The moderator of the seminar, journalist Jonette Øyen, Norway, pointed out the differences in the concept of moderation she had observed in Norway and Denmark. As an example she mentioned the Danish way of talking dustmen into removing an extra load of house refuse: put two bottles of beer on the lid of the garbage can. It works fine in Denmark, however, try this method in Norway and you would be reported to the police!

The seminar was opened by the Chairman of the Danish Brewers Association, Mr. Flemming Lindeløv. He gave the floor to Mikko Paunio M.D., Docent of Epidemiology, University of Helsinki, Finland. Mikko Paunio gave a historical perspective of the question of alcohol and health through the observations of Her Majestys Registrar General William Farr, and Professor Raymond Pearl of the Johns Hopkins School of Hygiene and Public Health. William Farr lived and worked during the 19th century and is the father of public health services. Raymond Pearl is the father of the U-shaped curve of alcohol and mortality. Both men, although fully aware of the detrimental effects of alcohol abuse on public health, were convinced that alcohol in moderation was good for health.

Mikko Paunio went on to report new results from the extended follow-up of the ATBC study (AT=alpha-tocopherol, BC=beta-carotene). The published ATBC study results of the observed strong preventive effect of beer (and to a lesser extent alcohol per se) against kidney stones imply but do not prove causality due to ingredients other than alcohol itself. The U- or J-shaped observational results of the ATBC study with regard to cardiovascular end points and daily alcohol consumption are in accord with the large majority of observational and experimental studies. When totality of evidence is considered todays' results are well in accordance with the idea that moderate alcohol consumption protects heart and increases longevity. New research should focus on the joint effect of physical activity and moderate alcohol consumption on protection against coronary heart disease.

Denise Baxter BSc, PhD, is Scientific Director at Brewing Research International. Ms Baxter spoke of their programme of research relating to potential healthy ingredients in beer, in particular the malt and the hops. Beer contains a wide range of antioxidants, including antioxidant vitamins such as folate, and complex polyphenols similar to those found in red wine. However, beer also contains smaller compounds such as phenolic acids derived from malt and hops, which are more easily absorbed by the body than the larger polyphenols. The results of recent research suggest that the ferulic acid in beer is better absorbed than ferulic acid in tomatoes. The antioxidant activity of beer is relative to malt colour- dark ale is better than light lager!

"Is it fattening?" was the first question Eve asked about the apple in the Garden of Eden. According to Professor Arne Astrup, The Royal Veterinary and Agricultural University, Denmark, a large proportion of the female population avoids beer because they consider beer to be more fattening than, for example, dry wine. The results of studies addressing the effect of alcohol on food intake and energy balance is ambiguous, while studies comparing different types of alcohol are lacking. Epidemiological studies do not provide any evidence for a fattening effect of alcohol. Arne Astrup has undertaken experimental studies to address the issue of whether there are differences between the ability of sweet soft drinks (Sprite Regular), beer (Carlsberg Hof), and wine (dry red wine) to increase caloric consumption in 22 younger men during a test meal with cold pasta salad, goulash with bread, and a firm cake. Both alcoholic beverages tended to increase food intake compared to the soft drink. In another experiment performed with the same ad libitum meal, but with the beverages now also provided ad libitum, the result was a total higher energy intake with wine due to a higher energy intake from both the foods and the wine. Wine may be more fattening than beer in men, however, it remains to be elucidated whether the same phenomenon exists in women.

"Why does Jeppe drink?" This question was first asked 250 years ago by the Danish author Ludvig Holberg in his famous play "Jeppe on the Mountain". This question has not yet been answered. In his presentation Bengt Ekdahl, Pol.Mag., Value Merge Consulting, Sweden, pointed out that there is an alternative alcohol policy aim, which can help Jeppe out of his drinking problem. The solution lies in providing Jeppes friends and relatives with a perspective on their own and other peoples drinking, in order to allow them to understand Jeppes individual problem and be in a better position to help him.

The alcohol typology is a tool that may help people to gain a perspective on the role that drinking plays in their own lives, and the role it plays in the lives of others. Bengt Ekdahl presented four dimensions in attitudes to drinking. The first dimension deals with the fundamental value of drinking: Is it used to add a positive aspect, or to remove something negative? The second dimension reflects the role of the food and wine culture for ones identity. Are food and wine just food and drink, or is the food and wine culture a means of strengthening ones personal identity? The third dimension concerns the individuals opinion of alcohol policy restrictions, and the fourth dimension concerns the importance of alcohol to the experience of a festive mood.

In many societies, most people drink alcohol beverages regularly, but few of them ever experience alcohol-related negative consequences. Professor David J. Hanson, State University of New York Potsdam, USA, in his presentation described the keys to their success. The abstainers do not have to explain why they dont drink alcohol. The moderate drinker does not have to hide his glass of beer. The abuse of alcohol is totally unacceptable at any age and under any circumstances. The common belief is that alcohol acts as a disinhibitor. But in societies, where people believe otherwise, people never become disinhibited by drinking alcohol. It is a matter of culture. We drink differently at a wedding party than we drink at a New Years party.

The final speaker, Hubert Sacy, is Director of Éducalcool an organisation devoted to alcohol education in Quebec.Quebec is the province where alcohol is most freely available, yet there are fewer alcohol-related problems than anywhere else in Canada. Like 58% of his fellow citizens Hubert Sacy believes that alcohol taken in moderation is good for your health. Éducalcool promotes the culture of taste against the culture of drunkenness in Quebec. "There is such a thing as a safe level of alcohol consumption - unlike tobacco and illegal drugs. One drink is good - 10 drinks is bad. One cigarette is shit - 20 cigarettes is 20 x shit".commented Sacy.The speaker then quoted a question from a Norwegian colleague: "Why drink if not to get drunk?" Hubert Sacy got the impression that to a Norwegian, drinking and not getting drunk is abuse of alcohol! "We have to make people drink better", the Canadian lecturer urged. And how do we manage to do that?

• drink less on each occasion - and not more than five drinks per drinking session
• drink for the right reason - and not to drown your problems
• drink in the right context - and not as the main activity
• drink better quality products
• sometimes don't drink at all - e.g. during pregnancy, driving a car or operating machinery
• respect those who choose not to drink

Each individual is unique; age is an important factor. Regularity is the key, and moderation is important. The scientific findings concerning the beneficial effects on longevity in moderate alcohol consumption applies to all alcoholic drinks. However, there is more to it than drinking like exercise, good food, not smoking etc. Finally, you dont have to drink.

Dr.Erik Skovenborg is a Medical Practicioner, a specialist on alcohol and health and a member of the AIM Editorial Board.