Thread by @EricTopol

A stern warning about the risk of #cancer associated with alcohol
by @theNCI's @Bill_Klein_NCI @pbjacobsen
jamanetwork.com/journals/jama/… @JAMA_current w/ the curious trade-off of less heart attacks thelancet.com/action/showPdf… @TheLancet 1/x
But 👇

@theNCI @Bill_Klein_NCI @pbjacobsen @JAMA_current @TheLancet 1. All this work relies on observational studies with drink diaries and shaky recall, and, at best, associations (not causality)
2. The naïve assumption is that all humans are equally responsive to #diet and beverage intake, which is reductionist and flawed 2/x

@theNCI @Bill_Klein_NCI @pbjacobsen @JAMA_current @TheLancet 3. We know the major predisposition genes for #cancer and can sequence these inexpensively to identify people who are at risk for both the monogenic types (#BRCA, Lynch syndrome, etc) and common, polygenic types (risk scores for breast, prostate, colon cancer. 3/x

@theNCI @Bill_Klein_NCI @pbjacobsen @JAMA_current @TheLancet 4. Likewise for heart disease, a polygenic risk score can help provide context for an individual's risk instead of the population herd mentality. In @TheLancet paper cited above, there was increased risk of all types of heart disease associated w/ alcohol except heart attacks 4/x

@theNCI @Bill_Klein_NCI @pbjacobsen @JAMA_current @TheLancet 5. It is almost 2020 and our knowledge of what to eat and drink is remarkably dumbed down— vis-à-vis a large body of research data that is completely ignored and could be built upon.
+ There's always confirmation ("myside") bias: so it's Friday, and time for a 🍷🍺😉