milkshakes to 300 per serving. It is Action on Sugar's job to make Public Health England seem relatively reasonable. To that end, they are calling for it to be a crime to sell a milkshake with more calories than this.

In its early days, Action on Sugar only counted added sugar (AKA extrinsic sugar). In that context it made sense to talk about teaspoons. It also had some relevance to the government's sugar guidelines which, arbitrary and unjustifiable though they are, relate to added sugar, not the sugar that occurs naturally in the product (intrinsic sugar).

Those days are over - and it makes a big difference. Plain old semi-skimmed milk is 5 per cent sugar and has 50 calories per 100ml. In other words, the intrinsic sugar (lactose) is responsible for most of the sugar in a milkshake and the milk is responsible for most of the calories. Grams of lactose are in no sense 'teaspoons' and they do not count towards your daily sugar 'limit'.

Ignoring this entirely, Action on Sugar put out a press release yesterday saying:

CALL FOR BAN ON EXCESSIVELY HIGH SUGAR AND CALORIE MILKSHAKES SOLD IN HIGH STREET RESTAURANTS & FAST FOOD CHAINS

Milkshakes sold across high street restaurants and fast food chains contain grotesque levels of sugar and calories, warns NEW survey by Action on Sugar

Some have a shocking 39 teaspoons of sugar – over 6 TIMES the recommended daily amount of sugar for a 7- to 10-year-old

At the top of their list, with 39 'teaspoons' of sugar is the Toby Carvery Unicorn Freakshake. Freakshakes were pretty much invented to annoy the kind of people who would set up a group called Action on Sugar, but they are desserts, not milkshakes. That's why they are on the dessert menu and come with a spoon. Two of the other villainous milkshakes in their top 6 are also freakshakes. The other three are patently indulgent drinks from Five Guys and Pizza Hut. It would be unwise for the average person to consume any of these everyday, and nobody does.

Of the milkshakes available in supermarkets, only one exceeds Public Health England's calorie limit - and only just, with 304 calories. Faced with this disappointing result, Action on Sugar resort to complaining that '90% of the 41 products surveyed (sic) would receive a 'red' (high) label for excessive levels of sugar per serving as sold'. Well, d'uh. They're milkshakes.

The press release contains a quote from Holly Gabriel, a nutritionist, who does a good impression of a finger-wagging scold who should mind her own business:

“It is unnecessary and unacceptable to sell milkshakes with over half an adult’s daily calorie needs in a single serving. There should be a limit of 300kcal per serving on these drinks."

Unnecessary? Unacceptable? In a free society, that is surely for the individual to decide.

Equally outraged is Linda Greenwall from the Dental Wellness Trust...

"These findings are remarkable, especially given tooth decay among children in Britain is now at a record high, largely because food and drink products are packed with unnecessary sugar."

Given that Linda is a dentist working for a dental charity it is hard to believe that she is ignorant of the fact that tooth decay among children in Britain is at a record low...

The Office for National Statistics has run the Children’s Dental Health Survey since 1983 and the figures are striking. The number of 12-year-olds who exhibited clear signs of tooth decay fell from 81 per cent in 1983 to 28 per cent in 2013. One in three kids of this age had a cavity in 1983 but by 2013 this had fallen to one in nine. 

Perhaps she is deliberately lying? Why would she do that?

And there's that word 'unnecessary' again. Unnecessary to what? Not unnecessary to flavour, clearly. Sugar costs money. Restaurants wouldn't use it unless it improved the taste.

Look, we know that milkshakes are unnecessary to sustain life. Added sugar is unnecessary, technically speaking, but so is alcohol, sausage rolls, vape juice and the latest remastered version of the White Album but I'm going to keep buying them anyway because I like them. Whether you think they are unnecessary - or, heaven forfend, unacceptable - is of no account and the government should not be banning things because they are 'unnecessary', nor because they exceed a recommended quantity of some ingredient or other. The clue is in the word 'recommended'.

As always, the only response to this hand-wringing wowserism is that if you don't like these products - or if you don't want your children consuming them - then don't buy them.

UPDATE

I was on the telly this morning talking about this. There are some clips below...




Monday, 12 November 2018

Alcohol sales up four per cent since minimum pricing

Six months after the introduction of minimum pricing in Scotland, data emerges in dribs and drabs. We'll have to wait for at least a year for official data on alcohol-related deaths, although we may get some modelled estimates and propaganda from the 'public health' lobby before then.

In the meantime, various sales figures have been released. So far, my prediction of a big fall in strong cider sales combined with a rise in spirits sales seems to have been borne out (not that this was hard to predict).

White cider sales are indeed down...

Sales of super-strength Frosty Jack’s cider have plummeted by 70 per cent in Scotland since minimum booze pricing came in, a report reveals.

The Retail Data Partnership found the sales value for the tipple, which contains 22.5 units per three-litre bottle, fell from £148,605 between May and September 2017 to £46,289 in the same period this year.

But the Retail Data Partnership also found that overall alcohol sales in the convenience sector rose by 14.9 per cent between May and July compared to the previous period in 2017. They confirm that 'gin sales leaped hugely', as was first reported in October:

Brian Eagle-Brown of The Retail Data Partnership (TRDP) gave an overview of convenience performance in recent months, noting that alcohol sales were up “across the board” since the implementation of MUP.


“What was unexpected is that the result of minimum pricing is not declining, but actually increasing alcohol sales. Gin sales are up 90% year on year,” he said.

It was recently reported that Scots are drinking an extra two million bottles of wine since MUP was implemented. As for Scotland's best selling beer...

Tennent’s owner C&C Group said Scotland’s best-selling lager brand had traded well since the introduction of minimum unit pricing north of the Border.... During the six months to the end of August, Tennent’s volumes were up by 1 per cent in the off-trade...

And there's then Scotland's most notorious tipple, the caffeinated wine Buckfast AKA wreck-the-hoose-juice...

Scots are glugging an extra 3,600 bottles of Buckfast a day in the wake of minimum pricing. Sales of ‘Bucky’ have soared since the SNP’s crackdown on cheap alcohol, with Scots drinkers turning to the potent tonic wine.

Nats introduced minimum unit pricing in May and sales of Buckfast have since risen by £5.3million to £36.5million.

It should be noted that both Tennent's and Buckfast cost more than 50p a unit before minimum pricing was introduced. It is not surprising that semi-premium drinks priced just above 50p have benefited from MUP (indeed, the makers of Tennent's actively lobbied for the policy). More interesting is the impact on the total market. So far, volumes are up...

Scots spent 11 per cent more on drink, and consumed four per cent more, than in the same 24 weeks last year.

I don't remember a rise in alcohol sales being in the model. Do you?

Friday, 9 November 2018

Scrooge's victory

Killjoys hate Christmas. Nobody is in the mood to listen to their whining during the festive season and so they go to ground and prepare their (dry) January media assault. But it's not Christmas yet and November is the time for bitching about the Coca-Cola truck. This is a relatively recent tradition dating back to 2015 when the disgraced MP and sweet shop proprietor Keith Vaz told Coke not to come to Leicester.

Last year, attention switched to Liverpool where Councillor Richard Kemp, a miserable bastard from an obscure political party, called for the truck to be banned, citing the fictional childhood obesity epidemic as justification. His campaign was supported by Public Health England's chief fat cat, Duncan Selbie as well as Simon 'caps lock' Capewell and several local 'public health' groups including Food Active and the Health Equalities Group.

The Coca-Cola truck tour schedule for 2018 was published this week and Liverpool isn't on the list. Naturally, some the worst people in the country are celebrating this as a campaign win.



The tweet below nicely captures the snobbery of the 'public health' racket and the appetite for banning anything that doesn't personally appeal to them.


Coca-Cola say that last year's campaign has nothing to do with Liverpool being left out this time. They say they change the route every year. This may be true. Who knows? But as far as the likes of Food Active are concerned, they found something that gives a lot of people a little bit of joy and stamped it out. It must be very satisfying for them.

Regular readers will not be surprised to hear that Food Active is a taxpayer-funded pressure group, albeit a rather strange one. It is one of a network of interchangeable nanny state groups set up by Heart of Mersey, including Give Up Loving Pop (GULP), Healthy Stadia and HoM Partnerships. Heart of Mersey's trading name is the Health Equalities Group. I was looking at their accounts recently. They make for interesting reading.

Heart of Mersey is, as it states in its accounts, ‘primarily an advocacy organisation’. It has four trustees, one of whom is the aforementioned Simon Capewell. Its official charitable objective is to tackle cardiovascular disease but it puts most of its efforts into clamping down on e-cigarettes and fizzy drinks.

In 2016/17 Heart of Mersey had an income of £63,088 but it spent £239,974, of which £166,632 went on staff costs. Not bad going for an organisation that only employs two people.

It has been spending much more than it pulls in for years. Between 2013 and 2017, it had an income of £1,770,555 but spent £2,471,081 - a £700,526 overspend. But it could afford it. Heart of Mersey used to get grants from the NHS and by the time these dried up in 2012 they had £853,506 in the bank. They have been ploughing through this pot of cash ever since. Its (dwindling) income has mainly come from local authorities.

But the party is nearly over. By 2016/17 the bank reserves had fallen to £9,285. In 2017/18, Heart of Mersey spent £22,000 from an income of £15,000. It is now so small that it doesn't need to file accounts with the Charity Commission, but it doesn't take Carol Vorderman to work out that the money has all gone. Unless they attract some serious money soon they won't be able to pay the rent.

In its last (ever?) set of accounts, Heart of Mersey say:

These are clearly very challenging economic times for charities whose main commissioners are traditionally within the public sector. This has been reflected in our reduced income.

With judicious use of the charity's reserves, built up over its eleven year history, Heart of Mersey is able to continue its heart health activities.

Its not clear how the charity managed to save up so much money, nor why the money was not spent on its intended purpose at the time. So far as one can tell, Heart of Mersey has always been overwhelmingly funded by the taxpayer. For the last six years it has been burning through what is essentially a slush fund for handsomely remunerated northwest nanny statists.

It could be time to say farewell to Heart of Mersey/the Health Equalities Group. Half its trustees have quit in the last two years and it's old secretary, the disagreeable vape-hating Robin Ireland, has scuttled off to Glasgow to do a PhD.

But its network of front groups lives on. Food Active is still getting money from local authorities, some of which is used to fund the ludicrous GULP. Healthy Stadia, which is principally focused on banning vaping in outdoors sports grounds, is still getting money from the European Commission.

The sockpuppet state is a many headed beast.

PS. You might be interested to learn that another hectoring charity, the National Obesity Forum, no longer exists. In its last year as a going concern, it raised a grand total of £10. This is a shame for Tam Fry who I also found to be a sincere, if misguided, gentleman. But that's what happens when you let Aseem Malhotra and his reverse Midas touch near your operation.

Wednesday, 7 November 2018

Slippery slope: Meat tax edition

I told you this would happen...

Taxing red meat would save many lives and raise billions to pay for healthcare, according to new research. It found the cost of processed meat such as bacon and sausages would double if the harm they cause to people’s health was taken into account.

It is a modelling study (of course) involving Marco Springmann and our old friend Mike Rayner. The estimates of risk and mortality used are ridiculously high and the levels of tax they recommend are politically impossible for the time being. I was pleased to see the Chief Secretary to the Treasury give it short shrift...


But it's early days. What happens next is that a load of money goes into this field of research, more and more modelling studies are produced with each suggesting greater benefits than the last. Eventually, the evidence becomes 'overwhelming' and a future government, under pressure from environmentalists, vegans and 'public health', puts the idea out to public consultation. It dithers for a while but eventually introduce a tax at a rate of 10 or 20 per cent after pressure groups accuse it of being in the pocket of Big Pork.

I've written about this for the Spectator...

Leaving aside the garbage-in, garbage-out methodology at the root of these numbers, it seems unlikely that a British government – even one that bans plastic straws and taxes fizzy drinks – will introduce a 78 per cent tax on processed meat any time soon, although that is what the authors recommend. It is even less likely that everybody in the world will go vegan, although that is what the lead author, Marco Springmann, told delegates needed to happen at the End of Meat conference last year.

And yet every nanny state policy sounds absurd until the public have been battered with soundbites, dodgy statistics and empty promises for a few years. Nobody who has witnessed the unstoppable rise of the ‘public health’ movement over the last two decades can dismiss the possibility of a meat tax being introduced in the foreseeable future, probably followed by an advertising ban and graphic warnings.

Do have a read.