A Little Alcohol May Hurt: New Data on Drink Danger
Seventy million Americans, according to latest estimates, are habitual users of alcoholic beverages. Almost all of them would describe themselves as “social drinkers.”
A cross-tabulation of government surveys a few years ago by alcohol researcher Robin Room produced a definition of a heavy drinker as “someone who drinks twice as much as I do.” While the social, psychological and biomedical consequences of heavy drinking are well known, most social drinkers derive great comfort and reassurance from the heralded reputation of moderate drinking as a beneficent adjunct to life that not only eases stress but contributes to good health and even longevity.
The news report a few weeks back of a possible chemical connection between alcohol and cancer had to give pause to every drinker who read or heard it. The report was based on a finding by Heinz Fraenkel-Conrat and Bea Singer, a husband-and-wife team of molecular biologists at UC Berkeley. Writing in the Proceedings of the National Academy of Sciences, the scientists declared that alcohol and acetaldehyde--to which alcohol converts in mammalian cells--combine to change DNA in a manner similar to changes produced by other cancer-causing chemicals.
“These reactions could play a role in the recently documented association between moderate use and increased incidence of breast cancer,” the two scientists explained in a carefully worded press release. And from their vacation home in England, Singer added, with equal caution, “If indeed there is other evidence indicating that alcohol is a carcinogen, this could be a mechanism.”
Although a statistical corollary between drinking and cancer has long existed--the more you drink, the greater your risk of developing cancer--no one until this point had been able to say precisely what role alcohol played. Many authorities speculated that alcohol bathes the body cells to such a degree that they become vulnerable to known carcinogens found in tobacco and even in the alcoholic beverage. Asbestos fibers, for example, have been found in beer, wine, sherry and vermouth. Until now, there had always been disagreement as to whether alcohol itself was a carcinogen; should the work of Fraenkel-Conrat and Singer be validated by further studies, that question will be answered.
The full significance of their research, however, can only be appreciated in context. It is one more in a series of relatively recent findings that appear to put the knock on alcohol consumption at levels few drinkers had ever considered dangerous.
Over the last 15 years, a number of researchers in the United States and abroad have developed the proposition that what passes for social drinking today in many parts of the world is so fraught with biomedical hazards it could be exposing millions of self-described “social drinkers” to serious health hazards, among them: liver problems, including cirrhosis; hypertension; cancer of the digestive tract; severe side-effects for those who simultaneously ingest alcohol and other mood-altering agents, or prescription and over-the-counter drugs; fetal damage even before confirmation of a pregnancy, and the impairment of sober intellectual capacities.
At what level of consumption might such damage occur? Although there is no universal agreement among those alcohol researchers responsible for the above findings, the consensus would appear to be that risks begin to rise after the consumption of the equivalent of 28 grams of absolute alcohol, or ethanol, a day--the approximate amount found in two 1.5-ounce martinis made with 80-proof gin, two five-ounce glasses of 12% wine or two 16-ounce cans of 4.5% beer.
The alcoholic-beverage industry disputes all such calculations about what constitutes a safe-drinking threshold, as well as most of the research on which they are based. It argues that the association between alcohol and diseases has never been conclusively established, and it contends that physical and genetic factors and even cultural perceptions about what constitutes “heavy” drinking make the answer different for each individual. The industry maintains that most Americans are not only moderate drinkers--per capita consumption in the United States being half that of Portugal and France, and well below that of Italy, West Germany and even Switzerland--but have tended in recent years to “lighten up,” increasingly favoring beer and wine over spirits.
While the industry is on solid ground in resisting the categorization of drinkers at arbitrary cutoff levels, its characterization of drinking patterns in the United States is, at best, misleading. While it’s true that most American drinkers drink moderately, per capita consumption of absolute alcohol in this country is strikingly higher today than it was in the 1950s. During that decade, consumption held steady at two gallons per year per person. From 1960, it rose steadily, reaching a high of more than 2.7 gallons in the early 1980s, before tapering off to 2.62 gallons in 1985, the last year for which figures are available. Since per capita calculations include non-drinkers as well as drinkers, the increase in consumption among drinkers during this period was probably twice what the figures indicate--meaning that by the early 1980s, those who drink were consuming at least 60% more than they or their counterparts were consuming in the 1950s.
Per capita comparisons between countries are equally misleading. When you factor out the much higher prevalence of abstainers in the United States than in the countries where per capita consumption is greater--when you compare drinkers and drinkers, in other words--Americans are right up there with the leaders. As to the trend toward “lighter” alcoholic beverages, unless you’re drinking a light beer or wine, a drink is a drink is a drink; each contains the same approximate amount of ethanol.
Misleading estimates about how much Americans drink are not exclusively the fault of the alcoholic-beverage industry. Most drinkers delude themselves about the kind of drinker they are. Survey data demonstrate that the difference between how much Americans say they drink, when asked, and what they actually drink is at least 30%, and may be closer to 50%, below actual consumption.
The upshot of these consumption patterns is that a significant percentage of America’s 70 million habitual drinkers could be consuming at levels now perceived as potentially dangerous by a contingent of investigators. And the news from these investigators is probably not going to get better. The trend in the alcohol research field is toward implicating smaller and smaller amounts of alcohol in adverse consequences of drinking. In addition to the aforementioned diseases, scientists are looking into the effects of social drinking on the bone marrow, the gastrointestinal tract, the reproductive system, the immune system, nutrition--and sleep.
In the decades following the repeal of Prohibition in 1933, alcohol researchers were afraid to challenge the conventional wisdom that problems associated with drinking reposed in the drinker and not in the substance he or she drank. Today, the focus is equally on the substance--a focus that will not likely be diffused by cries of “neo-Prohibitionism” from the alcoholic-beverage industry.
What should social drinkers do as the conflicting claims fly back and forth? Statistics tell us that most drinkers will not contract specific illnesses as a consequence of their drinking. Singer, for one, continues to drink moderately and pleasurably. But statistics also tell us that those who imbibe three to five drinks a day are at greater risk of early death than those who imbibe one or two, and those who drink six or more drinks a day are at greater risk yet. Prudent drinkers--women in particular, who appear to be twice as vulnerable as men to biomedical problems associated with alcohol--will confine themselves to one or at most two drinks a day and monitor their consumption carefully, measuring drinks, drinking slowly and avoiding “spree” drinking on weekends.
Alcohol is a potent drug--in the view of many, the most potent of all. The difference between beneficial and dangerous drinking may prove to be very small.
