Alcohol Use Disorders (30) Do people understand the harms of alcohol? (5) How can they be better informed? (2)

8 February, 2024

Perhaps people would be better informed if there were more consistency among healthcare information providers?

1. The World Health Organization says 'when it comes to alcohol consumption, there is no safe amount'.

https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-cons...

2. By contrast the Mayo Clinic (one of the most respected centres in the US) says this in a recent article on their website (Sept 2023):

'If you already have a glass of red wine with your evening meal, drinking it in limited amounts may improve your heart health.

'Antioxidants in red wine called polyphenols may help protect the lining of blood vessels in the heart. A polyphenol called resveratrol is one part of red wine that's gotten noticed for being healthy... But study results on resveratrol are mixed...

'Many studies have shown that drinking regular, limited amounts of any type of alcohol helps the heart. It's not just red wine...

'Researchers keep studying whether red wine and other alcoholic drinks can help the heart. Those who drink regular, limited amounts of alcohol, including red wine, seem to have a lower risk of heart disease. Drinking regular, limited amounts is called drinking in moderation.

'But there might be other reasons for the lower risk of heart disease in people who drink red wine in moderation. For instance, they might eat a healthier diet and be more active than those who don't drink red wine. And they might have higher incomes and better access to health care as well.

'More research is needed about whether red wine is better for the heart than other types of alcohol, such as beer or hard liquor.

Full text: https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/re...

3. A recent (2023) Lancet Rheumatology editorial notes: 'Many studies have shown that low or moderate amounts of alcohol (particularly red wine) can reduce risk for cardiovascular disease, diabetes, and even death—possibly due in part to a tendency to reduce systemic inflammatory mediators. These benefits might be limited to adults older than 40 years, according to a 2022 analysis from the Global Burden of Disease study, which found no such benefit at younger ages.

'Potential benefits of light to moderate alcohol consumption have also been reported among patients with rheumatoid arthritis...

'WHO calls for increased education on the cancer risks associated with alcohol consumption—perhaps including health warnings on alcohol labels—and few would argue against better-informing the public with regard to health. But the absolute risks of light to moderate drinking are small, and while there is no known safe level of drinking, it seems reasonable that the quality of life gained from an occasional drink might be deemed greater than the potential harm.'

https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00073-5/fulltext

4. There is no direct contradiction between the WHO stance ('there is no safe amount') and the stance of others. It is conceivable that small amounts of alcohol may increase risk of some of the 200+ diseases it is associated with, even if a real protective effect for heart disease were ever to be proved. It's also notable that alcohol is recognised as a carcinogen, which would imply that 'there is no safe amount'.

But it's understandable that there may be confusion among those responsible for health education (including frontline healthcare providers) and the general public that relies on them.

HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org