Currently browsing posts about: Alcohol

So much is happening on the alcohol frontier these days that it is getting hard to keep up.  Let’s start with the multiplicity of reports on alcohol and health arriving one after another.  I’ve written about the NASEM and Surgeon General’s reports recently.  I’ve also written recently about their implications for the forthcoming Dietary Guidelines.

I.  The ICCPUD report.  Now we have yet a third report from the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD).  This one says:

• Males and females who consumed 1 drink per day had an increased risk of liver cirrhosis, esophageal cancer, oral cancer, and injuries, but a lower risk for ischemic stroke…females had a higher risk for liver cancer and a lower risk for diabetes mellitus when they drank 1 drink per day…even infrequent high per-occasion drinking may eliminate the lower levels of risk for ischemic stroke.
• Alcohol use is associated with increased mortality for seven types of cancer (colorectal, female breast, liver, oral cavity, pharynx, larynx, esophagus [squamous cell type]). Increased risk for these cancers begins with any alcohol use and increases with higher levels of use. Women experience a much greater risk of an alcohol-attributable cancer per drink consumed.

II.  The Alcohol industry’s reaction to the ICCPUD report. The reaction to this from a group of National Agriculture, Beverage and Hospitality Associations is pretty tough.  In an email and press release titled “New U.S. Alcohol Report Tainted by Bias, Conflicts,” its representative said:

The controversial report, which is based on observational studies rather than any randomized controlled trials, is blatantly biased, with many panel members failing to disclose conflicts of interest, including affiliations with and funding from anti-alcohol and international temperance organizations…it’s essential to consider the findings of the recent Congressionally-mandated report from the National Academies of Science, Engineering and Health (NASEM), which found moderate drinking may be healthier than teetotaling (Axios).

Its recommendation

We urge the Secretaries of Agriculture and Health & Human Services to uphold the integrity of the DGAs to promote informed and responsible decision-making around alcohol. The agencies should disregard the ICCPUD report in their final assessments for the 2025-2030 Dietary Guidelines.

III.  Call for public comment on the NASEM and ICCPUD reports

From the HHS Office of Disease Prevention and Health Promotion (I am an alum)

HHS and USDA will invite the public to provide input on two separate but complementary reports [ICCPUDand NASEM] on the relationship between alcohol and health starting January 15. These reports and the public comments received will be considered by the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) as the two departments collaborate to develop the next edition of the Dietary Guidelines for Americans. The comment period will close on February 14, 2025. Additional details on this public comment opportunity are available on DietaryGudelines.gov.

IV.  Treasury Department proposes new and more informative labeling of alcohol drinks, also with a call for public comment  

TTB Proposes Mandatory Disclosures of Major Food Allergens and Alcohol Facts in the Labeling of Wines, Distilled Spirits, and Malt Beverages.

Allergens: In Notice No. 238, we propose to require a label disclosure of all major food allergens used in the production of alcohol beverages…labels must declare milk, eggs, fish, Crustacean shellfish, tree nuts, wheat, peanuts, soybeans, and sesame, as well as ingredients that contain protein derived from these foods, if used in the production of the alcohol beverage.

Alcohol Facts: In Notice No. 237, we propose to require Alcohol Facts label disclosures for alcohol beverages subject to TTB’s regulatory authority under the Federal Alcohol Administration Act. This disclosure would include the serving size of the product; the number of servings per container; alcohol content as a percentage of alcohol by volume; the number of fluid ounces of pure ethyl alcohol per serving; the number of calories per serving; and the number, in grams per serving, of carbohydrates, fat, and protein.

Wow!  This has been a long time coming.

To comment:

• For Allergens see Notice No. 238 and/orDocket No. TTB–2025–0003 at Regulations.gov and this comment form. 
• For Alcohol Facts see Notice No. 237 and/or Docket No. TTB–2025–0002 at regulations.gov and this comment form.

Electronic comments submitted via Regulations.gov are due by 11:59 p.m. ET on April 17, 2025, and comments submitted by postal mail must be postmarked by that date.

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

*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

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

• Surgeon General calls for cancer warnings on alcohol
• The battle over what to tell Americans about drinking
• US diet panel adds another researcher with alcohol industry ties
• Major study of drinking will be shut down

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

• More about WHO’s work on health taxes
• Global report on the use of alcohol taxes, 2023
• WHO technical manual on alcohol tax policy and administration
• Health taxes database

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?

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.

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 daily, March 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.

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.