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New alcohol guidelines are not realistic

So now men have to cut their alcohol consumption in half, [according to new guidelines issued in the UK in January 2016]. It is important to remember that the studies leading to the issuing of such warnings are of populations, not individuals. Also they are frequently observational, rather than randomised, trials, which are more or less impossible to do ethically in a democracy.

Therefore, although we know that drinking alcohol is bad for some of us, I cannot tell, for example, how moderate, or even high, intake will affect me, except by trying it. Even then, I would not know how I would have fared as a teetotaller. Biological variation means that, if I come from a family of long-lived drinkers, I will probably have a higher than average chance of being somewhat resistant to its ill effects. It is ridiculous to suggest, as the chief medical officer has done, that there is no safe level of alcohol consumption. Does this mean only that we do not know the safe limit, and for whom? In fact, in England there is evidence that teetotallers live slightly shorter lives on average than moderate social drinkers. We live in a culture in which alcohol plays a part in normal life for many people. It is a bit like suggesting that we reduce all speed limits to zero in order to eliminate road fatalities. We would lose the benefits as well as the fatalities and injuries. It has been pointed out that the risks of drinking up to the new limits are about as great as being a car user or eating a bacon sarnie twice a week.

Social context and individual biology are clearly important here. Western European populations evolved using fermentation as a means of making water safe to drink and thus developed biochemical means to deal with alcohol. Other populations boiled water and made tea. I am reminded of a conversation between a GP and a patient. When the patient asked whether giving up certain habits, including drinking, would make him live longer, the doctor replied after some thought: “I’m not sure, but it will certainly seem longer.” I look forward to returning to Spain, where the recommended level of alcohol for men is 35 units a week and it is enjoyed as part of a healthy Mediterranean diet, and it is also much cheaper.

Brian Curwain

Christchurch,

Dorset

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2016.20200471

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