Since 1989, every bottle of beer, wine, and liquor sold in the United States has carried a two-part government warning that is by now almost as familiar as the bar code: "(1) According to the surgeon general, women should not drink alcoholic beverages during pregnancy because of the risk of birth defects. (2) Consumption of alcoholic beverages impairs your ability to drive a car or operate machinery, and may cause health problems."
Soon you may start to notice a new sort of label on wine bottles. "To learn the health effects of wine consumption," the proposed label says, "send for the Federal Government's Dietary Guidelines for Americans." If you like to be lectured, or you simply can't get enough of the thrilling prose generated by government-appointed committees, you can get a look at the guidelines by writing to the U.S. Department of Agriculture's Center for Nutrition Policy and Promotion or by visiting its Web site; addresses for both are helpfully provided.
But Strom Thurmond would prefer that you didn't. In fact, the Republican senator from South Carolina, who sponsored the legislation that brought us the surgeon general's warnings about drinking and pregnancy, drinking and driving, and drinking and health, was said to be "absolutely furious" when he heard that the Bureau of Alcohol, Tobacco, and Firearms (BATF) planned to let wineries mention the Dietary Guidelines on their labels.
What is so subversive about the federal government's own nutritional advice? Thurmond objects to two sentences in a discussion of alcohol that is otherwise unrelentingly negative: 1) "Alcoholic beverages have been used to enhance the enjoyment of meals by many societies throughout human history." 2) "Current evidence suggests that moderate drinking is associated with a lower risk for coronary heart disease in some individuals."
Although both of those statements are verifiably true, Thurmond worries that acknowledging any positive aspect to drinking will contribute to alcoholism. It's the sort of attitude you might expect from a Southern teetotaler who is old enough to be a paleoprohibitionist. What's surprising is that Thurmond's position is echoed by so many people who claim to speak in the name of science and public health.
Public health may be blind to the plea-sure that people get from drinking, but a discipline aimed at minimizing morbidity and mortality has to take into account the large body of evidence that moderate alcohol consumption reduces the risk of heart disease and prolongs life. Beginning in the 1980s with the famous Framingham study, epidemiologists discovered that alcohol is good for the cardiovascular system. It combats atherosclerotic buildup in the blood vessels, which eventually results in the blockage characteristic of coronary artery disease--by far the leading killer of both men and women in this country. Because they are less prone to coronary artery disease, moderate drinkers live longer than abstainers.
Despite this discovery, public health information about alcohol in the United States continues to be almost uniformly negative. As a result, having learned about alcohol from grade school on, American students still don't appreciate the difference between hazardous and beneficial drinking. Seven in 10 high school seniors disapprove of adults having "one or two drinks nearly every day." Yet this is just the sort of drinking that is associated with greater longevity in the epidemiological studies. (Such a pattern also avoids the dangerous aspects of the drinking binges that are typical among high school and college students.)
The Dietary Guidelines for Americans, which are produced jointly by the Department of Agriculture and the Department of Health and Human Services (HHS), originally reflected the federal government's general tendency to portray drinking as something to be avoided. The 1990 edition, for example, said drinking alcoholic beverages "has no net health benefit, is linked with many health problems, is the cause of many accidents, and can lead to addiction. Their consumption is not recommended." But by 1995 (the guidelines are revised every five years), the evidence of alcohol's health benefits had become so strong that it could no longer be ignored. After considerable debate, the committee of scientists appointed to revise the guidelines decided to include the two sentences that so upset Thurmond.
Committee member Marion Nestle, chairwoman of the Department of Nutrition and Food Studies at New York University, seemed amazed that she and her allies had managed to add some balance to the discussion of alcohol. "It's a miracle, a miracle," she told The New York Times. "It is a triumph of science and reason over politics. The committee process was very contentious, but the outcome makes the fuss seem worthwhile."
Philip Lee, assistant secretary for health at HHS and a wine drinker whose father owned a vineyard, was also pleased. "In my personal view," he said, "wine with meals in moderation is beneficial. There was a significant bias in the past against drinking. To move from anti-alcohol to health benefits is a big change." Elisabeth Holmgren, director of research and education at the Wine Institute, the vintners' trade group, pronounced herself "full of joy."
For all the celebrating, the section on alcohol in the Dietary Guidelines remained daunting. It said up front that alcohol "has effects that are harmful when consumed in excess. These effects of alcohol may alter judgment and can lead to dependency and a great many other serious health problems," including increases in "high blood pressure, stroke, heart disease, certain cancers, accidents, violence, suicides, birth defects, and overall mortality." Hence the guidelines urged moderation for those who choose to drink, meaning "no more than one drink per day for women and no more than two drinks per day for men." Finally, considerable space was devoted to specifying who should not drink, including alcoholics, children and adolescents, women who are pregnant or trying to conceive, and people using prescription drugs or operating machinery.
Still, from the perspective of vintners who were eager to counter the surgeon general's warnings on their products with something positive, the new guidelines presented an opportunity. In June 1996, the Wine Institute proposed a label similar to the one that was ultimately approved. The only difference was that the Wine Institute originally referred to "the health benefits of moderate wine consumption," which the BATF thought should be changed to "the health effects of wine consumption," lest it sound like a reason to drink.
Even though the label, especially as edited by the BATF, amounted to little more than a plug for the Dietary Guidelines, a coalition of 20 health organizations attacked the Wine Institute's request. The coalition included HHS, co-author of the very document cited on the label. In July 1997, John M. Eisenberg, acting secretary for health (Philip Lee had left HHS by then), told the BATF he was "deeply concerned" that the label "would be construed by the public as encouraging the consumption of alcoholic beverages." Surgeon General David Satcher warned that it would send "mixed messages."
Seeing the labeling request as part of a general campaign by vintners to make hay over reports of health benefits from alcohol, the Center for Science in the Public Interest issued a report in October 1997 entitled "Vintage Deception: The Wine Institute's Manipulation of Scientific Research to Promote Wine Consumption." The CSPI warned that publicizing alcohol's health benefits would encourage people to drink, resulting in more alcohol-related disease and social problems.
Given its longstanding resistance to anything that could be construed as a health claim for alcoholic beverages, the BATF was probably sympathetic to this argument. But as then-Treasury Secretary Robert Rubin noted in a March 1998 letter to Thurmond, the bureau simply does not have the legal or constitutional authority to reject a label statement that is neither false nor misleading. So last February, almost two years after the initial proposal, the BATF finally approved the Wine Institute's language, along with a label from California's Laurel Glen Winery that urged consumers to "consult your family doctor about the health effects of wine consumption."