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United Kingdom: Why those killjoy new alcohol rules are just plain wrong: A devastating critique by an award-winning writer on how alcohol affects our health

United Kingdom: Why those killjoy new alcohol rules are just plain wrong: A devastating critique by an award-winning writer on how alcohol affects our health


    Dame Sally Davies said 1 daily glass of wine can put you at risk of cancer

    As Chief Medical Officer she announced the latest advised alcohol limits

    Men’s weekly limits slashed from 21 units to 14, in line with women’s

    Tony Edwards says, in light of the research, ‘she’s simply wrong’


Source: Daily Mail

By Tony Edwards

11 January 2016


Even one glass of wine a day can put you at risk of cancer. That was the apocalyptic message from Britain’s Chief Medical Officer, Dame Sally Davies, last Friday, as she announced that maximum advised alcohol limits have now been reduced sharply.


Men’s weekly limits are to be slashed from 21 units to 14, in line with women’s, while everyone is advised to take ‘several days’ off drinking to let their bodies recover. Furthermore, we were told that alcohol probably doesn’t protect the heart, as has been previously claimed.


The basic message is that alcohol is a danger to health, however little you drink. ‘There is no safe level of drinking,’ says Dame Sally unequivocally.


Her warning received huge publicity – but, having looked in detail at the research into alcohol and health, I’m afraid to say she’s simply wrong. Her motivation may be admirable, but her knowledge of the scientific and medical evidence is decidedly not.


The irony is that if people who already drink within the old guidelines do follow her advice and completely stop drinking, their risk of disease and premature death will increase. Medical studies now running into many hundreds and published in the world’s top journals say that, providing you don’t go overboard on the booze, drinking will help you live a longer and healthier life.


The pioneer of these studies was Professor Sir Richard Doll, the brilliant British research scientist who first discovered the link between smoking and lung cancer. With tobacco, he found that the more cigarettes people smoke, the younger they die.


But with alcohol he found the complete reverse. None of the drinkers he surveyed (incidentally, his fellow doctors) died sooner than the ones who didn’t drink – even the heaviest drinkers.


Since his groundbreaking work in the Nineties, there has been a small tsunami of similar research studies which broadly confirm Doll’s original data, although it’s now clear that above a certain intake, death rates do rise substantially over the teetotal level. Most at risk are alcoholics and binge drinkers – typically people who get plastered every weekend. However, the data clearly still show that sensible drinkers live longer and healthier lives than non-drinkers.


How come? Contrary to the claims behind the new guidelines, alcohol reduces the risk of many diseases which lead to premature death.


Heart disease is the world’s No 1 killer… and the No 1 medicine for preventing it is a moderate daily intake of alcohol, according to hundreds of medical studies.


What the people behind the new guidelines ignored – either deliberately or accidentally – are two clinching pieces of evidence.


The first is that when alcohol is tested in clinical trials (i.e. just like a pharmaceutical drug), it increases HDL (‘good’) cholesterol, and reduces blood clotting and the ‘inflammatory markers’ associated with heart disease. The second is that in post-mortems, moderate drinkers have lower levels of atherosclerosis (clogged-up arteries).


Rates of diabetes are also lower in moderate drinkers – again explained by clinical studies which show that alcohol reduces insulin levels.


The evidence also shows that moderate drinkers have lower risks of dementia, strokes caused by blood clots, arthritis, obesity, prostate problems, kidney stones, and even the common cold.


Not a single one of these benefits was factored in to the new guidelines.


What about liver damage?


Yes, drinkers are at extra risk of liver disease – but the dangers are often exaggerated.


For example, a recent official survey showed that, in the heavy-drinking South-East of England, only 6.7 per cent in every 200,000 people die from alcohol-related liver diseases per year, not much more than the death rate from playing sport or doing exercise.


And even that low figure is misleadingly high, with official figures for ‘alcohol-related’ deaths not quite what they might seem.


In detailed email exchanges with the UK Office for National Statistics last year, they told me that under the heading of ‘alcohol-related’ deaths, ‘we include all deaths from liver cirrhosis except for (the rare) biliary cirrhosis . . . we are aware that liver cirrhosis can also be caused by drugs, exposure to chemicals, bile duct obstruction, diabetes, malnutrition, hepatitis C, other infective agents, and several other conditions.’


That’s an astonishing admission. Here we have Britain’s official source of health statistics blaming the nation’s liver cirrhosis problem almost entirely on booze, and yet there’s compelling evidence that two equally significant causes of cirrhosis are obesity and hepatitis C.


Another indication that the alcohol/liver problem is overblown is what happens to alcoholics. In 2003, researchers at Canada’s prestigious Centre for Addiction and Mental Health surveyed the entire international evidence and found that only one in seven of the heaviest drinkers has any liver problems at all. ‘Alcoholics drink an average of 160 grams of alcohol [i.e 20 units – more than half a bottle of scotch] per day,’ they observed, but found only ‘about 14 per cent of alcoholics will develop cirrhosis if they drink this quantity for a period of eight years’.


But what about sensible drinkers? Take a look at Finland, the country with Europe’s highest rates of liver disease. Post-mortem studies by pathologists at Helsinki University show that ‘in males, daily ingestion of alcohol below 40 grams for a period of 25 years does not increase the risk of alcohol-related liver disease’.


What’s 40g? Five units ie. half a bottle of wine, two to three pints of beer, or four measures of spirits.


But as you drink more, the liver does start to be affected and ‘the incidence of liver cirrhosis increases significantly when daily alcohol intake exceeds 80 grams (ten units/day) – (but this occurs) in only 20 per cent of heavy consumers’, the Finns reported in the journal Alcoholism: Clinical And Experimental Research.


What about the cancer risk?


Yes, cancer is a potential hazard if you drink. The most clearly alcohol-related cancers occur in the parts of the body where booze hits first, i.e. the mouth, throat and gullet.

Studies associating moderate alcohol consumption and breast cancer are contradictory


However, these cancers are fairly rare in non-smoking drinkers. More commonly associated with alcohol are cancers of the colon, breast and liver, but the overall evidence shows that the risks are not only relatively low, but also somewhat inconsistent.


Take breast cancer. Read one study and you’ll scare yourself rigid about downing a single G&T; read another and you’ll have a booze-up to celebrate there’s no health danger.


In fact, some research scientists aren’t entirely convinced there’s an alcohol/breast cancer connection – certainly at moderate intakes.


Writing last year in Advances in Experimental Medicine and Biology, U.S. alcohol expert Dr Samir Zakhari called the connection ‘ambiguous and confusing’.


He went on: ‘Since studies associating moderate alcohol consumption and breast cancer are contradictory, a woman and her physician should weigh the risks and benefits of moderate alcohol consumption’.


Why listen to Dr Zakhari? Because he’s a recently retired supremo at the National Institute on Alcohol Abuse and Alcoholism, the U.S. Government’s top-notch alcohol research outfit.


The benefits he refers to are not only in heart disease, but also in cancer itself.


Utterly surprisingly, alcohol has been found to reduce the risk of about half a dozen cancers: kidney, thyroid and many of the blood cancers. That might explain the findings of a 2013 survey of the health of nearly half a million Europeans (part of the European Prospective Investigation into Cancer and Nutrition, one of the largest-ever studies) which showed a 21 per cent reduction in men’s death rates from cancer after ‘life-time alcohol consumption’ of up to two-and-a-half units per day.


Moderate drinkers live longer


Given alcohol’s benefits (and relatively few hazards) at sensible intakes, it’s not surprising that studies show drinkers live longer than non-drinkers. But once again the people behind the new guidelines have chosen to ignore this evidence, arguing it’s not 100 per cent proved.


And they’re right: it isn’t – just as the claim that alcohol causes cancer isn’t 100 per cent proved. When research scientists want to answer difficult questions about human health, they often ask dumb animals. About 30 years ago, the Canadian Addiction Research Foundation did a very simple test on the lifespan of 400 mice.


Four groups of identically housed and fed animals were given either plain water, or water mixed with low, moderate or ‘maximum tolerable’ amounts of alcohol.


Completely counter to what you’d expect, the first to die were those given water and the lowest dose of alcohol. Hot on their tails were the heavy boozers, expiring 18 days later; but the last to die were the moderately drinking mice, which clocked up an extra two months.


But once again, this landmark experiment appears to have been ignored by Dame Sally’s advisers.


The clearest human lifespan evidence comes from an international analysis of the health records of about a million people in 2006.


Writing in The Archives of Internal Medicine, University of Milan statisticians reported that European men can drink roughly eight-and-a-half units of alcohol a day before their death rates climb above non-drinkers’; women’s increased mortality level was found to occur at about a third of that intake.


The longest-living men were those who drank between one and two-and-a-half units a day – in women, the amount was roughly half this.


Scientists at London University have put this in context: writing in the Journal of Epidemiology and Community Health in 2001, they calculated that if every Briton completely gave up drinking, national death rates would rise by about 2 per cent.


But none of this ‘pro-alcohol’ research seems to cut any ice with the people behind the new health guidelines. Historically, that’s a real anomaly. When the NHS was founded in 1948 and doctors drew up a list of permitted prescription medicines, alcohol was on it.


Yes, GPs were allowed to prescribe wine to their patients, and even in hospitals there was always a bottle of sherry on the drugs trolley – a story I got from Professor Karol Sikora, a leading cancer expert (who wrote the foreword to my book about alcohol and health).


But all that changed in 1987 when the Royal College of Physicians wrote a paper on alcohol, describing it as ‘evil’ – a remarkably non-medical adjective – in response to what they saw as ‘growing.alcohol abuse’ in the UK.


At the same time, they thought they should specify what they meant by abuse, so they drew up the world’s first guidelines on ‘sensible’ intakes. Overnight, doctors’ centuries-old knowledge that ‘a modest amount of alcohol is good for you’ became ‘alcohol is bad for you, but if you really must drink, don’t have more than x’.


Today it’s the same message, with the intakes now being set even lower.


I don’t doubt the medical authorities’ motives in encouraging us all to drink less, but the scientific evidence is clear that the only people whose health would be significantly improved are heavy drinkers and ‘binge’ drinkers – typically, the idiots who get completely smashed every weekend.


Both these groups are a danger to themselves and the wider society – in extra costs of healthcare, A&E, crime, policing, matrimonial bust-ups, road deaths and all the other ghastly consequences of our countrymen’s notorious inability to handle their drink.


But will any of those extreme behaviours be curbed by either reducing the alcohol guidelines or exaggerating the health risks of sensible drinking? Of course not – because these are the very people who should listen but won’t.


Give us the whole picture


As for the rest of us, surely we’re not so stupid that we’re forbidden to know that a moderate amount of something can be healthy, but a lot is not.


Other countries have already seen the light.Recently, the U.S. government assembled a 15-strong committee of top scientists across America – ironically the birth-place of Prohibition – to decide on the role of alcohol in a healthy lifestyle. The resulting Scientific Report of the 2015 Dietary Guidelines Advisory Committee was unambiguous about alcohol’s benefits:


‘The Committee confirmed… that moderate alcohol intake can be a component of a healthy dietary pattern, and that if alcohol is consumed, it should be consumed in moderation and only by adults.’ ‘Moderate’ was defined as up to three-and-a-half units a day for men, and half that for women.


People will rightly be mystified by the fact that the British and U.S. authorities have come up with such wildly different messages about alcohol and health. After all, both countries employed expert committees, each spending about 18 months investigating the medical evidence.


The answer may be the background of the people in charge.


Dame Sally Davies is a medical doctor with a distinguished career in medical administration; her specific expertise is in blood disorders.


By contrast, the U.S. government appointed Professor Barbara Millen, who is a director of nutrition research with a lifetime’s expertise in public health. An even more crucial difference is that Dame Sally is a doctor and Professor Barbara is an academic.


While researching the medical evidence for my book on alcohol, one clear pattern emerged: studies written by academics and statisticians were neutral in tone, but ones by doctors tended to be judgemental – indeed, almost propagandist – about alcohol.


Perhaps that’s understandable. After all, the job of doctors is to help sick people rather than healthy ones, so they inevitably see only the casualties of alcohol, never its beneficiaries.


This schism lay behind a long-forgotten tussle 20 years ago, when the Department of Health decided to review the original 1987 Royal College of Physicians’ alcohol guidelines.


They did a thorough analysis of the existing medical evidence, finally producing their ‘Sensible Drinking’ report in 1995, which recommended up to three to four alcohol units a day for men, and two to three units for women.


But the report made a big political mistake in alluding to alcohol’s clear health benefits. ‘The maximum health advantage lies between one and two units a day,’ it said firmly. ‘The benefits come from drinking small amounts of alcohol fairly regularly.’


The juxtaposition of the two words ‘alcohol’ and ‘benefits’ was a red rag to the medical establishment. Senior medics condemned the work of ‘civil servants’ . . .’in the pockets of the booze industry’, whose report was ‘a boozer’s charter’ and ‘an encouragement to people to drink more’.


But that 1995 report was actually a huge advance in evidence-based government policy, and its insights have been amply confirmed by subsequent medical research.


Unfortunately, despite this, the 1995 report is now almost entirely forgotten. And in its place we’re now offered a health message based on a seriously incomplete assessment of the medical evidence, with the clear intention to demonise your daily tipple.


Tony Edwards is an award-winning science journalist and former BBC producer (where he worked on science series Horizon and QED). His book, The Good News About Booze, is published by Premium Books (£11.99).

One limit for both sexes? It’s nonsense


The new guidelines are at variance with international expert opinion in failing to differentiate between men and women.


By slashing both sexes’ weekly intake to 14 units, Britain is now out of kilter with almost every other nation, where the guidelines ‘allow’ men to drink roughly twice as much. This is based on decades of medical research which clearly shows that men can safely drink about twice as much as women.


Factors may be female hormones, body fat and water composition (women have less water to dilute alcohol), but the fundamental reason is simple: men’s alcohol-processing enzymes are roughly twice as efficient as women’s.


Why should women be so disfavoured? Nobody has the faintest idea, but that doesn’t make it any less true.


World experts who all agree: Moderate drinking can be healthy


Curtis Ellison, Professor of Medicine and Public Health Boston University School of Medicine, U.S. and director of the International Scientific Forum on Alcohol Research.


I’m very surprised and rather shocked by the new UK guidelines.


Statements suggesting abstinence is better than light drinking in terms of health and mortality are erroneous and do not reflect current scientific literature, with well-conducted studies showing that mortality is lower for light-to-moderate drinkers than for lifetime abstainers. For regular moderate drinkers, I am not aware of data suggesting they should avoid for a certain number of days a week.


For example, the beneficial effects on blood clotting are shown to last about 24 to 48 hours after alcohol is consumed. So telling light-to-moderate drinkers to skip days might raise their risk of cardiovascular disease.


As for cancer, studies show that for light regular drinkers, the risk is non-existent or minimally increased. The exception is breast cancer, where there’s a slight increase in risk, even for women who have only one drink a day. The risk is primarily among women who binge drink, under-report their intake, have low intake of folate [a B vitamin], or are on hormone replacement therapy.


The well-demonstrated benefits of regular light-to-moderate alcohol consumption are primarily in middle-aged and older adults; it tends to lower their risk of most diseases of ageing (including coronary heart disease, stroke, diabetes, and even dementia).


Dr Augusto Di Castelnuovo, Professor of Statistics and Epidemiology, the Institute for Cancer Research, Italy.


The new recommendation that there is no ‘safe’ alcohol limit is misleading: low to moderate consumption (up to one-two units a day in women, up to two-three in men) of any type of alcohol – with the possible exception of spirits – significantly reduces the risk of cardiovascular disease. Moderate drinking is associated with a modest excess risk of oral and pharyngeal, oesophageal and breast cancers. But the balance between these two different effects is in favour of drinking in moderation.


Dr Mladen Boban, Professor of Biomedicine and Public Health, University of Split Medical School, Croatia.


The guidelines do not mention the health benefits associated with moderate alcohol (especially wine) intake, thereby ignoring huge scientific evidence – for example, reduced incidence of type 2 diabetes and the strong cardiovascular benefits of alcohol. Moderate intake may even be protective against some cancers.


Dr Erik Skovenborg, founder member of the Scandanavian Medical Alcohol Board.


I am surprised to see the same limits for weekly alcohol consumption for men and women, in spite of the well-established greater susceptibility of women.


The danger is that the new guidelines will give women the false impression they are on a par with men in their ability to tolerate alcohol.


I am also very surprised that the well-proven risk reduction for coronary heart disease has been dismissed, particularly for men.


Dame Sally Davies’s advice to the public ‘to take at least two – possibly even three – days off a week to give their livers a rest’, also flies in the face of the evidence.


I am also surprised that smoking is not mentioned as a possible factor in the alcohol-cancer association. In a recent U.S. study of over 135,000 doctors and nurses, moderate male drinkers who had never smoked had no appreciably raised risk of alcohol-related cancer.


Read more: http://www.dailymail.co.uk/health/article-3394679/Why-killjoy-new-alcohol-rules-just-plain-wrong-devastating-critique-award-winning-writer-alcohol-affects-health.html#ixzz3x0Ti0Mnx