Beer Marketer's Insights - Advocates Issue "No Safe Level" Guidance Questioning DGA; Canada Replay?

Citing "growing concern" about what the next edition of the Dietary Guidelines for Americans (DGA) will say about alcohol, the country's leading alcohol-focused public health advocacy group took matters into its own hands this week. "There is no safe or healthy level of alcohol use," the US Alcohol Policy Alliance (USAPA) wrote in its self-published "Alcohol Consumption Guidelines for the American People." Though the language appears under the heading "What the Science Says," it is not. And other parts of the document disregard its own scientific "resources." Yet the group seeks "to generate as much awareness and visibility for our guidelines as possible," tearing a page out of the playbook used by allies in Canada who successfully misled media all over the world about that country's drinking guidance. "Worried" About Industry Influence, Org Discredits Next DGA Ahead of Release USAPA CEO Mike Marshall shared the org's "guidelines" and the reasoning behind them with members in an email newsletter this week, again referencing concern about the Dept of Health and Human Services (HHS) under the leadership of Secretary Robert F Kennedy Jr. "Increasingly worried about HHS bowing to alcohol industry pressure and the lack of unbiased, science-based, truthful information about the harms of alcohol, we felt this was a necessary step," he explained. In his usual bluster, Marshall doubled down on his critiques of the industry, emphasizing that "Americans deserve honesty, not watered-down half-truths written to protect alcohol industry profits." He urged USAPA members to download social media toolkits to help the org spread the word.The guidelines themselves begin with a reminder about the DGA's purpose and formulation before taking direct aim at the next edition, calling its contents into question before it's even been released. The DGA "promises" to be "based on science and informed by independent panels reviewing the full body of evidence," the USAPA document begins. But the org is worried the next edition, due any time and required before the end of the year, "may overlook or downplay this evidence," according to the USAPA.Presents Unsupported Implication That Any Lifetime Drinking Raises Risk While the USAPA worries that the actual DGA will underplay potential harm with "watered-down half-truths," its own one-page guidelines go the opposite direction, overplaying the risks in ways that stretch the science and at times directly contradict the findings of the "resources" it cites. Unsurprisingly, the document hinges its "no safe level" assertions on cancer risk, claiming that "each additional drink increases the risk of harm." It goes on to assert that "even small amounts raise risk, which climbs steadily with higher intake."However, the "guidelines" make these assertions about "what the science says" without any reference to daily or weekly consumption. And no respected research attaches risk to the first drop of alcohol consumed. The vast majority of alcohol science is observational, dependent on self-reported average consumption over the course of a day or week. Some researchers, including those endorsed by advocates like those at the USAPA, now prefer to compare regular drinkers to those who drink only rarely in an effort to correct for perceived biases in earlier studies that compared regular drinkers to abstainers. Such studies can't be used to make claims about the relative risk of any consumption at all. So by omitting any reference to time, the USAPA guidelines appear to suggest that "each additional drink" over a lifetime raises risk. That claim cannot be supported by "the science" we have now.Even the Alcohol Intake & Health (AIH) Study, the draft of which was published by the Interagency Coordinating Committee of the Prevention of Underage Drinking (ICCPUD) early this year, does not make this claim. That report emphasizes that "the risk of dying from alcohol use begins at low levels of average use" (our emphasis), generally measured in drinks per week. The USAPA guidelines ignore this all important "average," yet lists the AIH Study from ICCPUD as its very first supportive "resource." (Note that just a few weeks ago, the org's CEO Marshall joined authors of the ICCPUD report to complain that the final draft was not published and effectively buried, recall. Yet here, the org cites it as if it were. Again, the admittedly substantially similar draft is still available on ICCPUD's website.)Repeats Core Findings of ICCPUD's AIH, Misrepresents Others In other ways, USAPA's guidelines directly follow the AIH Study from ICCPUD, including by emphasizing how any "alcohol use increases the risk" of "injuries and addiction," roping in "gun violence, suicide, crime, and incarceration." Recall, some critics of that study argued that such behavioral outcomes have no place in dietary guidelines. The USAPA also repeats the AIH's core assertion that someone who consumes 7+ drinks per week has a "1 in 1,000 risk of alcohol-related death," with risk increasing at higher consumption levels.In the same brief section about "why it matters," the document asserts that any "alcohol use" also raises the risk of "heart disease" without any qualifiers. But that also directly contradicts a large body of research as well as the findings of its primary "resource," the AIH. Even that report (which recall, is especially harsh on alcohol) summarizes research showing that 1, 2 or even 3 drinks per day does not increase risk for certain heart ailments, most notably ischemic heart disease. It specifically cites a study showing that moderate consumption without binge drinking reduces the risk of cardiovascular disease. And in its summary statements, it points out that "males and females who consumed 1 drink per day had&hellip;a lower risk for ischemic stroke."Overall, the AIH claims that "the impact of alcohol use on health is complex and multifactorial," noting "mixed research" about whether light drinking has a "protective effect" against "conditions such as ischemic heart disease, ischemic stroke" and more. That determination doesn't just contradict the USAPA's blanket claim about heart disease risk. It also undermines its overarching insistence that "the evidence is clear: there is no safe or healthy level of alcohol use."Attempt at Replicating Canada's Confusion? This isn't the first time that advocates aligned with the WHO's "no safe level" rhetoric have offered their own drinking guidance to consumers in conflict with national standards. In 2023, the Canadian Centre for Substance Use and Addiction (CCSA) released its "Low-Risk Alcohol Drinking Guidelines," recommending no more than 2 drinks per week to "likely avoid alcohol-related consequences." It still presents them as "Canada's Guidance on Alcohol and Health" on its website, which points to a brief one-page infographic that the org distributed broadly.But it is not the country's official guidance on alcohol consumption, presented by Health Canada. However, in part because CCSA is in part funded by the government and was established by "an act of Parliament," the guidance &mdash; in truth an ultimately unsuccessful effort by researchers at CCSA to change Health Canada's official stance &mdash; quickly created a media frenzy. To this day, leading news outlets, including in the US, refuse to correct misconceptions that the CCSA's guidelines may be Canadian in origin, but do not represent the government's official recommendations.Connections between the CCSA, WHO, USAPA and ICCPUD are well established. Recall, two of the lead researchers behind the report that underpins CCSA's guidance, Drs Kevin Shield and Tim Naimi, were recruited by ICCPUD to be among the 6 researchers to author the AIH report. Shield, at least, is a regular contributor to WHO's work on alcohol; both frequently participate in USAPA's semi-annual conferences; and Naimi spoke at a recent fundraising event for the org. Dr Alicia Sparks was both the USAPA's board chair and the primary outside contractor managing ICCPUD projects at the time that the AIH research panel was formed and its task set. Could USAPA be attempting to replicate the CCSA's media success? Stay tuned. In the same newsletter sharing the org's guidelines, CEO Mike Marshall touted recent press appearances and announced the org's coming podcast, The Shift, debuting later this month.Cheers,

Advocates Issue "No Safe Level" Guidance Questioning DGA; Canada Replay?

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