Beer Marketer's Insights

Is the Link Between Moderate Drinking and Better Heart Health "Compelling" Yet?

04-15-2010

The same edition of the cardiology journal included a positive overview of the current state of the research from pioneer alcohol/health researcher Dr. Arthur Klatsky from the Kaiser Permanente Medical Care Program in California. At this point, Dr. Klatsky believes there is a "compelling" case that "persons at coronary artery risk obtain a benefit from light-moderate drinking" even though "absolute proof…will not appear soon."

Dr. Klatsky reminds that links between moderate drinking and better health date back to at least the mid-19th century when "Anstie, a prominent public health activist" proposed a "sensible limit" of "approximately 3 standard sized drinks" daily. (Not many "prominent public health activists" today would agree.) What's more, Dr. Klatsky notes that research linking moderate drinking to better health dates back to 1926, when a Baltimore study found moderate drinkers had lower mortality rates than heavy drinkers and abstainers. Many similar studies in subsequent decades came to the same conclusion.

The association goes beyond correlation, Klatsky suggests. "Points favoring a causal protective effect of moderate alcohol drinking include proper time sequence, consistency in diverse healthy or unhealthy populations, plausible biological mechanisms … controlled trial data for surrogate end points and weakness of data supporting alternative explanations." Despite this, and despite the fact that the studies that do separate "sick quitters" from lifelong abstainers have found similar risk reductions, he acknowledges that some "residual uncertainty remains." Dr. Klatsky also points out that while the "sick quitter" charge might "spuriously" increase an apparent benefit for drinkers, the fact that alcohol consumption is widely under-reported would "spuriously lower the apparent threshold for harm." Finally, the unlikelihood that a truly large, lengthy, random controlled trial of drinking vs non-drinking (including heavy drinking) will ever be undertaken, will always leave some doubt. In the end, there is no "universal sensible" drinking limit to be had, Dr. Klatsky advises, given the potential risks of even moderate drinking for breast cancer, youth drinking and driving, etc. "Advice about lifestyle must be based on something less than certainty," Klatsky concludes. "There is no substitute for balanced judgment by a knowledgeable, objective health professional" who can synthesize "common sense and the best available scientific facts." Ref 2