Whitman et al must be commended from providing simple but strong evidence, from the real-life setting, that promoting alcohol as heart healthy is harmful: The 1/3 of Health eHeart participants who believed alcohol to be heart healthy drank substantially more alcohol than the others and cited the lay press as the origin of that perception. This deserves comment from France, the world’s biggest wine producer in 2014.
First, “modest alcohol consumption (5 to 15 g/day)” is not a healthy lifestyle: alcohol causes a dose-related increase in prevalence of oral cavity, pharynx, esophagus, and breast cancers, beginning at the 1 to 2 drink/day level.
Second, no intervention trial showed evidence that a “modest” alcohol consumption has benefits for health. The “French paradox,” from studies sponsored and publicized by the alcohol lobby, is not observed when avoiding selection bias. Even if low doses of alcohol could be proved to have a coronary protective effect, it would only be very small and it would be limited to those at risk, which is not the case for many, for example, young subjects and women before 50 years.
A Google search for the marketing claim “abstaining is worse than drinking” retrieved 7,260 hits (August 31), but lay media are not the sole responsible: The chairman of the French Society of Cardiology recently concluded in the main French medical journal “The consumption of a moderate amount of wine improves cardiovascular health and increases survival.” This contrasted with the American Heart Association’s statement “If you drink alcohol, do so in moderation. Drinking more alcohol increases such dangers as alcoholism, high blood pressure, obesity, stroke, breast cancer, suicide and accidents.” and the College’s wise comment: as Saint Augustine put it, is that “complete abstinence is easier than perfect moderation” ( https://www.acc.org/latest-in-cardiology/articles/2015/01/05/13/06/alcohol-consumption-and-cvd-the-case-for-moderation?w_nav=LC ). Indeed, who can expect a moderate use with an addictive substance? This is an oxymoron. Proctor showed how the tobacco industry molded public opinion to transform an addictive carcinogen as a lifestyle choice. The alcohol industry transformed an addictive carcinogen as a healthy lifestyle choice.
References
- 1. Whitman I.R., Pletcher M.J., Vittinghoff E., Imburgia K.E., Maguire C., Bettencourt L., Sinha T., Parsnick T., Tison G.H., Mulvanny C.G., Olgin J.E., and Marcus G.M.: Perceptions, information sources, and behavior regarding alcohol and heart health. Am J Cardiol 2015; 11: pp. 642-646
- 2. Bagnardi V., Rota M., Botteri E., Tramacere I., Islami F., Fedirko V., Scotti L., Jenab M., Turati F., Pasquali E., Pelucchi C., Bellocco R., Negri E., Corrao G., Rehm J., Boffetta P., and La Vecchia C.: Light alcohol drinking and cancer: a meta-analysis. Ann Oncol 2013; 24: pp. 301-308
- 3. Rehm J., and Shield K.: Alcohol consumption. In Stewart B.W., and Wild C.B. (eds): World Cancer Report 2014. Lyon, France: International Agency for Research on Cancer, 2014.
- 4. Stockwell T., Greer A., Fillmore K., Chikritzhs T., and Zeisser C.: How good is the science? BMJ 2012; 344: pp. e2276
- 5. Jackson R., Broad J., Connor J., and Wells S.: Alcohol and ischaemic heart disease: probably no free lunch. Lancet 2005; 366: pp. 1911-1912
- 6. Roehr B.: Cardiovascular researcher fabricated data in studies of red wine. BMJ 2012; 344: pp. e406
- 7. Holmes M.V., Dale C.E., Zuccolo L., Silverwood R.J., Guo Y., Ye Z., Prieto-Merino D., Dehghan A., Trompet S., Wong A., Cavadino A., Drogan D., Padmanabhan S., Li S., Yesupriya A., Leusink M., Sundstrom J., Hubacek J.A., Pikhart H., Swerdlow D.I., Panayiotou A.G., Borinskaya S.A., Finan C., Shah S., Kuchenbaecker K.B., Shah T., Engmann J., Folkersen L., Eriksson P., Ricceri F., Melander O., Sacerdote C., Gamble D.M., Rayaprolu S., Ross O.A., McLachlan S., Vikhireva O., Sluijs I., Scott R.A., Adamkova V., Flicker L., Bockxmeer F.M., Power C., Marques-Vidal P., Meade T., Marmot M.G., Ferro J.M., Paulos-Pinheiro S., Humphries S.E., Talmud P.J., Mateo Leach I., Verweij N., Linneberg A., Skaaby T., Doevendans P.A., Cramer M.J., van der Harst P., Klungel O.H., Dowling N.F., Dominiczak A.F., Kumari M., Nicolaides A.N., Weikert C., Boeing H., Ebrahim S., Gaunt T.R., Price J.F., Lannfelt L., Peasey A., Kubinova R., Pajak A., Malyutina S., Voevoda M.I., Tamosiunas A., Maitland-van der Zee A.H., Norman P.E., Hankey G.J., Bergmann M.M., Hofman A., Franco O.H., Cooper J., Palmen J., Spiering W., de Jong P.A., Kuh D., Hardy R., Uitterlinden A.G., Ikram M.A., Ford I., Hyppönen E., Almeida O.P., Wareham N.J., Khaw K.T., Hamsten A., Husemoen L.L., Tjønneland A., Tolstrup J.S., Rimm E., Beulens J.W., Verschuren W.M., Onland-Moret N.C., Hofker M.H., Wannamethee S.G., Whincup P.H., Morris R., Vicente A.M., Watkins H., Farrall M., Jukema J.W., Meschia J., Cupples L.A., Sharp S.J., Fornage M., Kooperberg C., LaCroix A.Z., Dai J.Y., Lanktree M.B., Siscovick D.S., Jorgenson E., Spring B., Coresh J., Li Y.R., Buxbaum S.G., Schreiner P.J., Ellison R.C., Tsai M.Y., Patel S.R., Redline S., Johnson A.D., Hoogeveen R.C., Hakonarson H., Rotter J.I., Boerwinkle E., de Bakker P.I., Kivimaki M., Asselbergs F.W., Sattar N., Lawlor D.A., Whittaker J., Davey Smith G., Mukamal K., Psaty B.M., Wilson J.G., Lange L.A., Hamidovic A., Hingorani A.D., Nordestgaard B.G., Bobak M., Leon D.A., Langenberg C., Palmer T.M., Reiner A.P., Keating B.J., Dudbridge F., and Casas J.P.: Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data. BMJ 2014; 349: pp. g4164
- 8. Braillon A., and Dubois G.: Wine is good for those…who sell it! Letter on the article “Wine: good for all cardiovascular diseases?”. Presse Med 2015; 44: pp. 127-128
- 9. Proctor R.N.: The Golden Holocoaust. Origins of the Cigarette Catastrophe and the Case for Abolition. Berkeley: University of California Press, 2012.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
