It’s a near-constant refrain from cardiologists: moderate drinking reduces the risk of heart disease. We’ve recently had another dose of this advice following the publication of a study in the Archives of Internal Medicine which looked at the relationship between drinking habits and heart attack risk in healthy men . The US researchers responsible for this study found that the lowest risk of heart attack was in men having two alcoholic drinks a day. Yet more evidence, it seems, that moderate drinking is ‘healthy’.
As I pointed out in my blog from Monday on white bread and cancer, studies which look at associations between things (known as ‘epidemiological’ studies) do not prove that one factor causes the other. So, just because moderate drinking is associated with a lower risk of heart disease doesn’t mean it’s the alcohol that is providing benefit. It might, for instance, have something to do with the fact that moderate drinkers are also more health-conscious in other ways. For instance, moderate drinkers, generally speaking, may smoke less or have healthier diets than teetotallers or heavier drinkers. It might be these sorts of factors, therefore, that explain the apparent association between moderate drinking and reduced risk of heart disease.
Another major issue with these studies is that they traditionally focus on heart attacks (or the condition that leads to heart attacks known as coronary heart disease). This is obviously an important condition, but it actually accounts for only about a quarter of deaths in the Western world. Alcohol is associated with an increased risk of other conditions that can kill us including and liver disease and certain forms of cancer. So, to get a really good idea of whether alcohol is beneficial to health, we need to look at not heart attack rates, but death rates (also known as ‘overall mortality’).
When studies focus on overall mortality, a different picture regarding alcohol’s effect on health generally emerges. One study, for instance, found that in women up to the age of 54 and men up to the age of 34 the optimal amount of alcohol to drink was none at all. In this study, there seemed to be some benefits of alcohol consumption later in life. Optimal intakes of alcohol for men and women over the age of 65 were 8 units and 3 units respectively each week. These levels of alcohol consumption are far lower than generally recommended.
Now, this study did not take into account of other lifestyle factors (such as diet, smoking and exercise habits) that can affect the results and may have further weakened any apparent benefit of that alcohol appears to be having. The bottom line is that the ‘benefits’ of drinking alcohol seem to have been somewhat overstated.
Even though I’m a drinker myself, I do think it’s important for us to be aware of the apparent over-promotion of alcohol, so that we can make more informed choices about our drinking habits.
If you are wondering how it is that this ‘drinking is good for you’ message has got so widely propagated, then I suspect the manufacturers of alcoholic drinks and the trade bodies that represent them has had some hand in this. The alcohol industry is mightily powerful it seems. How is it, do you imagine, that while foodstuffs and even cosmetics and toiletry products must declare their ingredients, there is no similar requirement in law for alcoholic drinks? Does it not seem a little strange that, by law, companies can sell us stuff to ingest, but they don’t have to tell us what’s in it?
Personally, I believe the pro-alcohol lobby is a malign influence in health. Just this week, a story has been circulating about plans that were afoot to ban alcohol sponsorship and advertising across Europe. The EU’s health chief Markos Kyprianou was planning to introduce laws similar to those applied to tobacco the tobacco industry. Then, suddenly, the idea was scrapped. Mr Kyprianou is on record for complaining about being fiercely lobbied by the alcohol industry. But he denied that this had influenced his decision to drop the proposed measures. Yeah, right.
I read this morning that UK Health Secretary Patricia Hewitt is urging Chancellor Gordon Brown to up the taxes on alcoholic drinks, especially ‘alcopops’, to help combat binge drinking. Let’s see how far she gets.
1. Mukamal KJ, et al. Alcohol Consumption and Risk for Coronary Heart Disease in Men With Healthy Lifestyles Arch Intern Med. 2006;166:2145-2150
2. White IR, et al. Alcohol consumption and mortality: modelling risks for men and women at different ages. BMJ 2002;325:191