Many countries have drinking guidelines. These show what governments consider reasonable drinking levels. However, drinking guidelines differ widely. Some maximum levels are twice as high as others. Yet the medical research findings are available to all countries!
Overview
- Guidelines not Science-Based
- Consumption Under-reported
- Case Study of Bias
- Implications
- Resources: Alcohol Guidelines
I. Guidelines not Science-Based
It’s clear that these maximum consumption levels have little basis in medical research. Instead, a society’s history, culture and attitudes toward alcohol largely determine them.
For example, Dr. Richard Smith was a member of the committee that formed the drinking guidelines for the United Kingdom. He reported that the figures were not based on any clear evidence at all. Indeed, he said the guidelines “were really plucked out of the air.” He said that “It was a sort of intelligent guess by a committee.”1
At least the U.K. drinking guidelines were started by the Royal College of Physicians. In the U.S., it was a group of government lawyers.
II. Consumption is Underreported
An important fact is that people tend to underreport the quantity of alcohol they drink. Researchers use many different methods to know when people underreport drinking. And they also conduct research around the world. Most research finds underreporting by about 40% to 60%.
For example, one large study found that people under-reported consumption of wine by 38%. For beer, it was 49%. And for spirits, it was 66%.2
This problem causes false conclusions. Let’s say researchers find that reported consumption of three daily drinks seems to cause a specific problem. Underreporting suggests that the real consumption level is perhaps five or more daily drinks.
However, underreporting is never reflected in official guidelines. Because of this, official guidelines are clearly too low.
On the other hand, ideological bias is an even more serious problem. We can see a good example of bias in this case study.
III. Case Study of Bias in Drinking Guidelines
The U.K. decided to review its alcohol drinking guidelines. So the Chief Medical Officer, Sallie Davies, formed a committee The guidelines obviously should be based on the best medical evidence. However, Davies didn’t appoint any medical experts or representatives from medical organizations.
Davies herself advocates abstention from all alcoholic beverages. In fact, she publicly and falsely described the health benefits of moderate drinking as “an old wives’ tale.”3 As a result, Davies packed her committee with other anti-alcohol promoters.
Institute of Alcohol Studies
The Institute of Alcohol Studies (IAS) was heavily represented on the committee. The IAS an anti-drinking group. Its official goal is “to spread the principles of total abstinence from alcoholic drinks.”
It began as the National League for the Total and Legal Suppression of Intemperance. Then it changed its name to the UK Alliance for the Suppression of the Traffic of All Intoxicating Liquors. It later became the UK Temperance Alliance. Now it’s the Alliance House Foundation.
Then part of it became the deceptively objective-sounding Institute of Alcohol Studies. Davies appointed IS director Katherine Brown to the committee. She also appointed its advisers, Gerard Hastings and Petra Meier.
Then Davies appointed Ian Gilmore. He is chair of the Alcohol Health Alliance. That’s an anti-alcohol group of which the IAS is a member. Gilmore is a “staunch anti-alcohol campaigner.”4 Among his goals is a total ban on all alcohol beverage advertising.
Mark Bellis had written an article shortly before Davies appointed him. In it, he argued that existing alcohol recommendations were much too high. He said they “read more like an alcohol promotion slogan.”5
She also selected Neo-prohibitionist John Holmes. And as adviser to the committee, Davies appointed Tim Stockwell. Probably because “Stockwell is the world’s most persistent and prominent critic of the evidence showing that moderate alcohol consumption saves lives.”6
Of course health recommendations should be based on scientific medical evidence. Not on opinion. And certainly not on the opinion of a highly biased anti-alcohol activists. Yet they were.
Private Agenda
The committee had its own private agenda in developing the new British drinking guidelines. And it didn’t want to be bothered by medical facts. That’s why the committee explicitly rejected any “call for evidence, preferring instead to rely on their own wisdom. Several new reports were commissioned, but all were co-authored by members of the committee.”7
The committee systematically minimized the many health benefits of drinking in moderation. At the same time, it systematically exaggerated the few health risks of doing so.
The temperance-oriented committee was clever but dishonest. The best measure of health and longevity is all-cause mortality. That is, death from any and all causes. The question is simple. Other things being equal, how long do abstainers live? Light drinkers? Moderate drinkers? Heavy drinkers?
The problem for the committee was simple. It’s that light and moderate drinkers tend to live longer than both abstainers and heavy drinkers. Research has demonstrated this for decades around the world.
Their solution was also simple. Ignore all-cause death rates. Instead, focus on death from “chronic alcohol-related causes.” Of course, alcohol abstainers never die from such causes. But drinkers do. Problem solved.
The Royal Statistical Society criticized the the guidelines. It said they give statistically unjustified advice that would cause unnecessary fear among the public. This is inconsistent with giving people accurate information. Thus, they are unable to make informed choices.
IV. Implications of Drinking Guidelines
People might consider ignoring their country’s guidelines. They could then select those of a more reasonable country.
However, that doesn’t solve the problem of 40% to 60% underreporting. This suggests that the guidelines should be about double what they now. And those in the U.K. should be perhaps four times higher. That is, if they were based entirely on medical evidence.
Medical research finds that abstaining from alcohol is a risk factor for poor health. Abstaining is also a risk factor for a shorter life. That is, abstaining increases the risk of poor health and earlier death.
Therefore, this suggests that most people should be drinking at least some alcohol. The big question is how much.
Fortunately, it’s much easier to say how often it’s wise to drink. Studies show that drinking daily is better for health. In fact, daily drinking may be more important than the exact amount consumed each day.
In addition, the evidence shows that it’s wise to eat when you drink. This reduces spikes in blood alcohol concentration (BAC).
Ultimately, the decision is a very personal one. For example, women have a 5% chance of dying from breast cancer. On the other hand, they have a 50% chance of dying from cardiovascular disease.
Drinking alcohol can slightly increase the chance of death from breast cancer. But it can greatly reduce the much greater chance of cardiovascular disease. However, most women fear breast cancer much more. So a woman must make the choice with which she is most comfortable. And that’s true of everyone.
V. Resources: Drinking Guidelines
Web Pages
Readings
- Bellis, M., et al. Off Measure: How We Underestimate the Amount We Drink. London: Alcohol Concern, 2009.
- Boniface, S. and Shelton, N. How is alcohol consumption affected if we account for under-reporting? Euro J Pub Health, 2013, 23(6), 1076-1081.
- Cameron, D. Dry advice. Ill Bev Guide, 2016, 16(7), 2.
- Farrar, D. Capture by activists. kiwiblog.com, March 1, 2016.
- Furtwaengler, N. and de Visser, R. Lack of consensus in low-risk drinking guidelines. Drug Alco Rev, 2013, 32(1), 11-8.
- Haylor, M. The Vision of a Century, 1853-1953. The United Kingdom Alliance. London, UK Alliance, 1953.
- Livingston, M. & Callinan, S. Underreporting in alcohol surveys. Whose drinking is underestimated? J Stud Alc Drugs, 2015, 76(1), 158-164.
- Midanik L. The validity of self-reported alcohol consumption and alcohol problems: a literature review. Brit J Addict., 1982, 77, 357-82.
- O’Neill, S. Anti-drink lobby drew up official safety limits. Controversial guidance ‘˜induces public fear.’ Sunday Times, May 30, 2016.
- Poikolainen, K. Underestimation of recalled alcohol intake in relation to actual consumption. Brit J Addict, 1995, 80, 215-216.
- Smart, L. Alcohol and Human Health. Oxford: Oxford U Press, 2007.
Footnotes
1 Norfolk, A. How “safe drinking” experts let a bottle or two go to their heads. The recommended maximum intake was set 20 years ago by doctors who simply plucked a limit out of the air. Sunday Times (UK), Oct 20, 2007.
2 Stockwell, T., et al. Who underreports their alcohol consumption in telephone surveys and by how much? Addict, 2014, 109, 1657-1666.
3 Singleton, N. The Great Alcohol Cover-up. Aprol 11, 2016.
4 Snowdon, C. No wonder Britain’s alcohol guidelines are so extreme – just look at who drafted them. Spectator Health, Feb 25, 2016.
5 Ibid.
6 Ibid.
7 Ibid.