Alcohol in the 2010 Dietary Guidelines for Americans

In a recent Los Angeles Times op-ed piece, Reason contributor Stanton Peele notes that the pentennial argument about how to treat alcohol in the federal government's Dietary Guidelines for Americans has broken out once again this year as a panel of experts works on the 2010 edition. Opponents of acknowledging the health benefits of moderate drinking, as usual, worry that doing so will encourage excess. But the evidence of health benefits has become harder and harder to ignore, as reflected in the evolution of the government's advice:

1985: "One or two standard-size drinks daily appear to cause no harm in normal, healthy, nonpregnant adults."

1990: "Some studies have suggested that moderate drinking is linked to lower risk for heart attacks."

1995: "Current evidence suggests that moderate drinking is associated with a lower risk for coronary heart disease in some individuals."

2000: "Drinking in moderation may lower risk for coronary heart disease, mainly among men over age 45 and women over age 55."

2005: "The consumption of alcohol can have beneficial or harmful effects depending on the amount consumed, age, and other characteristics of the person consuming the alcohol, and specifics of the situation....Moderate alcohol consumption may have beneficial health effects in some individuals. In middle-aged and older adults, a daily intake of one to two alcoholic beverages per day is associated with the lowest all-cause mortality. More specifically, compared to nondrinkers, adults who consume one to two alcoholic beverages a day have a lower risk of coronary heart disease."

This year the the Dietary Guidelines Advisory Committee's report (the main basis for revising the guidelines) includes these findings:

Strong evidence consistently demonstrates that compared to non-drinkers, individuals who drink moderately have lower risk of coronary heart disease....

Moderate evidence suggests that compared to non-drinkers, individuals who drink moderately have a slower cognitive decline with age....

An average daily intake of one to two alcoholic beverages is associated with the lowest all-cause mortality and a low risk of diabetes and CHD among middle-aged and older adults.

In addition to acknowledging these associations, the committee proposes a more liberal definition of moderate drinking. The 2005 edition (like earlier editions) defined moderation as "the consumption of up to one drink a day for women and up to two drinks a day for men." In this year's advisory report, by contrast, "moderate alcohol consumption is defined as average daily consumption of up to one drink per day for women and up to two drinks per day for men" (emphasis added). The committee says this definition better fits the epidemiological evidence, which is based on questions about average daily, monthly, or yearly consumption. "Because most US citizens do not drink every day," it says, "the [committee] recommends that the definition for moderation be based on this general 'average' metric over the course of a week or month instead of an exact threshold of '1 drink per day for women or two drinks per day for men' each day." Still, the report cautions against cramming a whole week's drinking into a day or two, recommending that women consume "no more than three drinks in any single day" and that men have "no more than four drinks in any single day."

What the committee does not say is that subjects in epidemiological research (and surveys generally) probably tend to understate their alcohol consumption. If so, the levels of drinking associated with the best health outcomes may be higher than the data indicate, meaning that even the relatively generous standard recommended by the committee could be unnecessarily strict. In any case, as in all the previous editions of the guidelines, warnings about the hazards of drinking take up far more space than the few passages mentioning potential benefits. Given this overwhelmingly negative context, the concerns about encouraging excessive consumption seem overblown.

Back in 1996, Stanton Peele discussed alcohol and the dietary guidelines in  Reason.

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  • Suki||

    Would they run an article like this when Virgina Postrel was here?

  • Astrid||

    I see what you did there.

  • Suki||

    ;)

  • Tim||

    Well, I didn't.

  • Almanian||

    lulz!

  • Fist of Etiquette||

    If drinking in moderation can reduce the risk for heart disease, then it stands to reason getting shitfaced every night will cure my chronic hypertension. Finally, medical science is working for me!

  • WTF||

    If a little is good, more is better?

    I don't know the latin name for this logical fallacy, but I bet there is one.

    About the only thing I can think of right now that it's true for is money. And maybe tookie.

  • Suki||

    WTF, the logical fallacy around here is abbreviated MNG.

  • Obama (at the printing press)||

    About the only thing I can think of right now that it's true for is money.

    I hear that!

  • Heroic Mulatto||

    If a little is good, more is better?

    I don't know the latin name for this logical fallacy, but I bet there is one.

    It's called: bukkake.

  • -||

    "Diminishing returns," tho' not technically a logical fallacy.

  • ||

    many drugs have what is referred to as a "U shaped dose/response curve"

    basically, it's a big upside down "U"

    alcohol is one of them

    moderate doses are healthier than no dose, but heavy doses can be quite unhealthy.

  • WTF||

    It's called: bukkake.

    I ell-oh-elled there.

    But I don't think that's latin.

  • ||

    So my practice of going on a weeklong binge followed by a couple months on the wagon is cool?

  • Jason||

    No, you should binge more often.

  • -||

    A mini-binge a day keeps Obama away.

  • ||

    I'll drink to that!

  • ||

    The stress of going through life sober will kill you quicker than the booze ever will.

  • ||

    So is Reason not doing a story on the big intelligence leak in Afghanistan?

  • Afghanistan||

    My intelligence is not "leaking" - I just pissed myself, thank you.

    GIMME ANOTHER BEER BONG!! WOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO!!!

  • Suki||

    They had it in morning links. The one they will ignore is Obama's letter to Scotland to let the Lockerbie bomber go.

  • ||

    It makes a nice companion with the Administration's public protests of the same.

  • Suki||

    Ah, balance. I keep missing that aspect with this regime.

  • JEP||

    I think Balko linked this in an article about judges not understanding the science behind forensics about 2 years ago. It's a good read.

    http://www.newyorker.com/archive/2002/05/27/020527fa_FACT

  • ||

    Even if the effects were health-neutral, having an IPA every night would enhance one's quality of life.

    Now, Epi's periodic alcohol- and drug-fueled descents into impotent rage and perverse sexual trysts, generally involving gay midgets, ponies, trampolines, and Wesson oil -- not so life-enhancing.

  • ||

    And by "periodic", I mean "occasionally passing out so he gets a brief interlude between the otherwise continuous madness and lechery"

  • ||

    Don't disrespect midgets unless you are midget qualified.

  • kilroy||

    Does this mean free booze on the Reason cruise?

  • Ghost of Ed McMahon||

    HIYO!

  • Suki||

    Just a sign in the bar that says "Free booze tomorrow."

  • ||

    +1

    It is called postponed gratification, a very puritan virtue.

  • ||

    Does this mean free booze on the Reason cruise?

    No, and they do cavity searches at boarding time, so watch out.

  • TickleStick||

    "that men have "no more than four drinks in any single day.""

    That sounds about right.

  • Brett L||

    I never drink that many before the sun sets.

  • Almanian||

    I dunno, it enhances my life to hear about it, in that "I felt bad because I had no shoes, until I met....etc. etc." way.

  • Almanian||

    Oops - that was meant for prole

  • BakedPenguin||

    Oh yeah - I felt bad because I had no shoes, until I met a man with no feet.

    Because then I took his shoes. He didn't fucking need 'em.

  • Almanian||

    Exactly. See the Happy Bunny books..."Hey, footless dude!"

  • ||

    Moderate evidence suggests that compared to non-drinkers, individuals who drink moderately have a slower cognitive decline with age....

    That's moderately encouraging to this moderate drinker. Of moderately strong drinks.

  • ||

    Where is alcohol in the Food Pyramid? In the grains section?

  • Suki||

    For some, it is the cap of the pyramid. For others, they make huge pyramids out of the empty cans and bottles.

  • Anomalous||

    Well, wines would be fruit, beer and most distilled spirits would be grains. And you, if you overindulge, may become a vegetable.

  • ||

    Vodka done right would be under starches.

    Mead is under sugars.

  • Death Panelist||

    For a magazine called Reason, you sure do want me to decrease my chance of heart disease.

  • Fluffy||

    I am risking my health here. I currently have around 5 drinks a year, not 5 drinks a week.

    I would have thought that counted as moderate drinking.

    I guess that's yet another instance of the phenomenon where everyone thinks that their own habits are average.

  • ||

    That almost makes you a teetotaler. Just what the hell are your vices then? Because you have to have some.

  • Tim||

    Subtle innuendos follow,,,

  • ||

    Dear God, I know what you're talking about.

  • ||

    Damn MTV!

  • WTF||

    "Stand and Deliver" was better.

  • ||

    I am adamant in my displeasure.

  • BakedPenguin||

    I bet you wear white socks.

  • Mike||

    Only with dark slacks and dress shoes.

  • ||

    Holding down the shift key.

  • Butts Wagner||

    taking my talents to the shift key

  • Hank||

    After an exhaustive 25 year study, I have found that 4 to 5 hits the spot. I recommend this to myself frequently, but reserve the right to stray from time to time. Perhaps Big O could reveal the appropriate number for, say, a beer summit.

  • TickleStick||

    Two parts Black Wabel to one part White.

  • WTF||

    Racist.

  • ||

    you making fun of Elmer Fudd, blacks, or whites?

    Must be racist, but that's OK because Vilsack will offer you an apology and a job.

  • Astrid||

    He would have to start drinking beer first.

  • Citizen Nothing||

    Dietary Guidelines for Americans 2020: "The Department of Health and Human Services mandates consumption of from two to four drinks daily for all Americans."

  • ||

    Boozers/smokers actually save the state money by dying early, so by 2020 the Dr. Emanuels of the new world may well have reformed the hyppocratic oath and be telling you to drink yourself to death.

  • Tim||

    Are we talking beer, wine or moonshine here?

  • ||

    Moonshine is free range organic. I am surprised they don't sell it at Whole Foods.

  • Zeb||

    As far as I have heard, the benefits seem to come from ethanol in whatever form. Depending on the source, the other stuff in moonshine may or may not outweigh the benefits of the ethanol.

  • DaveS||

    I wonder if there is some evolutionary component going on here.

    When you consider that "clean" drinking water has only been around a relatively short period of time, to avoid water borne disease we(as a species) grew up drinking alcohol almost as a staple of our diets.

    Much like how we instinctively crave salt to keep electrolytic balance, perhaps there is some deeply rooted instinctive craving to drink alcohol, and in response to this instinct our bodies developed to utilize small amounts of alcohol in ways unrelated to keeping our insides free of bacterial nasties.

  • dfd||

    Unlikely. We (as a species) grew up over the last 200,000 years while alcohol has been around for only small fraction of that time. Also, I doubt that finding clean water was any more of a problem for humans than other animals during most of that time at any rate. What is recent, in evolutionary terms, is civilization and thus an inability to find clean water is also only a fairly recent problem. Further, evolution of dietary needs go back millions of years so seems rather unlikely that the relatively very recent introduction of alcohol would have had any measurable impact on our evolution.

  • Zero||

    You make sense but do you have support on how long humans have been drinking alcohol? (I don't know) Considering how easy it is to 'accidentally' make alcohol Ogg might have found some old juice in the back of the cave.

  • ||

    Maybe that's how Neanderthals bit the dust. Too much partying.

  • ||

    Evolution can occur quickly as well as slowly. The invention of alcohol would bring on a (relatively) rapid burst of new evolutionary pressures, from sexual selection to disease mitigation to social bonding to alcoholism.

  • ||

    I can't imagine anything the USDA might have to say about diet that I would care about. At all. Ever.

  • ||

    Eat lots of corn. And wheat. And dairy. Lots.

  • ||

    Sadly, we just finished off our homemade batch of butter-pecan-bacon ice cream.

    I wonder where that sits on the fooking pyramid?

  • The Gobbler||

    Wow! That sounds tasty!

  • ||

    This week:

    Finishing up a batch of Bailey's Irish Cream ice cream. Just made a batch of raspberry champagne spuma.*

    *a sorbet, only with whipped egg whites mixed in. Smooth, light, and creamy, even though there isn't a drop of milk in it.

  • ||

    Hovering above it.

  • John Marshall||

    By the doctrine of chances it must be raining somewhere.

  • Neu Mejican||

    warnings about the hazards of drinking take up far more space than the few passages mentioning potential benefits.

    There is a reason for this. The hazards of drinking excessively are really well documented, very serious, and have huge public health consequences. It's a tough needle to thread from a public health stand-point.

    Here's one of the public relations dilemmas I like best. Women frequently ask me about the safety of drinking a glass of wine or two during pregnancy since I do research on the topic. The answer the facts demand is that I tell them there has been no study that can demonstrate a safe level of alcohol for pregnant women when effects are measured on the group level. For an individual woman, however, the risk is unknown as there is clearly a genetic susceptibility involved with some children of mothers who drink heavily having no measurable negative consequences and some children of mothers who drink very little having serious problems.

    So I always give them this advice: If you are pregnant and feel the need to have a chemical help you relax...heroin is the much safer choice when compared to that glass of wine. This doesn't mean that heroin is good for the baby.

  • robc||

    I tell them there has been no study that can demonstrate a safe level of alcohol for pregnant women when effects are measured on the group level

    I will take your word for it. And I realize there are more issues than just birth weight, but one of the articles above mentioned studies showing that women who have one drink have heavier babies than those having zero, but at two drinks they are lighter than the zero group babies.

    That doesnt mean a "safe" level, but it does suggest some benefit.

  • ||

    hey, try to push that little dude through YOUR vaginal canal, and tell ME that a heavier baby is a "benefit" :)

  • ||

    It's for the baby, nobody gives a rat's ass about your canal.

  • ||

    i don't have a canal, but thanks for the concern. it's a joke. lighten up, francis

  • Neu Mejican||

    Rob,

    Indeed. I looked it up and Bakker et al attribute the difference in birth weight to other factors. Their findings are that there is no reliable association between light drinking and birth weight. Which fits with other studies.

  • Neu Mejican||

    The primary organ that is damaged by alcohol is the brain. Birth weight can also be an an issue, but it is a separate issue.

    I assume you are referring to the study by Bakker et al (2010).

    iirc they found that any association was better explained by socio-demographic and lifestyle-related differences.

  • robc||

    Looking back at those articles, I was referencing the Abel 1995 meta-study. Obviously a 2010 one would probably be better, did it reference the Abel study?

  • Matt C||

    The problem with all the data on alcohol benefits is the sticky issue of a lack of RCTs on alcohol's effects on heart disease. If I recall almost all of the information is observational. If we ever got over the tricky ethical issues and finally did an RCT, and saw the same results (or better), I would be happy.

    I am drinking more than 2 a days anyways.

  • Ravinder ||

    Guidelines doesn't matter for people who drink. Every one know it's harmful but they drink.
    Very few people don't cross there limits.
    Good information

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