Beer Before Wine, Everything Fine? Not So, Says Science!

A new study answers the age old question: Wine before beer, sick for a year?

This week, I am forced to ask a question I thought I never would – has our pursuit of truth and science in medicine finally gone too far? Have we answered a question we weren’t meant to answer, and, if so, what hath we wrought and how will the world be different tomorrow?

That’s right, science has finally determined whether you should drink beer before wine to avoid a hangover.

Grape of grain but never the twain? A randomized controlled multiarm matched-triplet crossover trial of beer and wine.

OK it’s not exactly the cure for cancer, but the study, appearing in the American Journal of Clinical Nutrition is fun and it’s good to remember that science can be fun sometimes.

Researchers took 90 participants between the ages of 18 and 40 and, essentially, had a cocktail party.

My college study groups proceeded in much the same fashion.

In matched triplets, one member was assigned to drink beer followed by wine, one wine followed by beer, and one to stick with the date they came in with. Each drank to a blood alcohol content of 0.11%. A week later the orders were switched.

Though it’s a bit of a silly study, the design is rather elegant. By using matched triplets and a crossover approach, the researchers maximized their power to detect a difference in their primary outcome of interest: score on the Acute Hangover Scale. Yes, apparently there is an Acute Hangover Scale. It’s a bit meta; it includes the question “Please Rate How Hungover You Feel” proving, once again, that I am in the wrong line of work.

“How is the research going, son? Saving the world?”

“Well, I’d rather be doing the silly research than blogging about the silly research”.

The results? As expected, it didn’t matter whether you drank beer first or wine first or stuck with only one. The hangovers were equally bad in all the groups.

In fact, the only factors predictive of hangover severity were a subjective feeling of drunkenness and vomiting. Yup, 21 people vomited in the course of this study. We solute their sacrifice on the porcelain altar of science.

My kind of scientists.

Now, I could note that there are some flaws in the study design. There was no blinding; prior studies literally put blindfolds on participants and plugged their noses so they couldn’t tell what they were drinking. The researchers didn’t go that route in this study, “out of respect for the brewers and vintners”.

But this is a great example of a study where we don’t really need perfect design. Because there has never been a good biologically plausible argument for why drinking types of alcohol in various orders should matter or not. Remember, every study needs to be interpreted in the light of the probability of the central hypothesis. It’s improbable that it should matter what order you drink alcohol in – so a negative study, even one with limitations, is probably good enough to put this one to bed. Though I don’t envy it when it wakes up in the morning.

Where shall the piercing eye of science turn its beam of truth next? Beer than liquor never sicker? Perhaps, in the words of Nigel Tufnel, “best leave it unsolved”.

“It’s like, how much more conclusive could this be? And the answer is none - none more conclusive”.

-Nigel Tufnel