USA: Progress on Alcohol in ‘Dietary Guidelines’
The Dietary Guidelines Advisory (DGA) Committee of the United States forecast changes to advice given on alcohol in their dietary guidelines. While there is some progress in the new advice, more improvement would better inform consumers on the risks of consuming alcohol specifically regarding alcohol and cancer risk.
Men should cut back their alcohol intake to one alcoholic drink per day rather than two, according to the DGA, an influential panel that is advising the U.S. government on new dietary guidelines due to be updated later in 2020.
What previous guidelines recommended
Movendi International’s Maik Dünnbier analyzed the “Dietary Guidelines for Americans 2015-2020” in his widely read 2016 blog post “The Curious Case Of All The New Guidelines”.
The 2015-2020 Dietary Guidelines mention alcohol once, addressing it in appendix 9 – because it is not a component of the USDA Food Patterns. The text reads:
If alcohol is consumed, it should be in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age.
For those who choose to drink, moderate alcohol consumption can be incorporated into the calorie limits of most healthy eating patterns.
The Dietary Guidelines does not recommend that individuals who do not drink alcohol start drinking for any reason; however, it does recommend that all foods and beverages consumed be accounted for within healthy eating patterns. Alcohol is not a component of the USDA Food Patterns. Thus, if alcohol is consumed, the calories from alcohol should be accounted for so that the limits on calories for other uses and total calories are not exceeded…”
2015-2020 U.S. Dietary Guidelines
At the time, the Distilled Spirits Council of the US (DISCUS), a lobbying front group for liquor giants, got so excited about these dietary guidelines, that they put out a news release with a false and misleading quote, claiming alcohol “in moderation” could “help individuals achieve healthy eating patterns”. Obviously, this is a deliberate misinterpretation of the the actual wording of the dietary guidelines.
DISCUS spent more than $4 million, leading the alcohol industry in the United States, on lobbying in 2015 – according to OpenSecrets, in their attempt to weaken the wording on alcohol and hinder health groups’ efforts to actually improve the dietary guidelines, for example to include a message that alcohol use is not healthy and that is causes cancer.
What the new guidelines recommend
The new guidelines are set to clear up previous confusing advise by the DGA which foment the myth that “moderate” alcohol consumption is good for health, despite unimpeachable scientific evidence showing there’s no amount of healthy or safe alcohol use regarding cancer risk.
The new guidelines improve recommendations, stating:
- Men who use alcohol are advised to consume no more than one unit of alcohol per day; and
- People are advised not to consume alcohol to lower the risk of cardiovascular disease or achieve other health benefits.
Politico reports that the committee said in its draft report:
For those who drink alcohol, recommended limits for better health are up to 1 drink per day for both women and men.”
Guidline Drafting Committee
Consuming the current limit of two alcoholic drinks per day for men was associated with a “modest but meaningful increase” in death rates due to all causes, compared with maximum one alcoholic drink per day, according to the panel. The recommended advice would be unchanged for women.
The Hill reports that the DGA also advices in the new guidelines that “at all levels of consumption, drinking less is generally better for health than drinking more.”
As the 2015 struggle over the content of the guidelines showed, they have been subject to fierce lobbying and political interference for decades, undermining the scientific base of the guidelines, For instance, the Dietary Guidelines for Americans have long fomented the myth that moderate alcohol consumption contributes to a longer life. As recently as 2010, the DGA made unscientific recommendations such as: “Strong evidence from observational studies has shown that moderate alcohol consumption is associated with a lower risk of cardiovascular disease.” The 2015 guidelines dropped that statement, but stopped short of referring to the science linking alcohol and cancer.
Despite the lobbying of the alcohol industry, despite industry-funded research and despited old flawed research, new “Mendelian randomization” studies, which compare populations with genetic variants associated with lower alcohol consumption to those with more conventional genotypes, now clearly show that alcohol actually increases the risk of some cardiovascular diseases. There is a wealth of empirical evidence building up that links alcohol use to cardiovascular diseases.
Last year, Movendi Internatonal reported on a landmark study which found a relationship between alcohol use and high blood pressure as well as stroke. The landmark study also showed that evidence suggesting alcohol was a protective factor against stroke is non causal and confounding.
Considering the growing evidence base debunking the myth of alcohol’s protective effects against stroke, the DGA updating their alcohol use advise and stating not to consume alcohol for health benefits is long overdue progress.
Room for improvement: What about alcohol and cancer risk?
The link between alcohol and cancer is well established in science. Despite this fact the DGA has omitted mentioning any information on alcohol’s cancer risk in their new guideline.
Research has found alcohol is the third most important cause of cancer within the control of a person. Despite this, it has been found that fewer than half of Americans know about alcohol’s cancer risks. Considering this the guidelines will fall short of their potential if they fail to warn American consumers that alcohol can cause cancer.
In late August 2018, a new landmark study showed that no level of alcohol consumption improves health or is good for health.
The level of alcohol consumption that minimised harm across health outcomes was zero standard alcohol drinks per week,” wrote the researchers in the summary of their study.
Max G Griswold, et. al. Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016, The Lancet, Volume 392, Issue 10152, 2018, Pages 1015-1035, ISSN 0140-6736, https://doi.org/10.1016/S0140-6736(18)31310-2.
This systematic analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 for 195 countries and territories, 1990–2016, is the most comprehensive estimate of the global burden of alcohol use that has ever been compiled. This latest GBD analysis applies state-of-the-art epidemiology and uses methodological enhancements of previous iterations of the GBD to produce a definitive understanding of alcohol-related harm.
Thomas Gremillion, the director of Food Policy at the Consumer Federation of America suggests that the DGA guideline on alcohol should include evidence of alcohol’s cancer risk and statements such as: “For cancer prevention, the safest level of alcohol consumption is zero.”
With accurate information, consumers will take better action to protect their interests, including their health, and public health across the board will improve,” says Mr. Gremillion, as per The Hill.
Thomas Gremillion, Director Food Policy, Consumer Federation of America
In 2015, the European Cancer Code was updated and its message on alcohol improved in line with scientific evidence:
If you drink alcohol of any type, limit your intake. Not drinking alcohol is better for cancer prevention.”
European Cancer Code, 2015 Update
It is this commitment to scientific evidence, not political interference of the alcohol industry, that should guide the DGA. What scientific prove is still lacking according to the federal government in the US about alcohol harm? As the guidelines continue to exclude wording about the fact that there is no safe or healthy amount of alcohol use, consumers are harmed while the alcohol industry continues to be advantanged. Health experts in the US wrote in 2016:
The entire affair is an insult to the advisory committee that worked hard to do the right thing.”
Health experts, 2016
Politico writes that the guidelines have long been the subject of political infighting and industry lobbying because they influence marketing in the trillion-dollar food sector, dictate what’s served in multibillion-dollar federal nutrition programs like school meals and shape the advice doled out by health professionals.
The latest conclusions, which were unveiled last week during a webinar that lasted more than eight hours, are still in draft form. The final scientific advisory report is expected to be publicly released in mid-July.