Tuesday, January 12, 2016

Why the UK's new guidelines on alcohol consumption are misguided

   Dismissing decades of research on alcohol and health, the UK’s new stringent guidelines on drinking bring to mind a quote from champagne lover Sir Winston Churchill: “Statistics are like a lamppost to a drunk; used more for support than illumination.” In announcing the new policy, England’s chief medical officer and neo-prohibitionist Sally Davies scorned the idea that a daily glass of wine could be healthy, proclaiming it an “old wives’ tale” and suggesting a cup of tea instead. The policy is said to be based on the latest statistics, but do these truly shed any new light? We are hardly in the dark about the effects of wine on health, with many thousands of research papers on record.
   Davies’ fundamental mistake is to judge all types of drinking the same while focusing the outcome narrowly on cancer, failing to consider the opposite: that an equally narrow focus on wine drinkers might have different outcomes when overall health is concerned. Nothing in the “latest data” counters the fact that on average, people who drink wine with meals on a daily basis outlive nondrinkers, are healthier, and enjoy a higher quality of life by objective measures. Davies’ advice to avoid any drinking at all several days a week is similarly imprudent as it can only serve to encourage bingeing instead of healthy drinking. All types of drink are not the same, and all types of drinking are also varied in their effect on health.
   The policy shines a spotlight on alcohol and cancer where broad daylight is needed in order to see the whole picture. But even here the statements in the new policy take liberties with the facts, with assertions such as “no level of alcohol consumption is safe” while acknowledging in the same document that drinking within the guidelines carries the same cancer risk as not drinking. But even that self-contradictory statement oversimplifies the question, because the relationship is nonlinear; for wine, many disease conditions including most types of cancer plot out on a J-shaped curve. In other words the risk is lower for moderate drinkers, then about the same, and increasing rapidly with heavy drinking.  Unfortunately for the Brits and their pub culture, the J curve is shallower for beer. Unfortunately for the new policy, it similary fails when alternating drinking and teetotaling.

   Perhaps the UK would do well to heed Churchill’s view on drinking: “I have taken more out of alcohol than alcohol has taken out of me.”

Thursday, January 7, 2016

Increasing alcohol levels in wine spurs debate on health effects

     Much ado has been made about a recent article documenting that the alcohol content in wines is often higher than stated on the label, and increasing. It’s been an open secret among winemakers for some time, but if the trend continues it threatens the whole concept of healthy drinking. Policymakers in the UK and elsewhere are already using it to bolster anti-drinking campaigns.
     The analysis, from the University of California Davis and others, was comprehensive and included several factors.  Over the past 2 decades, Old World wines have seen a greater increase in alcohol levels, but New World wines started out higher. Using heat index climate data, the authors found that part of the increase correlated to warmer growing conditions (resulting in higher sugar content translating into more alcohol), and part driven by consumer preference for riper wines with more concentrated flavors. Several factors contribute to the trend and confusion about what it means.
     In the U.S., federal law allows for a tolerance of plus or minus 1.5% of stated alcohol content for wines with less than 14%, which means that a label can say for example 13.5% but actually contain almost 15. Studies on wine and health typically presume an alcohol content of 13% or less, consistent with how wines have traditionally been made. Because people tend to like higher alcohol wines, the regulation is essentially a health benefit loop-hole; it’s sort of like telling us we can get credit for eating our vegetables even though they are deep-fried.
     Alcohol is a part of the healthy drinking equation, but only up to a point. Wine is not just sugar-free grape juice, and there is evidence that de-alcoholized wine does not provide the same level of health benefits. The problem is not that wine has alcohol, it’s a matter of how much is ideal.

     The concept of healthy drinking goes back thousands of years. Philosophers in ancient Greece gathered around wine drinking parties (called symposia) and developed the very ideas upon which civilization is grounded. What is worth noting however is that the wine was always diluted with water, and it was considered unsophisticated to drink it undiluted; even a 50:50 mixture was deemed quite strong. The average wine from recent vintages today would have been judged barbaric by ancient standards.

     There’s a lot at stake for the future of the wine industry and the well-established relationship with healthy living. How will winegrowers adapt to climate change and the shift in consumer preferences without erasing our excuse to enjoy wine? Let’s have a glass or two and philosophize about it – maybe we can figure something out.