← Harvard Data Science Review Podcast
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- [00:02]
Liberty Vittert
Hello and welcome to the Harvard Data Science Review podcast. I'm Liberty Vittert, the feature editor of the Harvard Data Science Review, and joining me is my co host and editor in chief, Shali Mack. Last month, to celebrate HDSR's fifth anniversary, we hosted a symposium centered around wine, featuring leading experts from around the globe. The talks were so engaging that we decided to share some of the celebration with you at home. Today we are joined by our estate esteemed guest, Laura Catena, Managing Director and Catena Institute of Wine founder and board member. She is a fourth generation Argentine vintner of Catena Zapata, physician and author. We're also joined by Ahmed, talkal, Director in Cardiology at Mass General Hospital. We'll explore the health benefits and potential drawbacks of wine, discuss how alcohol related research is conducted, and learn about the future of wine research. For all of this and more, stay tuned for this month's episode of the Harvard Data Science Review podcast.
- [01:05]
Shali Mack
Well, thank you, Laura and Ahmet for joining us. And I first want to thank both of you for attending the vine to Mind symposium and for your great conversation there and about the wine in the house. And today we will have the opportunity to bring the conversation to the broad audience and the readership of Harvard Data Science Review. I want to start with a question I think most listeners might be interested in. You know, Laura, knowing you are the fourth generation of the winemaker, people must be curious a little bit about that. You also study medicine and both of you actually met at Stanford. And Ahmed, people will be asking your medical doctor, how do you end up doing research on wine and alcohol? So the question goes to both of you. Maybe Laura, you go first.
- [01:52]
Laura Catena
Yeah, so I actually studied biology at Harvard and when I was there I thought, okay, I want to do something sciency, but I don't really like the lab like Ahmed does. I need to be outside with people. And so I thought, okay, medicine, that's perfect. And actually my father was very upset when I told him because apparently he thought I was going to work with him in the winery, which at that point I had no intention.
- [02:16]
Shali Mack
I see.
- [02:17]
Laura Catena
Because I wanted to help people and I didn't know how I would help people with wine. And then I practiced emergency medicine for 27 years and also ran the winery for the last 20 or so. And today I'm pretty convinced that if you promote wine in moderation and take good care of the land and of your staff, that you can make a good impact on people's happiness through wine, especially when you're emphasizing the moderation part.
- [02:45]
Shali Mack
Thank you, Hamid.
- [02:47]
Ahmed Talkal
So I've been long interested in what is healthy for the cardiovascular system in the arteries, for example, and wasn't really focused on alcohol and haven't been actually over my research years. But I'll tell you two vignettes. When I was a cardiology fellow, my training years in cardiology, I did get intrigued by the information around alcohol and a reduction in cardiovascular disease when alcohol is taken in moderation. And we actually did a study back in the day where we injected alcohol directly into the forearms of people, into their arteries at a level that would be consistent with people having a blood alcohol level after drinking one or two drinks. And we wanted to test the hypothesis that that would lead to an improvement in blood vessel function. Well, we found that it reduced the resistance to flow, but it didn't act in a way that we thought it wasn't through the improvement in blood vessel function in the way that we were expecting. So we published that finding in 2004. And I didn't think much about studying alcohol again until just maybe four or five years ago.
- [03:58]
Liberty Vittert
You talk about a study you did a long time ago, but you also did a study last year. There was a very popular study, actually reported on it, that talked about how sort of cardiovascular risk in relation to stress and alcohol. So would you mind telling our listeners sort of about your study and what its findings were?
- [04:17]
Ahmed Talkal
Well, you know, there was a 20 year gap between that first study where we looked at alcohol and all the other studies that we did studying cardiovascular disease and arterial health. And more and more we were focused on brain, heart connections, how the brain can impact cardiovascular disease, and in particular, how stress and depression really lead to an increase in adverse changes down the stream in terms of the pathophysiology that triggers the development of heart disease. One of the things that we started looking at, in addition to just looking at the pure biology, is what kinds of interventions can perturb that. And of course, we were interested in stress reduction techniques. We were interested in studying the effect of exercise and couldn't help but notice that there were MRI studies to show that alcohol reduces the activity within the part of the brain that leads to a lot of these downstream adverse things, the amygdala. So acutely alcohol reduces amygdala activity, and we thought that was intriguing. At that point, I became interested in further evaluating could alcohol, taken in light to moderate amounts, reduce that adverse amygdala activity in a way that can reduce cardiovascular disease events? And that's what got us that study that you're referring to that came out in 2023. That study was one where we started off looking at 53,000 patients who were parts of the Mass General Brigham Biobanks. They were participants, and they gave detailed information about their lifestyle. And also in many of those patients, we had genetic data and we had decades worth of outcome data on these individuals. In addition to lots of advanced imaging. That's when things got really interesting. Using those data, we saw that people who drank light to moderate alcohol, first of all had a reduction in cardiovascular disease events. It was a substantial reduction, and it withstood a lot of additional adjustments, so we were able to account for lifestyle. These are things that are not often accounted for in the larger studies. For example, larger studies would say, well, we see a reduction in cardiovascular disease events, but is that simply because people who are drinking wine in moderation are also exercising more or sleeping better or what have you? We had those data and we were able to adjust for that. We also adjusted for the overall health of the individuals coming in because we had lots of data on multiple different diseases that they could have had at the time that they entered the study and provided their information. And we also had genetics, so we can adjust for their genes of certain things. And when we looked at all of these in context, we still found that light to moderate alcohol associates with a reduction and cardiovascular disease events. But before we raise our drinks and celebrate, we also saw an increase in cancer risk. So I'm not saying that the light to moderate alcohol is healthy. It has health effects that are apparently beneficial, but also health effects that are concerning with regards to the cancer. Yet we still were interested in asking, if alcohol reduces cardiovascular disease, could it act through the brain? That's where we saw some really interesting data. We found that using PET imaging of the brain, we can study the metabolism in the amygdala, for example. And there we found that amygdala activity relative to cortical activity came down nicely with light to moderate alcohol intake. And we found that a substantial fraction of the reduction in cardiovascular disease events could be explained by those changes in the brain. We then said, okay, if alcohol is acting through the brain by reducing the stress signals in the brain, could it be more effective in reducing heart disease if people are stressed? We simply compared the impact of alcohol among individuals who didn't have a history of stress versus individuals who had a history of anxiety. We found that alcohol was actually twice as effective at reducing heart disease among individuals with a history of anxiety, which gives us a little more confidence that alcohol may be acting through the stress portions of the brain by reducing the stress signals, which in turn reduces some of the adverse downstream effects.
- [08:38]
Shali Mack
You know, there have been so many opinions and medias about alcohol consumption, right. From those who think some moderate consumption is good for us to those think that any level is bad for you. I think there's increasingly this kind of rhetoric out there. So it's great to hear from you from a really a medical perspective with data, to talk about the pros and cons about drinking wine. Laura, I want to ask you about, you know, why, from your perspective, both as a doctor and as a winemaker, why there's so much debate about a wine and a house and what is your take on it?
- [09:15]
Laura Catena
Yes, yes. This is such an important question. And there has been a lot of media recently, maybe the last year or two, covering predominantly negative aspects and really not covering anything positive other than maybe Ahmed's article. And I wanted to emphasize one thing about Ahmed's article, is that these people that were getting the PET scans, they weren't at that moment drinking. You know, Ahmed, can you clarify that? Because I thought that was so interesting.
- [09:44]
Ahmed Talkal
When you told me so the data are obtained after a person has been fasting. So, you know, there is no effect of alcohol that is acute. It's really the chronic activity that we're looking at.
- [09:57]
Laura Catena
Yeah, and I think that's a really good point, that what's beneficial is this kind of every other day, every day having a little glass of wine with dinner, maybe right after dinner. And that is what is good for you. So the reason, I think, for a lot of the debate is that people have been noticing this cancer data, and definitely for moderate drinking, which is defined in the United States as one unit per day for women and two units per day for men. And the units, maybe you can put it in the notes, but it's basically 5 ounces of wine, 12% alcohol, 1.5 ounces of spirits, and 12 ounces of beer, 5%. If you are drinking in those dosages, the potential cancer risks are small. There's some increase, slight increase in breast cancer, oral, esophageal, and this is in big observational diet studies. There's also some decreases in some cancers like renal, thyroid, non Hodgkin's lymphoma that were noted in these observational studies. But what this shows is that if you drink in moderation, it's kind of a toss up. You might have some slight increase in some of these cancer risks, but you might have some benefits in the cardiovascular side, which is in general, a bigger killer. So, you know, my personal view on my own consumption is that it's still maybe a little bit positive. But as a doctor, I mostly tell people, listen, if you drink in moderation, one glass per day, if you're a man, two glasses per day, it's probably pretty safe, unless you're, you know, mostly interested in cancer. And then you should really talk to your doctor about this. Now, why all this debate and all these articles? I think that there's health officials, like maybe the who, that is proposing this no safe limit, that are concerned about countries where there's a lot of binge drinking going on. So if you look at a country like Argentina, where I'm from, or Italy or Spain, people are used to drinking in moderation every day as part of the Mediterranean diet. There's really good data from the Mediterranean diet that consuming alcohol is pretty safe. In fact, it's even safe for cancer when you look at it within the Mediterranean diet. But now, if you're drinking, you know, that allocated one whole bottle because, you know, the seven drinks a week are about a bottle of wine or maybe a little over a bottle for a woman. If you're having all that in one seating, that is called binge drinking. So binge drinking is 4 units per day for woman, 5 units per day for a man. If you're doing that, what's happening is that the acetaldehyde, which is the breakdown product of alcohol sticking around, and that's where you get some of these cancer risks, and you're not necessarily getting the cardiovascular benefits, because probably these are related to alcohol acting as a blood thinner. So I think what's happening is that health officials are saying, hey, let's stop talking about there being any benefits for alcohol because we want to prevent binge drinking, we want to prevent accidents, we want to prevent alcoholism, and it's better to give a simple message. And public health people always love simple messages, like the cigarette message. But you know what? Alcohol is not like cigarettes. Cigarettes are bad at the first cigarettes. And, you know, from what Ahmed has said, and even considering the cancer data, I think that there's enough evidence that moderate drinking is at least neutral.
- [13:32]
Shali Mack
Thank you. I really love the way you explained. You know, you need to separate these different kinds of considerations. But since this is a data science podcast, I hope both of you don't mind, I'm going to push a little bit harder in terms of what we actually really seeing from the data. Laura, you mentioned about, you know, this definition of the drinking is the Variety of drinks, right? There's a, there's a spritz, there's, you know, beers, there's, you know, they all have alcohols. But this is for me as an amateur, you know, I love wine myself, but. And I don't like a spritz because it gives me headache. But the question is, like, when we talk about these risk effect, does it really matter to talk about what kind of alcohol or is just alcohol in general? Because, for example, I've heard people talk about maybe Emma, you a doctor, you can tell us if that's correct, that, you know, red wine is, has some benefit and white wine doesn't. Is that true? If that's more.
- [14:29]
Ahmed Talkal
It doesn't seem to be true to the best of my knowledge. It seems like it's an effect of alcohol per se.
- [14:35]
Shali Mack
I see.
- [14:36]
Ahmed Talkal
And not the type of alcohol. But what I would add too is since we were talking about the relative health effects, on one hand we see a reduction in cardiovascular disease events. And so these are hard events, but there are some increases in some cardiac complications too, some arrhythmias, atrial fibrillation. Risk goes up a little bit, especially at higher amounts of alcohol. And the other thing that I could say is when we look even in our biobank sample of roughly 50,000 patients that we studied, we found that the relative reduction in cardiovascular disease events overall was matched by a similar increased risk in cancer. So it was a very similar reduction and increase. I wouldn't therefore then claim that alcohol is healthy. The direction that we took with our study was simply to ask if there is a selective relative benefit in one disease, what's the mechanism? And that took us down the reduction in stress related biology. And that's how we pursued that relative angle. And then the other thing that I would add about alcohol, the cautionary part, is when the alcohol consumption goes up. Also I worry not only about cancer and heart disease, because heart disease then goes back up. There's a J shaped or U shaped association between the amount of alcohol and the risk for cardiovascular disease. After that dip, it goes back up. The other thing that I worry about is the impact on the brain. So excessive alcohol has adverse impacts on the brain, increased cancer risk and heart disease risks. And at lower doses, you have that risk of cancer as well. So you need to consider alcohol in your overall health context. You should really focus on moderation. And what I tell my patients when they ask me this is don't drink alcohol for health benefits. You can choose other ways you can exercise and impact your brain in that very nice way that reduces stress related neurobiology. But consider the other illnesses that you may have. For example, if you already have arrhythmias or heart failure or certainly cancer, then the risks of alcohol then climb further. So I just want to nuance that discussion around recognizing that you really do need to consider some of these other aspects of alcohol. And then when we talk about how much alcohol, I do have concerns about even going above seven drinks. So I know the current American guidelines say one to seven for women, then up to 14 drinks a week for men. But when I look at the data, especially on the brain, of greater than 7 for men or women, the signals aren't very attractive. And so I would say if you're thinking in the long term, do consider cutting it to the lower end of those guidelines when you're looking at your own personal health equations.
- [17:40]
Laura Catena
Yeah, I think that Ahmed has summarized it so well in that it's very nuanced. I just want to add one point in terms of me being a woman and being at higher risk of breast cancer, that every year about 400,000 women die of cardiovascular causes in the US and about 45,000 die of breast cancer. So I think that that's where you need to go to your doctor and look at what your risk factors are and make your best decision. And I think that to continue on Xiaoli's previous question, why are so many people concerned? It's that when somebody says to you, oh, this might be good for your health, you tend to think that a little more is not going to harm you. Whereas with alcohol, like Ahmet said, just a little more can really put you in that area of significant harm. So although it might be safe to consume one glass of wine per day if you follow the guidelines for men too, Ahmed is putting some question to that. And I would agree with him that there are some questions about that in the literature about whether two glasses are safe. You really want to think of your overall lifestyle. How healthy are you eating? Are you following the Mediterranean diet? What is your weight? There's so many other factors. And it's important to realize that if you drink in moderation, but then one day a week you're having a whole bottle of wine by yourself, then most of these positives are gone and now you're entering the negatives.
- [19:10]
Ahmed Talkal
I do like the fact that you've combined it with lifestyle. That's a really interesting point. For example, when I think about the adverse impacts that could happen on the brain, there's a reduction in the limbic system. And at the higher doses of alcohol, there's an impact on the cortex. So the amygdala is in the limbic system and you want the amygdala to be relatively quiet because when the amygdala is too active, then you become alerted and alarmed by little things and your body starts to produce too much adrenaline and you start to be systemically inflamed as a result. So quieting down that response is great. Alcohol does that to a certain degree, but at a higher dose it then starts to quiet down other parts of the brain. So how does this become something that I then link to lifestyle? Well, think of exercise. Exercise actually does something different. Exercise doesn't have much of an impact on the limbic system, but it drives up the cortex. So if a person is drinking alcohol, I would advise them to double down on exercise because it will actually blunt, potentially, theoretically blunt, some of the adverse impacts of alcohol on the brain. And in no case should they think that they can drink excessively and have anything that's going to blunt adverse effects. But even at what's considered reasonable amounts of alcohol, light to moderate, I would advise people who drink to exercise. I would advise everyone to exercise. But especially if they love that.
- [20:48]
Laura Catena
I love that.
- [20:50]
Ahmed Talkal
One thing to add.
- [20:50]
Liberty Vittert
You're not inspiring me to go out tomorrow and go for a run. I can drink tonight if I run tomorrow.
- [20:57]
Ahmed Talkal
We imaged the same people in the study that I referred to and looked at the impact of exercise. What exercise did is it had a dose response, a positive effect on the cortex. When you combine the two effects, one is driving up the cortex exercise, one is driving down the amygdala. That's a really nice balance. That's going to make you a pretty cool cookie.
- [21:22]
Shali Mack
I take it?
- [21:23]
Liberty Vittert
I love it. I do have to ask though, you know, you mentioned, Ahmed, the J shaped or the U shaped curve. So, you know, how does this work as a confounding factor? Because what I have heard before and what I've read before is that what it, you know, the confounding factor here is that those who don't drink at all look like they have worse health than those who drink moderately. But that could be because non drinkers, people who don't drink at all, are abstaining due to their health. So how does that factor in to know that it's not just a compounding factor that shows that people who don't drink at all are less healthy or have less of a cardiovascular risk than.
- [22:08]
Laura Catena
Those who drink A little bit?
- [22:10]
Ahmed Talkal
Brilliant question. Really important points. So there have been studies, including ours, that simply removed people who were abstaining to get rid of the abstainer bias. So what you're describing is it'll make the folks who are drinking alcohol look healthier because you remove the people who had health problems and were told not to drink alcohol and put them into the other bucket. Right. So the way we dealt with that is multiple different ways. One, we did an analysis where we removed abstainers. That's one. We did another analysis where we had all of their major medical problems and we accounted for those major medical problems. So we scored them based on those major medical problems as well. And we still saw very similar looking curves. It didn't really shift the curve that much. So in my humble opinion, I think the abstainer bias does not explain what's been seen with that J shaped association.
- [23:11]
Laura Catena
Yeah, And I would agree with Ahmed that many studies have looked at this, you know, doing the same thing that Ahmed did, you know, removing the abstainers, keeping the abstainers, comparing socioeconomic status or other factors, always removing ex heavy drinkers. You know, that population definitely has to be removed. But they still find this J curve where drinking a small amount is reducing mortality for some of these reasons that we've discussed. But what is still lacking is a randomized controlled study which would answer a lot of these questions. A very large randomized controlled study that would answer the questions definitively.
- [23:55]
Shali Mack
Well, you just preempt the question I was going to ask because this is the Data Science podcast. They would be listening and said, what about the golden standard? Randomized, Randomize the trial. And I know that's probably, it's hard to conduct, probably not ethical to conduct. Sometimes there's this nature kind of experiment. Right. There's something happened by a random chance. It was not by design, but it can be utilized as randomized mechanism. One great example is in this court system to study if one judge is biased and or not. Sometimes these cases are randomly assigned to different judges just as a way to allocate a workload. Right. Later people found out, well, that's actually great natural mechanism to study the randomization. Right. Is there any such opportunities that can really push the boundary of study? Say, hey, no matter how much we control, there's always a confounding factor. Maybe we do not know. But if there's something can be acted naturally as the way of the clinical trial, then that probably will help a lot. Is there any possibilities here?
- [25:02]
Laura Catena
So there is actually one very large study going on the Predimed study in Spain, and it's led by a professor who is affiliated with the Harvard School of Public Health. His name is Dr. Miguel Angel Martinez Gonzalez. And he's been doing this Mediterranean diet research for a long time. And he has managed to get a grant approved for looking at two populations. All people who sign up for the study saying, okay, I drink in moderation, and this is how much I drink. And I am willing to stop drinking. I'm willing to be randomized to a non drinking group. And that kind of fixes your problem of the sick non drinker or the sick abstainer, because these are people who have been regularly drinking and also who follow the Mediterranean diet. So you're also, you know, controlling for maybe, you know, one person has much worse habits than another, which there's this great study in Denmark where they looked at people's baskets and the wine drinkers were all eating really healthy foods, and, you know, the beer and spirits drinkers were eating less healthy food. So, you know, you can't compare those population. But back to this Mediterranean diet study. So what it's looking at is people who drink, you know, this kind of more moderate, the one to two glasses per day, and then I think they're looking at two to three glasses per day as like a slightly higher drinking group of people. And both are being randomized, one to abstaining and the other one to reducing. And what's really cool about this study is that they're following people for five years, so they might not be able to see cancer outcomes, but they will definitely see some cardiovascular and mortality outcomes. And also they managed to get the doctors participating in the studies to give free counseling sessions. So actually, all the people that are asked to stop drinking get free counseling and have to go to counseling to learn how to abstain. And the people who are reducing, same thing, which I think is really great, because we might also acquire some knowledge on how to get people to drink in moderation, because that really is the best way to drink with at least a neutral effect on health, maybe not the benefit. Because I agree with Ahmed that we don't know enough to be able to tell people that it's actually healthy. So if we were to learn how to get people to moderate, I think that would also be incredible, incredibly helpful knowledge. So that is a study that's going on, and there's another study that was planned, but that was canceled. I don't know. Xiao Li, if you want me to tell you about that one, please, please. Yes. Okay. So in I think it was 2018, but before the pandemic, there was a group actually led by Harvard researchers. One of them is Ken Mukamal, and the other one is Eric Rim, who was one of the people who helped define the current dietary guidelines. And they had planned a very, very ambitious study that was going to cover people all over the world. Several centers in the us There was actually a center in Argentina. That's how I learned about the study. There was a center in Nigeria, there were centers in several countries in Europe. And they were going to randomize about, I think it was almost 8,000 people all over the age of 50. Because one thing is very clear, and we haven't said this so far, that there are no potential benefits below the age of 40. So if you're a young person, you're drinking, you don't need the cardiovascular benefits and actually you're having the harms of potentially drunk driving and all these things. So every time we say something about cardiovascular benefits, we're speaking of people over the age of 40 or 45 or 50. But anyhow, this study was planned, it was a very ambitious study. It had actually been approved by the NIH with great score. Xiao Li, you said something about potentially not being ethical, but actually they were taking people who already drank in moderation and randomizing them to drinking or not drinking. So, you know, in that way I think it was very ethical. But the interesting thing is that at some point it got to Congress and this is a well known thing, and a politician basically said that it should be canceled. And I'm going to explain to you why the money was actually coming from the alcohol industry. And a lot of the press that we've seen have said, oh, the alcohol industry is behind all this research. But when they actually looked at how much research the alcohol industry had funded, there's actually a really well done study on this. They looked at 380something studies and actually less than 5.4% had been funded by the alcohol industry. And they actually showed results no different than the studies that had not been funded. But for this particular really large study, which was going to be very, very expensive, the nih. So the National Institutes of Health had actually gone to the alcohol industry and proposed that they fund this study. Because we all know that pharmaceutical companies fund drug studies. So alcohol being the most widely consumed drug in the world, you know, over 60% of Americans drink, and lots of Europeans, Argentinians, it made sense that the alcohol industry should fund this study. It was actually no wine producers. Apparently the wine people stayed out because they thought wine was healthy already. It was mostly spirits. And beer producers, which I thought was very commendable, were going to put money in some kind of a foundation fund of the nih and then they were told that they would find out the results when they were published. They would have absolutely no capacity to influence the results or the research or what was studied. But then this became controversial and the whole study was canceled. And I think that is a terrible thing. In fact, the New York Times kind of vilified one of the researchers as saying that he had taken money or was connected to the alcohol industry when all this guy had done was go to the NIH and the NIH had solicited the funds and they never got a penny. So I personally, being a wine producer, I think it would be very appropriate that the alcohol industry fund this research as long as we can be sure that there's no influence on the results. But I would love to know Ahmed's opinion on this.
- [31:30]
Ahmed Talkal
So first, from my perspective, I would love to see more mechanistic studies to better understand how is it that alcohol is exerting its effects, because that would teach us not only what it's actually doing, but whether a we can replicate it in different ways. Are there other compounds that could be designed to impact the same pathways in a healthier way without the side effects? And also this is a far fetched goal. But what if we learned enough about these mechanisms so that we can interrupt or interfere with the adverse effects? Right. So there.
- [32:08]
Laura Catena
That would be amazing.
- [32:10]
Ahmed Talkal
A bunch of reasons. This is not something that people are going to stop consuming. This is a very, very widely consumed compound. And we certainly need to learn far more about alcohol and how it impacts the body, the positives and the negatives. And so yes, we need more information on that. The question is, how do you get the best information? NIH provides a very high bar for outstanding science. And so I would love to double down on NIH mechanisms to achieve those goals. And the NIH really is often more likely to support mechanistic studies anyhow. So I think this would be the opportunity. The challenge though is to design the right kind of studies and ask the right kind of questions about doing that. That's a challenge. I would love to see a lot of my colleagues go after.
- [33:04]
Shali Mack
Thank you. I have a follow up question and particularly you said about you would love to see the wine industry to support these studies. This reminds me to ask you what are other things the wine industry can do or anyone can do? Kind of keep the benefit or at least the enjoyable benefit of the wine, but reduce the harm on the alcohol side. For example, at the symposium we serve this so called no low, there's no alcohol, low alcohol wine. And I understand there are certain trends there. I want to ask you as a winemaker, because what do you think about this kind of no alcohol, low alcohol, and where would that take us to?
- [33:52]
Laura Catena
Well, I want to go back to actually your first question about is there a kind of alcohol that's better than others? And there are some studies. For example, there was this large Lancet study, 2018 that mostly aggregated all the information, but when you break it down and you look at their appendix, you see more benefit from wine than from beer and spirits. But we don't know why. So back to your question about what can the alcohol industry do? And I think this is so important. And that's why I think what's currently happening with the media being so against alcohol and mostly showing negative studies is that it's alienating the alcohol industry so that they don't want to talk about it. And I actually think that the alcohol industry needs to embrace the fact that it's not easy to consume in moderation, that it's very easy for somebody to say, oh, you know, I had such a hard day, I'm going to just have a ton to drink, you know. And so I think the alcohol industry has a responsibility for training, for always having spit buckets when they do tastings. You know, I go to wineries that don't have spit buckets still that don't offer you water. I think restaurants should actually have spit buckets for somebody that wants to drive. And it's really hard not to drink if they pour you a whole glass of wine. So I think the industry has a lot of work to really encourage moderation in terms of no low alcohol drinks. This is a really exciting field. I think the beer producers are producing really good beers with no alcohol or 0.5. I think the spirits producers are doing some really interesting stuff and they're also getting very engaged with a lot of bartenders who have decided to not drink. There is definitely a sober movement within the industry and I think that the industry needs to do a really great job to embrace people who want to stop drinking altogether, who should be able to stay in the industry. I have a friend who is a wine journalist who loves wine. She decided that she was not able to drink in moderation and she is not drinking anymore. But she loves the wine industry, she loves the travel, she loves writing about the producers and she is actively staying in the industry and also talking a lot about this. So I think that that's really important. In terms of wine, I think there are some sparkling products that are really great and actually we are making some no alcohol and some 7% drinks that you will hopefully see in the next year. Because I do think that it's easier to moderate when you don't drink a couple of days per week. And the addiction data supports that. If you want to really drink in moderation, maybe do the don't drink Tuesday, Wednesday, Thursday. That's what I do personally. But I think even more research in that area would be helpful.
- [36:38]
Shali Mack
The Nolo wine I tried and one of them I really like, but the other one is just too sweet for me. Which reminds me that we have been talking about the risk of alcohol, but what about the sugar level? Because I got a constant reminder by my doctor said, well, when you're drinking wine you get too much carb. So what's the risk factor there?
- [37:00]
Laura Catena
Yeah, so even a no alcohol wine with some sugar that you taste is going to be less caloric than a wine with alcohol. Alcohol has quite a few calories. So, you know, let's say one of these sparkling no alcohol drinks that has a little bit of sugar, you know, you can taste the sugar, it's not like coca Cola, but it's a little bit sweet. You know, that might have, you know, 60 calories for, you know, 100 milliliters, whereas if it was alcohol, it would have closer to 100 plus. So in terms of the calories, even with a slightly sweet drink, you would have less calories, you would have more sugar because most wine is dry. But I think that the more producers start making these no alcohol or low alcohol drinks, they will learn how to make them without as much sugar. And I have had some, we are actually making some that are without that much sugar and that taste pretty well. I don't think they are as good as alcohol though. So what I do personally is if I want to have one of these no alcohol drinks, because it's 6pm and I know I'm going to go out to dinner and I want to be able to have a glass of wine with dinner, I will have it before I have alcohol. So once you have a real glass of champagne, if I were to give you one of these no alcohol sparkling, you would not like it. So that's one of those things that you learn by doing that. You want to start maybe with your afternoon no alcohol drink, but then once you have alcohol? No, alcohol does not taste any good.
- [38:35]
Ahmed Talkal
Well said.
- [38:36]
Liberty Vittert
Well, I'd say we always wrap up with a magic wand question. And Laura, in honor of you, I did get a Catena wine tonight. So I am on my way to drink that after our magic wand question. There's so much more research that could be done around wine and alcohol and health. And I think that brings me to my magic wand question for both of you. If you could receive funding and a magic wand, so as much funding as you want and a team to conduct some alcohol related study, what would it be? How would you design your study? What would the questions that you be asking be?
- [39:15]
Ahmed Talkal
I'd want to go in two directions. So I'm going to be. I'm going to be a little more expansive than one study. The first study.
- [39:22]
Liberty Vittert
Greedy with your two mattresses.
- [39:24]
Ahmed Talkal
Definitely going to be greedy. Yeah, absolutely greedy. I'm going to go for an advanced imaging study to evaluate alcohol's long term effects on the brain, the stress, neural activity and downstream cardiovascular events. Just to really focus on mechanisms. I'd want to have very careful biomarkers to kind of really study the mechanism in between really nailing those effects, understand the impacts on the system. Those are expensive studies. They don't need to be quite as long as multicenter trials that look for clinical endpoints. But they give you a lot of information about the mechanisms. As we talked before and maybe we'll learn things that I was hoping for. Can we find the things that cause the positive effects and learn more about the things that lead to the negative effects and double down and interrupt as appropriate. The other thing that I'd be interested in is studying more about the impact of alcohol on blood clots. We didn't mention this before, but the other really interesting thing about alcohol is that it appears to reduce blood clotting risks in certain ways. And so I'd want to learn more about those mechanisms as well because that's another interest of mine. Looking at blood clots and blood clotting complications.
- [40:33]
Laura Catena
Yeah. So I'm going to do two also. The first one is this big randomized controlled study. I really wish that study had been done. I think that study is really necessary if it could be actually done for 20 years so that we could even get the cancer effects. I think that would be amazing. So that's number one. Number two, I'd like to look a little bit at the pleasure and the conviviality and the spending time with friends and family in groups because I do know that there is this loneliness epidemic that the surgeon general talks about. And in my culture, in Mediterranean cultures, people gather around food and wine in moderation, and that gives you pleasure, that helps reduce inflammation by bringing you together with friends and family. And I would love to study the impact of those moments related to alcohol on pleasure, on happiness. And I don't know how you would do that study because there would be so many confounders. But I think that we need to remember why we want to be on this earth. You know, we want to live, work hard, but we also want to have pleasure. And I loved what Ahmed said about, you know, if you drink, do some exercise, because then, you know, you might have something that has some potential negative effects, but then you balance it with something else. And you could say the same thing about eating your fruits and vegetables and eating a really healthy diet. Well, that reduces your cancer risk. So that could mitigate any potential cancer risk. So I would love to look at the impact of pleasure and the pleasure that comes from moderate drinking.
- [42:28]
Shali Mack
Thank you to both of you for such really very scientific and very informative session. And I think for me, myself as a wine lover, and obviously I wanted to know not just as a wine lover, but also the data scientist, really understand what's good, what's bad, what the data tell us. And Amara, I really like your emphasis on understanding the mechanism. That's ultimately what we do. As for the scientific studies, I want to end this episode by sharing with the readers that I just got a forward article today from a wine friend who attend the Wine to Wine event. He just showed me this article from New York Times. A food critic from New York Times is quitting because he realized that he has the world most unhealthy job by eating out four nights, five nights, and he's having all kinds of health problems, right? And it just reminds me that everything you need to consume with the moderation and I think very few people are saying food is bad for you, but apparently many of us get over ourselves trouble by eating too much. Even, you know, every single food might be very healthy and but the combination, it's the overeating is too much. And I just thought it was really a great reminder to all of us and that life is all about the balance, right? It's all about, you know, consuming at the right way. And clearly alcohol just like anything else when eating too much. But I think what's important here for this episode, and I really think that's what data scientists should do, is really bring this information in a very honest way, which I think both of you have done a really wonderful job. There are pros and their cons in the end that we as a consumer, we should all be informed and make our own choice. It's a life quality versus life longevity or whatever you want to call it. And thank you so much for this very informative session. Thank you very much.
- [44:25]
Laura Catena
Yeah, thank you.
- [44:27]
Ahmed Talkal
My pleasure.
- [44:29]
Liberty Vittert
Thank you for listening to this week's episode of the Harvard Data Science Review podcast. To stay updated with all things HDSR, you can visit our website at HDSR, MITPress, MIT.edu or follow us on Twitter and InstagramHDSR are a special thanks to our executive producer Rebecca McLeod and producers Tina, Toby Mack and Arianwen Frank. If you liked this episode, please leave us a review on Spotify, Apple or wherever you get your podcasts. This has been the Harvard Data Science Review. Everything Data Science and Data Science for everyone.