Studies like this are so contrary to 'public health' dogma that it's amazing that they get published at all these days. But every now and then someone has the balls to do it.
Impact of Alcohol Intake on Parkinson's Disease Risk and Progression: A Systematic Review and Dose–Response Meta-Analysis of Prospective Studies
Spoiler: it's good news for drinkers. And although the title of the systematic review doesn't mention them, it's even better news for smokers.
One reason why smoking isn't in the title may be that the protective effect of smoking really isn't in any doubt. As a 2024 study said: "The link between smoking and a lower risk of Parkinson's disease (PD) is
one of the strongest environmental or lifestyle associations in
neuroepidemiology." The only question is about the biological mechanism (it doesn't seem to be nicotine).
The new study is equally unequivocal...
The association between alcohol consumption and Parkinson's disease (PD) risk remains unclear, whereas smoking has an inverse relationship with the disease.
The authors looked at the entire scientific literature on alcohol and PD and found that...
Using abstainers as the reference group, a pooled analysis showed a significant inverse association between total alcohol consumption and PD risk (RR = −0.45, 95% CI −0.58 to −0.32, I2 = 50%, P = 0.739).
That's a 55% reduction in risk, but don't drink too little because...
Sääksjärvi et al. reported that light drinkers (<5 g/day) had an increased PD risk compared with non-drinkers (RR 1.81, 95% CI 1.12–2.93), indicating that former or low-level alcohol intake may not offer protection, or that early disease symptoms lead to reduced alcohol consumption.
Unsurprisingly, Mendelian Randomisation has been used a couple of times in the hope of erasing these findings. Those two studies found "inconsistent results" (surprise, surprise) but one of them found a protective effect from genetically-predicted alcohol consumption and both of them found a protective effect from genetically-predicted smoking.
So far these results are most satisfactory.
Compared with non-drinkers, protective associations were observed in both men and women across all consumption levels.
Happy days. And it gets better...
Using non-drinkers as a reference, the lowest risk was found among ever-smokers who drank alcohol (LRR = −0.37, 95% CI −0.54 to −0.20), suggesting an additive protective effect.
...Although the inverse association between smoking and PD risk is well established, few previous meta-analyses have assessed the combined or interactive effects of alcohol consumption and smoking. In contrast, our review included two prospective cohort studies that evaluated joint exposure. Both studies consistently reported the lowest PD risk among participants who both drank alcohol and smoked, suggesting a potential additive or synergistic effect of these habits.
So if you want to avoid Parkinson's Disease, smoking will help enormously but you'll also want to drink alcohol, and plenty of it.
That, surprisingly, is not the authors' conclusion.
Neither alcohol consumption nor smoking can be recommended for PD prevention because of their established overall health risks.
But that's just their opinion.
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