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For full versions of posted research articles readers are encouraged to email requests for "electronic reprints" (text file, PDF files, FAX copies) to the corresponding or lead author, who is highlighted in the posting.

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Monday, July 26, 2010

Critique 011: A Review of the Proposed New US Dietary Guidelines


Members of our International Scientific Forum on Alcohol Research have submitted a detailed review of the draft recently circulated by the United States Department of Agriculture for proposed new US Dietary Guidelines for 2010. In general, Forum members were very pleased with the alcohol recommendations in the proposal, finding them interesting, balanced, and accurate. Many commented that, rather than just focusing on warnings against heavy drinking, the new Guidelines appear to take into account the large amount of recent epidemiologic and experimental data that support many potential beneficial health effects of moderate drinking.

Among specific recommendations from the Forum were the following:

■ A stronger statement is needed of the effects of light-to-moderate drinking on total mortality, in that recent prospective studies show a considerably lower of risk of death for moderate drinkers.

■ Additional emphasis is needed on the reduced risk of developing diabetes for moderate drinkers, and the much lower risk of cardiovascular disease among diabetics who consume some alcohol.

■ Further information should be presented on the consistent scientific data showing that women who drink moderately are at reduced, not increased, risk of weight gain in adult life.

There were a number of topics not discussed in the draft Guidelines that members of the Forum thought deserved consideration for inclusion.

■ Recent reports have consistently shown that among people who have already had a myocardial infarction or other cardiovascular event, moderate drinking is associated with a reduced risk of further cardiovascular events and death.

■ More emphasis in the Guidelines should be put on the pattern of drinking (regular moderate rather than occasional binge drinking) and also on the much lower blood alcohol levels after drinking when the beverage is consumed with food, rather than on an empty stomach.

■ It was also suggested to the Guidelines Committee that the beneficial effects on cardiovascular risk of polyphenols and other substances in wine and certain beers, in addition to alcohol, be discussed more adequately.

There were also some suggestions from ISFAR regarding future research needs in the field.

■ The Forum strongly supports the need for further research on the risks and benefits of light-to-moderate alcohol consumption, rather than focusing research only on alcohol abuse.

■ The Forum proposed emphasis on future research dealing with targeting recommendations for groups of people according to age, gender, other behaviors, etc., although there was some disagreement among Forum members as to whether or not moderate drinking has strong health effects in the young and not just in middle-aged and older adults.

■ ISFAR considers moderate drinking, unless contraindicated by certain conditions (e.g, former abuse, some types of severe liver disease), to be an important aspect of a healthy lifestyle. It should be a complement, not an alternative, to other lifestyle factors such as not smoking, getting exercise, eating a healthy diet, and avoiding obesity.


For the full ISFAR critique of the proposed new Guidelines, click here


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