The latest critique from the ISFAR considers recent research into the effect of moderate consumption of alcohol on ones overall health

The latest critique from the ISFAR considers recent research into the effect of moderate consumption of alcohol on one's overall health

A group of Italian scientists has prepared a consensus paper to review the available evidence on the association between moderate alcohol use and health and disease.

The report resulted from extensive discussions among 36 prominent Italian scientists, and provides a working document for the scientific and health professional communities. The report has been signed by 19 separate societies or federations in Italy, including societies in nutrition, cardiology, and general medicine, as well as organizations of scientists dealing with diabetes, hypertension, and obesity. 

The consensus report ends with four conclusions:

  1. "In healthy adults and in the elderly, spontaneous consumption of alcoholic beverages within 30g ethanol/d for men and 15 g/d for women is to be considered acceptable and does not deserve intervention by the primary care physician or the health professional in charge. In fact, there is no evidence to suggest complete abstention from alcohol drinking by moderate users.
  2. Patients with increased risk for specific diseases - for example women with a family history of breast cancer - or subjects with familiar history of early CVD or cardiovascular patients should discuss their drinking habits with their physician.
  3. No abstainer should be advised to drink for health reasons.
  4. Alcohol use must be discouraged in specific physiological or personal situations or in selected age classes (children and adolescents, pregnant and lactating women and recovering alcoholics). Moreover, the possible interactions between alcohol and acute or chronic drug use must be discussed with the primary care physician.”

Forum reviewers considered this to be a well-done and generally well-balanced appraisal of the current literature on alcohol and health; it could help inform physicians and the general public about our current knowledge on this topic. However, forum reviewers were concerned by several aspects of the report.

The authors of the report provided good data to support their first two conclusions, and recent publications that were not available to the authors at the time they prepared their report strongly support these conclusions.

However, forum members found little data provided in the paper to support the third statement in their summary; in fact, the information the authors presented in the text would tend to support the opposite conclusion. Further, while it may be correct, their fourth conclusion was not supported by scientific data in the paper. 

Forum members agreed that the importance of the effects of alcohol consumption on total mortality must always be considered, and agreed with the statement of the authors that “low levels of alcohol intake (1-2 drinks per day for women and 2-4 drinks per day for men) are inversely associated with total mortality in both men and women”.

Key areas that the forum believed could have been given more emphasis related to the association between alcohol and diabetes mellitus, where data strongly support an approximately 30% lower risk for moderate drinkers, in comparison with non-drinkers.

Furthermore, the risk of cardiovascular disease is considerably reduced among diabetics who consume alcohol moderately. In addition, the potential effects of moderate drinking on reducing the risk of congestive heart failure, a rapidly increasing health problem related to ageing of the population, were not discussed. Forum members also wished that more emphasis had been given in the consensus report to the pattern of drinking: Current data indicates that regular moderate drinking, rather than sporadic or binge drinking, is the pattern associated with the most favourable health outcomes. 

Overall, this consensus report is an important and useful addition to the scientific literature on the relation of moderate alcohol consumption to a variety of health outcomes. It could be of great value to physicians and policy makers when providing advice to the public regarding the effects of alcohol on health.

To read the full critique, click here.

These critiques are published by just-drinks with the permission of ISFAR.