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11.2011

Massachusetts Beverage Business

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Article By: Harvey Finkel, MD

The World Health Organization (WHO) is famous both for monumental good works and for embarrassingly shoddy judgment when allowing politics to enter its activities. WHO’s just-published global status report on alcohol and health is not one of the former.

It is more than abundantly clear, from clinical observations, epidemiologic studies and controlled research, that light to moderate drinking promotes health and prolongs life of most individuals, compared to abstainers, and that excessive drinking, especially in binges, does the opposite. WHO’s report seems to pretend never to have heard of the J-shaped curve, just described. Only the illiterate can be ignorant of the mountain of medical and lay publications attesting to the foregoing. It is unfortunate that an ostensibly authoritative body is misinforming the public and influencing policy makers.

The very title of the report is doubly misleading. The “status” is far from timely, based as it is on statistics six and seven years old. And it is, to my reading, not about “alcohol and health”, would that it were, but more a prohibitionary polemic, which forgets the lessons of America’s ignoble experiment. Count the number of appearances in the foreword of terms such as “harm”, “harmful” and their equivalents, then search in vain for any hint of the health benefits of moderate drinking. The emphatic introduction is almost wholly devoted to the damage alcohol is capable of. After reading it and subsequent sections, I was surprised that drinking is not blamed for hangnails and Whitey Bulger. The remainder of this nearly 3OO-page gnomish document, well padded with unenlightening tables of old statistics, continues in the same vein.

I suppose the severe slant taken might have been predicted by noting that the report was produced by the Management of Substance Abuse Team in the Department of Mental Health and Substance Abuse of WHO. I am reminded of the proverbial hammer that sees everything as a nail. Although the team’s members are not enumerated, I’m betting none or very few are real doctors (clinicians who take care of people), research scientists or objective epidemiologists – true experts who know both edges of alcohol’s sword.

WHO notes, I suspect approvingly, that nine countries completely ban alcohol: Afghanistan, Brunei Darussalam, Iran, Maldives, Mauritania, Pakistan, Saudi Arabia, Somalia, and Sudan. The WHO team, it seems to me, would like to reduce, eliminate alcohol by any means, fair or taxing. One might guess that the report’s list of references was selected with bias aforethought, for conspicuous by their absence are studies demonstrating the medical rewards of moderate consumption of alcohol, particularly of wine.

The International Scientific Forum on Alcohol Research (ISFAR) is a group of three dozen unpaid professorial physicians and other scientists from across the world, all authorities on alcohol’s effects upon health, beneficial and adverse. The Forum has critiqued the WHO report, much as I have, though with gentler language. [disclosure: I am a member of ISFAR.] To quote the nub of its displeasure: To a large extent, the WHO report disregards the massive amount of scientific data indicating that in all developed countries, moderate consumers of alcohol are at much lower risk of essentially all of the diseases of ageing: coronary heart disease, ischemic stroke, diabetes, dementia, and osteoporosis. And the report does not describe the decrease in total mortality among middle-aged and elderly people associated with moderate alcohol consumption, which has been found consistently in studies throughout the world (bu.edu/alcohol-forum/review/).

In my opinion the WHO report is a waste of funds that would be better used to kill mosquitoes.

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