Wednesday, 13 April 2016

Inconsistent alcohol guidelines

From The Times (but you can read it in The Australian):

If you like a drink but are worried about your health, you might want to move to Chile, or the United States. Men there can get through five glasses of wine a night before doctors think they are having too much, according to a study that found huge variations in national alcohol guidance.

... "It’s not scientifically possible that women should drink [a bit] less than men, half as much or the same as men. But we find all these things in the guidelines,” Professor Humphreys said.

He argued that guidance reflected cultural choices, not pure science. “Governments and countries make judgments that are more than empirical,” he said. “In some it’s socially unacceptable for women to drink whereas in others there’s a feminist understanding that women shouldn’t be embarrassed to drink as much as men.”

All countries agreed that large amounts of alcohol were dangerous, he said. The debate was “more around whether it’s one, two or three” daily drinks.

That is pretty much what I said in the recent Spectator Health debate about whether we can trust health advice. I started my speech like this...

Before answering the question of whether we can trust health advice we must first ask: ‘Which health advice?’ It varies so much over time and between countries. In 1979, the government advised men to drink no more than 56 units of alcohol a week. This was later reduced to 36 units, then 28 units and then 21 units. Last month, the Chief Medical Officer reduced it once again, this time to 14 units. Upon announcing this, she also asserted that there is no safe level of drinking and that the health benefits of moderate alcohol consumption were ‘an old wives tale’.

Male drinking guidelines vary enormously around the world, from 52 units a week in Fiji to 35 units in Spain, all the way down to seven units in Guyana. There is no other country in the world that has the same guidelines as the UK. The day after Sally Davies released her report, the US National Institute on Alcohol Abuse and Alcoholism announced the results of its review of alcohol guidelines and maintained the recommendation for men of up to 25 units per week. This government organisation estimates that 26,000 deaths a year are prevented by moderate alcohol consumption thanks to reduced risk from heart disease, diabetes and stroke. In America, the guidelines for women are lower than they are for men, as they are in all but a handful of countries worldwide. Britain is now one of the few.

Therefore, in order to trust this latest piece of health advice from our Chief Medical Officer, we must believe not only that every previous Chief Medical Officer got it wrong but that every other country in the world has got it wrong. That requires a degree of patriotism that I am unable to summon up, particularly since the current advice bears no relationship whatsoever to the scientific evidence.

The author of the Addiction study sounds surprisingly reasonable...

Uncertainty in the evidence is at least partly a result of people lying about how much they drink and Professor Humphreys said that “a certain amount of humility would be appropriate” from the authorities. “Public health people approach life in terms of risk minimisation but the rest of us approach life at least partly in terms of fun,” he added.

He's not going last long in 'public health' with that kind of attitude.

1 comment:

ted said...

The Australian link goes to a subscription only article.