Just like ‘an apple a day keeps the doctor away,’ many of us have come to believe years of messaging that claimed moderate drinking is good for health, especially for the heart. Turns out you had best stick with the apples.

“To date, no reliable correlation has been found between moderate alcohol consumption and a lower risk of heart disease,” says the World Heart Federation (WHF) in a press release dated 22 January.

In the release, which announced its latest policy brief, WHF lays out the deadly nature of drinking: In 2019, more than 2.4 million people died because of alcohol, accounting for 4.3% of all deaths globally and 12.6% of deaths in men aged 15 to 49. “Studies have shown that even small amounts of alcohol can increase a person’s risk of cardiovascular disease, including coronary disease, stroke, heart failure, hypertensive heart disease, cardiomyopathy, atrial fibrillation, and aneurysm,” says the brief, titled The Impact of Alcohol Consumption on Cardiovascular Health: Myths and Measures. 

And for women, “even in smaller quantities, alcohol consumption can increase the risk of breast cancer. It can cause more severe motor and cognitive dysfunction in women at much lower levels of consumption than men,” adds the document.

A wide range of mental health consequences

An earlier NCD Alliance (NCDA) publication noted, “In addition to the physical harm associated with alcohol use, there are a wide range of mental health consequences, for example significantly increased rates of depression, anxiety and suicide, relationship, social problems and legal consequences, as well as psychosis and withdrawal states.”

So why have we been hearing all these years that drinking can be good for us?

“The portrayal of alcohol as necessary for a vibrant social life has diverted attention from the harms of alcohol use, as have the frequent and widely publicised claims that moderate drinking, such as a glass of red wine a day, can offer protection against cardiovascular disease,” said Monika Arora, a member of the WHF Advocacy Committee and co-author of the brief. “These claims are at best misinformed and at worst an attempt by the alcohol industry to mislead the public about the danger of their product.”

In fact, says the brief, there are many reasons to let go of the ‘healthy drinking’ myth:

• Evidence to back up the belief has been mostly based on observational studies
• No randomized controlled trials—considered the gold standard in research because they assign patients by chance to different treatments to compare benefits and harms—have confirmed health benefits of alcohol
• Most evidence is observed only in the Caucasian population
• Some studies that show positive effects are funded by the alcohol industry.

Separate research into the alcohol industry in Latin America and the Caribbean (LAC) has found that it uses various strategies to promote consumption. Lobbying, image advertising, alliance-building, and court actions are used to influence government policies in four key areas: alcohol availability, pricing and taxes, marketing regulations, and action on drink-driving, according to the report, The Alcohol Industry´s Commercial and Political Activities in Latin America and the Caribbean: Implications for Public Health.

Alcohol industry borrows strategy from Big Tobacco

Public health measures in the LAC have been difficult to enact, even with strong scientific evidence that they reduce alcohol-related harm This is because the alcohol industry has adopted strategies and tactics borrowed from Big Tobacco. which is a key finding of the report, produced by NCD Alliance, the Global Alcohol Policy Alliance, the Healthy Latin America Coalition (HLAC), and the Healthy Caribbean Coalition.

“Almost every country in Latin America and the Caribbean has been exposed to some of these tactics,” said Beatriz Champagne, HLAC Coordinator. “Far from being a passive supplier of alcohol products, the industry is actively involved in promoting demand for alcohol in order to increase sales and profits, particularly in new market segments like women and young adults.”

As NCDA noted recently, “disproportionate power, actions, and influence of the alcohol industry have delayed policy implementation, diluting responses with weak mechanisms such as voluntary or self-regulation, deflecting with false claims, and denying and dispersing doubt on the evidence. These tactics have been and are widely used by tobacco, food, gambling, and other harmful commodity industries.”

Table taken from the WHF report.

CDC casts doubt on studies linking drinking and improved health

A Google search reveals the persistence of the moderate drinking myth that the alcohol industry has helped to sustain. But it is weakening. In 2016, the United Kingdom changed 20-year-old advice on moderate use of alcohol and its benefits to the heart, saying those were less than previously thought and issuing new guidelines that state alcohol raises the risk of certain cancers, according to another report co-authored by NCDA entitles Trouble Brewing. 

The US Centers for Disease Control and Prevention is also casting doubt on previous advice: “While some studies have found improved health outcomes among moderate drinkers, it’s impossible to conclude whether these improved outcomes are due to moderate alcohol consumption or other differences in behaviours or genetics between people who drink moderately and people who don’t,” says its website.

One researcher is certain that recent studies which found benefits from moderate drinking failed in their design by not accounting for differences in people’s wealth. “We show that once you control for how rich or poor someone is the relationship between alcohol and health no longer exists,” said Associate Prof Andy Towers, an addiction researcher from the school of health sciences at Massey University in New Zealand, quoted in The Guardian newspaper.

People who drink moderately are also people “who are richer, have better houses, have better jobs, have better education and can – as a result – afford better lifestyles that support better health,” Towers told the Guardian.

With the alcohol myth genie being pushed back into the bottle, WHF recommends several steps to reduce the devastation caused by drinking:

•    Restrict availability of alcohol
•    Improve access to screening and treatment
•    Ban alcohol advertising
•    Raise prices through taxation
•    Mandate prominent health warnings on alcohol products.