Health professionals slam alcohol guidelines
By Annabelle Love
Deadline looms for licensees to take part in the consultation on the new alcohol guidelines which, effectively, mean TV and the odd bacon sandwich are more damaging than alcohol.
DRINKING a maximum of two to three units of alcohol a day is not only safe, but may actually have positive benefits for health and even offer protection against a range of serious illnesses including cancer, heart disease, diabetes and dementia, right? Well not any more, according to Chief Medical Officer (CMO) Dame Sally Davies.
Dame Sally has spent the last three years conducting a comprehensive review of 28 pieces of evidence looking at alcohol harm and the public’s behaviour, and has stated there are now no safe levels when it comes to drinking alcohol. Instead, we should all be pouring a cup of tea after a hard day’s work, and when women think about reaching for a glass of wine they should be debating whether they really want it or whether they actually want to raise their risk of developing breast cancer, suggests Dame Sally.
The public consultation on alcohol guidelines – which closes on April 1 – asks for comments on whether people think each of the new guidelines, and the reasons behind them, are clear and easy to understand. But it also states: “We are not asking for your thoughts on the scientific evidence or how the expert group has used it to decide on their recommendations…”
The current guidelines were last changed in 1995 to add maximum daily limits of two to three units for women (14 units a week) and three to four for men (21 units a week). Dame Sally was asked by the Government to review the limits in 2012 over concerns they were not safe.
She convened a group of experts including Professor Sir Ian Gilmore, a liver specialist, and the Chief Medical Officers of Scotland and Wales to look at updating the advice in the light of scientific progress and the new guidelines were announced on January 8.
One of the key recommendations is that both men and women should be drinking no more than 14 units a week – making the new weekly limits for men and women the same for the first time in its history.
The guidance also recommends that people have several booze-free days a week and not save up all 14 units for a binge.
Unveiling the new guidelines process, Dame Sally said that people needed to take into account the clear link between alcohol and cancer.
She added: “Drinking any level of alcohol regularly carries a health risk for anyone, but if men and women limit their intake to no more
than 14 units a week, it keeps the risk of illness like cancer and liver disease low.”
Adopting the ‘low-risk’ approach marks a departure from the premise on which previous guidelines were based – that is to say, a weighing-up of the possible benefits and harms. Instead, the new low-risk guidelines attempt to set limits below which the risk of
alcohol-related harm is minimal. Controversially, the new guidelines concluded that: “…there is no level of regular drinking that can be
considered as completely safe.”
However, experts at the Royal Statistical Society were quick to argue that it is not true that all alcohol is dangerous and highlighted a
‘protective effect’ from small amounts. In a letter to Health Secretary Jeremy Hunt, they also stated, “We are concerned that… the
Department of Health did not properly reflect the statistical evidence provided…and this could lead to both a loss of reputation and
reduced public trust in future health guidance.”
One of the signatories, Sir David Spiegelhalter, professor of the public understanding of risk at the University of Cambridge and
President-Elect of the RSS said the new guidelines define ‘low-risk’ drinking as giving you a less than one per cent chance of dying from
an alcohol-related condition. At risks of this level, he said, that watching TV for an hour a day, or
eating a bacon sandwich a couple of times a week is actually more harmful to our long-term health.
Writing in the Daily Mail, award-winning science journalist Tony Edwards also insisted that Dame Sally’s message was “simply wrong”.
While cancer is a potential risk if you drink, with the most clearly alcohol-related cancers occurring in the parts of the body where it is
first ingested – the mouth, throat and oesophagus – these types of cancer are fairly rare in drinkers who do not smoke, he said. This
suggests that smoking increases the risk of developing these types of cancer.
Mr Edwards, author of The Good News About Booze, has also uncovered a major flaw in the way that statistics on liver disease deaths are
compiled by the UK Office for National Statistics. They admitted to him that ALL deaths from liver cirrhosis (apart from biliary cirrhosis) are recorded under the heading of ‘alcohol-related deaths’ despite the fact that liver cirrhosis can also be caused by things like obesity, drugs and hepatitis C.
It is true that breast cancer, colon cancer and liver cancer are more commonly associated with drinking but alcohol has actually been found to reduce the risk of several cancers too – including kidney, thyroid and some types of blood cancer.
Hundreds of scientific studies have found that it can also have a preventative effect in heart disease – the number one killer in the UK
and the world – boosting good cholesterol and reducing blood clotting. Similarly, rates of diabetes are lower in moderate drinkers and
moderate drinkers are also at reduced risk of other health problems including dementia, strokes, arthritis and prostate problems.
In fact, in 2001, researchers at London University calculated that, if everyone in Britain stopped drinking any alcohol at all national death rates would actually rise by about two per cent.
Dr Richard Harding, who helped draw up the booze limits in 1995, also believes that the health of the nation might worsen, rather than
improve, if people follow the new guidelines. In an open letter he wrote: “The danger is that, if existing light to moderate drinkers
drink less frequently or abstain completely, they will have shorter and less healthy lives.”
But instead of assimilating the huge body of evidence from around the world which points to the potential benefits of low to moderate levels of drinking, the new guidelines seem to simply ignore it. Dame Sally even went so far as to dismiss the notion that drinking a glass of red wine a day is good for you as “an old wives’ tale.”
Critics of the new guidelines have also raised concerns about what message reducing the number of units for men to the same for women
will send out. The move means that the UK will be one of only six countries (out of the 34 in the world who issue drink advice) to set
the same limits for both genders despite a wealth of scientific evidence showing that men and women process alcohol differently and at
different rates. Some have raised concerns that this will actually encourage women to think that they can now drink the same as men and
match them drink for drink.
It also means that only three other countries – the Netherlands, Grenada and Guyana – now have lower limits for men than the UK.
The latest guidelines were issued against a statistical backdrop which suggests that alcohol is actually becoming less of a problem in the
UK. Total alcohol consumption has fallen by almost 20 per cent since 2004, binge drinking has fallen by 20 per cent since 2007 and alcohol consumption by children (aged 11-15) has fallen 36 per cent since 2003.
In a statement issued on the day the new guidelines were unveiled, Henry Ashworth, Chief Executive of the Portman Group, said, “The vast majority of us – more than four in five adults – drink within the current risk guidelines. Guidelines are important because they help
people make informed choices about their own drinking so it is vital that they are trusted and understood by consumers.”
Mr Ashworth also said it was surprising that the UK was breaking with international established precedent by recommending the same
guidelines for men and women. He later added that it: “…does not pass the common sense test,” and suggested that the new guidelines
could be counterproductive if they are not credible or put in context, because people might choose to ignore them.
Other critics have accused the CMO of a nanny-state approach – with certain advice branded basic common sense. Some of it – that people should drink more slowly, avoid ‘risky places and activities’ as well as making sure they get home safely – would surely seem obvious to most people without it needing to be spelt out to them. Some suggestions in the 2016 guidelines however are welcome, including advice on encouraging people to avoid ‘risky’ drinking patterns, identifying ‘at-risk’ groups like young people and the advice that pregnant women and those planning to conceive should avoid alcohol altogether.
So what happens now? The public consultation closes on April 1 and it is vital that as many people involved in the licensed trade respond – everyone from those running the major drinks firms right down to individual licensees running single venues.
It is also worth writing to your local MP or MSP to make sure that he or she is also aware of your response to the new guidelines.
The more people who respond to the consultation, the stronger the message it will send to the Government.
To take part in the consultation, please click HERE.