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Discussion: "The American Paradox"
by Harry S. Pariser
One of the most controversial and stimulating discussions to emerge in recent years relating to alcoholic consumption revolves around the relationship between moderate alcohol ingestion and the reduced risk of heart attacks. Screening on November 17, 1991, a "60 Minutes" broadcast focused on the "French Paradox" presented evidence that the moderate consumption of French red wine may protect the French--who have a lower incidence of coronary heart disease--from heart attacks despite a higher level of fat in their diets.
On January 14, 1992, a panel discussion entitled "The American Paradox," centering on the conflict between the wine industry's interest in promoting health claims and the government's recalcitrance in this regard, was sponsored by the Fine Beverage & Food Federation in San Francisco, California.
William Earle, Chief of Industry Compliance Division of the Bureau of Alcohol, Tobacco, and Firearms, led off the discussion with a brief presentation followed by a question-and-answer session. While he maintained that he would like to cooperate with regard to "getting the information out there" regarding the possible health benefits of alcoholic beverage consumption, he voiced skepticism about industry claims, pointing out that these "beneficial effects" are not helpful "for those who should not be drinking at all." In addition, he pointed out that the wine industry, by attempting to claim health benefits, might be playing into the hands of the neo-prohibitionists who claim that "wine is a drug." Drugs are subject to FDA regulation, and the FDA also tightly controls all labeling and advertising. In answer to a question he mentioned that the FTC has proposed that a "blue ribbon panel" study be done that would come to some conclusion as to the health benefits of low to moderate alcohol consumption.
Following Mr. Earle, each of the panelists was introduced in turn. Missing from the session--owing to the transition in Washington--was Robert W. Denniston, the Director of the Division Communication Programs of the Center for Substance Abuse Prevention. First to speak was Gene Ford, the publisher of the bi-monthly Moderate Drinking Journal and a syndicated columnist and the author of a number of books including the recently published "The French Paradox and Drinking for Health."
Opening with quotes from Ecclesiastes and Shakespeare, Mr. Ford noted the "ambivalence about drinking since prehistory." Labeling himself "an angry citizen," he vehemently proclaimed that the government had launched an attack on his lifestyle and that the government policy to reduce drinking by 25% is one "made by bureaucrats" without "legislative authorization."
Next up was Dr. Brian Katcher, a post-doctoral fellow at the Alcohol Research Group in Berkeley, CA where he is researching the history of post-prohibition medical knowledge about alcohol. Maintaining that alcohol is "dangerous from a public health standpoint," Dr. Katcher asserted that the health benefits of alcohol are "modest" and that "20% of all hypertension cases are estimated to be related to alcoholic consumption. While he enjoys drinking, he asserted that alcohol is a "dangerous drug, but "let's just enjoy it!"
Dr. Arthur L. Klatsky, currently the Chief of Division of Cardiology at Kaiser Permanente Medical Center in Oakland, CA, spoke next. Citing the "two-faced" ambivalent attitude towards alcohol that has been evidenced in every society throughout the ages, Dr. Klatsky maintained that there is "precious little evidence of any harm from light to moderate drinking." While there is little evidence that wine has a more beneficial effect than other alcoholic beverages in terms of reducing the risk of a heart attack, he said that wine drinkers studied in California did better than hard liquor consumers. However, one factor that may play into this is that wine drinkers and beer drinkers may have an overall healthier lifestyle. "The interpretation of data needs further work," he concluded.
The next speaker was Robert L. Reynolds, the Associate Director of the Trauma Foundation in San Diego and the former Campaign Director of the Californians for Nickel-A-Drink--the organization spearheading a failed California 1990 alcohol tax initiative. Mr. Reynolds began his discussion by responding to claims by Mr. Ford that the government in general, and the NIAAA in particular, never said anything positive about alcohol by quoting from NIAAA report that prominently mentioned the possible positive benefits of alcoholic consumption. However, he asserted that it does not make sense to indiscriminately recommend this to an entire population. He cautioned that a high percentage of those who drink daily "tend not to drink moderately" and that the nation cannot afford an increase in the number of dependency drinkers.
Author of the recently published book "The French Paradox and Beyond: Living Longer With Wine and the Mediterranean Lifestyle," Lewis Perdue is the editor and publisher of Wine Business Outsider and is an outspoken advocate for the wine industry. Mr. Perdue began his discussion by having an assistant walk backwards from the table while unfolding a computer printout of data base abstracts regarding research concerning the possible health benefits of alcoholic beverage consumption for potential heart attack victims. His assistant went out the door and to the vicinity of the exit while carrying the printout. Perdue cited this as evidence that a substantial body of research regarding these claims already does exist. Claiming that Director Earle is an example of a "good man in a bad system," Perdue asserted that the NIAAA deliberately distributes "bad" and "incomplete" information and that "they are lying and "fighting the wrong war." According to Mr. Perdue, the government "doesn't attack abuse" and "abuse is a serious problem." The people, he asserts must "go to court" in order to stop them from lying.
A lively and spirited discussion by the panel followed. While Perdue asserted that Katcher's "side" was choosing to focus on an "aberrant study," Katcher countered that "All of the data will never be in about anything. The problem arises when we start giving health advice." As evidence of such problems, he cited the example of margarine vs. butter in which consumers were initially told that butter was less healthy, but the evidence coming in now suggests that it may be more dangerous. Ford asserted that we have the lowest percentage of drinkers of any Western nation and that "we have scared away the moderate drinkers." Naturally enough, no agreement was reached between the two sides, and both questioned the statistics of the other.
The session concluded as a representative of the Fine Beverage and Food Federation presented awards to various wineries as well as an "Award of Excellence" to Women for Winesense for their efforts "in promoting the message that fine wine and spirits can be part of a balanced and healthy lifestyle."
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