A champion beer
A very old fashioned German-style Premium lager with ABV of 5.9% made from Pilsner, Maris Otter and flaked barleys fermented at a low temperature and lagered for six weeks. The malt flavour is augmented by Czech Saaz hops to give a unique drinking experience. This is a lager as she was made to be drunk during the late sixteenth century up to the invention of carbonation and refrigeration.
Doctor: “I can’t find anything wrong with you; it must be the drink.”
Patient: “Then you should try again when you’ve sobered up!”
Definition: An alcoholic is somebody who drinks more than their GP.
Everybody has likely heard about the guidelines issued by the UK’s Chief Medical Officers and that the country now has one of the lowest recommended upper limits for alcohol consumption by men in the world. This advice states that men should not consume more than 14 units of alcohol per week, which equates to five pints of beer at 5% ABV strength. These guidelines replaced the previous ones set in 1995, which said that men should limit themselves to 21 units or less of alcohol per week. The total recommended for women remained unchanged at 14 units.
The actual evidence underpinning these new guidelines is flimsy to say the least.
What exactly is a unit? A unit in the UK is equivalent to 8g of pure alcohol but in the US a unit is around 14g and there is no international consensus on unit size so I shall be using the UK unit for comparative purposes. A unit works out at just under a half-pint of best bitter or a single measure of spirits.
Male drinking guidelines vary enormously around the world; from 52 units a week in Fiji, 35 units in Spain, it’s 25 units per week in the US, Ireland is 21.2 units, Denmark 21, New Zealand 19 all the way down to 7 units per week in Guyana.
France, always the exception, has absolutely no national guidelines on alcohol consumption. No wonder they are all convinced that they have liver trouble. In Germany the “national organ” is a mysterious affair called the Circulation while in the UK our national health obsession is the regularity of our bowels.
The advice has also changed with time: in the UK in 1979 for men it was no more than 56 units a week. This was lowered successively to 36, 28 and then 21 units until, in January 2016, it became 14. When she announced this, the Chief Medical Officer also asserted that there was no safe level of drinking and that the health benefits of moderate alcohol consumption were, “an old wives’ tale”.
However, I too can produce a quote to illustrate the speciousness of the above statement.
Captain Blackadder: “That’s right; there was one tiny flaw in the plan.”
George: “Oh, what was that?”
Captain Blackadder: “It was bollocks!”
Therefore, in order to trust this advice, we must believe not only that every previous Chief Medical Officer was wrong but that every other country in the world is wrong as well. That doesn’t just require patriotism; it’s into chauvinism territory. It also means that the current advice bears no relationship whatsoever to the scientific evidence but since when has that stopped a public official with a politico-behavioural agenda.
Looking at epidemiological studies of drinking habits, there is a J-shaped relationship between alcohol consumption and mortality. In other words, the risk of death declines substantially at low levels of alcohol consumption and then rises but doesn’t reach the level of a teetotaller until the person consumes between 40-60g of alcohol a day, which is between 35-50 UK units per week.
This J-shaped association was identified over 40 years ago and has been repeatedly shown in studies from around the world. Now, many in the temperance and “public health” lobbies do not want to accept the benefits of alcohol consumption. As a result this epidemiological finding has been subject to more scrutiny than anything else in the field of alcohol research. It is precisely because it has been subjected to this level of attention that we know it to be robust.
Lifelong teetotallers tend to be less likely to smoke and are more likely to have a better diet than drinkers so it seems moderate drinking, but still above the 14 unit per week guidelines, does indeed have a mildly protective effect. Perhaps it eases worries, who knows?
There is one pitfall in this research, people under-report how much they drink. The amount of alcohol sold in the UK is about twice the amount that people claim to drink, so unless we throw away a huge amount of booze, it is certain that people either forget how much they have drunk or they lie. This means that people who say they consume two drinks per day probably have three to four. In this case, the amount that people have to drink to assume the same risk level as a non-drinker is even more than the research might suggest.
Why has the evidence been misrepresented? There are two possible reasons.
The authorities are doing something that behavioural economists call anchoring – they put an unrealistically low number in our minds knowing that most people will probably exceed those guidelines but might think twice about exceeding them by two or three times – and those are levels at which health might genuinely start to be impaired. In public health, it seems, there is no room for the public to be able to handle nuanced information. Things are either good or bad and they want to portray alcohol as bad, hence the need to downplay the benefits and the rhetoric about there being “no safe level”. It’s nonsense but it is a clear message and, apparently, that’s what counts.
The guidelines are not really aimed at us at all. The number of people exceeding weekly drinking guidelines has been falling for years. By lowering the recommendations for men, the Dept of Health has pulled two million more drinkers out of its metaphorical hat. Now that the guidelines have been halved, it is almost impossible not to exceed them. The problem has been inflated so panic ensues and the political agenda of the “public health” lobby, with all its taxes, bans and gruesome warnings, is boosted.
There is a telling comment in the minutes of one of the meetings held to set the latest drinking guidelines. “It is important to bear in mind that, while guidelines might have limited influence on behaviour, they could be influential as a basis for government policies.” Influencing government policy is the real aim of the game.
They don’t trust us to handle accurate information. We can no longer trust them to give us it.
Moral: don’t trust these doctors and their orders. Instead you can trust our Doctor’s Orders from Angles Ales a fine craft lager at 6% ABV from our Head Brewer Dr Nick Ashley now there is a doctor whose orders you can trust.
How do the UK’s new alcohol guidelines compare with the rest of the world’s?
George Arnett, The Guardian, 8th January 2016
The great alcohol cover-up: how public health hid the truth about drinking.
Christopher Snowdon, The Spectator, 10th February 2016