by Marion Nestle

Currently browsing posts about: Alcohol

Jan 14 2025

Alcohol in the Dietary Guidelines: What the Fuss is About

The 2025-2030 Dietary Guidelines Advisory Committee did not make a recommendation about alcohol.  The agencies, HHS and USDA, will do that later based on two expert reviews.

I wrote about the first, from the National Academies, last week: Review of Evidence on Alcohol and Health.

I also wrote about the Surgeon General’s Advisory on Alcohol and Cancer Risk

Still to come is the report from the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD).

At issue is the amount of alcohol that is safe to drink, if any.

Just for fun, I did a summary of what the Dietary Guidelines say about alcohol from 1980 to 2020.  Note that the Moderation advice has not changed since 1990 (but then see the note on 2020).

                                      Alcohol recommendations: Dietary Guidelines for Americans

YEAR ALCOHOL ADVICE BENEFITS MODERATION
1980 “If you drink alcohol, do so in moderation.” “One or two drinks daily appear to cause no harm in adults.”
1985 “If you drink alcoholic beverages, do so in moderation.” “One or two standard-size drinks daily appear to cause no harm in normal, healthy, nonpregnant adults.”
1990 Ditto “Some studies have suggested that moderate drinking is linked to lower risk for heart attacks.” No more than 1 drink/day for women, and 2 for men.
1995 Ditto “Alcoholic beverages have been used to enhance the enjoyment of meals by many societies throughout human history…Current evidence suggests that moderate drinking is associated with a lower risk for coronary heart disease in some individuals.” Ditto
2000 Ditto “Even one drink per day can slightly raise the risk of breast cancer…Drinking in moderation may lower risk for coronary heart disease, mainly among men over age 45 and women over age 55.” Ditto
2005 “Those who choose to drink alcoholic beverages should do so sensibly and in moderation.” “Alcohol may have beneficial effects when consumed in moderation.  The lowest all-cause mortality  [and heart disease mortality] occurs at an intake of one or two drinks per day…compared with women who do not drink, women who consume one drink per day appear to have a slightly higher risk of breast cancer.” Ditto
2010 “If alcohol is consumed, it should be consumed in moderation…and only by adults of legal drinking age.” “Strong evidence from observational studies has shown that moderate alcohol consumption is associated with a lower risk of cardiovascular disease….[and] reduced risk of all-cause mortality among middle-aged and older adults and may help to keep cognitive function intact with age…[but also] increased risk of bfreast cancer, violence, drowning, and injuries from falls and motor vehicle crashes.” Ditto
2015 Ditto [heart disease and breast cancer not mentioned Ditto
2020* “Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages” “Emerging evidence suggests that even drinking within the recommended limits may increase the overall risk of death from various causes, such as from several types of cancer and some forms of cardiovascular disease. Alcohol has been found to increase risk for cancer, and for some types of cancer, the risk increases even at low levels of alcohol consumption (less than 1 drink in a day). Caution, therefore, is recommended.” Ditto

*From the 2020 Dietary Guidelines Advisory Committee report: “evidence points to a general rule that drinking less is better for health than drinking more. Therefore, the focus should remain on reducing consumption among those who drink, particularly among those who drink in ways that increase the risk of harms. The Committee concluded that no evidence exists to relax current Dietary Guidelines for Americans recommendations, and there is evidence to tighten them for men such that recommended limits for both men and women who drink would be 1 drink per day on days when alcohol is consumed.

Despite the language in the 2020 guideline, the agencies did not change the overall recommendation about moderate drinking.

Will the Surgeon General’s Advisory and the upcoming third report cause the agencies to suggest no more than one drink a day for men?  Or suggest that no level of alcohol intake is safe?

I’m looking forward to finding out.

Resource: the process for alcohol in the Dietary Guidelines

Jan 7 2025

The big fight over alcohol recommendations: not over yet

What are we to make of this?

The National Academies of Sciences, Engineering, and Medicine’s Review of Evidence on Alcohol and Health says moderate drinking

  • Reduces all-cause mortality (moderate certainty)
  • Reduces the risk of cardiovascular disease (moderate certainty)
  • Increases the risk of breast and colorectal cancer (but can’t decide about others)

The Surgeon General, Vivek Murthy, says in his Advisory on Alcohol and Cancer Risk

  • Consuming alcohol increases the risk of developing at least 7 types of cancer.
  • The causal relationship between alcohol consumption and cancer is firmly established.

Let me try some context.

That alcohol is a risk factor for cancer has been known since the 1980s.

The Surgeon General’s conclusion is especially noteworthy for its lack of ambiguity.  He says flat out: alcohol causes cancer, and 7 kinds no less.

In contrast, the NASEM report talks about low and moderate certainty for its conclusions.

Presumably, both reports were based on the same data.

Here’s what this is about.

At issue: what the 2025-2030 Dietary Guidelines will say about how much alcohol is safe to drink (if any).

Since 1990, Dietary Guidelines have said two standard drinks a day for men and one for women could be considered low risk.

But the 2020-2025 Dietary Guidelines Advisory Committee, based on recent research indicating harm from any level of alcohol intake, said only one drink a day for both men and women was probably OK.

This alarmed the alcohol industry and other industries that profit from drinking.  They convinced Congress and federal agencies to revisit the effects of moderate drinking.

Yet another report on moderate drinking and health, this one from federal agencies, is expected any day now.

The bottom line

While all this is going on, the moral is pretty clear: the less alcohol, the better.

Resources

NASEM report press release

Industry pressure to make sure Dietary Guidelines to not toughen alcohol restrictions

New York Times: What is Moderate Drinking?

Example of alcohol industry pressure on Dietary Guidelines

Rani Rabin has been right on top of this fuss.  See, for example

 

 

 

 

Feb 14 2024

The World Health Organization: Health Taxes (e.g., on Sugar-Sweetened Beverages)

The UN’s World Health Organization (WHO) has long led efforts to tax unhealthy products, starting with tobacco.

WHO describes its health tax efforts here.

It recently issued Global report on the use of sugar-sweetened beverage taxes, 2023.

The report finds that 108 countries have some kind of tax on sugar-sweetened beverages.

But, it finds

Less than a quarter of countries surveyed account for sugar content when they impose taxes on these non-alcoholic beverage products. Countries with a sufficiently strong tax administrative capacity are encouraged to tax beverages based on sugar content, as it can encourage consumers to substitute with alternatives that have lower sugar content as well as incentivize the industry to reformulate beverages to contain less sugar.

One of its major overall findings:

Among its conclusions are these:

  • Existing taxes on SSBs could be further leveraged to decrease affordability and thereby reduce consumption. While other perspectives and competing factors have to be accounted for when designing taxation policies, the protection of health should be a key consideration, particularly considering the health and economic burden associated with obesity and diet-related NCDs.
  • This report concludes that excise taxes on SSBs are not currently being used to their fullest potential. Improving tax policy and increasing taxes so that SSBs become less affordable should be pursued more systematically by countries in order to effectively reduce consumption and prevent and control diet-related NCDs, including obesity and dental caries.

Here’s the evidence.  Get to work!

Resoures

Jan 31 2024

Food question of the week: Why is fruitcake so indestructable?

If you still have fruitcake left over from Christmas, you are undoubtedly wondering why it is still around and whether it is still edible.

Fortunately, we have Scientific American to thank for shedding light on this pressing issue.

According to the U.S. Department of Agriculture, these seemingly indestructible pastries typically stay fresh for six months in the pantry and up to a year when refrigerated. But anecdotally we know that they can last for decades; some of the oldest have been preserved for more than a century. In 2017 a then 106-year-old fruitcake left behind by members of a 1910 Antarctic expedition was unearthed from one of the continent’s first buildings. And in 2019 the Detroit News reported that a Michigan family treasured a then 141-year-old fruitcake as an heirloom. And you could theoretically still eat these century-old cakes without harm—if you can get past the nauseating, rancid smell.

The reasons for fruitcake’s indestructability are because it is made with:

  • Alcohol,
  • Dried fruit
  • Sugar
  • Not much liquid

Bacteria are killed by alcohol and do not reproduce well under conditions of high sugar, low water, and low oxygen (high cake density)—dryness, in a word.

So if yours is still around, you can eat it as long as it smells OK.  If it starts smelling  bad, it’s because the fats are getting rnncid.

Aren’t you glad I asked?

Jan 25 2024

Mind-boggling product of the week: Doritos spirit

I learned about this one from Beverage Daily:

Unexpected and bold: The iconic nacho cheese taste of Doritos imbued into a first-of-its-kind spiritThe Frito-Lay brand has collaborated with Danish flavour innovator Empirical to launch Doritos Nacho Cheese Spirit – a limited edition, multi-sensorial experience that really tastes like nacho cheese…. Read more

Limited edition bottles will be available in select New York and California markets for $65 for a 750ml bottle.

Now you get to have your ultra-processed snack and 42% alcohol by volume—all at once!

Oh no!  According to the company, the product is sold out.

You can’t make this stuff up.

Jan 11 2024

Food crops for biodiesel? Apparently so.

I’ve been appalled by the vast percentage of domestic corn production used to produce ethanol—nearly half.

But I had no idea food crops were also being grown to make diesel fuels—until I saw this tweet/post:

I went right to the source: Renewable Diesel Feedstock Trends over 2011-2022

The growth in renewable diesel production capacity in the U.S. was dramatic in recent years, with capacity in the last two years expanding by 1.8 billion gallons, or 225 percent (farmdoc dailyMarch 8, 2023). ..In a previous farmdoc daily article (May 1, 2023), we examined historical feedstock usage trends for the combined total of renewable diesel and biodiesel over 2011 through 2022.  Our most recent farmdoc daily article (December 11, 2023) article examined feedstock usage trends for biodiesel alone, and found that  soybean oil dominated as a feedstock for FAME [Fatty Acid Methyl Ester] production…(see the complete list of articles here).

Here’s what’s being used for biodiesel production.

I’m OK with animal fats for this purpose.  We aren’t raising animals specifically to produce biofuels.

But: Corn?  Soy?  Canola?

And don’t get me started on the implications of expanding palm oil production for this purpose, or what soybean production is doing to the Brazilian jungles.

This may be great news for Big Ag producers of these commodities, but could we please closely examine the implications of growing food for biofuels on food security, environmental degradation, water use, and climate change.

Note: The New York Times says our diets are to blame for ground water depletion--all those soybeans.  Another reason to question using soybeans to make fuel.  Biodiesel may be more energy efficient than ethanol, but growing crops for either depletes groundwater.

Dec 11 2023

Conflicted interests: obesity drugs, alcohol, clinical trials

DRUGS

Here’s the headline: Maker of Wegovy, Ozempic showers money on U.S. obesity doctors

Drugmaker Novo Nordisk paid U.S. medical professionals at least $25.8 million over a decade in fees and expenses related to its weight-loss drugs, a Reuters analysis found. It concentrated that money on an elite group of obesity specialists who advocate giving its powerful and expensive drugs to tens of millions of Americans.

What’s extraordinary about this situation is the amounts.  Some doctors got millions.

This account follows one about similar efforts in the UK: Revealed: experts who praised new ‘skinny jab’ received payments from drug maker.

The drug giant behind weight loss injections newly approved for NHS use spent millions in just three years on an “orchestrated PR campaign” to boost its UK influence.  As part of its strategy, Novo Nordisk paid £21.7m to health organisations and professionals who in some cases went on to praise the treatment without always making clear their links to the firm, an Observer investigation has found.

Novo Nordisk knew what it was doing, and its efforts (presumably legal) are certainly paying off.

ALCOHOL

The headline: Scientists in Discredited Alcohol Study Will Not Advise U.S. on Drinking Guidelines: Two researchers with ties to beer and liquor companies had been named to a panel that will review the health evidence on alcohol consumption. But after a New York Times story was published, the panel’s organizers decided to drop them.

Five years ago, the National Institutes of Health abruptly pulled the plug on an ambitious study about the health effects of moderate drinking. The reason: The trial’s principal scientist and officials from the federal agency’s own alcohol division had solicited $60 million for the research from alcohol manufacturers, a conflict of interest and a violation of federal policy.

I wrote about that in a previous post.

I’m told by people in the know that I should not be too hard on the scientists.  NIH told them it would not fund the study and they should get the funding from industry.  If true, that is unfortunate.

For sure, NIH is not interested in nutrition research except for genetically based “Precision” nutrition aimed at individuals.  That leaves population studies out of the picture.  Unfortunate, indeed.

CLINICAL TRIALS

The study: Industry Involvement and Transparency in the Most Cited Clinical Trials, 2019-2022

Among 600 clinical trials with a median sample size of 415  participants:

  • 409 (68.2%) had industry funding
  • 303 (50.5%) were exclusively industry-funded
  • 354 (59.0%) had industry authors
  • 280 (46.6%) involved industry analysts
  • 125 (20.8%) were analyzed exclusively by industry analysts.

Among industry-funded trials:

  • 364 (89.0%) reached conclusions favoring the sponsor.

Industry involvement in research in general and in nutrition research in particular deserves close scrutiny and much skepticism.

Drug companies are required to do research and to find their own funding.  That is not true of nutrition.

Everyone should be lobbying for more independent funding for nutrition research.

Oct 13 2022

Will we ever get better labeling of alcoholic beverages? Yet another try.

My book talk today: Online with Hunter’s Food Policy Center in conversation with Charles Platkin, 9:30 to 10:30 a.m.  Registration is HERE.

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The Center for Science in the Public Interest (CSPI) announces that it and the Consumer Federation of America and the National Consumers League are filing a lawsuit calling on the Treasury Department to compel a decision on mandatory alcohol content, calorie, ingredient, and allergen labeling on alcoholic beverages.

Plaintiffs seek relief from Defendants’ nearly nineteen-year delay in responding to a 2003 petition submitted by Plaintiffs, 66 other organizations and eight individuals, including four deans of public health.  [See Petition]…The Petitio urged TTB to reequire alcohol labelig with the same basic transparency consumers expect in foods.  For alcohol, that means labeling that has alcohol content, calorie, and ingredient information—including ingredients that can cause allergic reactions.

Nineteen year delay?  Yes.  Why?  The alcohol industry would much rather that you don’t know what you are drinking.  It has opposed virtually every attempt to expose what’s in its products.

Just for fun, I looked up the alcohol labeling chapter in my book with Malden Nesheim, Why Calories Count: From Science to Politics.

We titled the chapter, “Alcohol labels: industry vs. consumers.”

Here, for your amusement, is the table illustrating current labeling requirements.

CSPI deserves much applause for trying to fix this situation and for its patience.

We need something a lot better than this.

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