For alcohol beverages, "Proof" is 2X percent. 'Hard liquor' products tend to be 80 to 100 proof, labeled as such, whereas wine and beer are labeled percent alcohol content. |
The observation about alcohol in any form, i.e., wine, beer,
spirits, got support from what is described as a “J-shaped curve”, meaning that
the relationship between alcohol and cardiovascular or all-cause mortality was
not a straight line – with more drinking linked to more deaths – but rather a
curved line the lowest risk at a modest alcohol intake, higher risk at zero
alcohol intake, and ever-increasingly higher risk at higher and higher intakes (visually,
the line resembles an aslant letter “J”). The “sweet spot” (lowest risk) looked
to be around one-half to one drink per day.
Red wine contains proanthocyanidins, large molecules that
contribute to the astringency of wine. Red wine also contains resveratrol, a
small molecule upon which huge health claims were heaped. All sorts of health
claims were made for resveratrol dietary supplements, even though the ingredient
in question was being extracted from Japanese knotweed rather than grapes.
Whilst positive results were demonstrated in animal models, in the end, human
trials showed no benefits for lifespan, anti-cancer, anti-dementia, and so on.
There was a lot of hullabaloo about resveratrol-like compounds as drugs, but
that petered out. The proanthocyanidin story was latched onto by proponents of
other natural sources of these compounds, leading to some positive-finding
research and a lot of market hype for dark chocolate, blueberries, purple grape
juice, and so on. Research on this is still a work-in-progress. Newest thinking
is that while proanthocyanidins have antioxidant activity, this is not the
mechanism of action.
Back to alcohol. Clearly, there are non-benign consequences
of excessive drinking, defined both as a high average per week and occasions of
binge drinking, the latter defined as five or more drinks for men and for or
more for women. The Centers for Disease Control and Prevention (CDC) estimates
that alcohol consumption accounts for approximately 100,000 deaths annually in
the United States. That includes motor vehicle fatalities, drownings, suicides
and homicides, liver cirrhosis and at least seven types of cancer. Excessive drinking
also contributes to non-fatal negative consequences (injuries, arrests, home
violence…). As to the alcohol “J-shaped curve,” it turns out that in many cultures,
when compared to not drinking at all, modest amounts of alcohol consumption tends
to be associated with many risk-lowering behaviors, such as less absence of obesity,
more exercise, better diet and being non-users of tobacco. Non-drinkers can also
have mental and physical illnesses that led them to never starting to drink in
the first place, or else are non-drinkers now because of past illness. Either
way, their non-drinking could contribute to the higher incidence of disease and
death of non-drinkers that had nothing to do with any purported benefits of
modest drinking.
All this leads up to the fact that the Dietary Guidelines
for Americans, a document that is updated every five years, is about to revise
downward the definition of moderate consumption of alcohol. Below, a summary of
the proposed guidelines for consumption of alcohol-containing beverages. It
remains to be seen whether lobbying by the alcoholic beverages industry will
lead to a restoration of the current definition of moderation – for men – as up
to two drinks per day, of if this downward revision will stick. Draft wording:
A) Do not begin to drink alcohol or purposefully continue to drink because you
think it will make you healthier; b) If you drink alcohol, at all levels of
consumption, drinking less is generally better for health than drinking more;
and C) For those who drink alcohol, recommended limits are up to one drink per
day for both women and men.
Different countries, different definitions of ‘moderation.’
Back in the 1950s, France recommended that people limit themselves to no more
than one bottle per day. Currently no more than two drinks a day for both men
and women, recently changed from three and two.