Alcohol: keep a clear head

A new government report on drinking alcohol aims to give us easy to understand, no-nonsense advice. But are we ready to listen?

Is red wine good for you? This seemingly straightforward question has become perhaps one of the most hotly contested health issues of a generation, fuelled by endless studies and conflicting newspaper and magazine articles. Confusion reigns when it comes to alcohol, amid daily revelations about the dangers and benefits of drinking too much, too little or not at all.

 

So it was welcome news yesterday when an influential group of MPs acknowledged the Government's role in creating this confusion and said it was high time that official guidelines were reviewed. The Science and Technology Select Committee has, however, issued some urgent advice, perhaps sensing the dishonour in Britain being crowned the liver-disease capital of Europe.

People must have at least two alcohol-free days a week: an easy to understand message that the Scottish government, which is fast pulling away from England in its willingness to deal with the burdens of alcohol, has already adopted.

Alcohol is rarely out of the news. It's unsurprising given that hospital admissions in England for alcohol-related diseases hit more than a million last year. It fuels half of all violent crimes; and leads to the loss of 17m working days each year.

But despite a long history of alcohol consumption and misuse in the UK, the first attempt by government to introduce guidelines for safe drinking didn't come until the 1980s.

The "sensible limits" advice of 1987 advised a weekly maximum of 21 units for men and 14 for women, guidance widely supported by medical experts.

But by the early 1990s, scientific evidence emerged suggesting that red winemight reduce the risk of coronary heart disease, prompting a rethink. It led to a change from weekly to daily sensible limits, that yesterday's report concludes was probably a mistake. Too many people misunderstood the daily limits to mean it was safe to drink two to four units every day. The committee went as far as to say that the benefits of alcohol have been overstated ever since.

While alcohol is responsible for much more than liver disease, including 12,500 avoidable cancers every year, it is the liver, more than any other organ, which needs time to recover from the thrashing that alcohol gives it. But the alcohol-free-days message, delivered in the right way, could also prevent full-blown alcoholism from taking hold.

Eric Appleby, chief executive of Alcohol Concern, says: "This is sound advice from a health and psychological point of view, as what becomes a habit can slide into an unbreakable habit and then into dependency. While having a couple of days off will make no difference to weekend binge drinking, it would serve as a very useful check for people to make sure they can function with and without alcohol."

The Government is under growing pressure to rethink its imminent alcohol strategy and its guidelines for sensible drinking. Experts argue that these evidence-based policies would help tackle one of the greatest challenges: the change in the way drinks are being made and served.

A pint of beer or lager used to mean, almost uniformly, two units of alcohol, but a trend towards stronger lagers means a pint can be three or even four units. Wines have also got stronger, but the biggest change here has been the serving size: from a standard 125ml to 250ml – a third of a bottle.

In response, the drinks industry has agreed to ensure 80 per cent of products will include units and guidelines on their labels from 2013. The Department of Health say it would consider whether new guidelines were necessary.

Professor Alan Maryon-Davies, from Alcohol Research UK, says: "People need a straightforward, evidence-based message, and it should not be beyond the wit of government to come up with a campaign to bang home that message."

 

Glass half full? Drink advice decoded

The NHS define binge drinking as consuming eight or more units in a single session for men and six or more for women. It officially advises that men should not regularly drink more than three to four units of alcohol a day, while women should not regularly drink more than two to three units a day.

A small (125ml) glass of ABV 11 per cent wine is 1.4 units, while a large glass (250ml) is 2.8 units. However, it makes no difference whether you drink beer, wine or spirits, it is how many units you drink that counts. An average pint of beer (ABV 5 per cent), large glass of wine (250ml, ABV 11 per cent) or large vodka (70ml, ABV 38 to 40 per cent) are all around 2.8 units of alcohol.

Whether or not to drink during pregnancy remains one of the most contentious issues. A recent study found that drinking a little alcohol during pregnancy is fine for most women and having one or two drinks a week while pregnant could give your children a slight developmental advantage. However, the current official line is that pregnant women or women trying to conceive should avoid drinking at all.

Alcohol doesn't just affect the liver (below). There is a direct link between alcohol consumption and cancer: a landmark review last year found that in the UK, drinking is responsible for 2,500 cases of breast cancers, 3,000 bowel cancers and 6,000 cases of cancers of the mouth, throat or windpipe. The researchers extrapolated the results to the general population and estimated that, across Europe, 10 per cent of all cancers in men and three per cent of all cancers in women could be attributed to alcohol consumption.

A 2010 study that compared drinkers in Belfast and several regions in France, where consumption of alcohol is the same but patterns of drinking vary, found that spreading alcohol consumption across the week is better for the heart than a small number of heavier drinking sessions. Binge drinkers are at twice the risk of a heart attack as those who consume the same amount, but spread over the week.

Since the early 1990s it has been suggested that a small amount of alcohol might be a good for the heart. Red wine, in particular, contains antioxidants that help to reduce the build up of atherosclerosis (fat building up on the walls of arteries). However, MPs on the Select Committee now feel the health benefits are limited to men over 40 and post-meonopausal women.

Gillian Orr

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