Archive for » July, 2013 «

Alcohol – THE universal prophylactic

A farmer in remote Sri Lanka, totally out of contact with the English-speaking media and the virtual world, is still more than 90% likely to report with conviction that drinking ‘non-excessive amounts’ of alcohol is good for his health and likely to lengthen his life. My guess is that the same holds for similar individuals in Venezuela, Vietnam or Vanuatu. By how much should we credit international and national health agencies for this remarkable achievement in global public education – in the event that my guess is correct?

My guess is also that these individual are far less likely to hold with similar conviction that tobacco smoking causes heart disease or leads to premature death. And who should we blame – in the event that my guess is correct here too – for this failure of public education?

You may not think my guesses accurate. I invite you to test with the next 10 people you meet how strongly they believe the alleged benefits of alcohol use versus the harms of smoking – and come to your own conclusions. You may find quite illuminating to test whether the views of farmers (or accountants, teachers or others) differ from those of doctors.

Have we too readily jumped to the conclusion that associations between better health outcomes in people consuming non-excessive amounts of alcohol, compared to abstainers, reflects a causal link? An article in the journal Addiction  http://onlinelibrary.wiley.com/doi/10.1111/add.12104/full claims that we have. The author, Hans-Olav Fekjaer, provides the most cogently argued case you will likely come across as to why this is so. Quite apart from other causality criteria that aren’t met in the ‘alcohol health benefit’ case, he demonstrates the complete lack of plausibility of biological mechanism or mechanisms underlying the diverse conditions allegedly ‘prevented’ by alcohol, which include:

Alzheimer’s disease/dementia

Asthma

Colorectal cancer

Common cold

Coronary heart disease

Diabetes (type 2)

Gallstones

Hearing loss

Intermittent claudication

Liver cirrhosis

Low birth weight, prematurity

Lower urinary tract symptoms (in men)

Metabolic syndrome

Negative child development

Osteoporosis

Overweight

Psychiatric disorders

Renal cell cancer

Rheumatoid arthritis

Stroke (ischemic)

General health status

(and total mortality)

The article provides details of the published studies that show the beneficial associations. Positive statistical associations with ‘non-excessive alcohol consumption’ are shown for the majority of these conditions in more than one study while seven are confirmed by several studies or meta-analyses.

No mechanism put forward by ‘alcohol trade friendly’ scientists so far is more plausible than that these findings are the result of vector behaviour (namely, such influences as alcohol industry induced selective publication). The second most plausible cause or contributor to the implausible list of ‘protections’ is the fact that abstainers, in the countries where such studies are conducted ad nauseam, are a tiny minority – clearly in a less than 5%, or abnormal, segment of the population.

Joys, sorrows, wealth

The rich are considered fortunate and the immensely rich immensely so. Since the poor don’t count, all is well with the world.

People classified as ‘below the poverty line’ are reassured that every effort is being taken to help them ‘escape’ poverty. (These reassurances too are only from the few, among those who count, who notice the unfortunates.) And one or two among the underprivileged not only ‘escape’ but zoom into the highly wealthy realms. Their achievements are heavily publicised and held up as evidence that the rest of those below the dreaded line too could have reached the same heights had they not been lazy.

What would likely happen to our wellbeing as we move from poverty to colossal wealth – should the voyage take place – deserves reflection. If I were to start off from the state of abject poverty, my happiness and quality of life has to improve with increasing income or wealth. But gains in mental and physical wellbeing may not for long increase in direct proportion to income. The point at which the relative gain for each slab of income added keeps dwindling is reached rather soon, I’d guess. Diminishing returns in felt comfort and security, for every given increase in cash, would probably become noticeable even before I officially escape poverty.

Gains, even though at dwindling rates, are still welcome, we’d suppose. But ‘research’ is said to show (always good to have our assertions backed by research) that a wellbeing plateau is reached after income reaches a certain point. Unless the wealthier folks are quietly leading researchers astray, this finding implies that it is sensible to stop striving to earn or retain more, after that threshold is reached. Should money keep flooding in, even after we stop actively pursuing it, we can let it do so while we get on with the business of enjoying life. There can’t be major drawbacks attached to increased wealth, as long as we aren’t distracted by the blind pursuit of it.

Or can there be?

 

Potential costs of huge wealth

Increasing wealth, and its handmaiden power, can lead to unexpected consequences – a boring life, for instance. I did ask the richest person I had met (up until then) whether he did not find life boring. I meant it in all seriousness but he laughed the question off. I did not know whether it was because he thought I was only trying to be entertaining or because he didn’t want to take my question seriously. The latter, I think. But I do know he continued to be engrossed in the money-making mission.

Being on money can be rewarding in the same way as being on heroin – blind to cost. Should the joy of huge money lie in making more, the mechanism of reward is no different to feeding an addiction. The cost of limiting our repertoire applies across the board to all addictions: cocaine, electronic games, gambling or financiering.   The only difference with addiction to cash, compared to other things, is that uninformed outsiders do not see the downside of inordinate wealth and respond with admiration, or awe, instead of pity.

The majority of the supra-wealthy, fortunately for them, probably aren’t nursing a money addiction. But can there be other potential drawbacks of mega-wealth?

 

Loss of connection

When we have enough wealth to indulge all our whims, every action may become mere distraction. We may then be forced to take up a cause, to feel alive. Ideally, one that involves absorbing religious or political battles. I wonder whether even these, when indulged for the purpose of masking the lack of challenge in daily life, can truly engage? We’d have to invest emotion to feel involved.

Passionate hatred for designated enemies may be one means for remaining alive, once we’ve become rich enough not to worry about tomorrows. The vehemence with which we condemn chosen villains (usually our political ‘enemies’) once we become well-off enough may serve the purpose of providing some emotional connection with the world.

 

Boredom

When anything I want is available for the asking, the risk of severe boredom becomes real. Indulging primal appetites – for food and sex – does not, of course, become boring. But they can’t occupy all of the week. Satisfying these basic desires leads to periodic satiation not gluttony. Fortunately there remain other things too – love, caring, non-material personal goals – which aren’t likely to dull rapidly as riches pile up. But I am not sure they can hold out for long. Religious involvement probably has more potential for providing purpose.

What hope for those of us who aren’t particularly religious, should we too become loaded? Increasing or managing capital leads only to symbolic pleasure. Contrived symbolic goals cannot long provide even a semblance of purpose. We’d have to create new wealth-based games and competitions and hope enough others buy in, to make us the object of envy. This is not a practical solution though, for real wealth is not for display. Nor is it satisfying to pursue ever sillier symbols, to show others and ourselves that we are really enjoying life to the hilt.

 

Losing symbols

Although money is good for acquiring symbols, having lots may, paradoxically, constrain our capacity for providing symbols. We’d probably find, for instance, that whatever we choose to give as a gift loses much of its worth when we can afford everything and more. Giving must lose lustre when a billion this way or that makes no difference.

 

Insensitivity

What helps me connect to other humans is feeling, with them – joys and sorrows. For some (most?) individuals, connection is the whole point of existence; its loss soul-destroying.

Take a few such sensitive people and experimentally load them with mountains of wealth and imagine the likely outcome. Let’s say that they, in turn, keep or ‘invest’ the cash. My guess is that elevation to higher spheres in wealth increases the chances of our becoming insensitive to others around us. When we reach the heights where multiplying our holding a hundred fold or reducing it a hundred fold makes no difference to our life we probably lose all connection with those for whom a ten percent difference matters. Might not great wealth also distance us from those as wealthy as us, even as we limit all our social relations to them?

Loss of connection with others can be fatal to wellbeing, for quite a few of us.

 

What about wealthy nations?

Does the potential for huge power and wealth to result in loss of resonance with others apply to nations as well?

If retaining sensitivity is tough for an individual it is impossible for a nation. A quick look around at the conduct of rich and powerful nations confirms this beyond slightest doubt.  Should we pity rather than envy them?