Moderate moderation - By the Way

Cheers, July-August, 2003 by Jack Robertiello

Poor Dr. Robert Atkins. Not a month after his passing from head injuries, the respected New England Journal of Medicine has published a study that bears out much of the maligned diet doctor's work, indicating that, indeed, consuming fewer carbohydrates and more protein often leads to lower body weight without creating health risks. The jury is still out, of course, yet Atkins' decades long battle against conventional wisdom seems to be turning a dietary tide.

Part of that conventional wisdom is the US Dietary Guidelines, which have pushed consumption of grains, legumes, and other carbo-laden products. Why do we care? Because the same guideline makers define moderate beverage alcohol consumption as no more than one drink per day for women and no more than two drinks per day for men. (A drink is defined as 12 ounces of beer, five ounces of wine, or one and a half ounces of 80 proof distilled spirits.) Seems low to us, and we're not alone; the US guidelines appear to be the lower than those in most countries, except, perhaps, prohibitionist theocracies.

Last year, at a symposium in Brussels, delegates heard about the myriad benefits of moderate beer consumption. Nearly all defined moderate consumption as around a quart of medium strength beer per day. One delegate pointed out that the American idea of moderate consumption would dismay healthy beer drinkers in Spain because it would seem so low.

In general, European definitions are higher. A Danish study has defined moderate wine consumption as four to six glasses daily. Australian guidelines, based on slightly smaller drink portions, recommend that men consume an average of no more than four and not more than six drinks in any one day. Women are advised to consume an average of no more than two drinks and not more than four drinks in any one day.

Are Danes harmed by their greater "moderate" consumption? Do Aussies die sooner from their consumption patterns? If so, it's not reflected in life expectancy data: the average in Australia was 79.8 in 2000, in the US, 77.1, and in Denmark, 76.5. Perhaps other health statistics are more revealing, but you'd think that there'd be some remarkable difference when citizens are told that it's healthy to drink two to three times as much as Americans.

No one is arguing that moderate consumption isn't good. The question is, who is deciding what is moderate, and how have they decided it? It is now widely accepted in the medical community that moderate consumption can provide protection against cardio-vascular disease, stroke, even diabetes ulcers and Alzheimer's disease. And that's for all types of beverage alcohol.

But if the Danish, Australian and American guidelines are so different, shouldn't this discrepancy be explored? If the Danes are correct, then it's possible the US government's alcohol guidelines are inadequately arming Americans against certain illnesses. Are our guidelines decided scientifically, or based on preconceived notions? It's an issue I wish I could explore with the late Robert Atkins.