The Impact of Alcohol on Health

In this chapter we consider the effect that alcohol, including in the form of beer, might have on the overall state of healthfulness of the body. What harm might it do - and might it actually do some good? And let us start from a baseline statement that alcohol is relatively non-toxic, with an oral LD50 for the rat of 13.7 g/kg (i.e. the amount of ethanol which will kill half of the animals in an experimental population) (Bakalinsky and Penner 2003)
Increasingly the evidence is that there appear to be bene ts in drinking beer (and other types of alcoholic beverage). Guallar-Castillon et al. (2001) concluded that the consumption of total alcohol (wine and beer) was associated with a lower prevalence of sub-optimal health. Hospitalisation is less acute for daily moderate drinkers (Longnecker & McMahon 1988), especially for women who had consumed between 29 and 42 alcoholic beverages in the fortnight prior to lling in the questionnaire. Artalejo et al. (2000) found that moderate drinkers in Spain were less likely than abstainers to use healthcare services. Meanwhile Wiley and Camacho (1980) showed that moderate alcohol consumption (17-45 drinks per month) was associated with the most favour­able adjusted health scores.
Beer drinkers were shown by Richman and Warren (1985) to have signi cantly lower rates of morbidity (sickness) than expected - one drink per day giving 15% less disability than was the case for the general population.
There will be those reading this who will not be able to countenance such ndings. If these people nd it hard to swallow that drinkers, imbibing in moderation, could be less ill, then they might note that they have certainly not been shown to be more sick. However, we must stress always that many of these studies are dealing with correlation, not necessarily causality. Some will argue that there may be other confounding factors not explored in the studies, and that those who tend to drink in moderation may have other lifestyle attributes that are the true reason for their enhanced healthiness. However, the sheer frequency of studies that have demonstrated the bene ts of restricted alcohol intake, which we will explore in this chapter, weigh heavily in support of the merits of sensible drinking.
In the mid-1990s, the Department of Health within the British government addressed the matter of recommended safe limits for drinking. After (we presume) careful consid­eration of the scienti c and medical evidence available up to that stage, they increased
the recommended limit for men from 21 units to 28 units per week, with the advice to women being to drink no more than 21 units per week (previously it had been 14). They stressed that the daily maximum should be 4 units and that binge drinking (the equivalent of taking all of the weekly allocation at one sitting) is absolutely undesirable.
Table 6.1 describes a unit of alcohol in terms of volume of beer and other alcoholic drinks in the UK. It should be noted that the de nition of a unit differs between coun­tries . This table also indicates the recommendations concerning alcohol consumption in those countries. It must be stressed that beers can differ substantially in their alcohol content . Thus a mainstream ale or lager in most parts of the world is likely to contain between 3.5 and 5% alcohol by volume (ABV) and one unit is basically a half-pint (284 mL) of such a product. There are some beers