The Nanny State and Wine Appreciation
The dangers of excessive alcohol consumption have received increasing attention in the public health arena. Justifiably so! The risks of heavy drinking are well documented in the medical literature. The USA estimates 178,000 excess deaths annually caused by alcohol abuse. Alcohol raises the risk of liver, pancreatic and heart disease. It is associated with cirrhosis, obesity, job performance issues, social dysfunction, relationship problems, ulcers, cognitive impairment and dementia. It negatively impacts blood sugar levels, blood pressure and heart rate. It has been classified as a Class 1 carcinogen by the World Health Organization, the American Cancer Society and the American Society of Clinical Oncologists. It is addictive. Whew- I should have been a teetotaler!!
Governments and public health agencies have established standards and guidelines for consumers to follow in their alcohol habits. The need for clear guidelines and benchmarks is based on the conundrum created by the epidemiology associated with alcohol and health. All of the horrors identified above are clearly linked to populations who engaged in “excessive” or “heavy” drinking. The studies have not established strong links between disease and “moderate” or “social” drinking patterns. Public health leadership has an obligation to fill the knowledge gap so people can make intelligent choices. What level of consumption is OK? What is safe? The alcohol product industry (spirits, wine and beer) is a 1.9 trillion dollar global phenomena so it is crystal clear that many individuals embrace alcohol as an integral part of their lifestyle. Is there a red line that should be shouted form the mountaintops? The United States, Canada (soon to be our 51st state) and the European Union have established recommendations of two drinks per day for men and one drink a day for women. 14 drinks a week for men and 7 drinks a week for women. Anything above that amount increases your risk of negative health outcomes. A drink is defined as 12 ounces of beer, 5 ounces of wine or 1.5 ounce of spirits. With the exception of South Korea and Ireland, countries do not require health warnings on alcohol products. A significantly different approach to regulation than what we have followed with cigarettes. These guidelines have been in place for 35 years. Today, there is a movement (the neo-prohibitionists) pushing to toughen the guidelines and engage in explicit anti-alcohol public campaigns. What is the source of this thinking?
One recent study published by Health and Human Services (now under the control of nut job RFK Jr) reviewed 56 papers on the health impacts of alcohol. They concluded there is “no safe level” of alcohol consumption and that “low” levels of alcohol consumption are associated with cirrhosis, cardiovascular disease, oral cancer, esophageal cancer, breast cancer and blood cancer. They explicitly recommend the guidelines be adjusted downward dramatically- 2 drinks per WEEK for men and 1 drink per WEEK for women. Essentially, quasi or total abstinence. Canada is already moving to adopt this recommendation. The US Surgeon General concurs that there is “no safe level” and has asked Congress to require health warnings to be placed on all alcohol related products. The publicity is having a cultural impact. The “Nanny State” is kicking in and displaying its authority. Constellation and Diageo, two major firms, report lower sales and and weakening demand for the entire range of alcohol products. Sales for non alcoholic substitutes are increasing rapidly. Overall, this is probably a positive development. We know that based on self reporting that 25 percent of Americans drink in excess of the current guidelines and many researchers believe the “real” number is higher since people frequently underestimate their own drinking intake. No harm in raising awareness BUT…
There ARE conflicting studies on alcohol and risk in the public health universe. A comprehensive paper published by the National Archivist states that moderate levels of drinking do not materially impact health risks AND may actually lower cardiovascular disease risk. Their methodology was slightly different than HHS. They weighted more recent studies (2010-2019) more heavily because the actual level of consumption of the people in the study is better documented. They also removed people who had just quit drinking. They reiterated the high level of risk associated with heavy drinking, but concluded their is a clear dose response relationship between drinking an disease. Their conclusions mirror the host of Mediterranean diet studies in which consistently show lower rates of heart disease for moderate wine drinkers. We all remember the French Paradox reported by 60 Minutes years ago which publicised the positive and protective effect of polyphenol in red wine. So the data is actually conflicting and ambiguous. I analysed epidemiological studies for a living as a lawyer and believe the evidence for health risks associated with moderate or low levels of drinking, particularly for wines, is not compelling. What you need to confidently answer the question is a large population study, well crafted by professionals, which compares health outcomes for people who drank 2 glasses of wine per day for 50 years against who totally abstain from wine for the same length of time. There are no such studies. The current studies don’t define drinking levels with the necessary specificity and don’t consider confounding factors such as lifestyle, exercise, diet, obesity, socio-economic level, smoking history or genetics. Studies stating there is “no safe level” are meaningless. There is no safe level of anything in society- thousands of things can kill you if your exposure or usage is excessive. Heck, walking daily is a good thing. 10,000 steps a day recorded on your Fitbit is cause for celebration. Unfortunately, an individual with that walking history has a much higher risk of being hit by a car and killed than a totally sedentary person who never moves off the couch in his living room. There are hundreds of such examples. The issue is how to make intelligent decisions on lifestyle by weighing the quantifiable risk vs the rewards and benefits associated with a particular activity.
I believe the medical literature supports the reasonableness of the existing public health guidelines. They communicate the message that you should monitor and control your alcohol intake. I strongly recommend you enjoy two glasses of wine daily, starting when you are 21. I bet you feel great at 71! If you don’t, it is not the wine’s fault! You will be much happier than a Scrooge type person who decide to forego the joys of wine entirely. It is so much fun to be politically incorrect in this “woke” and “cancel” culture milieu. The low health risks of moderate consumption should be measured against the major social benefits of wine. You feel GOOD when you drink wine. It provides pleasure and sensory satisfaction. Wine is a social lubricant- encourages friendship and community. People bond over wine- think of all the wonderful dinners and weddings where you shared a glass of wine with people closest to you. Conversations improve with wine and you learn from one another. Instead of discussing the weather or the underperforming local sports team, you exchange views on music, art, film, books history and politics. There has never been a historically significant men without wine at the table. Remember the Last Supper! The primary characteristics of wine- texture, aroma, flavour, inspire an appreciation of the craft of winemaking. The wine itself becomes hot topic and you discover regions, varietals, winemakers, terroir etc. You become a more interesting companion. Wine is integral to history- the Greeks started the love affair and the Romans made it universal. Going into an Irish William Butler Yeats mode- wine is poetic. It eases stress and is a wonderful “socialisation" tool. It gets you off your phone. I guarantee that social media saturation and capture is a much greater risk to your long term heath than two glasses of Brunello each day.
Therefore, I am in the pro wine camp. The new prohibitionists are a drag. Remember Hitler avoided alcohol- so does Trump but Churchill and Roosevelt enjoyed their Bordeauxs and cocktails. Enough said- I rest my case. I conclude with others who can summarise the case much better than I
“A Meal Without Wine is Like a Day Without Sunshine” LOUIS PASTEUR
“Wine is Proof that God Loves Us and Loves To See Us Happy” BEN FRANKLIN
“Wine Is the Most Civilised Thing in the World” ERNEST HEMINGWAY
Come visit the Mahoney’s. We can discuss dry public health matters over 2 glasses of DONA AMALIA or GALAHAD. You will increase your life expectancy.
