As a practicing physician with training in public health, I think this article is somewhat disingenuous and dismissive of what is actually a well-studied issue.
The issue with large-scale epidemiological association studies is that it is impossible to control for all potential confounders. The paper that she herself cites as the basis for her argument itself acknowledges that -
In conclusion, while some studies have suggested a J-shaped relationship, there are limitations in the study design, confounding factors, and individual variability that challenge the generalizability and interpretation of these findings. More recent studies with advanced methodological designs have challenged the J-shape association.
Similarly, “safe” levels of alcohol are defined arbitrarily based on cutoffs that produce statistical significance when compared categorically, whereas the relationship is certainly continuous and to some extent exponential. Simply put, the more the worse, but when you go from 1 to 2 drinks a day for instance, the incremental risk is minimal. When you go from 4 to 5 drinks, the incremental risk is relatively higher. So therefore if you draw a line at a certain value and compare all the people below and above the line for differences in mortality, you are likely to see a bigger difference if the line is at a higher threshold than at a lower.
Beyond just a simple sticker outcome of overall mortality, the association with developing cancer, liver disease and so on is also relatively uncontroversial and indisputable.
From the WHO perspective, problem drinking is an issue in many low-to-middle income countries, and so I can see why they might choose to sacrifice a more nuanced message for something clearer and aimed at overall drinking reduction to address this issue. But that’s a side point.
Rather than cling to the falsely-reassuring belief that there must be a protective effect of “low” levels of alcohol consumption, it is far better for the average person to recognize that while alcohol consumption itself is directly harmful, there are many other associated benefits such as better mental health, wellbeing, cultural identity, family togetherness and so on that are not accounted for in a simple mortality outcome.
As with most things in modern life, it’s simply a trade-off. I drink wine despite knowing that it may increase my risk of cancer in the long-run, but choose to do so at a level that the incremental risk is (hopefully) low, and trade that increased risk for the happiness it brings me. At the same time, I try my best to mitigate this with other healthy behaviors such as regular exercise and a relatively healthy diet (to the extent that us wine lovers also tend to be food lovers).
The same could be said for other less controversial food exposures like sugar, salt etc which definitely increase overall risks of heart disease, mortality in the long run - but we still reach for the salt when eating because under seasoned food is no joy at all. Ignoring the issue doesn’t make it go away - but understanding it helps us continue to drink responsibly and stay happy!
Another recent controversy is that of the link between artificial sweeteners and cancer and the similar advice against consumption by the WHO last year. But these studies don’t account for the alternative - sugar - which is also linked to cancer and a whole host of other metabolic complications besides. I tell my patients to avoid both if they can, but if not, then the artificial sweeteners are still probably the lesser of two evils, but acknowledging that they still do come with increased risks overall. That’s life!