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The public now accepts that 2 glasses of wine are good for the
heart and evidence shows that moderate use is beneficial for other
aspect of health as well. Epidemiological research shows that
moderate alcohol consumption lowers the risk for ischemic stroke,
gallstones, kidney stones, pancreatic cancer, stomach ulcers,
Non-Hodgkin’s lymph cancer, benign prostate enlargement ,prostate
cancer and Parkinson’s disease. In sum, apparently some alcohol
is beneficial for health as expressed in lower risks for some
diseases or premature death. In other words, moderate use increases
life expectancy. The proverbial, L-, J- and inverted U-formed
curve depicts this association of amount of alcohol and health
in a clear and meaningful way. By statistical analyses including
correction for age, diseases, former alcohol consumption, other
substances use, gender, education, socio-economic status, the
most obvious conclusion is that it is alcohol itself that is the
main factor in this outcome. Other researcher claim however, that
other substances in wine, beer, spirits also contribute to this
outcome such as the anti-oxidative efficacy of polyphenols like
resveratrol, quercetine and ferulic acid and other substances
such as vitamine B6.
By focussing on these substances the impression is given that
they form the cause of the beneficial effects on health. If true,
it suffices to go the pharmacy to buy pure alcohol or pills available
that contain all these good elements found in alcoholic drinks.
The favourable effects of alcohol relate to cognitive health too.
The risk of Alzheimer’s, dementia or impairment of cognitive abilities
is lower with regular use of some alcohol. Regular,moderate consumption
of alcohol helps the elderly to preserve their daily basic activities
and intellectual abilities in comparison with non-drinkers and
heavy drinkers. Geriatric patients become more sociable, more
independent and improve their awareness of the external world
when a daily alcoholic drink is offered, as the so-called experimental
‘beer’- and ‘wine’-studies of the 1970’s showed.
Considering these positive outcomes it is no surprise that moderate
users of alcohol are more happier, commit less suicide, have less
health complaints, sick leave, hospitalisations, better recovery
from illness are better educated and enjoy higher incomes and
a richer social life. These findings remain also after having
taken into account other factors that may obscure the outcomes.
Therefore, the conclusion is forced upon us that it is the substance
of alcohol and the other components of alcoholic drinks, that
are responsible for these benefits. This conclusion has led to
continuing attempts of researchers to identify all these substances
and the mechanisms by which they work in order to explain conclusively
the health benefits of moderate us. The public - informed by the
media which takes its information from scientific journals - believe
that alcohol and these substances are healthy. Is this true?
Most people drink for enjoyment. Surveys show that 60% drink alcohol
for conviviality and 45% for relaxation -an alcoholic drink is
not unique in this. Pleasure, the stimulation of the senses, is
the common element that make people consume certain products or
do some activities. So the question is whether the pleasure of
having a drink rather than the alcohol might be the cause of the
effects on physical, mental and self-reported health. Unfortunately,
evidence on this aspect of alcoholic drinks is scarce. More evidence
is available on the effects of pleasure from music,leisure and
humour. The findings show that humour and music boost the immune
system, lower stress and make people relax. Leisure activities
contribute to good mental health, mood and work satisfaction.
Daily uplifts strengthen the immune system, keep people mentally
in balance and are an antidote to everyday stress. Enjoying a
drink is a combination of all these elements, after all it is
a pleasant activity, mostly done in company,in leisure time and
is associated with laughter and humour. One could say that a life
that contains these elements is a happy life style: with pleasure
at its core. Pleasure strengthens good health. Whether it comes
from drinking, humour, physical activity, chatting with friends,
going out or shopping is irrelevant; the pleasure itself is relevant.
The definition of this health-related lifestyle is quite different
from the one used by epidemiologists and which is used in everyday
life. This latter definition of health is disease-based. An example:
the life style that is associated with cardiovascular disease
consists of risk factors such as obesity, physical inactivity,
smoking, a fatty diet or an irregular and hectic life. To lower
the risk of cardiovascular disease, changing this behaviour pattern
and lifestyle is inevitably recommended.
But why not define health from the factors that define good health
and help people to strengthen these health promoting factors by
enjoying life by taking a drink, relaxing, visiting friends, having
hobbies, eating out and travelling? Following this reasoning,
it is logical to assume that people who drink for pleasure should
differ from those who use a drink to drown sorrows. Indeed a large-scale
study in Heidelberg in the 1990’s showed this difference. 50-60-year
olds were followed for 13 years, 2,5% of moderate drinkers died
from CHD against 3,4 % of the abstainers and 5,6% of the problem
drinkers. Similar differences were found for cancer, accidents,
aggression and crime.
There is other evidence showing that feeling guilty is the main
determinant in getting a hangover. Instead of feeling guilty due
to not obeying guidelines, one should stress the importance of
seeing alcohol not so much as a risk for health, but should emphasize
the beneficial effects of the pleasure of its sensible use on
physical, psychosocial and cognitive functioning. People cannot
help feeling guilty when the information on alcohol is negative,
and based exclusively on misuse. People are afraid of drinking
and worry about their behaviour. Health authorities should also
offer a positive perspective - to drink in moderation and in company.
The critical learning period of life is as a youngster -characterized
by trial and error for dating,, job or study, hobby or sport and
how to look and dress.Parents and peers are not worried about
these activities, since implicitly they know that with increasing
age the extremes evolve gradually to grown-up behaviour. The same
applies to alcohol use. Depriving youth of these experiences,
withholding information and models on how to learn to appreciate
an alcoholic drink leads to inadequate drinking behaviour of which
guilt is the main determinant.What is missing is a yard-stick
of what constitutes normal drinking. The benefits of the enjoyment
of a drink on physical, mental and subjective health will be clearer
when moderate users rid themselves of such needless worries.The
beneficial effects of moderate alcohol use will be much stronger
when studies focus on those who drink for pleasure.In short an
alcoholic drink is not healthy in itself, it is the pleasure of
it that promotes health: a drink is a healthy pleasure!
Extracts from: Alcohol, the sober facts — beneficial effects of
moderate use (in Dutch) by Jan Snel, Published June 2002 by Van
Gorcum Publishers.. Please contact Jan Snel, Dept. Psychology,
University of Amsterdam, via e-mail: pn_snel@macmail.psy.uva.nl |
