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(This article continues on from our issue earlier this week, which outlined the two separate panels of scientists generating work for the 2025 edition of the US Dietary Guidelines.) 

The research plan for a small panel of scientists looking into the health impacts of alcohol ahead of the 2025 edition of the Dietary Guidelines for Americans (DGA) is still in draft form and has yet to be submitted for public comment. But the authors already seem to know the outcome. The next DGA will “represent an opportunity to provide the public with updated information on how alcohol use impacts health,” the panel wrote in their draft protocol paper (our emphasis). They also seem to know which direction they want that update to go, while hinting at the desire for new resources. “Additional tools may be needed to actively promote changes in alcohol use, and to maintain such reductions,” they wrote (again, our emphasis).

That’s all from the draft protocol set by a 6-person panel appointed by the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD), including those with close ties to the anti-alcohol advocate community. The paper has not yet been peer-reviewed, as we noted last issue. Indeed, the self-publishing site currently hosting the paper warns that such “pre-prints” should not be “referenced by the media as validated information.” Recall, prior to the paper’s publication, the panel’s makeup and mandate was virtually unknown. So we cite this draft paper purely to better understand what these scientists plan (or at least planned) to do and how they expect(ed) to go about doing it.

New Overview Aligns with DGA Processes The panel’s draft plans may already be shifting, perhaps suggesting some internal pushback. An official DGA website recently added basic overviews of the work taking place by both the ICCPUD panel and the separate panel formed by the National Academies (NASEM). “Both projects will include opportunities for public participation and will include external scientific peer review,” the brief description confirms. They’re also both “slated to be completed by the end of December 2024.” That aligns with the timing of larger DGA efforts, but differs from ICCPUD’s own suggestion that the work will be “ongoing,” with a final report not published until the end of 2025. 

Further, each project “will result in a report with findings, not recommendations on alcohol consumption. These findings will be considered by HHS and USDA as the Departments develop the next edition of the Dietary Guidelines” (our emphasis). It was already clear that the NASEM panel would not develop recommendations for drinking guidelines. But that won’t be expected of the ICCPUD panel either, apparently. And that’s the norm: panels of scientists typically report on the science, but leave precise guidance up to DGA authors. 

Links to WHO, Controversial Canadian Recommendations The ICCPUD panel aims “to generate evidence on weekly alcohol consumption thresholds to minimize health risks,” according to the bare bones overview on the DGA website. It will also develop models that “estimate the lifetime risk of death and disability for different levels of average alcohol consumption” and use a “cause-specific” approach for building “absolute risk curves.” That method is preferred, the panel wrote in its draft protocol, pointing to the WHO, the widely-respected Global Burden of Disease (GBD) studies and guidance in other countries.  

For instance, it was the method used for research that led to the controversial recommendations that adults consume no more than 2 drinks per week, released by the Canadian Centre for Substance Use and Addiction (CCSA) last year. But that research was led by Dr Kevin Shield, also the first listed member of the ICCPUD panel and its proposed protocol paper. Given his links to the WHO, it’s also unsurprising that the paper does not cite the most recent GBD study on alcohol, published in 2022, which acknowledged some health benefits for older adults. Instead, it cites only the older 2018 study that kicked “no safe level” rhetoric into high gear.

Opportunities to Exclude Research Showing Benefits Ahead of the public comment period and its finalization, it remains unclear which aspects of the protocol will eventually happen. But the draft lays out a much more extensive process with many more sub-projects not referenced in the brief DGA website overview. Planned research into the “daily thresholds to minimize the short-term risk of injury or acute illness” references studies of behavioral outcomes that would not traditionally contribute to the development of dietary guidelines, like emergency room cases and roadside surveys, for instance. But that’s just one of the ways it diverges from those norms, INSIGHTS understands.

Plans for a “systematic review of systematic reviews on alcohol’s impact on health” would exclude any research published before 2010, studies that don’t use lifetime abstainers as the baseline, research into specific types of alcohol beverages and anything that examined “patterns of alcohol use and not total alcohol use,” the draft protocol details. Any of those decisions could exclude studies that showed benefits of moderate consumption. The plan also promises to favor researchers who publish most frequently; work co-authored by the 3 Canadians on the panel, Rehm, Shield and Naimi, is cited 19 times in the short paper. Other details hint at ways the panelists could tip the scales toward their stated aim to “promote changes in alcohol use, and to maintain such reductions.” 

Lofty Goals & Great Expectations The panelists conclude their draft protocol by explaining just how important they believe their work is. “The success of the Dietary Guidelines for Americans, 2026-2030 will depend upon the conclusions of this review, the dissemination and clarity of the guidelines, and upon the American public’s knowledge of how much beer, wine, or spirits constitutes a standard drink,” the protocol concludes. (Note: throughout, the paper uses the incorrect years for the title of the next edition of the DGA.) And the paper opens with perhaps the loftiest goal of all: “this project will establish a scientific consensus concerning alcohol’s impact on health.” But such consensus seems unlikely, given the long history of ambivalence toward alcohol, which is perhaps reflected in the fact that a whole other government panel of scientists is also exploring the topic. 

Cheers,

Back at helm of Voss Water, former CEO Jack Belsito is looking to rebuild indie DSD network after earlier alliance with PepsiCo didn't pan out while retaining multisource strategy that doesn't rely only on shipping water in from brand's country of origin, Norway. What's status of Dwyane "The Rock" Johnson, once a prominent frontman for the brand before turning more of his focus toward Zoa Energy along with his own Teremana tequila brand? He remains an investor and friend but isn't expected to play prominent role in rebuilding effort, Belsito indicated.