“The moderate drinkers tend to do everything right. They exercise, they don’t smoke, they eat right and they drink moderately,” said Kaye Middleton Fillmore, a retired sociologist from the UC, San Francisco, a critic.
Questions have also been raised about the financial relationships that have sprung up between the alcoholic beverage industry and many academic centers, which have accepted industry money to pay for research, train students and promote their findings.
“The bottom line is there has not been a single study done on moderate alcohol consumption and mortality outcomes that is a ‘gold standard’ kind of study — the kind of randomized controlled clinical trial that we would be required to have in order to approve a new pharmaceutical agent in this country,” said Dr. Tim Naimi, an epidemiologist with the Centers for Disease Control and Prevention.
Even avid supporters of moderate drinking temper their recommendations with warnings about the dangers of alcohol, which has been tied to breast cancer and can lead to accidents even when consumed in small amounts, and is linked with liver disease, cancers, heart damage and strokes when consumed in larger amounts.
“It’s very difficult to form a single-bullet message because one size doesn’t fit all here, and the public health message has to be very conservative,” said Dr. Arthur L. Klatsky reportedly, a cardiologist in Oakland, California. He had written a landmark study in the early 1970s finding that members of the Kaiser Permanente health care plan who drank in moderation were less likely to be hospitalized for heart attacks than abstainers. He is reported to have since received research grants financed by an alcohol industry foundation, according to the report.
The American Heart Association says people should not start drinking to protect themselves from heart disease. The 2005 United States dietary guidelines say that “alcohol may have beneficial effects when consumed in moderation.”
Alcohol is believed to reduce coronary disease because it has been found to increase the good HDL cholesterol and has anti-clotting effects. Other benefits have also been suggested. A small study in China found that cognitively impaired elderly patients who drank in moderation did not deteriorate as quickly as abstainers. Framingham Offspring Study found that moderate drinkers had greater mineral density in their hipbones than nondrinkers. Light drinkers are reportedly less likely than abstainers to develop diabetes, and that those with Type 2 diabetes who drink lightly are less likely to develop coronary heart disease.
Dr. R. Curtis Ellison, a Boston University physician who has conducted studies showing that alcohol in moderation is good for heart held a conference on the subject a couple of years ago to look at the criticism. A summary published a year later, said scientists had reached a “consensus” that moderate drinking “has been shown to have predominantly beneficial effects on health.”
The meeting, like much of Dr. Ellison’s work, was partly financed by industry grants. The summary was written by him and a senior VP for the International Center for Alcohol Policies, a nonprofit group supported by the industry. The center paid for tens of thousands of copies of the summary, which were included as free inserts in two medical journals.
In an interview, Dr. Ellison said his relationship with the industry did not influence his work, adding, “No one would look at our critiques if we didn’t present a balanced view.”
Arizona based Desert Heat Care Foundation holds an International Wine, Heart and Health conference every two years, where delWine has also been present. Both Dr. Klatsky and Dr. Ellison are import speakers at the conference, which Prof Serge Reynaud also attends from France. He, along with Dr. Ellison appeared in the historic ‘Sixty Minutes’ programme that brought in the ‘coining’ of French Paradox. The general consensus at these conferences has been that up to two glasses of wine a day are good for heart, diabetes type 2 and dementia. The next conference is being held in July, 2009 in Walla Walla, Washington where this burning topic ought to be discussed at length- since the last convention in 2007, a few negative studies have also cropped up besides the current controversy.
Some scientists say the time has come to do a large, long-term randomized controlled clinical trial, like the ones for new drugs. One approach might be to recruit a large group of abstainers who would be randomly assigned either to get a daily dose of alcohol or not, and then closely followed for several years; another might be to recruit people who are at risk for coronary disease.
But even the experts who believe in the health benefits of alcohol say this is an implausible idea. Large randomized trials are expensive, and they might lack credibility unless they were financed by the government, which is unlikely to take on the controversy. There are also practical and ethical problems in giving alcohol to abstainers without making them aware of it and without contributing to accidents.
At any rate, the new controversies generated would not cheer up the wine industry which is already reeling under the global recession and does benefit from the belief that it is good for health. |