Moderate drinking is good for the heart. Why won’t public health admit it?

    23 March 2017

    A new study in the British Medical Journal has found that moderate drinkers have a lower risk of heart attack, angina and heart failure when compared to teetotallers. It found that lifelong non-drinkers have a 24 per cent higher mortality rate than moderate drinkers and that the death rate among former drinkers is even higher.

    The authors, from Cambridge University and University College London, describe their research as ‘the most comprehensive study to date’ in this crowded field and with some justification. It involved nearly two million people, 62 per cent of whom claimed to drink within the old UK guidelines of 21 units for men and 14 units for women. The reduction in risk for heart disease was both clinically and statistically significant, and this is only the latest in a long line of studies stretching over five decades that have come to the same conclusion.

    If moderate drinking was a pharmaceutical with the same weight of evidence behind it, doctors would be prescribing it. If it was a fruit, wellness gurus would be getting rich off it. But you will never hear anyone from the ‘public health’ lobby telling teetotallers to start drinking. You will seldom even hear them acknowledge the fact that teetotallers die younger. More likely, you will see them resorting to long-debunked arguments to cast doubt on the scientific evidence. They will do almost anything to avoid advising people to drink alcohol.

    On the face of it, this is remarkable. We live in an age in which weak epidemiological associations are used to justify all manner of interventions in people’s lifestyles and yet here is a strong, proven link between the consumption of a product and substantially lower risks of both heart disease and overall mortality, and yet it is treated as a trivial factoid.

    There are two reasons for this. Firstly, the ‘public health’ lobby fears that non-drinkers will become alcoholics if they are advised to have a glass of wine. Put simply, they don’t trust us. They don’t think we are responsible enough to drink moderately and they would sooner see a few thousand of us die of angina than give us accurate information. Second, a large number of ‘public health’ campaigners think that alcohol is the new smoking and want to co-opt the ‘no safe level’ slogan that has worked so well in the war on tobacco. There is a blueprint and they are going to follow it.

    The new BMJ study is too strong to dismiss with the usual excuses about ‘sick quitters’ and so the strategy today has turned to presenting exercise and healthy eating as superior substitutes for moderate drinking. The subliminal message is that drinking probably isn’t much good for the heart and you should take up jogging instead.

    For example, here’s how James Nicholls of Alcohol Research UK responded to the study:

    ‘There are better ways to strengthen the heart such as exercise and good diet. All things being equal — and given the increased risk of suffering other health conditions linked to any amount of alcohol consumption — if you drink within the existing guidelines it is unlikely that alcohol will either lengthen or shorten your life.’

    And here’s how Rosanna O’Connor of Public Health England reacted:

    ‘Those who don’t drink should not consider taking up drinking to improve their heart health, but are better off stopping smoking, getting regular physical activity and eating a healthy diet.’

    Healthy eating and physical activity are to be encouraged, but this line of argument is a false dichotomy. You should not be told to choose exercise or moderate drinking. They are complementary. The evidence shows that even if you exercise regularly, eat healthily and don’t smoke, moderate alcohol consumption offers additional benefits that teetotal health fanatics do not enjoy. This study from 2006, for example, concluded that: ‘Even in men already at low risk on the basis of body mass index, physical activity, smoking, and diet, moderate alcohol intake is associated with lower risk for MI.’ MI is myocardial infarction, otherwise known as a heart attack.

    It could be argued that people who like alcohol do not drink for the health benefits. Likewise, people who hate the taste of alcohol are unlikely to start drinking even if it means they are more likely to have a heart attack. So what does it matter if ‘public health’ authorities downplay the benefits of drinking while exaggerating the risks?

    It matters because we are being treated like children who cannot handle nuanced information. It is deeply patronising to assume that we will drink ourselves to death if Public Health England gives us permission to have a couple of bottles of wine every week. It is an insult to our intelligence for the scolds of ‘public health’ to speak to us as if the only message we can comprehend is ‘abstinence good, drinking bad’.

    The benefits of drinking matter because the neo-temperance lobby thinks they matter. Drinkers do not need moderate alcohol consumption to be good for their health to justify their lifestyles, but the anti-drinkers desperately need to debunk the health benefits to justify their crusade.

    These are people who see a world of black and white in which activities are healthy or unhealthy, good or bad, banned or compulsory. It is a world of zero-tolerance and ‘no safe levels’ — a world in which the most important thing is to ‘send a clear message’. When Sally Davies, the Chief Medical Officer, declared last year that there is ‘no safe level’ of alcohol and derided the benefits of moderate drinking as ‘an old wives’ tale’ she was dragging us into this cartoon parallel universe.

    These are the slogans of a campaigner, not a scientist. The real world is more complex. In the real world, there are trade-offs to be made and the dose makes the poison. Science reflects the real world. Everything else is manipulation.