Is any amount of alcohol good? Resolving the conflict

Sometimes it happens that opposing views on a controversial subject juxtapose. Such is the case this week, with a new large study published on the role of alcohol and health, another outlining the reasons for it, and an opinion piece questioning whether any amount at all is beneficial. In brief, the argument goes something like this: Anti-tobacco activists point out that any amount of tobacco is harmful, and since alcohol in excess has many hazards it must be bad in small doses too, if less so. On the other hand, if moderate wine consumption is a good thing for health, as I affirm in my book Age Gets Better with Wine, then we must account for a positive role of alcohol in the health equation.

The case against alcohol is made by one Professor David Nutt, professor of neuropsychopharmacology at Imperial College in London. Professor Nutt outlines his reasons why he belives that it is a myth that small amounts of alcohol are not harmful: First, alcohol is a toxin, and amounts only 4 times as high as those required to reach legally defined intoxication levels can be fatal. True enough, but there is a long list of things that if consumed in 4 times a sensible amount would also be very bad news; for example, a radio station recently held a water drinking challenge that resulted in a fatality from drinking too much water! The professor then mentions that while most people are not likely to become abusers of alcohol, some do, and so that apparently is reason enough why the rest of us should abstain. The professor’s final argument is that the evidence for alcohol’s benefits is weak, which brings us to the just-released studies both in the British Medical Journal.

These two papers are particularly helpful because they are based on a review of all published studies on the question of alcohol and health, a major challenge. The focus of these reports was purely on heart disease, and the conclusion was “Light to moderate alcohol consumption is associated with a reduced risk of multiple cardiovascular outcomes.” The reasons for this are also well-defined, relating to improved levels of HDL cholesterol (the good kind), as well as apolipoprotein A1, adiponectin, and lowered levels of fibrinogen, all good things for cardiovascular risk. One questions whether professor Nutt actually read any of the literature on the subject before dismissing it.

Anti-alcohol activists are quick to point out the hazards of alcohol consumption, which are also well-known and itemized by the professor. The assumption is that these hazards would disappear if alcohol were to be banned or somehow eliminated. The opposite is more likely to be the case, as deaths from cardiovascular diseases would outnumber the decrease in alcohol abuse-related deaths by a substantial multiple. With hundreds of studies out now, questioning the health benefits of moderate drinking is just nutty.

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