IS WINE POISON? – We have the facts

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Humans have been consuming wine for thousands of years. We are part of a handful of mammals that can tolerate alcohol, and many believe that our resistance to ethanol evolved perhaps over hundreds of thousands of years after we got hooked from imbibing natural fermenting fruits. Some researchers suggest that Saccharomyces cerevisiae, the yeast necessary to ferment fruit juice into wine, may well be the first example of “animal” domestication which occurred long before we domesticated cattle or dogs, and never found in the wild but passed down through countless generations. Wine has long been associated with some of the so called ‘Blue Zones’ like Sardinia or Icaria where longevity is unusually high. Wine is considered as much a part of the Mediterranean Diet as olive oil.  Contrast this with refined sugar or tobacco which are merely hundreds of years old coming into use only after the Americas were discovered. Determining how moderate intake of wine in a world of rising obesity, inactivity, rising sugar consumption and pollution remains fraught with difficulties.

Few would dispute that Government has a duty of care to its citizens, but perhaps like me you may feel we are being told a simplified story on wine consumption. Latest guidelines are set at around 7 small glasses of wine per week irrespective of gender, age, weight, smoker or non-smoker, regular exerciser or couch potato, sugar and refined flour addict or Mediterranean diet devotee. It would appear that these weekly allowances will expose us to no more than a 1% lifetime risk of an alcohol related disease.

When commenting on the latest guidelines and asked to explain the 1% lifetime risk, Sir David John Spiegelhalter, statistician and Winton Professor of the Public Understanding of Risk in the Statistical Laboratory at the University of Cambridge, had this to say:

These guidelines define ‘low-risk’ drinking as giving you less than a 1% chance of dying from an alcohol-related condition. So should we feel OK about risks of this level? An hour of TV watching a day, or a bacon sandwich a couple of times a week, is more dangerous to your long-term health. It all seems to come down to what pleasure you get from moderate drinking.

I would suggest that it may be practically impossible to conduct long-term dietary experiments on humans. If it wasn’t, the fat v. carbs v. sugar arguments currently raging would have been settled a long time ago, and the multibillion-dollar industry of fad diets would be dead in the water. Trying to establish how one, two, or more glasses of wine could affect our health over a lifetime in the midst of rising obesity, diabetes, persistent use of tobacco, drugs and high sugar consumption, will continue to prove challenging. Nevertheless, we need well-balanced and meaningful information so we can make value judgments how wine can fit into our lifestyles. Using a simple story and engendering Project Fear will be counterproductive, and in the end, nobody will believe anything.

Last year BBC News (online) run a particularly frightening headline:

Even light and moderate drinking – could increase the risk of cancer

Risk of total and alcohol related cancer jointly by alcohol consumption and smoking history.

The basis for such scary headlines was a British Medical Journal summary of the results of two large US studies.

Few would dispute that the US suffers from serious public health issues. Diabetes, obesity, stress and work/life imbalances are considered increasing problems. The US is the largest consumer of sugar in the world at 126 grams per person per day against a W.H.O. recommendation of a maximum of 25 grams. Fast food, full of sugar and fat, is cheaply available and perceived as an integral part of American culture. Yet neither the BBC nor the British Medical Journal sought to comment on the obvious difficulties of trying to find out how the effects of moderate drinking could be extricated from such a complex cultural and public health background.

The studies’ aim – to find statistical correlation between alcohol and cancer – was ambitious and admirable, involving over 100,000 men and women over a period of thirty years. During this time dietary, drinking and other lifestyle habits were obtained by means of questionnaires every four years. Less than 400 participants kept detailed records (I can hardly remember what I ate or drunk a few days ago let alone four years ago), yet this was considered acceptable. The obvious shortcomings of obtaining data by self-reporting was acknowledged by researchers, but not considered detrimental to the study.  Again, highly questionable as its well-known we tend to underestimate food and alcohol consumption.

Smokers were not excluded from the study nor participants with energy intakes (excluding alcohol) as high as 3600 kcal/day for women or 4200 kcal/day for men.  These, and a myriad of other complex variables from Body Mass Index to aspirin-use, would be handled within the study by statistical tools and techniques.

If there is one major conclusion from the cohort studies it is that smoking aggravates matters under all circumstances. The diagrams below, taken from the study, clearly shows the increased risks for smokers (blue line) compared to never smokers (red line.)

The BBC headlines are indeed right but no longer as scary unless you smoke.  It is curious that in two of the diagrams, risk for non-smokers falls after increasing alcohol consumption. No explanation is given for this.

It remains to be seen if in the future similar studies are carried out elsewhere, perhaps on populations where diet and lifestyles will allow simpler correlations between alcohol and health.  We know that some of the longest-lived people in the Mediterranean drink wine daily and consider this an integral part of their longevity. It would be interesting to determine if this is really the case.

Here is my survival guide to drinking wine in moderation.

  • Look at the alcoholic label on the bottle. Keep away from wines approaching 15% ABV. The colder the country of production the lower the alcohol generally.
  • Develop a taste for German and Austrian wines which can be as low as 7% ABV.
  • Drink wine with food and water.
  • Buy half bottles (or decant half the wine into an empty half bottle. It will keep nicely for a few days).
  • Buy the best you can. Savour the wine.
  • Have a few dry days in the week.
  • Don’t force yourself to finish the whole bottle. Keep a container for leftover wines. At the very least, you will end up with seriously good vinegar for your cooking and salads.
  • Don’t smoke.
  • Drink sensibly.