Monday, 3 August 2009

There’s good news, and…

I may have a bit of a headache by the time I publish this… Positive news Monday’s here.

Someone’s been a bit honest about drinking – and the BBC published something slightly critical of the Labour Government at the same time.

Like. Wow.

Daily alcohol limit 'unhelpful'

By Michelle Roberts

Health Reporter, BBC News

Daily limits on alcohol consumption are meaningless and potentially harmful, experts have warned.

We’ve all been saying so for years, but you know how it is when the BBC reports that ‘experts have suggested’ that One in 25 deaths across the world are linked to alcohol consumption’ as recently as June, or the Horror from Scotland, or the government recommending weekly-calculated maximums – you’ve got to doubt yourself.

The government says men should drink no more than three to four units per day and women no more than two to three.

Liver specialist Dr Nick Sheron, of the Alcohol Health Alliance UK, says these limits were devised by civil servants with "no good evidence" for doing so.

Hey, I wonder who works out our carbon footprints

He says the advice runs the risk of people taking it to mean that it is safe to drink alcohol every day.

Dr Sheron's comments follow a report by MPs on the Public Accounts Committee which suggested public confusion about safe drinking levels was fuelling problem drinking.

Dr Sheron says we should go back to using the old weekly limits, which are based on sound research.

Or not, as it turns out…

Guidelines on safe alcohol consumption limits that have shaped health policy in Britain for 20 years were “plucked out of the air” as an “intelligent guess”. The disclosure that the 1987 recommendation was prompted by “a feeling that you had to say something” came from Richard Smith, a member of the Royal College of Physicians working party that produced it.

He told The Times that the committee’s epidemiologist had confessed that “it’s impossible to say what’s safe and what isn’t” because “we don’t really have any data whatsoever”.

So maybe a little more work for the BBC and BMA to carry out, huh?

The 1987 sensible drinking limits, which set the bar at 21 units per week for men and 14 units per week for women, remained in place until 1995.


“The Times reveals today that the recommended weekly drinking limits of 21 units of alcohol for men and 14 for women, first introduced in 1987 and still in use today, had no firm scientific basis whatsoever.”

It’s that made-up spurious guessing again, unless I missed something?

It was then that the government decided to switch the limits from weekly to daily in a bid to curb binge drinking and emphasise the harms of saving up a week's limit to blow in one or two sessions at the weekend - a decision it stands by today.

But Dr Sheron says this was a mistake: "They were turned into daily limits by a community of civil servants and the reasoning behind it is shrouded in mystery and is not largely supported by experts.

I wonder if they figure out all that stuff about the temperature of the Earth this way too?

"The weekly limits were based on robust studies and were set at a level at which alcohol harms outweigh any putative benefit."

Some studies show that alcohol, in moderation, can reduce the risk of heart disease.

In terms of damage to the liver, the risk begins when regular weekly consumption exceeds about 30 units, said Dr Sheron.

Now we could really do to see the science on this – if it’s available in form readable by the educated layman. And I have to stress alongside what the libertarians would say here, BMA information should only be used as advice if it’s true, I think.

I mean there must be some pretty unpleasant long-term health risks from sexual promiscuity and we’d all hate the State to get involved with that, right?

But for other conditions, like cancer, the risk starts at zero and goes up proportionately with the amount of alcohol is consumed.

Although the daily recommendations originally included the important caution to have some alcohol-free days, Dr Sheron this message has got lost.

This would be like that whole thing where they originally legalized abortion only on the conditions set by a sceptical Parliament if two doctors agreed that a woman’s life would hang in the balance or health would be seriously threatened if she brought her pregnancy to term or delivered normally. Then the message got elided to ‘and also if it’s going to upset her really badly or the kid’s probably going to be a mong or a spacker.’

Or really, really upsetting. *

Mission creep and the loss of an original ‘truth’ – the joys of state-financed ‘science.’

The advice now warns against regularly drinking over the daily limit and says drinkers should also "take a break for 48 hours after a heavy session to let your body recover."

Dr Sheron said that by setting a daily limit, people might take this to mean they could drink every day.

Dr Rachel Seabrook, research manager at the Institute of Alcohol Studies, agrees.

And this is a fair point. Man is a rationalizing animal and all that, and we’ll wriggle around any kind of advice or prohibition if we can. If the daily maximum thing is true, then there is still a problem, but the good news is, amazingly, the BBC’s prepared to back the medics against HMG.

"The Royal Colleges' recommendation for two days of abstinence a week has quietly disappeared. It was probably dropped to keep the message simple. But that is not a good move.

"And we are quite concerned about the use of 'daily' in the message. It implies that you can drink on every day.

No it doesn’t, any more than providing subsistence payments for the healthy unemployed sends the message that the State will finance you to not work for the rest of your life, and…


So maybe mission creep and message loss are true. Perhaps in addition to the delight of seeing the BBC getting a bit snippy with Gordon’s gophers, we should get some science here.

"There should be an explicit warning against this."

A Department of Health spokesman defended the current recommendations saying: "Advice on limits is based on scientific evidence from studies in populations in this country and worldwide about long-term health harms for broadly average, healthy adults.

"The scientific evidence base was examined by an inter-departmental working group in 1995. This has been kept under review since then.

Was it as good as the committee that chooses our soldiers’ vehicles. I’m sure that we all want to know.

"There are a number of public health campaigns to help people understand government guidelines around drinking alcohol.

"Ongoing and future campaigns will also help people to live more healthily."

In Britain in 2007, 69% of people reported that they had heard of the government guidelines on alcohol consumption. Of these people, 40% said that they did not know what the recommendations were.

Although binges are dangerous and can cause harm - largely through accidents caused by reckless behaviour - in terms of long-term health risks, it is the average amounts consumed over the weeks, months and years that count.

This is interesting, may be true, and I for one would like the BBC and the government to show us the science so I can make an informed choice.

A person who regularly drinks 50g of alcohol a day - around 6 units or three pints of normal strength beer - has nearly double the risk of stroke, high blood pressure and pancreatitis as someone who abstains.

Collocation does not prove causality, though.

In a snapshot survey for England in 2006, 12% of men and 7% of women reported drinking alcohol every day during the previous week.

In the same year, 23% of men and 15% of women reported binge drinking.

So there you have it. Good news: the BBC spurns the government. A little bit.

Highly qualified good news that doesn’t lead us to any utopia, and a remarkable absence of positive alternative information from the message-bearer, too… Good news from a gloomy conservative. Truth will out, sometimes. It may be incomplete and inconclusive and we still don’t have sight of the evidence or the research that proclaims this newly-republished old truth because the BBC doesn’t usually do links for some reason, but it is good to see government spin being debunked.

Oh, and notice when the government accepted the figures? Back in 1987: in the perfect decade.


*And here’s some good news from my point of view that I found along the way. Good news about tragic situations. Good news that does not permit any hope of a perfect and painless world, but good news still. If social conservatives are going to continue to win this argument, the bad news is that we’re also going to have to be equally persuasive about the better practical alternatives as we appear to be in winning the moral argument. We really, really have to be on the ball about this one, people, because ‘winning’ is only half the job.

Oh, and this is fun. Someone (else) ought to encourage him to move on to ‘B.’


James Higham said...

Five units a day in one hit - that's the ticket.

JuliaM said...

"... I for one would like the BBC and the government to show us the science so I can make an informed choice."

Which is the last thing they want you to be able to do...


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