Wine, Health, and Complexity

The trajectory of the status of wine in discussions about health has been remarkable. Beginning in the 1970’s, data from numerous studies showed that wine, when consumed in moderation, had positive health effects, especially on cardiovascular health. Suddenly, within the last decade pubic health officials  have been singing a much different tune claiming that there is no safe level of alcohol consumption.

What changed?

I’m no expert on health matters, but as far as I can tell, the only substantial change is some new data on the effect of alcohol on certain cancers. This editorial by an MD and a public health professional, published in Wine Industry Advisor, effectively summarizes that data:

Current evidence, including that from the 2020 Global Burden of Disease, indicates that “truly moderate” drinking does not increase the risk of cancer per se. Alcohol consumption is only associated with an increased risk of certain, but not of all, cancers….

In essence, the risk of the other age-related diseases and total mortality are all reduced when compared with the risk among non-drinkers, by an average of 11%.

They go on to accuse anti-alcohol scientists of cherry picking studies in their meta analyses that support their preferred position while excluding data that tends to support positive outcomes for moderate alcohol consumption.

But that just raises the question why public health officials would ignore widely accepted research on the benefits of moderate alcohol consumption.

Looking at it from the outside, it is hard to know what their motives might be. But I suspect it has to do with how public health officials see their role. Their job is protect public health. There is no doubt that excessive alcohol consumption is a public health disaster. And the negative effects of alcohol increase rapidly as consumption increases beyond the recommended two drinks per day for men. (One drink per day for women.)

It would be much easier to make progress protecting public health if people drank less. I’m sure there is a large contingent of public health officials who think a simple, consistent message Don’t Drink! would be more effective than a nuanced recommendation that certain kinds of alcohol, for certain people, under particular conditions is acceptable. (Remember the message “Just So No!” was supposed to reduce drug addiction.)

Apparently, those officials in the public health community who prefer simple, direct messages even if they are misleading are gaining the upper hand for now. Their intentions are good but they would have more credibility if they acknowledged the complexity of the data and just told the truth. The world is complex—simple messages won’t change that.