The Health Effects of Alcohol. Why Government and Policy makers insist on a “Nanny State” approach

There was plenty of controversy in the last few weeks in the U.K. when the Chief Medical Officer (CMO) Dame Sally Davies published new alcohol drinking guidelines. The number of units that UK citizens are recommended to drink dropped from 21 to 14 units for Men and remained at 14 units for women. The committee behind the latest guidelines chose to dismiss any positive effects of alcohol on health and yet wholeheartedly endorsed the negative effects — “Nanny State” at its worst and based on some really bad science.

Many of the governments and public health bodies as well as charities of the world want alcohol to go the same way as tobacco with an assertion that “no level of drinking alcohol is safe”.

Davies’ report claimed that “”Evidence for a net protective effect of alcohol from risk of death (which has been linked to possible reduced risks of heart disease late in life) is considered less strong than it was. A reduced risk still exists, but, in the UK, it now appears to matter overall in a significant way only for women aged 55 or older.13 The 1995 report for the current guidelines found this protective effect applied at that time to men over 40 and postmenopausal women. This change in understanding is consistent with changes in the profile of heart disease in the UK and a changing population. “.

Through a dubious analysis by a group of academics based at Sheffield University, they managed to dismiss years of very strong clinical research that moderate consumption of alcohol has a positive impact on cardiovascular disease, stroke risk and mortality.

One of the most compelling pieces of evidence was published in 2006 by Di Castelnuovo et al. They used used a meta analysis technique where the results of 34 studies were reviewed The study looked at the link between the amount of alcohol drunk and death rates in men & women in clinical trials conducted before the end of 2005 with over 1 million subjects.

A J-shaped relationship between alcohol and total mortality was confirmed in both men and women. Consumption of alcohol, up to 4 drinks per day in men and 2 drinks per day in women, was inversely associated with total mortality or the chance of dying, maximum protection being 18% in women and 17% in men. Higher consumption of alcohol was detrimental.

The results were consistent with studies by other research including Sir Richard Doll, who was famous for proving the link between tobacco and lung cancer.

In addition to clinical research there is the “The French Paradox”, a term first used by Serge Renaud, a scientist from Bordeaux University in France, and has been in use since the early 1990s.

Renaud pointed out France presented a markedly lower annual mortality from CAD (coronary artery disease) compared with other industrialised nations, despite the fact that cardiovascular risk factors such as cigarette smoking, blood pressure, body mass index and serum cholesterol concentration were similar among these countries.

Renaud’s observations regarding the apparent disconnect between French patterns of high saturated fat consumption and their low rates of cardiovascular disease can be quantified using data from the Food and Agriculture Organisation of the United Nations. In 2002, the average French person consumed 108 grams per day of fat from animal sources, while the average American consumed only 72 grams. The French eat four times as much butter, 60 percent more cheese and nearly three times as much pork. Although the French consume only slightly more total fat (171 g/d vs 157 g/d), they consume much more saturated fat because Americans consume a much larger proportion of fat in the form of vegetable oil, with most of that being soybean oil. However, according to data from the British Heart Foundation, in 1999, rates of death from coronary heart disease among males aged 35–74 years were 115 per 100,000 people in the U.S. but only 83 per 100,000 in France.

• High per capita consumption and appreciation of wine in France, particularly red table wine — Resveratrol, Procyanidins and polyphenols
• Aspects of the French diet — The French diet is rich in vitamin K2, it is rich in short-chain saturated fatty acids and low in trans fats despite dishes like Fois Gras, Confit de Canard etc.
• Whole diet — Higher fruit and vegetable intake, more fish, Early life nutrition
• Generally don’t tend to over eat and don’t eat quickly — quality over quantity, portion control and lack of over consumption
• Limited processed and packaged ready meal type foods (many of which are high in sugar and salt)
• Less snacking and more moderate exercise

Many other researchers have concluded that alcoholic drinks and particularly wine in moderation have a beneficial impact on health. Arranz et al said that “Wine consumption should not replace a healthy lifestyle. However, light-to-moderate wine drinkers, without medical complications, may be assured that their wine consumption is a healthy habit.” Cordova AC 2009 in “Polyphenols are medicine: Is it time to prescribe red wine for our patients?” states that “The habit of having one or two drinks of red wine every day with meals may translate to a longer, healthier and better quality of life.”

Yet the UK CMO has dismissed all this evidence. In 2014, a study by Knott in the BMJ claimed that drinking only had a protective effect for certain groups. But the authors gathered data which clearly showed health benefits from moderate drinking and then divided it into so many subgroups that it was almost impossible for them to produce statistically significant results. In the end the only people who appeared to benefit from drinking were post-menopausal women.

Anti alcohol zealots point out that the risk of breast, throat, gullet and other cancer is raised in alcohol drinkers. Yet these same zealots do not point out that kidney and prostate cancer risk is reduced, the relative risk is much smaller than say the impact of smoking on lung cancer (2300% increase risk) and the picture from many clinical studies is conflicting or “heterogenous” in many cases.

So in summary, the constant pressure from health bodies to dismiss the positive effect of moderate alcohol and particularly red wine is a blatant attempt to oversimplify the public health message that alcohol is bad for you in any quantity. But based on science this message is plain wrong, moderate alcohol drinking has a solid base of evidence that it will increase not decrease your life span.

See FermentedGrape.Com for further reading on alcohol/wine and health.