Contents (Click on an Item/ Page No

Vol. 21 No. 4 November 2007

This month saw the launch of the Alcohol Health The recently published World Alliance, a group that will lobby in the UK with the Cancer Fund report is reviewed aim of reducing alcohol related harm through higher on pages 15-19, with an analysis taxation, limiting hours of sale and restricting or by R. Curtis Ellison. banning alcohol advertising. Following the launch of Harvey Finkel’s article asks ‘Do Drinkaware, and other governement initiatives this we need alcohol in our wine?’ year, and at a time when excessive drinking statistics and Creina Stockley reviews the appear to be falling, our lead article questions why new Australian alcohol guidelines the group is being formed now. issued by the National Health and Medical Research Council. Contents (Click on an item/ page no. to be taken directly to your choice of article) News from around the world 2 ◊ US impaired driving still common amongst Lead article: Alcohol Health Alliance - high school seniors 12 why now? by Helena Conibear 3 ◊ Miller publish ‘Sustainable Development Report’ 12 Social and Policy News 5 ◊ Delaware forms underage drinking task force 13 ◊ Alcohol Health Alliance launched in UK 5 ◊ US designated driver study 13 ◊ The Lancet calls for a framework convention on alcohol control 5 Diet, drinking, lifestyle and cancer risk - a comprehensive review 15 ◊ Ofcom and ASA publish research on the impact of alcohol advertising rules 6 Commentary on World Cancer Fund report by R. Curtis Ellison 17 ◊ UK industry standards review 7 Food, nutrition, physical activity, and the ◊ Diageo responsibility advertising in UK 7 prevention of cancer: a global perspective 17 ◊ Don’t let a good night turn into a bad one 7 Do we need the alcohol in our wine? by ◊ First Alcohol Awareness week in Scotland 8 Harvey E. Finkel, MD 20 ◊ Call for research into attitudes to alcohol in Review of the National Health and Medical Scotland 9 Research Council’s Australian Alcohol Guidelines by Creina Stockley 21 ◊ Alcohol and sport drinkaware.ie guide 9 ◊ European Alcohol and Health Forum Medical News - next steps 10 ◊ Does moderate drinking lower risk of heart ◊ New film competition to explores Irish failure? 15 attitudes to alcohol 10 ◊ Moderate alcohol consumption make be ◊ Pernod Ricard USA launch social beneficial for lung function 19 responsibility campaign 10 ◊ Abstracts related to alcohol consumption from ◊ Canadian campaign to encourage students the scientific sessions of the American Heart to drink responsibly 11 Association 22 ◊ New road laws in Ontario affect drink International Medical Advisory Group Conference 26 drivers 11 Book Review - ‘Addiction Proof Your Child’ by ◊ ‘Saving Faces’ research into binge drinking 11 Dr Stanton Peele 26

www.aim-digest.com www.drinkingandyou.com NEWS FROM AROUND THE WORLD

Australia Ukraine AIM Digest PO Box 2282 The New South Wales Government A drinks trade body in Ukraine BATH, BA1 2QY, UK says it will spend an extra $3.6 has proposed a minimum price for T: +44 (0)1225 471444 million to reduce alcohol-related F: +44 (0)1225 427444 vodka in the country, according to crime as it implements its new local reports. E: [email protected] liquor laws. Web sites: www.aim-digest.com The Union of Alcohol and Tobacco www.drinkingandyou.com The laws will allow more small Wholesalers (SOVAT) has proposed Annual Subscription to AIM: venues to operate, but also provide to the Ukrainian government that GBP £ 600- greater legal powers to deal with it introduce a floor of UAH11.15 USD $1,200- problem venues and increase Euro 900- (US$) per half-litre bottle of vodka penalties for providing alcohol to Corporate Sponsorship Level: in the country. minors. Silver GBP 1,500- The association set the price The state’s Gaming and Racing USD $3,000- for vodka with an abv of 40% Euro 2,300- Minister, Graham West, says minimum. Gold GBP £3,000- the laws will be complemented USD $5,000- by education campaigns about A ‘lowest price’ for spirits had been Euro 4,500- responsible drinking and better in effect in Ukraine up until 2005, Platinum level available on request. late night transport schemes to get the agency said, although this was Please contact Sherry.Webster@aim- patrons home safely. West says the disbanded “to harmonise a domestic digest.com for information about AIM’s sponsorship levels. laws can only be put into practice legal framework in line with WTO requirements”. Please make cheques/drafts in British with the help of the community. pounds sterling, dollars or Euros payable “Where we need to be continually A minimum price for vodka would to AIM Digest at the above address working is the responsible stem the rise of counterfeit and consumption of alcohol,” he said. illegally-made versions of the spirit, Peter Duff – Chairman, T: +44 (0)1225 471444 “That’s not something the SOVAT has suggested. E: [email protected] Government can do alone, it’s The proposal has received the Helena Conibear – Executive Director, something we’ve got to do working backing of the country’s Ministry T: +44 (0)1300 341601 with the community and with of Agricultural Policy, which has E: [email protected] things like local liquor accords. But drawn up a draft law setting a Alison Rees - Deputy Editor also with this money we can help lowest retail value for all spirits in E: [email protected] educate young people, especially the Ukraine of UAH46.63 per litre Sherry Webster – Finance and around some of the dangers of Administration Director of 100% abv equivalent. excessive alcohol consumption T: +44 (0)1225 471444 E: [email protected] and encourage them to keep our community safe.” The publisher takes reasonable care to New Zealand ensure the accuracy of quotations and other information contained herein, but is not Alcohol-related antisocial behaviour The liquor ban from Christmas to responsible for any errors or omissions. on the Mahurangi Peninsula in Easter was passed at the first full Opinions and recommendations quoted New Zealand has resulted in many herein are usually excerpted, digested or public meeting of the new Rodney condensed, may be edited for continuity, popular beaches and holiday spots District Council. It was supported and are only part of the opinions and introducing an overnight summer by a 1027-signature petition from recommendations expressed in the original sources, which should be consulted for alcohol ban. Mahurangi residents following a details. rise in reported public disorder © AIM Digest 2001. All rights reserved. incidents between Christmas and Material may be reproduced with Easter during the past four years. attribution to AIM. Published by: AIM Digest, PO Box 2282, BATH, BA1 2QY.

Aim Digest PAGE LEAD ARTICLE

Alcohol Health Alliance - why now? by Helena Conibear, Executive Director, AIM The Alcohol Health Alliance a made in server training, and are drinking moderately however, group of 24 bodies, that includes banning drunken and rowdy and nearly 50% of 11–15 year olds medical associations and charities customers via Pubwatch and public now do not drink at all (up from such as Alcohol Concern and The private partnerships to improve 35% in 1994) - a promising start. British Liver Trust, was launched on the environment and street safety The health ramifications of the the 13th November. The Alliance (Citisafe and Best Bar none), growth in heavy drinking in the will serve as a lobbying group with coupled with on the spot fines, 1980’s and 90’s, particularly among the aim of reducing alcohol related stricter laws and more diligent young women will continue to harm in the UK through higher policing. Similarly selling to under be seen for a number of years. taxation, limiting hours of sale age drinkers by all sectors of the Experts believe that heavy drinking, and restricting or banning alcohol trade has reduced dramatically combined with an increase in advertising. The launch of the through ‘Challenge 21’ and the obesity in this period, will lead to Alliance is considered surprising formation of the Retail Standards a continued growth in incidence of in the light of the formation of the Group in 2005. As a result, those fatty liver and cirrhosis, not always pioneering Drinkaware Trust last underage are buying and drinking attributable to alcohol. year. Both Alcohol Concern and less. Designated driver campaigns The Royal College of Physicians are More to be done Trustees of this public facing body An area that remains of concern, is whose role, with industry funding Although trends are in the right the number of breath test failures is specifically to reduce alcohol direction, much of the work in which has remained largely static related harm. reducing public drunkenness and at approximately 84,000 a year disorder has been ‘preventative’ – since 1992. As a percentage of The government has also whether getting drunk as a legitimate undertaken to comprehensively the population, convictions have and aspirational social pastime has dropped (there has been a 3 million review the pricing advertising and decreased in attractiveness in the promotion of alcoholic drinks population growth in that time) but UK is debatable, and although there inspite of ‘repeat offenders’, perhaps in the UK in a systematic and is much more information available evidence based manner (contracted the time is right for a powerful ‘don’t for consumers on responsible drink and drive’ initiative combined this November). With these steps drinking via labels, websites, school and the programmes laid out in with more designated driver and and college projects, more can be safe ride home programmes. ‘Safe. Social. Sensible’ that show a done, especially in the retail, school proactive and active Alcohol Harm Drinking and driving must remain and college sector. The figures are socially unacceptable – a perfect Reduction Strategy for England, showing that more young people which consulted all stakeholders opportunity for Drinkaware to concerned, it is wondered why the group is being formed now, when figures across the board in the UK are showing a decline in damaging patterns of drinking Statistics from 2005 and 2006 are clearly showing that UK citizens are indulging less in damaging patterns of drinking and are behaving better on our streets. Recognition must be given to the on trade for the Source: Information Centre, National Health Service, “Smoking, Drinking and significant effort that has been Drug Use Among Young People in England in 2006”

Aim Digest PAGE LEAD ARTICLE

The good news The bad news The UK amongst its EU peers However, 31% of 16 –24 young Drink drive The EU average per capita adult men still binge weekly. Although the UK has some of the consumption of pure alcohol is 11 Heavy drinking (8 units for men and safest roads in the world in terms of litres per annum. UK consumption 6 and above for women once a week accidents and deaths per kilometre was 11.4 litres in 2004 and has or more) is now at 19% for all men travelled and per capita, the number fallen to 10.9 in 2006 (ONS and and 8% for all women, a significant of people failing breath tests has HM customs). The UK ranks well reduction from 1998 – 2003. remained largely static since 1992 below Germany (12.7), France at 84,000 per year. Startlingly the Underage drinking declining (12.3) Spain (11.7) or Luxembourg number of female convictions has at 18 litres. 5.5% of pupils in year 8 (age 13) and doubled in that time from 5,600 to 8% of 13-14 year olds drink 7 units 10,258. Fewer adults are exceeding the or more a week. This rises to 19% Crashes involving drunk drivers, sensible daily guidelines of 2-3 units of Year 10 (age 15). Although less however, are extremely low at 2.3% for women and 3-4 for men. A drop young people are drinking (46% of of drivers (6,397 out of 281,000). from 39% in 2004 to 35% in 2005 11 –15 year olds have never drunk), for men and 22% down to 20% for those that are drinking regularly are Sick man of Europe women (ONS and www.statistics. drinking more (average 10.9 units UK adults are the fattest in Europe gov.uk). The General Household a week). - 23% are obese against 9.4% of survey finds a similar trend Drunkenness offences French and 8.5% of Italians. downwards with those drinking at harmful or hazardous levels falling Convictions for drunkenness have Alcohol related deaths from 27.4 % of males in 2000-02 fallen from a high of 123,000 in 1980 In ‘Safe. Social. Sensible’, the to 24.5% in 2005 and females from to 34,250 in 2004. The further fall government links excessive alcohol 17% to 14.5%. to 24,300 in 2005 can be attributed consumption to between 15,000 partially to the introduction of the and 22,000 premature deaths, with fixed penalty notices. directly attributable deaths at 6,500 Sources: Smoking and drinking among young (4,160 from alcoholic liver disease). adults 2006, Drinking: Adults’ behaviour and knowledge 2006, www.statistics.gov.uk, Although women are beginning to www.apho.org.uk and www.dh.gov.uk improve their patterns of drinking Test purchases again after two decades of increasing Failure of test purchases have excess, the health ramifications will continue to be seen for a number Adults exceeeding recommended daily benchmarks reduced significantly since their of alcohol on at least one day during the last week: by of years. Although death rates from sex, Great Britain introduction in 2004, from 38% to 15%, and according to the Trading cirrhosis and liver disease are low at The number of 16 – 24 year old girls Standards Institute the proportion 5.8 per 100,000 women under 65 who drank more than six units (8g) of 14 - 17 year olds buying alcohol per annum, (against 64 per 100,000 on one occasion in the last week, has fallen from 40% to 28% in two for heart disease), this is above the fell from 28% in 2002 to 22% in years and those drinking weekly has EU average of 4.8. 2005 – the lowest rate since 1998. fallen from 50% to 44%. Alcohol-related death rates by sex in the UK, Home Office funded Test Purchase Campaigns 2004-2007 1991–2005

AMEC + Alcohol Misuse Enforcement Campaign, TVCP = Tackling Violent Crime Programme, TUSAC = Tackling underage Sales of Alcohol Campaign, BCUs = Basic Command Unit of the Police Source: National Statistics Alcohol-Related Deaths

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Alcohol Health Alliance launched in UK At a time when clear indicators “We will look at how we can Five key drinks organisations - the are showing an improvement in work together to achieve common Wine & Spirit Trade Association, drinking patterns in the UK (see objectives.” the British Beer & Pub Association, article on page 2) a powerful group The Royal College of Physicians the Gin & Vodka Association, has been formed - comprising (RCP), who chair the AHA, is the National Association of Cider 24 health bodies in total which openly in favour of a rise in alcohol Makers and the Scotch Whisky includes Alcohol Concern, The taxation. RCP President Professor Association sent an open letter British Liver Trust and The Royal Ian Gilmore said: “Raising the tax to professor Ian Gilmore of the College of Physicians - to lobby for on alcohol would help reduce our AHA three days before the launch, stricter regulation and control of consumption, and reduce the future challenging the campaign. alcohol in the UK. burden of ill-health from alcohol It said: “In our view, the measures The Alcohol Health Alliance misuse, while generating more you are seeking would increase officially launched on 13th funding for treatment services. the burden on taxpayers, further November. It suggested that there This is a win-win for the nation’s restrict personal freedoms and limit should be dedicated funding for health.” consumer choice, while at the same alcohol treatment and prevention. It However, David Poley, chief time have little or no impact on also called for higher taxes on drinks executive of the Portman Group alcohol misuse. In fact, in some and for a ban on alcohol advertising said raising taxes would not solve areas it may make the situation on television before 9pm. the problem. He commented: worse by encouraging an illicit Alcohol Concern chief executive “Considering taxing adult drinkers market in alcohol.” Srabeni Sen commented to stop children breaking the law is Sandra Gidley, Liberal Democrat “It’s basically a collection of illogical, especially as international MP’s Alcohol Harm reduction Bill organisations that have a shared comparisons prove that higher prices received a second reading in the objective to reduce the amount of would not deter binge drinkers or House of Commons in October, harm that alcohol causes to peoples people addicted to alcohol”. calling for price controls and an health and society as a whole. alcohol advertising watershed.

The Lancet calls for a framework convention on alcohol control

The Lancet has in a recent control measures to be taken more “These lax attitudes along with editorial called for a Framework seriously by national governments. free trade and competition rules, Convention on Alcohol Control. Reference is also made to the recent which treat alcohol as any other The journal says that next year’s statements by World Medical commodity, have undermined World Health Assembly provides Association and the American effective alcohol control measures, a crucial opportunity for WHO Public Health Association, who have such as increasing taxes or restricting and member states to make those voiced their support for stronger the hours or days of sale. Instead, first steps towards a global treaty to international efforts to prevent at country level, ineffective control reduce alcohol-related harm. alcohol problems by adopting strategies (warning labels, education The editorial refers to the an international framework in schools) have been adopted. Framework Convention on convention. Internationally, resolutions on Tobacco Control as “one of WHO’s alcohol control exist but are non- Compared to all the efforts to binding and easily flouted.” greatest achievements” and argues fight tobacco smoking, The Lancet that a similar international treaty is describes the attitudes towards The Lancet 2007; 307:1102 also needed on alcohol, for alcohol alcohol as “lax”:

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Ofcom and ASA publish research on the impact of alcohol advertising rules On 16 November 2007, Ofcom people saying that they feel alcohol olds saying they regularly drink to and Advertising Standards adverts are aimed at them. get drunk. Authority (ASA) jointly published • Young people still feel • alcopops have declined in a research report on the impact advertisements make the drink look popularity. Between 2005-2007, of alcohol advertising on young appealing and that the adverts will there has been an 11% drop across people following the tightening of encourage people to drink, with all ages of those who claim to the Advertising Codes in October 34% believing this to be the case have drunk RTDs in the last six 2005. The new rules were designed in 2007 compared with 25% in months. to make alcohol advertisements 2005. • There has been an increase in less appealing to the under 18s • There has been a significant the amount of cider that young and, in particular, to prevent decline in young people’s recall of people report drinking. This is alcohol advertisements from being alcohol adverts, with unprompted particularly the case among 14- associated with or reflecting youth mentions of alcohol ads remembered 17 and 18-21 year olds – three in culture. Ofcom, together with its down from an average of 3.95 ads ten young people from both these co-regulatory partner, ASA, jointly remembered to 3.31. groups have drunk cider in the last commissioned a two-part research Considerable market changes since six months (compared to 14% and project to examine the appeal of 2005 mean that the two research 11% respectively in 2005). The alcohol advertisements to under- waves are not directly comparable. proportion of television spend 18s. Although the second wave does represented by the cider market The first wave of research published not generate conclusive data on increased from 1.8% in 2002 to in December 2005 aimed to the impact of the rule changes, it 15.5% in 2006. establish the appeal of alcohol provides information on trends Ofcom’s Director of Content, Kate advertising to young people, and and statistics that will be useful Stross, said: “This research shows was created as a benchmark against for informing the ASA Council that the revised rules on alcohol which the impact of the new rules on future decisions about whether advertising have ensured that fewer could be assessed. specific ads have breached the young people feel that TV ads are The second and most recent wave alcohol code rules. aimed at them. These are issues of of research aimed to evaluate the In addition, the research has considerable public concern. We impact of the tightened Codes and identified changes in reported welcome the fact the ASA will keep the changes to the alcohol market drinking behaviour between 2005 the matter under review and ensure over the last two years. Key findings and 2007, including: the rules remain effective and from this second part of the research appropriate.” • The proportion of 11-13 year olds show: who have never drunk alcohol has The ASA Director General, • Alcoholic drink suppliers have increased from 31% in 2005 to 46% Christopher Graham said: “The shifted their advertising spend away in 2007. (This is consistent with ASA welcomes this report as part of from television with a reduction of the findings of a 2007 Government an ongoing process of implementing 26.2% on TV compared to a 2.9% report - ‘Safe. Sensible. Social. The the new rules rigorously. It is of fall via all media from 2005-2007. next steps in the National Alcohol concern that some ads are still of • Children and young adults are Strategy’, HM Government June strong appeal to under-18s, but the being exposed to fewer alcohol 2007 - which found that there has ASA stands willing and ready to advertisements on television. been an increase in the proportion play its part in tackling this issue. Between 2002 and 2006 advertising of 11-15 year olds who claim not to We will be taking the findings of impacts fell by 31% for 16-24 year drink alcohol since 2001). the report on board when assessing ads against the Codes to ensure that olds and 39% for 10-15 year olds. • There has been very little change young people are protected.” • There has been a significant in the proportion of 11-17 years decline in the proportion of young The research report is available at www. ofcom.org.uk and www.asa.org.uk.

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UK industry standards review Don’t let a good night turn into a bad one The Industry ‘Social Responsibility the review is balanced and an a key Standards for the Production and element of the industry’s interest is Black cabs half-painted as police Sale of Alcoholic Drinks in the to ensure that each code is reviewed cars and ambulances are being used UK’ are being reviewed by the in context. in the UK as part of the latest Know Your Limits safer drinking publicity Home Office, with a particular It has already been established campaign. focus on implementation and the that the Advertising Standards effectiveness of self regulation. and Portman Codes will be treated Seen from the front, the forty The WSTA has voiced concerns separately from other standards. vehicles resemble a traditional black cab, or hackney carriage, but they that the solutions have been The Invitation to tender was issued have been painted so that from the identified by Government before in October 2007 with a contractor rear, they look like either police the review has been undertaken. expected to be appointed in cars or ambulances. The two halves Their objective is to ensure that November 2007. are linked by a simple line of text: ‘Don’t let a good night turn into a Diageo responsibility advertising in UK bad one’. The taxis will be on Liverpool Students in the UK are being urged Union of Student Services, Ltd. and Manchester streets for eight to use a new safe drinking device Ama Uzowuru, vice president weeks and have also be rolled out over the festive period. (Welfare) National Union of in Birmingham and London. They The mobile phone alcohol unit Students, said: “We welcome this form part of a wider advertising calculator helps them keep track innovative campaigning method to effort that also includes a fleet of of the number of units they are promote safe drinking.” 1,000 buses emblazoned with a bus consuming on a night out. In addition Diageo has announced route-style map. Using the same The calculator is part of the ‘Know details of its Christmas responsible ‘Don’t let a good night…’ strap line, What’s In It’ campaign, now in drinking TV ad campaign that the journey depicted on the side of its third year. The campaign seeks shows how excessive drinking ruins the buses terminates at the Accident to promote unit awareness by nights out. and Emergency department. highlighting the different levels The “Choice is Yours” campaign Home Office Minister Vernon of alcohol in different brands. It includes two ads that depict men Coaker said: is being run in conjunction with and women enjoying their night, “The Know Your Limits campaign the National Union of Students before showing results of drinking has been reminding young people and will run in 15 student unions too heavily. of the dangers of excessive drinking across the UK during November. Ads will run over four weeks in an imaginative, non-preaching Beer mats, bar runners and posters in November, prior to the and hard-hitting way since October will also feature in student bars to Government’s anti-drink driving 2006. Since the publication of the draw attention to unit information ads, which run in December, but alcohol strategy in June this year, on alcohol. after its “Know Your Limits” ads. we have stepped up our efforts to The scheme is run by Diageo Great The TV ads will be accompanied educate people about the harm Britain, in association with National by outdoor and that alcohol can do not only to print advertising and themselves but also to those around the website www. them. At this time of year when thechoiceisyours.com. people will be out having a good time, these vehicles will, I hope, make people think twice about having one drink too many.”

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First Alcohol Awareness week in Scotland to as many people as possible across • Alcohol awareness workshops Scotland. for employees The Scottish Association of Alcohol • Display of Awareness Week and Drug Action Teams throughout materials at industry sites and Scotland Distributed promotional visitor centres materials and organised educational • Responsible drinking events. information sent to all distillers, There was advertising on buses backed up by individual company Scotland’s first Alcohol Awareness in various regions and there were communications interactive stalls in shopping Week, one of the initiatives under • 250,000 ‘unit calculators’ centres. the Government’s partnership distributed across the industry and agreement with the alcohol 250,000 unit calculators were more widely. industry, ran from 21–27 October distributed through supermarkets, Douglas Meikle, SWA Alcohol 2007. There was a joint programme corner shops, pubs, off-licences, Policy Manager and a member of events in which Government, health practitioners and police and of the Alcohol Awareness Week the alcohol industry, health every Army Mess in the country steering group, said: professionals and the voluntary promoting responsible drinking sector work together to provide throughout the week. Campaign “The Awareness Week is another useful information to members of materials were also distributed to step in trying to change Scotland’s the public and promote a joined 10,000 employees in the Scotch tolerance of alcohol misuse. up message about responsible Whisky industry and displayed at Making inappropriate and excessive consumption of alcohol. The industry sites and visitor centres drinking unacceptable will require campaign objectives were to get across the county. All 32,000 Big a sustained effort, continuing the Scottish adult drinking public Issue readers receive an alcohol ‘unit partnership, and a multi-faceted thinking how much alcohol they calculator’ policy approach, ranging from consume by raising understanding better alcohol education to stricter Distillers ask ‘Does Your Drinking of what a unit of alcohol is and enforcement of licensing laws. Add Up?’ to help people understand their The Scotch Whisky industry is own drinking habits and levels of Scotch Whisky companies ran a committed to playing its part to consumption, in the context of the nationwide series of activities in the full both this week and over the sensible drinking message. Alcohol support of Scotland’s first Alcohol long term.” Awareness Week was officially Awareness Week. The events BMA Scotland Highlights Need launched by Shona Robison, encouraged Scots to learn more For Clearer Information For Minister for Public Health. about the units of alcohol in different Consumers drinks under the banner ‘Does Your 400,000 beer mats, along with Drinking Add Up?’ Improved unit In October BMA Scotland called posters, flyers and tent cards, awareness and understanding of the for new legislation to introduce distributed to 1,400 pubs and clubs daily Sensible Drinking guidelines compulsory labelling on all alcoholic throughout Scotland, reaching over have been identified as key elements products to help people understand 1.5 million customers and around in efforts to tackle alcohol misuse. and manage their drinking habits 7,500 staff. Retailers including better. In the week leading up to A wide range of activities were Asda, Morrisons, Sainsbury’s, Alcohol Awareness week, Dr Peter organised and supported across the Tesco, Threshers, The Co-op, Terry, Chairman of the BMA in Scotch Whisky industry, including: Marks and Spencer, Somerfield, Scotland, said: Majestic, and Waitrose distributed • Nationwide TV advertising “This week provides us with an materials and held in-store events highlighting the negative impact of opportunity to raise awareness to get the sensible drinking message excessive drinking about dangerous drinking levels.

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Call for research into attitudes to alcohol in Binge drinking and alcohol misuse Scotland have serious social, psychological and physical consequences. BMA On 15 November, Members of the Douglas Meikle, the Scotch Scotland believes that much more Scottish Parliament debated Motion Whisky Association’s Alcohol should be done to promote sensible, S3M-668 on ‘Perceived Norms of Policy Manager, commented on the moderate drinking and to move Alcohol and Tobacco Consumption debate: away from the cultural norm of - Pilot Studies in Scottish “Changing misperceptions about the drinking to get drunk. Educational Institutions’ lodged by incidence of excessive drinking can “The only way that individuals Dr Bill Wilson MSP. Research in play an important role in tackling can keep a check on their own Scotland and the USA has shown alcohol misuse. The Scottish norm is drinking patterns is to have access that what is perceived as ‘normal’ to drink responsibly as part of a healthy to clear information about what drinking behaviour has a strong lifestyle. Academic research shows they are consuming. Consistent influence on how individuals drink. that by consistently highlighting information on alcohol content University students, for example, that fact, rather than focusing solely and units along with guidelines tend to overestimate alcohol on excessive behaviour, individuals on the daily drinking limits would consumption amongst their peers . can be persuaded to question and help people to better understand The greater the over-estimation of change their own drinking patterns. their own drinking habits. what is ‘normal’ to drink, the more The industry welcomes this timely an individual feels justified in his/ “By legislating for standardised Parliamentary debate and both her own consumption. labelling on all alcohol products, we Ministerial and cross-party MSP can avoid mixed messages and help Researchers concluded raising support for further research into people to make informed choices awareness of the fact that the norm how social norm interventions about what they drink. is most people drink responsibly is can change attitudes to alcohol “This approach would be a a powerful tool to reduce alcohol consumption.” valuable addition to the Scottish misuse. Government’s plans to tackle Scotland’s drinking problem.” Alcohol and sport drinkaware.ie guide drink more without getting drunk To coincide with the launch, or that hangovers can be sweated drinkaware.ie announced that out of your body. 10,000 copies of the guide will be The booklet has information on how inserted into competitor registration and why alcohol affects your body packs for Monday’s Dublin City and impacts on your performance. Marathon. The guide also reminds readers of “The ‘Alcohol, Sport & You’ guide the key ‘Rules of Game’: gives useful and practical advice The new guide from drinkaware.ie, • Avoid alcohol 24 hours before for all those who participate in ‘Alcohol, Sport & You’, was launched sport and exercise – whether you by Irish Heptathlete Leona Byrne playing or training; • Drink lots of water; are training seriously, toning up and RTÉ sports presenter Shane or having a kick around the park,” O’Donoghue in October 2007. • If your injured, don’t drink added Fionnuala Sheehan. The pocket sized drinkaware. alcohol until you have had treatment; For more information, visit www. ie guide dispels commonly held drinkaware.ie. fitness myths that fit people can • Eat before you drink.

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New film competition European Alcohol and Health Forum - next to explores Irish steps attitudes to alcohol The first meeting of the Alcohol and sales promotions and other forms A new film competition aimed at Health Forum took place on 17th of marketing, and trends in alcohol highlighting and exploring attitudes October. The Forum has established advertising and sponsorship. to alcohol was launched on 15th two Task Forces, each composed of The Task Force on Youth will: November. 20 experts, which will work towards agreed objectives on the basis of • examine trends and drivers in Dare2Bdrinkaware is a digital specified mandates. The Task Force drinking habits of young people film competition for third-level on Marketing Communication and of the alcohol-related harm students, sponsored by drinkaware. will: they suffer; ie and organised by the Digital Hub Development Agency (DHDA). • examine approaches that have a • examine best practice actions It was launched by Dr. Stephen potential to reduce the alcohol- aimed at promoting responsibility Brennan, Director of Marketing and related harm suffered by young in marketing, and preventing Strategy at DHDA, and Fionnuala people, and in particular strategies irresponsible marketing; Sheehan, CEO of MEAS. aimed at curbing under-age • examine and build upon the drinking and drink-driving by “With dare2Bdrinkaware, we are report of the Directorate General young people, actions aimed at offering 5,000 euros to aspiring for Health and Consumer promoting responsible selling and film-makers to produce short Protection on the Advertising serving, and interventions aimed films challenging the relationship Round Table; at educating and empowering between Irish culture and drinking” • examine trends in product young people. explained Ms. Sheehan. development, product placement, Further information available at www.dare2Bdrinkaware.com. Pernod Ricard USA launch social responsibility campaign A Public campaign that focuses online version of the binge drinking governmental agencies and third- on drunk driving, underage advert shows shot glasses filling up party organizations. consumption and binge drinking with typical excuses. Other elements of the campaign has been launched this Autumn by “Although the vast majority of include a media outreach effort, Pernod Ricard USA. The campaign adult Americans who drink do so in financial contributions by Pernod included newspaper and magazine moderation, and the incidence of Ricard USA to a selected group advertisments, as well as web site underage drinking is declining, we of organizations and initiatives to banners and a new website www. have an obligation to fight against address alcohol-related issues, and acceptresponsibility.org. irresponsible consumption,” says ongoing development of innovative, Headlined: “Drunk driving doesn’t Alain Barbet, President and CEO educational tools to reach parents start with a drink. It starts with an of Pernod Ricard USA “Our new and their teenagers. excuse,” the ads feature a martini responsibility campaign focuses glass illustrated with the text of on recognizing and overcoming typical excuses people make when enabling excuses so we can act they drive after drinking too much, responsibly.” such as “I’m 220 lbs - it takes a lot The Acceptresponsibility.org more than three drinks to slow this site lists numerous links for guy down,” and “I’ve driven home authoritative information on from here so many times I could drunk driving, underage drinking do it blindfolded.” An animated, and binge drinking provided by

Aim Digest PAGE 10 SOCIAL AND POLICY NEWS

Canadian campaign to encourage students to New road laws in drink responsibly Ontario affect drink drivers The campaign approach highlights and celebrates responsible behaviour Bill 203, new legislation recently in each of these areas: announced through Ontario’s • Friends (taking care of friends) Ministry of Transportation, targets • Safety (watching friend’s drinks) drink-drivers and street racers. The new legislation is planned to take • Academic (healthy balance effect in late 2008 and will include: The Student Life Education between school and play) Company (SLEC) and Molson • Designated Drivers (safe Creating escalating administrative brewers have launched their 2007 driving) sanctions for repeat drinking drivers measuring 0.05 to 0.08 blood campaign dedicated to responsible • Personal Protective Behaviour alcohol concentration (the “warn” drinking among university and (eating before drinking) range) college-age students. This year’s • Balancing Finances (good • First instance: driver suspended campaign, which was delivered to personal financial management) 150 campuses for the start of the new for three days. “Molson recognizes that college campus year, includes an interactive • Second instance: driver and university students are a key Web site: www.herestomychoice. suspended for seven days and must target audience for our responsible com. undergo remedial measures course. drinking message,” said Ferg “University and college students Devins VP, Government & Public • Third or subsequent instance: are sometimes under tremendous Affairs, Molson. “In order to better driver suspended for 30 days, pressure to drink to excess,” said reach this group in a meaningful must undergo remedial measures Frances Wdowczyk, Executive way, we partner with the Student course, and have ignition interlock Director, Student Life Education Life Education Company. This condition on their licence for six Company. “Drinking on campus is helps us reach students at colleges months. a reality and what we want to do and universities and ensure that Measures to increase installation is make sure students are armed responsible drinking messages have of ignition interlock devices by with the information to do so a strong presence on campus.” convicted offenders. responsibly.” In addition to the interactive Allowing the use of the civil The 2007 campaign focuses on six Web site, the campaign also forfeiture law to take vehicles away main communication elements. features posters, buttons, radio from people who continue to drink Each of these elements addresses advertisements and age-of-majority and drive. specific responsible behaviour birthday cards. among university/college students. The announcement of this new legislation comes following the recent publication of MADD ‘Saving Faces’ research into binge drinking Canada’s 2007 Progress Report, The UK Department of Health Teachers remarked that “students in which the organization says funded study by ‘saving faces’ were very shocked and disgusted. although there is “real progress”, in into teenage drinking culture has They were also surprised at the kind the fight against drunk driving with interviewed 9,000 pupils aged of injuries that could be caused by tougher laws, there is still room for 13 and 14 who have completed drinking too much alcohol. A lot improvement. a baseline questionnaire and mentioned that they would think surgeons have visited schools all twice about getting drunk….” over the country to deliver graphic Pupils will complete follow-up presentations about the link questionnaires next year. between binge drinking and severe For more information website: facial injury. http://www.savingfaces.co.uk

Aim Digest PAGE 11 SOCIAL AND POLICY NEWS

Self regulation of advertising – a success story Miller publish ‘Sustainable for beer Development Report’ continue to provide the blueprint for the entire sector,” said Rodol- phe de Looz-Corswarem, Secretary General of the Brewers of Europe. “Clear systems for complaining about irresponsible beer advertising are in place and we would encourage anyone who has a problem with Recent research published in ‘Beer any advertisement to complain.” Advertising in Europe’ and con- Miller have published their Complaints about alcohol advertis- ducted on behalf of the Brewers of Sustainable development report for ing in general are very low – less than Europe by independent research- 2007. 3% of all advertising complaints. ers reveals that a record 97% of The number of complaints about In 2006, SABMiller, the parent beer advertisements on TV and in beer advertising is even lower. company, identified 10 global the printed press successfully meet sustainable development priorities, standards set by Europe’s national The Brewers of Europe is the offi- which include: discouraging bodies governing self regulation of cial voice of the European brewing irresponsible drinking; making advertising. sector to the European Union and more beer but using less water; its Institutions, currently including “The beer sector in Europe contin- reducing our energy and carbon 25 national brewing associations, ues to meet society’s expectations for footprint; having a vibrant representing over 95% of the beer respectful and responsible advertis- packaging reuse and recycling produced in the EU. ing. The standards we set out back economy; working towards zero in 2003 in the Brewers of Europe To view the report, http://www. waste operations; having supply Guidelines for Responsible Com- brewersofeurope.org/docs/ chains that reflect the company’s mercial Communications for Beer, publications/v1_23-4-2007.pdf values and commitment; benefiting communities; contributing to the reduction of HIV/AIDS; respecting US impaired driving still common amongst human rights and transparency in high school seniors reporting progress. In the effort to discourage 30% of American high school The survey appears in the November irresponsible drinking, Miller has seniors said they’d driven after heavy issue of the Journal of Studies on created programmes and supported drug or alcohol use or had been in a Alcohol and Drugs. initiatives which encourage car with an impaired driver at least “Most teens are aware of the dangers responsible consumption of alcohol once within the previous two weeks, of drinking and driving, yet many and that prevent youth access by according to a 2006 survey funded ignore it and many don’t seem to equipping adults and retailers with by the U.S. National Institute on recognize the dangers of drinking educational tools and resources. Drug Abuse (NIDA). and driving after using illicit drugs, The company has also promoted Rates of impaired driving among including marijuana,” NIDA alternative transportation initiatives teens have declined - from 35% Director Dr. Nora Volkow stated. in order to discourage drink driving to 31% between 2001 and 2003, and subject their marketing to and leveling off at just under 30% comprehensive processes of review between 2004 and 2006. and self-regulation. For a copy of the report, visit http:// www.millerbrewing.com/aboutMiller/ sustainableDev/responsibleDrinking.asp

Aim Digest PAGE 12 SOCIAL AND POLICY NEWS

Delaware forms US designated driver study underage drinking task force Nielsen Media Research conducted as a Designated Driver (58.2%). a study on behalf of Anheuser-Busch • 30.8% would use a tow service The US state of Delaware has in order to measure opinions about that would get them and their car announced the formation of a Designated Driver programmes and home. Adults 21-29 were the most legislative task force to study the their usage . A total of 1,036 persons likely to indicate they would use this service (35.7%). issues surrounding the underage 21+ were interviewed. consumption of alcohol and drunk • 96.9% of adults have heard of the • The least popular choice given was a scooter service that would driving. idea of a Designated Driver, and two-thirds have been a designated send a driver to drive you and your The task force is being chaired driver at least once. car. 28.9% would make use of this by Brian Fischer, vice president • 41.4% of adults have used a service with adults 21-29 the most of community relations of The Designated Driver at least once in likely (44.0%) to use it. Charmer Sunbelt Group, a national the past. For planning an evening out distributor of fine wines and • 71.1% of people who have ever had • 50.3% of respondents indicated spirits. occasion to drink alcohol beverages The task force will examine the that someone volunteers to be the have been a Designated Driver and Designated Driver. problem of underage drinking and 51.2% have used a Designated • Another 27.2% of respondents make recommendations on specific Driver. measures to combat, prevent and indicated that the Designated Driver • Parents are about 14% more likely is selected on a rotating basis. reduce alcohol-related harm within to have been a Designated Driver the state. and 30% more likely than the total • 69.0% of respondents chose to Delaware Speaker of the House population to have ever been driven describe their Designated Driver as “responsible” and Terry R. Spence said: “I established home by one. this task force during the past • One in five respondents (21.8%) • 25.6% chose “a true friend” as session to address what we, as policy had used a taxicab as their a description for their Designated Driver. makers, can do …. The group is Designated Driver. 30-39 year olds comprised of people from various are 57% more likely to have done For socialising at work agencies, including the Office of so, and men are 54% more likely to • 61.3% said their company Highway Safety, the Division of have done so than women. encouraged the use of Designated Alcohol and Tobacco Enforcement, • 92.8% of adults feel that promoting Drivers. Adults 21-29 were the most the use of Designated Drivers is an the Attorney General’s Office, the likely (71.4%) to work somewhere excellent or good way to help reduce Delaware Restaurant Association that the employer encouraged the problem of drunk driving. Designated Drivers. and the Delaware Chapter of • 26.0% of respondents have Mothers Against Drunk Driving— Some choices of Designated employers that offered free cab rides all committed to stemming the Driver proved more popular with respondents then others. home. underage consumption of alcohol.” • 56.3% or respondents’ employers Fischer commented: “It’s all about • 76.5% said they would use free or reduced-fare cab rides as a Designated ensure that employees are served finding ways to better educate our Driver. Adults 30-39 years old were alcohol beverages responsibly. youth and their parents about a the most likely to agree to using this • 72.1% of respondents said their zero tolerance policy on underage choice at 85.0%. employers offer plenty of food at the drinking. When most teens report • Nearly 90% (88.8%) said they party to help get employees home that they receive alcohol from would use a friend. Adults 30-39 safely. family and friends, we need to do were the most likely to agree to this • 69.0% of respondents chose “be more to address the problem of choice, as well (94.1%). the Designated Driver” as the best social hosting in which adults host • 41.3% would use mass transit. way to impress the boss. teen parties where there may be Adults 21-29 were the most likely to For more information, visit http:// underage drinking.” indicate they would use mass transit www.alcoholstats.net/

Aim Digest PAGE 13 AIM

AIM – Alcohol in Moderation was founded in 1991 as an independent organisation whose role is to communicate ‘The Sensible Drinking Message’ and to act as a conduit for information from the industry, its associations and relevant medical and scientific researchers, legislation, policy and campaigns.

AIM Mission Statement

· To promote the sensible and responsible consumption of alcohol · To encourage informed debate on alcohol issues · To communicate and publicise relevant medical and scientific research in a clear and concise format via AIM Digest and the AIM Research Highlights · To publish information via the ‘AIM Gateway to Responsible Drinking and Health’ on moderate drinking and health – comprehensively indexed and fully searchable without charge · To communicate with consumers on responsible drinking and health via www.drinkingandyou.com and via publications based on national government guidelines · To distribute AIM Digest without charge to the media, legislators and researchers involved in alcohol affairs · To direct enquiries from the media and others towards full and accurate sources of information.

AIM SOCIAL, SCIENTIFIC AND MEDICAL COUNCIL

Peter Duff, Prof. Dwight B Heath, Prof. Jean-Marc Orgogozo, AIM Chairman Anthropologist, Brown University Institut de Cerveau University of Bordeaux Helena Conibear, Elisabeth Holmgren Executive Director Stanton Peele PhD, Prof. Oliver James, Social Policy Consultant Prof. Alan Crozier Head of Medicine Prof. of Plant Biochemistry and University of Newcastle Dr. Erik Skovenborg, Human Nutrition, University of Scandinavian Medical Alcohol Glasgow Christopher Jarnvall, Board Publisher of Alcohol Update, Julian Brind, MW Sweden Creina S. Stockley MSc MBA, Senior Consultant, Waitrose The Australian Wine Research Arthur Klatsky MD, Institute Prof. R Curtis Ellison, Kaiser Permanente Medical Center Boston University School of Dr. Thomas Stuttaford, Medicine Alfred de Lorimier MD, Medical Correspondent to the Medical Friends of Wine Times and Author Harvey Finkel MD, Boston University School of Dr. Philip Norrie, Dr. Elisabeth Whelan, Medicine GP, Wine/ Medical Historian and President American Council on Author Science and Health Tedd Goldfinger, FACC, FCCP Desert Cardiology of Tuscon Ellen Mack MD Heart Centre, University of Arizona

Aim Digest PAGE 14 ARTICLES

Diet, drinking, lifestyle and cancer risk - a comprehensive review

The largest ever study of the links every day, because there is growing Comments on the report: between lifestyle and cancer has evidence that this helps to reduce the made 10 recommendations to risk of developing cancer. As their “We know that if you smoke, you reduce the risk of developing the fitness improves, people should aim increase your risk ... but with obesity disease. to do an hour of moderate exercise and being overweight, it is very clear or 30 minutes of vigorous exercise and it is a graded phenomenon... A scientific panel put together every day. The study found strong The more you drink, the higher the by the World Cancer Research evidence that exercise protected risk. but this had to be balanced Fund examined more than 7,000 against bowel cancer. with its (alcohol’s) ability to protect existing studies into cancer risks against heart disease’. to produce what is billed as the Recommendation 3: limit most comprehensive analysis of consumption of food and drink Sir Michael Marmot, professor of the relationship between diet and high in fat, sugar and calories epidemiology and public health at cancer. University College London and the Avoid highly calorific foods and survey chairman 10 lifestyle recommendations are drinks such as chocolate, which made to reduce cancer risk contains around 10 times more ‘After smoking, obesity is the calories than an apple, and sugary biggest risk factor for cancer, and Recommendation 1: be as drinks, such as fizzy drinks and the evidence showing the link lean as possible without being cordials. The report recommends continues to strengthen’. underweight that people drink water or Dr Lesley Walker, Cancer The researchers found “convincing” unsweetened tea or coffee, although Research UK’s director of cancer evidence that excess body fat could no more than four cups of the last. information.. cause six different types of common Drink no more than one glass of cancers, including those of the fruit juice a day, as it contains a lot ‘The main take-home message is breast, bowel and pancreas. Even of sugar. that you should enjoy a balanced, those falling within the normal Recommendation 4: eat a diet healthy diet and not overeat. If and healthy weight range should you do that, the occasional rasher slim down to reduce their risk of predominantly of fruit and vegetables of bacon is unlikely to cause any developing cancer. People with harm’. Green leafy vegetables such as a body mass index of between Professor Ian Rowland, head of spinach and broccoli “probably” 18.5 and 25 are deemed to be the Hugh Sinclair Unit of Human offer protection against cancers a healthy weight. But the study Nutrition at Reading University, warns that those at the higher end of the mouth, larynx, pharynx, of the normal weight range are at oesophagus and stomach. Fruits On breast cancer risk increased risk, and everyone should “probably” protect against mouth, aim to be as near to the lower end pharynx, larynx, oesophagus, lung ‘This report highlights what as possible. Cancers strongly linked and stomach cancers. Dietary fibre, we’ve known for some time - that with excess body fat include those found in cereals, roots, vegetables, maintaining a healthy weight, taking of the oesophagus, pancreas, bowel, fruits and pulses, “probably” helps regular exercise, breastfeeding for womb and kidney – as well as to prevent bowel cancer. The at least 12 months in total and breast cancer in post-menopausal evidence that fruit and vegetables limiting your alcohol intake can women. directly protect against cancer is decrease your risk of developing not as convincing as it was 10 years breast cancer.’ Recommendation 2: be physically ago. But eating a diet rich in fruit Dr Sarah Cant, policy manager at active in everyday life and vegetables can help to prevent Breakthrough Breast Cancer People should undertake a minimum weight gain, which is linked to of 30 minutes of moderate exercise cancer.

Aim Digest PAGE 15 ARTICLES

Recommendation 5: avoid eating Recommendation 8: avoid dietary processed meats and limit red supplements Comments on the Report (cont’d) meat It is not clear that supplements, such ‘You can’t eliminate the risk [of Red meat and processed meats, such as vitamin and mineral tablets, are cancer] and it is important people as ham, bacon, pastrami, salami an adequate substitute for eating a realise they can do everything on and frankfurters, should be avoided balanced diet. Some research shows this list and still get cancer’. that taking high doses of some because they are strongly linked Antonia Dean, a clinical nurse supplements may increase the risk to bowel cancer. People should specialist for the Breast Cancer of developing cancer. consume less than 500 grams, or Care helpline 18 ounces, of cooked red meat per Recommendation 9: breastfeeding ‘Don’t make the mistake of thinking week, and avoid processed meat protects mothers and children altogether if possible. that becoming a teetotaler means Women should aim to breastfeed you’ll lower your risk of the disease. Recommendation 6: limit alcohol their baby exclusively for six months, The new findings have to be looked consumption and after that on a complementary at as one more piece of information Drinking in excess over a long basis. This is because of strong among many risk factors. In the big period of time is strongly linked evidence that breast-feeding protects scheme of things; [alcohol] is a small to mouth and oesophagus cancer. women from breast cancer. There is issue” compared with something Moderate use may be linked to an also some evidence that breast-fed such as family history. Follow a increase risk of breast cancer (6 - children are less likely to become healthy lifestyle, with a good diet, 10% per daily drink). The report obese in later life, which reduces exercise, and avoidance of smoking recommends limiting drinking for their risk of cancer. and heavy drinking’. men to one pint of lager, beer or Recommendation 10: cancer Len Lichtenfeld, MD, American cider, or a small glass of wine or a survivors should get specialist Cancer Society deputy chief medical measure of spirits a day - and half nutritional advice officer. that amount for women. Cancer survivors, who include Recommendation 7: limit salt people living with the disease and consumption those who have recovered, should A commentary on the World Cancer Consume no more than 6g of salt a get specialist advice on their diet Fund report follows on page 17. day, because it is linked to stomach once their treatment is finished. This cancer. can help to prevent a recurrence of the disease.

Does moderate drinking lower risk of heart failure? To examine the association between as drinking increased (hazard ratios, a reduced risk of heart failure among moderate drinking and heart failure, 0.9 for 1–4 drinks per week, 0.8 for moderate drinkers in comparison researchers assessed data from 5–7 drinks per week, and 0.6 for >7 with nondrinkers (or, as in this study, 21,601 male participants in the drinks per week versus <1 drink per occasional drinkers). This lower risk Physicians’ Health Study who were week; P for trend=0.01). was found primarily in patients free of heart failure at that study’s · Drinking was not significantly with heart failure and CAD, and baseline. Analyses were adjusted associated with the risk of heart therefore may result from alcohol’s for potential confounders (i.e., age, failure in subjects without protective effects on myocardial smoking, body mass index, and antecedent myocardial infarction or infarction or other consequences of valvular heart disease). coronary artery disease (CAD). CAD. · During an average follow-up of 18 References: Djoussé L, Gaziano JM. Alcohol R. Curtis Ellison comments: consumption and risk of heart failure in the years, 904 incident cases of heart These results support what many, Physicians’ Health Study I. Circulation. failure occurred. but not all, recent prospective 2007;115(1):34–39 · The risk of heart failure decreased epidemiological studies have shown:

Aim Digest PAGE 16 ARTICLES

Commentary on World Cancer Fund report by R. Curtis Ellison

There has been considerable in morbidity and mortality from day, a straight line will necessarily media attention in the last weeks many of the diseases of ageing, and show an increase for 1 or 2 drinks/ regarding a major report on alcohol a lowering in total mortality. day. Further, the authors of the and cancer, a huge undertaking by report sometimes appear to base We have just begun reviewing the a large number of cancer experts their conclusions that alcohol mammoth report, but there are from around the world. The increases the risk of a type of cancer a few initial comments regarding report goes into great detail on if the majority of studies show an the chapter dealing with alcohol most environmental exposures that increase, but do not carry out a meta- and cancer. Most of the graphs may relate to one or more types of regression to evaluate potential bias compare the “highest” versus the cancer. The full 500+ page report in the various studies or otherwise “lowest” categories of alcohol is available on the internet at www. try to explain why some studies do intake with each type of cancer. dietandcancerreport.org/?p=ER. not show such a relation. While such analyses are helpful for In the paper on colon and breast seeking a relation between alcohol cancer, we briefly summarize the Overall, we think that we should and cancer, they in themselves do data presented in the report on the praise the new cancer report for not provide data permitting us to relation of alcohol to these common the huge effort the authors took to judge limits of alcohol associated cancers. In addition, we give below summarize a mammoth amount of with various health outcomes. a few general comments on the research relating alcohol to cancer. The information they report report and the response to it by the Even when the new report presents will be important in identifying media. increases in risk per 10 g of alcohol, modifiable factors associated with it seems that all of their analyses Many of the press releases on this cancer. Still, the media stories on are assuming a linear relationship. report end with recommendations this report appear to focus only This assumption is perhaps not that people should not drink alcohol on the dangers of drinking, and necessarily as inaccurate for cancer at all because of the potential ignore potential health benefits of as it is for cardiovascular disease or increase in the risk of many types of moderate alcohol intake on other mortality (where there is definitely cancer. A large number of reports conditions. The report is thus of a U- or J-shaped curve), but still have failed to point out that cancer limited value for groups setting up it makes it difficult to judge the is only one of many diseases and drinking guidelines, as it provides relation of moderate drinking to conditions associated with alcohol no information on more common cancer risk. For example, if you consumption, and the net effects causes of death, on total mortality, assume no increased risk at 0 and of moderate drinking in middle- or on the net health effects associated greatly increased risk at 6 drinks per aged and older adults is a decrease with alcohol consumption. Food, nutrition, physical activity, and the prevention of cancer: a global perspective Comments from the Institute on cancers of the mouth, pharynx, and Colorectal Cancer Lifestyle and Health at Boston larynx, and probably esophagus. University School of Medicine: The two common cancers that may Report Summary of Alcohol and relate to even moderate drinking are Colorectal Cancer Some of the cancers described are colorectal cancers and breast cancer known to be strongly associated There is ample and generally in women. We include some of the with excessive alcohol intake, consistent evidence from cohort graphs, and the report summaries, usually in conjunction with heavy studies. A dose-response is apparent. for these two cancers, as well as a smoking, and they occur primarily There is evidence for plausible few of our comments on these among alcoholics. These include mechanisms. The evidence that aspects of the report. consumption of more than 30

Aim Digest PAGE 17 ARTICLES

g/day of ethanol from alcoholic drinks is a cause of increase in risk over that of non-drinkers (the horizontal colorectal cancer in men is convincing, and probably line) appeared to only be evident above 20 g/day for also in women. the first two studies and above about 10 g/day for the third study. Comments: In the above charts from the Report, while number of drinks showed little relation with colorectal cancer in cohort studies (Figure 4.8.8), total ethanol estimates were associated with a 9% increased risk per 10 g/day for colon cancer (Figure 4.8.10) and a 6% estimated increased risk per 10 g/day for colorectal cancer (Figure 4.8.12).

Unlike the interpretation of a J-shaped association between alcohol and CHD, if one found a J-shaped association between alcohol and colon cancer (i.e., moderate drinkers have a lower risk than non-drinkers), one may argue that some people who developed GI symptoms before cancer was diagnosed may have reduced their alcohol consumption or stopped drinking completely (protopathic bias); the J-shaped association is not reflecting the alcohol and colon cancer causal relation but rather a reverse causation. In other words, the association with alcohol consumption, especially going from none to moderate, may reflect the consequence of pre-cancer disease status. The group identified as “non-drinkers” may include a number of ex-heavy drinkers, making the risk of cancer higher in this group than it would be for true, long-term non- drinkers.

Alcohol and Breast Cancer Report Summary of Alcohol and Breast Cancer There is ample, generally consistent evidence from case-control and cohort studies. A dose-response relationship is apparent. There is robust evidence for mechanisms operating in humans. The evidence that alcoholic drinks are a cause of premenopausal and postmenopausal breast cancer is convincing. No threshold was identified. Comments: The data from cohort studies summarized in Figure 4.8.15 shows considerable variability in the Few studies were included in the dose-response graph relation of alcohol to breast cancer, with a summary for alcohol and colon cancer (Figure 4.8.11), but all estimate of a 10% increase in risk for women consuming suggest that there may be a slight J-shaped curve; an 10 g/day of alcohol. In Figure 4.8.14, results from

Aim Digest PAGE 18 ARTICLES/ MEDICAL NEWS

Moderate alcohol consumption both cohort and case-control studies are included in an make be beneficial for lung attempt to determine a dose-response relation. Again, there is considerable heterogeneity, with some studies function suggesting a threshold amount of alcohol for an increase A new study reported by Dr. Stanton T. Siu, chief of in risk but others not showing such a relation. pulmonary medicine at Kaiser Permanente Hospital in Oakland, California, was presented at the American College of Chest Physicians annual meeting, in Chicago in October. The study suggests that moderate alcohol consumption may have a protective effect for lung function. “We found that that if you drank less than two glasses of alcohol per day of wine, beer, or spirits that you had much less likelihood of developing obstructive airways disease, which includes asthma and emphysema,” Sui said. Siu and his colleagues analyzed the health records of almost 178,000 patients living in northern California. All had undergone exams between 1964 and 1973 as members of the same local health plan. Exam questionnaires completed at the time recorded their smoking and drinking habits, as well as their lung function histories. As part of their exams, all the patients also underwent a range of pulmonary function tests (PFT) designed to gauge how well a person inhales, exhales and transfers oxygen from the lungs into the bloodstream. Siu’s team found that “light to moderate drinkers” (under two glasses of alcohol per day) were the least likely to have problems with lung function. The relationship between moderate drinking and healthy lungs was consistent regardless of smoking habits or a previous experience of lung and/or heart disease. The survey records had not broken down alcohol consumption according to type of alcohol consumed, so it’s not possible to tell from this study The summaries of studies upon which the report if any category of drink is healthier for the lungs than is based did not allow for evaluation of potential another. Siu said that light drinking’s protective effect modification of the risk of breast cancer associated with roughly translates to a 20% reduction in the risk for alcohol consumption by low folate intake, concomitant developing lung disease. The link between alcohol use hormone therapy, or binge drinking. Some studies and lung health was consistent across all ethnic groups, suggest that any increase in breast cancer risk from all age groups, and for both men and women. alcohol may be attenuated, or even prevented, by such behaviours. Source: Stanton T. Siu, MD; Neil Schachter, MD; Oct. 24, 2007, presentations, American College of Chest Physicians annual meeting, Curtis Ellison is professor of Medicine and Public Health at Boston Chicago University School of Medicine and Director of the Institute on Lifestyle and Health at Boston University School of Medicine. He is a valued member of the AIM Social, Scientific and Medical Council.

Aim Digest PAGE 19 ARTICLES

Do we need the alcohol in our wine? by Harvey E. Finkel, M.D.

There’s been a lot of talk lately heart attack, stroke, and related-- summarizes alcohol’s role in health about avoiding alcohol--the by more than 40%, and probably when used in moderation. The bête noire of many --while still alleviates the ravages of aging, paper cites J-shaped associations preserving the health benefits diabetes, dementia (including between alcohol consumption of wine, a sort of having your Alzheimer’s disease), immune and a number of disorders, antioxidant and not drinking it too. dysfunction, inflammation, cataract including coronary heart disease, Grape juice, dealcoholised wine, formation, and other degenerative diabetes, hypertension, stroke, and resveratrol capsules are being diseases. Research also suggests congestive heart failure, dementia, promoted as more temperate, more that wine consumption might lead and peripheral vascular disease, healthful alternatives to wine. Let’s to increased overall life span. and death from all causes. The critically examine what alcohol Immoderate drinking, in contrast, authors believe that alcohol confers brings, particularly to wine, most damages many body organs, impairs cardiovascular protection to high- particularly to the health of the wine health, hastens death, and fosters risk and low-risk men and women drinker. It should be remembered antisocial consequences. Alcohol is predominantly by improving insulin that drinking wine, or any alcoholic the only toxic component of wine, sensitivity and raising high-density drink should be for pleasure and but, as with many things in life, it lipoprotein cholesterol (the “good” relaxation rather than for any given is a matter of quantity. Little and cholesterol). It is also associated health benefits however. often is the take-home message as with reduction in abdominal obesity, a distinct cardiovascular Alcohol, that is, ethyl alcohol the antithrombotic effects of alcohol risk factor. Finally, the authors (ethanol), contributes body last for approximately 24 hours. agree that a modest daily allotment and flavour to wine - and other Recent research of alcohol, particularly with meals, naturally fermented beverages, is best, but warn against the risks helping to preserve and enliven it, Now there is additional evidence that of binge drinking and abuse of and, through its volatility, enables alcohol can be considered essential alcohol. the all-important bouquet to to the beneficial effects of wine upon bloom. Medical evidence over the health, and, therefore, that efforts to The moral seems clear to me: spare last 30 years shows repeatedly that eliminate alcohol are ill conceived. the alcohol and lose much of the alcohol itself accounts for at least Research at the US Department of pleasure and healthfulness of wine. 50-60% of the many and now- Agriculture laboratory, published Just don’t go too far. familiar health benefits of moderate recently by Chanjirakul, et al., in wine consumption. Polyphenolic the Journal of the Science of Food References antioxidants take care of most of the and Agriculture, demonstrates that Finkel HE. In Vino Sanitas? 2004 alcohol promotes the antioxidant Addendum. Washington: Society of Wine remainder. Some of the salubrious Educators, 2004. capacity of berries, and enhances effects involve a joint venture Baur JA, Pearson KJ, Price NL, et al. between alcohol and polyphenols. their resistance to decay in so doing. Resveratrol improves health and survival of Also, it has been thought for some mice on a high-calorie diet. Nature 2006; Most of the studied health benefits years that the alcohol elaborated 444:337-342. of drinking alcohol in moderation during fermentation improves the Chanjirakul K, Wang SY, Wang CY, et al. concern the cardiovascular system, extraction of healthful polyphenols Natural volatile treatments increase free- radical scavenging capacity of strawberries the heart and blood vessels, from grape skins. especially the arteries, which vitally and blackberries. J Sci Food Agric 2007; 87:1463-1472. supply the organs and tissues of A “State-of-the-Art Paper” from the University of Missouri, Kansas City, Corder R, Mullen W, Khan NQ, et al. Red the body with oxygen, nutrients, wine procyanidins and vascular health. and defenses against diseases and and the Ochsner Medical Center, Nature 2006; 444:566. injuries. New Orleans, in the Journal of the O’Keefe JH, Bybee KA, Lavie CJ. Alcohol American College of Cardiology and cardiovascular health: the razor- s h a r p Moderate drinking appears to of September 11, 2007, succinctly double-edged sword. J Am Coll Cardiol reduce atherosclerotic disease— 2007; 50:1009-1014.

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Review of the National Health and Medical Research Council’s Australian Alcohol Guidelines: health benefits and health risks by Creina Stockley, Health and Regulatory Information Manager, The Australian Wine Research Institute

The National Health and Medical part in high-risk activities or using Alcohol Strategy, and the term Research Council’s (NHMRC) illicit drugs). ‘safe’ is also no longer used. The Australian Alcohol Guidelines: rationale of the guidelines appears Indeed, compared to the current health benefits and health risks of to be more epidemiologically than Guidelines of 2001, minimal 2001 are under review and a new clinically based, referring to lifetime changes have been made to the draft has been recently released for risk of death from alcohol-related content in the new draft Guidelines public comment on http://www. diseases with no inclusion of a except for the following: nhmrc.gov.au/consult/index.htm. reduced longer-term risk from light • The universal Guideline 1 sees: to moderate alcohol consumption, The public comment period closes four standard drinks per day for which is in complete contrast with on 11 December 2007. These draft men reduced to two as per women the 2001 version of the guidelines. guidelines are intended to give with no gender differentiation For example, at each level, the ‘low- Australians clear guidelines on how regarding risk; no mention of a risk’ has been conservatively defined to avoid, or minimise, the harmful maximum amount for occasional as the level of alcohol intake that, consequences of drinking alcohol higher drinking days; no mention for healthy adults, should keep the — both the immediate effects of a maximum amount per week; risk of accidents and injuries, or of of each drinking occasion and no mention of a maximum amount developing alcohol-related diseases, the longer-term effects of regular per hour (related to binge drinking at low levels (compared with not drinking. Similar to the current patterns); and no mention of 2 drinking). This level should also Guidelines, the new draft, which is alcohol-free days per week. reduce the lifetime risk of death entitled Australian Guidelines for from an alcohol-related injury, or Low-Risk Drinking, contains three • Guideline 11 referring to from an alcohol-related disease, to levels of health advice: pregnancy and extended to breast less than 1 in 100, that is, one death feeding suggests that abstinence is • A single, universal guideline for for every 100 people who drink at the best option but does not provide Australian adults that provides a that specified level and pattern. a low risk amount or any guidance if recommended low-risk drinking pregnant and breast feeding women Submissions can be made in writing, level to reduce both the immediate opt to drink alcohol. It does not, by email or on audiotape and all and long-term harm from alcohol however, specifically state ‘do not comments will be considered by the consumption; drink’ if pregnant or breastfeeding. NHMRC. • Two guidelines with special • Guideline 2 referring to when Please send your submission to: precautions for children and responsible for private and public Project Officer – Australian Alcohol adolescents, and for pregnant and drinking environments is removed. Guidelines Evidence Translation breastfeeding women; and Section NHMRC • Guideline 12 referring to people • Additional health advice and GPO Box 1421 who choose not to drink alcohol is precautions for specific groups of CANBERRA ACT 2601 removed. adults who have an increased risk Tel: (02) 6217 9386 Fax: (02) 6217 (such as young adults, older people, The terminology has reverted back 9035 people with a family history of to the ‘low-risk’ terminology of Email: [email protected] alcohol dependence), for people the 1987 and 1992 versions of the with physical or mental conditions Guidelines, although still related made worse by alcohol, and for to harm minimisation which is the specific situations (such as taking premise of the [Australia] National

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Abstracts related to alcohol consumption from the scientific sessions of the American Heart Association, October 4-7, 2007 reviewed by R Curtis Ellison moderate drinkers (1 to 2 drinks/ day). However, > 4 drinks/day was associated with an 81% greater risk of angina than moderate alcohol use. Those drinking < 1 drink/day or > 2 to 4 per day had similar angina risk compared to moderate MD drinkers. Results did not vary by gender (p > .05 for interaction). the SF12 PCS instrument. As Alcohol consumption and one- The authors conclude that this study with angina, the highest risk of a year angina risk after myocardial extends prior evidence of a dose- poor functioning score was among infarction. Buchanan DM, dependent relationship between abstainers and heavy drinkers. This Mundluru S, O’Keefe JH, Reid KJ alcohol use and other cardiovascular study supports limited data on . . . . Spertus JA. Abst 3586 benefits/risks to post-MI angina. the effect of alcohol intake among Moderate alcohol consumption people who have had a MI. From Summary: The authors state that (1 to 2 drinks/day) was associated both the functioning point of prior studies show light to moderate with reduced risk of angina 1 year view and for angina, the moderate alcohol use is associated with reduced after MI compared to abstinence drinkers had the best outcomes. mortality and cardiovascular or heavy alcohol consumption. Moderate alcohol consumption events, whereas heavy use increases Excessive alcohol use (> 4 drinks/ mortality and cardiovascular risks. is associated with improved day) was associated with increased endothelial function. Suzuki K, The association of alcohol use risk of angina. and post-myocardial infarction Elkind MS, Boden-Albala B, (MI) symptoms is unknown. Comments: In this study of subjects Zhezhen J . . . Homma S. Abst They explored the association who had had a MI, there appeared to 3644 be a reduction in the risk of angina between alcohol use and risk of Summary: The authors state among consumers of alcohol of up having angina 1 year after an MI. that endothelial dysfunction to 4 drinks per day, but a significant Upon enrollment in the 19-centre contributes to atherosclerosis and increase in risk for those consuming prospective PREMIER registry, the pathogenesis of cardiovascular more. In the above figure, the risk acute MI patients (n=2,481) were disease. Effects of alcohol was lowest for those consuming 2-4 asked about alcohol use. Angina (any consumption on endothelial drinks/day, but it was stated in the vs. none) was assessed at 1 year with function may be relevant to these presentation that the percentage the Seattle Angina Questionnaire. cardiovascular outcomes, but very of subjects reporting angina was The association of alcohol use and few human studies have examined essentially the same for all subjects 1-year angina was modeled using a the effect of alcohol consumption consuming between 1 and 4 drinks/ hierarchical multivariable modified on endothelial function assessed day. The risk was higher, however, Poisson regression model. by flow-mediated dilation (FMD) for “binge drinkers,” defined in this of the brachial artery. In the Results indicated that 47% reported study as consuming 6 or more per population-based Northern never drinking and others reported occasion at least once a month: Manhattan Study (NOMAS), the having the following number of 34% higher than non-bingers for authors performed a cross-sectional drinks/day: 42% < 1; 6% 1 to 2; men, 55% higher than non-bingers analysis of lifetime alcohol intake 3% > 2 to 4; 2% > 4. After adjusting for women. for demographic, clinical, and and brachial artery FMD during treatment variables, patients who In the presentation, the speaker reactive hyperemia using high- reported never drinking were 45% said that the study also evaluated resolution B-mode ultrasound more likely to have angina than level of physical functioning, using images among 883 stroke-free participants (mean age 66.7 years,

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women 56.6%, Hispanic 67.5%, showing that moderate drinking is 1.15)] and small HDL particle black 17.5%, and white 14.9%). associated with better endothelial concentration in postmenopausal Results showed that the mean function. women [0.82 µmol/L (0.14, brachial FMD was 5.68% and 1.51)]. Drinking frequency was not Alcohol volume, not drinking associated with total HDL particle the median was 5.52%. Reported frequency, increases plasma high- lifetime alcohol consumption concentration or any of its sub- density lipoprotein sub-class classes. The authors conclude that was as follows: 147 (16.7%) non- particle concentration. Harriss LR, drinkers (<1drink/month), 616 alcohol volume (and not drinking English DR, Wolfe R, Tonkin AM frequency) was positively associated (69.8%) >1drink/mo to 2 drinks/ . . . Jenkins AJ. Abst 3645 day, 59 (6.7%) >2 to 5drinks/day, with NMR-determined plasma total 60 (6.8%) >5drinks/day. Compared Summary: The authors assessed the HDL particle concentration for to non-drinkers, those who drank hypothesis that usual daily alcohol men and women. These associations >1 drink/mo to 2 drinks/day intake (volume), beverage type and appeared to be regardless of beverage were more likely to have FMD drinking frequency influence plasma type, although comparison of above the median (5.5%) of FMD HDL sub-class concentrations beverage types was not possible (unadjusted OR 1.7, 95% CI 1.2- as determined by NMR. Six for women. These results suggest 2.5, p=0.004). In multivariate hundred and ninety volunteers that for any given weekly volume analysis, the relationship between (389 women) aged 40-69 years at of alcohol, the number of drinking moderate alcohol consumption and baseline (1990-1994) participated days does not influence HDL FMD remained significant after in a cross-sectional study using the particle concentration. adjusting for multiple traditional Melbourne Collaborative Cohort Comments: In our previous cardiovascular risk factors, Study, Australia. Measures included analysis of middle-aged subjects including age, body mass index, self-reported alcohol intake in the Family Heart Study, we hypertension, diabetes and smoking using beverage-specific quantity- found that in comparison with (adjusted OR 1.5, 95%CI 1.1- frequency questions (volume) and non-drinkers, men who consumed 2.2, p=0.02). No beneficial effect a drinking diary for previous week 2 drinks/day had about 9 mg/ on FMD was seen for those who (frequency). dl higher total HDL, while for drank more than 2 drinks/day. The The median alcohol intake was women the increase was almost 13 authors conclude that consumption 15.2 g/d (2.7, 32.0) for men mg/dl. In the present study, the of up to 2 alcoholic beverages per and 1.0 g/d (0, 9.6) for women. estimated increase that would be day independently was associated Alcohol volume was positively associated with 2 drinks/day was with improved FMD compared associated with total HDL particle the equivalent of an increase in total to nondrinkers in this multiethnic concentration in men and women. HDL of about 6 mg/dl for men and population. The effect on FMD may For men, a 10 g/d increment in 10 mg/dl for women, only slightly represent an important mechanism alcohol intake increased total HDL lower than our earlier population in explaining the protective effect particle concentration by 0.62 estimates. of alcohol intake on cardiovascular µmol/L (95% CI: 0.27, 0.98) and As has been shown in most studies, disease. small HDL particle concentration it is the alcohol in a beverage that Comments: Function of the by 0.34 µmol/L (0.01, 0.68). is the main determinant of HDL, endothelium, the lining of arteries, For women, total HDL particle rather than the type of beverage. is a critical factor associated with concentration increased 1.06 In this study after taking the the development of atherosclerosis µmol/L (0.60, 1.53) for every 10 amount of alcohol consumed into and myocardial infarction. This was g/d increment in alcohol intake. consideration, the frequency of a cross-sectional study, so the effects Results varied by menopausal status, drinking had no effect on HDL; of improved endothelial function as alcohol volume was positively however, these investigators did on subsequent disease can not be associated with large HDL particle not evaluate effects of alcohol ascertained. The study, however, concentration in premenopausal on coagulation and fibrinolysis, supports other research findings women [0.67 µmol/L (0.19, which may well have varied by

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frequency of drinking. The impact however, no such attenuation was to moderate ethanol intake. Zhou on heart disease risk associated with observed in the subjects with RBP. H-Z, Ma X, Cecchini G, Simonis differences between large and small On the other hands, in subjects U,Gray MO. Abst 511 HDL particles, the main object of with RBP, the increase of the PWV Summary: The authors state that this study, remains unclear. during a 6 year follow up was higher moderate alcohol consumption in the Heavy group than in other is cardioprotective in large part Raised blood pressure modifies the two groups (Figure). association between alcohol intake through mechanisms that converge and the progression of arterial The authors conclude that light- on mitochondria. As a primary stiffness: A 6-year observational moderate alcohol intake may entry point for reducing equivalents study. Matsumoto C, Tomiyama have a vasculo-protective effect into the respiratory chain, the H, Yamada J, Yoshida M . . . against structural arterial stiffening state of complex I activation has Yamashina A. Abst 2931 in subjects without RBP. In the important consequences for overall presence of RBP, however, this mitochondrial function and cell Summary: The authors state that protective effect is blunted and homeostasis. Complex I is a key a J-shaped association between heavy alcohol intake seems to be control point in regulation of alcohol intake and cardiovascular rather harmful in middle-aged carbohydrate oxidation and energy events has been reported. Increased subjects. production that influence the arterial stiffness is a cardiovascular extent of cardiac injury in hearts risk, and raised blood pressure (RBP) from ethanol-fed animals subjected (>130/85 mmHg) is associated with to ischemia-reperfusion (I/R). In a progressive increase of arterial this study, isolated hearts from stiffness. The present prospective C57BL/6 mice that had been fed study was conducted to examine the 10% ethanol (vol/vol) as drinking association between alcohol intake water for 16 weeks (E) and age- and the progression of arterial matched controls were subjected to stiffness, and also clarify whether 30 min global ischemia and 30 min RBP modifies this association over Comments: In both non- reperfusion. a period of 6 years. The brachial- hypertensive and borderline ankle PWV was measured and hypertensive groups, subjects with Hemodynamic results showed E alcohol intake was determined by light-to-moderate intake had the hearts had better contractile recovery interview on three occasions, at an most favorable level of arterial (left ventricular developed pressure interval of 3 years, in Japanese male stiffness, which is a risk factor for 62±6 vs. 24±5 mmHg) and less subjects without RBP (n=955) and atherosclerosis and coronary heart cell damage (creatine kinase release those with RBP (n=601) (age, 40±8 disease. In this study, heavy alcohol 0.32±0.1 vs. 0.65±0.1 U/min/g) years, 1279 men and 287 women). intake was associated with increased than controls after reperfusion. blood pressure among subjects with Mitochondrial NADH-Oxidase According to the results of the hypertension at baseline, but had (1.2±0.2 vs.0.58±0.1 _g/m/mg), interviews on three occasions, the little effect on blood pressure for NADH-ubiquinone reductase subjects were categorized according people not hypertensive. Further, (complex I, 1.04±0.2 vs. 0.48±0.1 to their daily alcohol intake into heavy drinking was associated _g/m/mg), state 3 oxygen three groups {non-drinker group with increasing degrees of arterial consumption rates (266±28 vs. 152 (Non), light-moderate (LiMo) stiffness over time among subjects ± 18 ngAtomO/m/mg), respiratory and heavy (Heavy) alcohol intake with raised blood pressure. control ratios (5.2±0.4 vs. 3.1±0.2), groups}. In subjects without RBP, aconitase activity (0.73±0.2 vs. the increase of the PWV during 6 Mitochondrial Complex I - 0.48±0.1 _mol/m/mg), and lipid years’ follow-up was lower in the Regulated alteration of carbohydrate peroxidation (MDA 216±22 vs. LiMo group than in the Non group, oxidation and energy metabolites 348±14 nmol/g ) were significantly even after adjusting changes in reduces ischemia-reperfusion improved in E hearts after I/R atherosclerotic risk factors (p<0.05); injury in hearts from mice exposed

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compared to control hearts (all blood alcohol levels in the animals but no change in HDL cholesterol. P<0.05, n=3-12). EM showed were not reported. This is another Concerning CPCs, the following that the severity of mitochondrial study of biologic mechanisms that alterations were observed: CD34+ ultrastructure deformation in E describes an important process by cells increased from 171 ±22 to 354 hearts was attenuated. In addition, which moderate alcohol may protect ±28 per million leucocytes. Within high resolution 1H NMR against cardiovascular disease. the CD34+ cells, the percentage spectroscopy revealed that the of CD133+ cells increased from myocardial metabolites alanine, Red wine consumption increases 30.8 ±5.7 % to 53.1 ±3.3 %, glycine, creatine/phosphocreatine, circulating endothelial progenitor and the percentage of CD117+ NAD, total adenosine nucleotide, cells and improves endothelial cells increased from 38.1 +5.8 % and ATP were better preserved, function in obese type II diabetics. to 57.5 +4.6 % (p<0.05 for all whereas lactate and succinate were Seck CL, Mueller-Ehmsen J, parameters). Brachial artery flow reduced in E heart tissue extracts Kreuter G, Hauser K-H . . . Flesch mediated dilatation increased from relative to control hearts. The M. Abst 3785 5.57 ±0.74 % to 11.13 ±1.34 authors conclude that (1) moderate Summary: The authors state that % (p<0.05) in response to six alcohol consumption reduces cardiovascular risk factors are weeks of red wine consumption. myocardial I/R injury; (2) the associated with decreased levels Nitroglycerin mediated brachial mechanism of the cardioprotection of circulating progenitor cells artery dilatation increased from in part depends on mitochondria (CPC). The aim of this study was 7.45 ±1.09 % to 11.31 ±1.09 % -mediated survival pathways; to determine whether the moderate (p<0.05). The authors conclude (3) within the mitochondria, consumption of red wine leads to that in obese patients suffering preservation of complex I activity an increase of CPCs. from type II diabetes, moderate is critical for maintaining overall consumption of red wine leads respiratory function and cardiac CD34 positive and CD133/CD34 to a significant improvement of energy generation. as well as CD117/CD34 double circulating progenitor cell count positive cells were measured by and endothelial function. No Comments: A large number of FACS analysis in peripheral blood adverse effects of wine consumption experiments have shown that of 15 obese patients suffering from on metabolic and cardiovascular animals that are preconditioned type II diabetes with stable oral parameters were observed. by giving them alcohol before drug treatment (67.3± 2.3 years, creating a myocardial infarction BMI 32.3 ± 0.5 kg/ m_) prior Comments: There was a striking (MI) in the laboratory tend to to and after a six week period increase in the flow mediated have less damage to the heart and of drinking two units (300 ml) dilatation (the standard measure better survival. This study confirms of red wine (Lemberger Classic, of endothelial function) and a such protection, showing several Württemberg, Germany). The marked improvement in circulating changes in the mitochondria that drinking period was anticipated progenitor cells associated with are associated with reduced injury by a four week fasting period, in 10 ounces of red wine/day in the (as well as less increase in cardiac which no alcohol consumption was diabetic subjects in this study. enzymes and better ventricular allowed at all. In addition, brachial These changes should lead to much function after a MI) and less artery flow mediated dilatation was lower risk of coronary disease, oxidation of lipids. The dose of determined prior to and after the which is the leading cause of death alcohol each animal received cannot drinking period. among diabetics. be easily determined, as the only water furnished to the experimental The six week drinking period had animals for 16 weeks prior to the MI no effect on BMI, systolic and contained 10% alcohol (essentially diastolic blood pressure, blood the equivalent of drinking no glucose levels, HbA1c-values and water but only light wine, such as liver enzymes. There was a non- a Riesling, for four months!), and significant drop in LDL cholesterol,

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International Medical Advisory Group Conference The 35th International Medical Smoking and Alcohol Use in University of Waterloo, ‘Drunk or Advisory Conference was held in Young Adults’ and Julie Staley, Sober? Getting What You Expect’. Nova Scotia October 14-16th. Yale University, ‘Delineating the Mark Fillmore, University of The Scientific programme was Regulatory Effects of Alcohol Kentucky, ‘Alcohol Impairment: provided by the Foundation for Drinking and Tobacco Smoking People differ in Their Expectancies’. Alcohol Research (ABMRF). The on Brain Nicotinic Acetylcholine Cecile A. Marczinski, University of conference programme included Receptor Availability’. Kentucky, ‘Alcohol Impairment and research undertaken by Canadian Interventions were analysed with Behavioral Control’. and U.S. grantees in various areas papers by Joseph LaBrie, Loyola Finally, the ‘Putting knowledge (‘Research Highlights’ sessions), Marymount University, ‘Group to work’ session looked at work to demonstrate the dedication Social Norms Motivational drug development for alcohol over time necessary to advance Intervention with Interactive Real- disorders Ivan Diamond, CV understanding (‘Building a Body Time Feedback’ Therapeutics & Founding Director of Knowledge’ sessions), and work Thomas Brown, Douglas Hospital Ernest Gallo Clinic & Research to offer insights into the long-term Research Center, ‘Ultra Brief Center, ‘Drug Development gains from basic research (‘Putting Motivational Interviewing for Using Targets Developed in Knowledge to Work’ session). DUI Recidivists Not Engaged Basic Academic Research: CVT The ABMRF Research highlights in Remedial Measures”, Brad Experience Developing a Selective looked at co-morbidity, especially Krevor, Brandeis University, “The Reversible Inhibitor of Aldehyde with nicotine with papers Responsible Retailing Forum’s Dehydrogenase 2 (ALDH2)’ presented by Kristina Jackson, New Model of Underage Sales and Raymond Anton, Medical Brown University, ‘Unraveling Prevention’. University of South Carolina, Alcohol and Tobacco Use Co- Sessions were held on ‘building a ‘Medications Development for Morbidity: Secondary Analysis of body of knowledge’ research ranging Alcohol Treatment: Promises and Prospective Data’ Sherry McKee, from from describing behaviour to Pitfalls’. Yale University, ‘Unraveling the exploring behavioral control with For further details contact Relationship Between Non-daily papers by Muriel Vogel-Sprott, [email protected]

Book Review - ‘Addiction Proof Your Child’ by Dr Stanton Peele Dr Stanton Peele According to Dr Peele, parents are will not become addicts or ruin comments in being misled—and disempowered. their lives—if they are armed with interviews on his Brainwashed by the constant real-life motivators to keep them new controversial refrains that addiction is a disease, addiction free: independence, but research-driven that abstinence is the only solution, critical thinking, responsibility, and book ‘Addiction and that any drug or alcohol use the ability to enjoy life. Proof Your Child’, requires treatment, society and ‘Addiction Proof Your Child’ shows “In a world where parents aren’t being presented with parents how to instill these qualities: binge drinking, recreational and the successful tactics they can use by teaching children to take pride prescription drug abuse, chronic to make their children addiction- in achievement and other bedrock overeating and anorexia, and proof—and to keep them safe if values, learning how to be calm internet gambling and pornography they do use drugs or drink, as so questioners and tolerant listeners, are all too common among teens, many will. fighting the urge to overparent, it’s time to rethink conventional Dr. Peele explains that, despite what and (if the parents drink) teaching wisdom about addiction. We clearly parents have been told, it’s normal kids how to drink in moderation at need something more than ‘just say for most kids to try alcohol and home. no’. This book is the alternative”. drugs, and that the large majority For copies please visit http://www. peele.net/ Aim Digest PAGE 26 ORGANISATIONS

UNITED KINGDOM EUROPE

Alcohol Concern Brewers of Europe Deutsche Wein Akademie GMBH First Floor 8 Shelton Street, London WC2 9JR Rue Caroly 23-25, B-1060 Bruxelles Tel: (++32.2) 672 Gutenbergplatz 3-5, 55116 Mainz Tel: (0207) 395 4000 Fax: (0207) 395 4005 23 92 Fax: (++32.2) 660 94 02 Tel.49-2641-9065801 (home office) website www. alcoholconcern.org.uk email: [email protected] 49-6131-282948 (head office) Fax:49-2641-9065802 website: www.brewersofeurope.org email:[email protected] Alcohol Education And Research Council website: www.deutscheweinakademie.de Abell House, John Islip Street, London SW1P 4LH Forum of Taste and Education Tel: (0207) 217 5276 Livornostraat 13 b 5 rue de Livourne – Brussel 1050 FIVIN The Medical Council on Alcohol Bruxelles, Belgium Plaza Penedés, 3, 3,08720 Vilafranca del Penedés, 3 St. Andrew’s Place, London, NW1 4LB Tel: 32 2 539 36 64 Fax: 32 2 537 81 56 Barcelona, Spain Tel: (0207) 487 4445 Fax: (0207) 9354479 email: [email protected] Tel: 0034 (93) 890 45 45 Fax: 0034 (93) 890 46 11 The Portman Group Enterprise et Prevention 7-10 Chandos Street, Cavendish Square, 13, Rue Monsigny, 75002 Paris, France GODA London W1G 9DQ Tel: 00-33-53-43-80-75 Gode Alkoholdninger, Kattesundet 9, DK-1458 Tel: 020 7907 3700 Fax: 020 7907 3710 email: [email protected] København K, Denmark Tel: 33 13 93 83 email: [email protected] website: www.soifdevivre.com Fax: 33 13 03 84 email: [email protected] website: www.portman-group.org.uk website: www.goda.dk IREB The Drinkaware Trust 19, avenue Trudaine, 75009 Paris FIVS International Federation of Wines & Spirits 7-10 Chandos Street, Cavendish Square, Tel: +33 (1) 48 74 82 19 Fax: +33 (1) 48 78 17 56 18, rue d’Aguesseau, F-75008 - PARIS France London W1G 9DQ email: [email protected] website: www.ireb.com Tél. 33 01 42 68 82 48 Fax 33 01 40 06 06 98 Tel: 020 7307 7450 Fax: 0207 307 7460 email : [email protected] website:www.fivs.org email: [email protected] OIV 18 rue d’Aguesseau, 75008 Paris, France website: www.drinkawaretrust.org.uk EFRD The European Forum for Responsible Drinking www.drinkaware.co.uk Tel: +33 (0) 1 44 94 80 94 Fax: +33 (0) 1 42 66 90 63 email: [email protected] website: www.oiv.int Place Stéphanie, 6, B -1050 Bruxelles T: + 32.2.505.60.72 Alcohol Focus Scotland STIVA F: + 32.2.502.69.71 2nd Floor 166 Buchanan Street, Glasgow G1 2NH Benoordenhoutseweg 22-23, NL-2596 BA, website: www.efrd.org Tel: 0141-572 6700 Fax: 041-333 1606 The Hague,The Netherlands website: www.alcohol-focus-scotland.org.uk Tel: +31 (0)70 314 2480 Fax: +31(0) 70 314 2481 MEAS Limited BBPA British Beer and Pub Association email: [email protected]. Merrion House Market Towers, 1, Nine Elms Lane,London. SW8 website: www.stiva.nl 1/3 Fitzwilliam Street Lower 5NQ Tel: 020 7627 9191 Fax:020 7627 9123 Dublin 2, Ireland Fundacion Alcohol Y Sociedad Tel: 00 353 1 611 4811 Fax: 00 353 1 611 4808 email: [email protected] Villalar, 4 1º izq. 28001 Madrid website: www.beerandpub.com website: www.meas.ie Tel: + 34 91 745 08 44 Fax: + 34 91 561 8955 www.drinkaware.ie Wine & Spirit Education Trust email: [email protected] International Wine & Spirit Centre website: www.alcoholysociedad.org The European Federation Of Wine & Spirit Importers 39-45 Bermondsey Street And Distributors (EFWSID) London SE1 3XF Scandanavian Medical Alcohol Board Five Kings House Telephone: 020 7089 3800 Fax:020 7089 3845 Vandværksvej 11 DK - 5690 Tommerup 1 Queen Street Place Email: [email protected] Tel: 45 64 75 22 84 Fax: 45 64 75 28 44 London EC4R 1XX email: smab@org Tel +44 (0) 20 7248 5377 Fax +44(0) 20 7489 0322 The Wine and Spirit Trade Association website: www.smab.org email: [email protected] International Wine & Spirit Centre 39 - 45 Bermondsey Street London SE1 3XF tel: +44 (0)20 7089 3877 fax: +44 (0)20 7089 3870 Email: [email protected] USA, CANADA, SOUTH AMERICA, AUSTRALIA

American Council On Science And Health FISAC The Century Council 1995 Broadway, 2nd Floor, New York, NY 10023-5860 (Fundacion de Investigaciones Sociales A.C.) Francisco 1310 G Street, NW, Suite 600, Tel: (212) 362-7044 Ext. 234 Fax: (212) 362-4919 Sosa 230. Coyoacan CP 04000 Mexico DF - Mexico Washington, DC 20005-3000 email: [email protected] website: www.acsh.org Tel:+52.5552 2194 Tel: (202) 637-0077 Fax: (202) 637-0079 Fax: +52 5554 0161 email: [email protected] Beer Institute email: [email protected] website: www.centurycouncil.org 122 C Street, NW #750, website:www.alcoholinformate.org.mx Washington DC 20001 California Association Of Winegrape Growers Tel:(202) 737-2337 Fax: (202) 737-7004 601 University Avenue, Suite 135 Sacramento, CA email:[email protected] The Wine Institute 95825 email: [email protected] website: www.beerinstitute.org 425 Market Street, Suite 1000, San Francisco, CA website: www.cawg.org 94105, USA Tel: (415) 512-0151 Fax: (415) 442-0742 Distilled Spirits Council Of The US Lodi-Woodridge Winegrape Commission 1250 Eye Street, NW, Suite 400, Traffic Injury Research Foundation. 2545 West Turner Road Lodi, CA 95242 USA Washington DC 20005 Suite 200, 171 Nepean Street, Ottawa, Ontario, email:[email protected] Tel:(202) 628-3544 website: www.discus.org Canada, K2P 0B4 Tel: 613-238-5235 website: www.lodiwine.com email: [email protected] Proyecto Ciencia Vino Y Salud website:www.trafficinjuryresearch.com Oldways Preservation & Exchange Trust Facultad de ciencias Biológicas, 266 Beacon Street Boston, MA 02116 617.421.5500 Casilla 114 D. Santiago, Chile ICAP Fax: 617.421.5511 website: www.oldwayspt.org Tel:/Fax: (56-23) 222 2577 International Center for Alcohol Policies email: [email protected] 1519 New Hampshire Avenue, NW The Australian Wine Research Institute Washington DC 20036 PO Box 197, glen Osmond 5064, South Australia, Éduc’ Alcool Tel: (202) 986-1159 Fax: (202) 986-2080 Australia. Tel: 61 8 8303 6600 Fax: 61 6 303 6601 606, Cathcart, Suite 700, Montréal, Québec, H3B 1K9 website: www.icap.org website: www.awri.com.au Canada Tel: (514) 875-7454 email: [email protected] website: www.educalcool.qc.ca

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