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A drink, a healthy pleasure: extracts from Alcohol, the sober facts
by Jan Snel
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

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