Monday, September 19, 2011

Moderate wine consumption and health in the news, again!

The debate over whether or not moderate wine consumption is a beneficial or a detrimental thing continues. I suppose it will never end, but here is the latest campaign by some people who are against it.

An article published in The Age, from Melbourne in Australia, "Experts see red over wine 'myth'," details the new push by the Alcohol Policy Coalition to discourage the consumption of alcohol.

The Alcohol Policy Coalition is an Australian group made up of the Australian Drug Foundation, Cancer Council Victoria, Heart Foundation, Turning Point Alcohol and Drug Centre and VicHealth, who share "concern relating to the misuse of alcohol and its health/social impacts on the community."

The "report" they refer to in their press release is really a press release, also, or in their words, a "position statement," so not a report at all. In it, they summarise some information relating to alcohol consumption and its association with non-communicable diseases.


My main concern about this statement is that they use data that result from the misuse of alcohol to support their statements such as, "Every drinking occasion contributes to the life-time risk of harm from alcohol, therefore, any reduction in the dose - that is the amount and frequency of alcohol consumed - will reduce the annual and life-time risk of alcohol related harm."

This is an unsubstantiated remark and of no relation to the information they have presented.

In paragraph two of the statement they say this:

"In 2008, alcohol misuse was responsible for 2.3 million deaths (3.8 per cent) globally."

This is fair enough, however, the key word there is "misuse."

I would hope that the vast majority of people do not misuse alcohol, meaning they have chronic and excessive consumption. It is also worth noting that in the report they cite as the source of the information (World Health Organization Global status report on noncommunicable diseases 2010) that 80% of the deaths are in low to middle-income countries, and therefore only 20% in the high-income countries.

Per capita consumption of alcohol is listed in the WHO report and low-income countries have a value of about 4 litres per capita and high-income at just over 10 litres per capita. Since the consumption level is lower in the countries that have the highest percentage of deaths due to alcohol, I read this as meaning that binge drinking and other forms of alcohol abuse are the reason why so many people are dying there. With more affluent societies, alcohol (and wine in particular) is consumed more regularly, but also more responsibly.

So I'm not convinced by their argument that we should increase taxes on alcohol in places like New Zealand, Australia, or other higher-income countries. The real problem seems to be in other places, where perhaps more control over people's access to alcohol is warranted, or better yet, the institution of policies that educate about alcohol use.

The other thing that I am always cautious about with studies relating to alcohol consumption and disease incidence is whether or not it is a cause and effect, or if the disease incidence change is due to other factors that are associated with alcohol consumption. We've already mentioned that higher income countries have more alcohol consumption, so you can draw relationships between such things as the number of television sets per household in a country and the level of alcohol consumption. So does that mean that to curb alcohol consumption we should limit the number of televisions?


A bit of an absurd example, but it makes the point - sometimes you can get correlations between factors, but they are not direct cause and effect. You need to look at the information and see exactly what it is they're testing, and make sure that they do have evidence that backs up their claims.

I, personally, am an advocate of moderate wine consumption. However, this is not from the health point of view, but mostly because I find it a fascinating beverage, and that it accompanies food so well. I would never recommend to anyone to start drinking wine because it will make you healthier, but I would recommend people try it and see if they like it.

What I'm not keen on is a tax-grab on alcohol, and wine in particular, under the pretext that we are being saved from ourselves.

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