What is moderation?

It is common for those writing on the topic of alcohol and health to refer to 'moderation'. What is it exactly?
In the Second Special Report to Congress on Alcohol and Health from the National Institute on Alcohol and Health in 1974, some de nitions of drinking habits were given:

• Moderate occasional. People who drink alcohol only in small amounts at any one time, never enough to become intoxicated and less frequently than daily
. Moderate. Same, except daily
. Heavy occasional. People who get drunk occasionally, with periods of abstinence or moderation
• Heavy. People who get drunk regularly and frequently
This is a general classi cation, but it still doesn't give any precise quanti cation. Most people would consider moderation to equate to one or two glasses of beer or wine per day. Even then, what a German consuming steins of lager or a Frenchman enjoying a bottle of wine daily would consider to be moderate might be considered to be excessive by those of other nationalities.
The World Health Organization suggests that 60 grams of alcohol per day should be a maximum. For a beer of 5% alcohol by volume, which equates to approximately 4% alcohol by weight, this means 1.5 litres, or a little over two and a half pints.
In his commendably balanced book, Stuttaford makes these perspicacious comments:
Approximately 90 per cent of men and 80 per cent of women in this country [United Kingdom] enjoy drinking alcohol from time to time. Only a tiny fraction drink to excess; few would ever fall down any steps ... and a couple of pints two or three nights a week will not turn most people into drunken hooligans. Opponents of drinking are selective in their reporting: they seize upon the disasters which overtake the minority who drink too much and draw conclusions from their behaviour and health which are then applied to the population as a whole. This way of generating statistics is unsound, and their misleading of the public is unjusti able. The medical advantages of alcohol have been hidden from the general public for thirty years, and the reason usually advanced for this obfuscation is the patronising one that alcohol, delightful as it is to take and good as it is for the heart, cannot be trusted to the masses lest they drink themselves to death.
If such is the case in the UK, then it is writ ten-fold larger in the US. Recently a colleague 'confessed' that he and his wife enjoyed a drink, but never in front of the children, for fear of giving them the wrong impression. The impact of this hypocritical behaviour is to persuade the younger element that drinking is some mysterious and hidden pleasure, a 'forbidden fruit'. Perhaps it is not to be wondered at that when a student here reaches the legal drinking age of 21 they too frequently succumb to the temptations of the drinking ritual, sometimes with such devastating consequences. Such ceremonies have generally involved the consumption of spirits, perhaps doubles, to match the number of years on the planet. Alas, too often they do not reach their next birthday. To consume that amount of alcohol in the form of beer would be virtually impossible on a volume basis, but that is not my point. Rather it seems to me that beer and other alcoholic beverages should be associated with messages of responsibility for the good that they can deliver when used in moderation - and not swept under the carpet.
Professor Pelc, a psychiatry lecturer at a leading Belgian university, was quoted in Le Journal de Brasserie (December 2002, page 17) as saying that banning the consumption of alcoholic beverages by young people actually increases the risk of harmfully excessive alcohol consumption and of criminal or other antisocial behaviour. He is said to have advocated what is surely the practice for many societies worldwide, namely an early introduction to the consumption of moderate quantities of alcohol in the family home as the best way to encourage safe and socially acceptable drinking habits. Y. Boes, writing in the same journal (page 7) suggests that traditional Belgian low-alcohol beer (biere de table) is healthier for children than cola or lemonade.
Between 1960 and 1980 there was an annual doubling of the amount of beer and spirits consumed in the US. Perhaps young people were rebelling against laws that restricted consumption of alcohol because of the association of alcohol with vice.
Fortunately there are legislatures that have far-sighted and common-sense attitudes. When the UK government freed up legislation to allow children to accompany their parents into public houses, the Home Secretary, Kenneth Clarke, suggested it would 'enable children to see people drinking sensibly and perhaps stop them becoming lager louts'. Incidentally, Clarke is by no means the only Member of Parliament to be favourably disposed to beer. In 1975 the then Prime Minister, Harold Wilson, having converted from whisky to beer, said: 'Contrary to all medical opinion, I've lost a lot of weight since I began drinking more beer. In fact, I've lost a stone in only a year.'
That prosaic Christian chronicler C.S. Lewis had written, rather earlier: 'The sun looks down on nothing half so good as a household laughing together over a meal, or two friends talking over a pint of beer.'
Wechsler and Isaac in 1989 produced evidence to show that the raising of the legal drinking age in the US from 18 to 21 had led to an increase in episodes of drunkenness from 25% up to 41% for men and from 14% to 37% for women (Wechsler & Isaac 1992). It seemed that the impact was a polarisation of drinking habits, with a disappearance of moderate consumers: students either drank not at all or to excess.