Alcohol

New Dietary Guidelines for Americans: A Triumph for Alcohol Lobbyists?

By Thomas Gremillion

Earlier this week, Reuters broke the news that the Trump Administration plans to drop recommended limits on alcohol consumption from the next Dietary Guidelines for Americans. What will replace the current recommendations? “Drink responsibly”? The specifics remain a mystery. However, judging from Wall Street’s response, the policy shift will help to sell drinks.

To the extent that’s true, the new Dietary Guidelines will add to alcohol’s toll on public health, a major drag on American’s life expectancy. Excessive drinking causes more than 178,000 deaths each year in the U.S., but researchers have increasingly documented harms from “moderate” or “light” drinking as well, including thousands of cancer deaths each year attributable to less than a drink and a half per day. Indeed, recent analyses show alcohol attributable cancer deaths in the U.S. have risen dramatically, doubling over the past thirty years, with a disproportionate effect on men.

The notion that even “moderate” drinking significantly increases cancer risk, and so there is no “safe” level of alcohol consumption, is not controversial. According to an expert panel report convened by the National Academies of Sciences, Engineering, and Medicine (NASEM), “compared with never consuming alcohol, consuming a moderate amount of alcohol was associated with a higher risk of breast cancer,” and “among moderate alcohol consumers higher versus lower amounts of moderate alcohol consumption were associated with a higher risk of colorectal cancer.” Those observations are consistent with recent reports from the U.S. Surgeon General and the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD).

The NASEM report’s acknowledgment of alcohol cancer risk deserves special emphasis though, because the report represents the culmination of a radically transparent campaign by the alcohol industry to obscure the science around moderate drinking. The NASEM study was funded by the alcohol industry’s allies in Congress following the last dietary guidelines process, which resulted in a recommendation to lower “moderate drinking” limits for men from 2 drinks per day to 1. NASEM was roundly criticized for assembling a committee of experts who had either little direct connection to alcohol and its health effects, or who had received substantial research funding from the alcohol industry. And the NASEM report was then criticized by alcohol researchers as being “economical with the truth.” Nevertheless, the NASEM report supports the statement that, for the purposes of cancer prevention, there is no safe level of alcohol consumption.

A statement like that could feature prominently in the next Dietary Guidelines, shorn of the “moderate drinking” limits that have differentiated men from women for decades. Or the new guidelines could tout the NASEM study’s (methodologically suspect) findings that moderate alcohol consumption reduces overall mortality, with a vague directive to “drink responsibly.”

Whatever the case, the alcohol industry faces an uphill battle. It has attacked the credibility of the scientists tallying the harms caused by its product, and even launched a website titled “Science over Bias” that condemns the “unaddressed conflicts of interest” among the experts on the ICCPUD panel. But the “conflicts” it flags are not like the financial interests that scandalized the NASEM panel. Rather, “Science over Bias” advances the specious argument that, because some of the panelists had previously concluded that there is “no safe level of alcohol use” based on their previous research,  they are unfairly aligned against the $543 billion U.S. alcohol industry. The industry’s defenders similarly panned the Surgeon General’s recommendation for an alcohol cancer warning because it, unlike say Europe’s artificial food dye warnings, would amount to “nanny state” overreach.

But while consumers are still largely uninformed about alcohol cancer risk, they are not dumb. The incentives behind the rival messaging around moderate drinking are easy to understand. As the Trump Administration’s Surgeon General nominee Casey Means recently wrote: “The restaurant and alcohol industries (which are between $500 billion and $1 trillion industries in the US alone and employ millions of people, and are businesses with one priority: growth) are desperate to make us think drinking is healthy, normal, and fun.” But the reality, Means continues, is that “even 1 drink per day can increase the risk of some cancers.”

This truth about moderate drinking and cancer risk may not appear in the next Dietary Guidelines for Americans, but fortunately, not all policymakers are as susceptible to the alcohol industry’s influence as Congress and the Trump Administration. Earlier this year, Alaska passed a law that requires a cancer warning on alcohol at the point-of-sale. Massachusetts legislators are considering a similar bill. Next year, Ireland will require a cancer warning on alcoholic beverage labels, and there is nothing to stop a state or even local government here from requiring a cancer warning on billboards and other alcohol advertising. The industry may fight these initiatives, but they will lose if science actually triumphs over bias. The result will not be a new prohibition, just consumers able to make more informed choices about alcohol.