New Alcohol Guidelines a Victory for Science over Politics

By Michelle Minton

Wednesday, December 30, 2020

 

It may be impolite to talk politics at the dinner table, but when it comes to government advice on what we eat, political agendas are usually baked in. Updated every five years, the official Dietary Guidelines for Americans have long been the subject of intense lobbying, with special interests vying for recommendations that favor their respective industry or point of view. The latest iteration, finalized by the government this week, was no different.

 

But, this time around, evidence won out over political agendas.

 

Back in July, the Dietary Guidelines Advisory panel, a group of 20 experts selected by the government to review the evidence, suggested the guidelines substantially cut recommended levels of sugar and alcohol intake. That triggered backlash from the food and beverage industry. But one recommendation in particular provoked an outcry from the scientific community: to halve the limit on alcohol intake for men.

 

For five decades or more, the scientific literature on alcohol consistently showed a strong link between moderate intake and better health outcomes compared with those who totally abstain from alcohol or those who binge drink. As such, government alcohol advice since the 1990s has recommended women have no more than one drink a day and men have no more than two drinks daily.

 

Yet the government’s advisory panel recommended the limit for men be reduced to just one drink a day. Such a change implies that the evidence about alcohol intake — on which the panel supposedly based such recommendations — has dramatically shifted in recent years. But that simply isn’t the case. The suggested changes weren’t based on evidence at all but, rather, the apparent agenda of certain members of the panel.

 

For some years, a growing contingent of activist-academics has set out to convince the world that there is no level of safe alcohol intake, no matter what the science says. Thus, even while the expert panel’s report conceded the evidence showing moderate alcohol consumption is associated with lower mortality than total abstinence and found just one study comparing the risks of one drink a day versus two drinks, it still recommended halving the upper limit on alcohol intake for men.

 

One study is hardly evidence enough to make such drastic changes to national guidelines, but as several prominent experts pointed out, evidence had little to do with the decision. Six Harvard researchers, half of whom previously served as guidelines advisers, wrote in a letter to the government that the current panel appeared to have cherry-picked evidence to “support a pre-determined and, in our view, unscientific conclusion.” H. Westley Clark, former director of the Substance Abuse and Mental Health Services Administration, put it more bluntly, noting that the guidelines “should not be a sleight of hand vehicle for Prohibition.”

 

It is unlikely most of the panel members want outright prohibition, but as noted by their report, the hope is that it will influence public policy that will lead to changes in consumption. Indeed, while most Americans may simply ignore the Dietary Guidelines, they have a significant impact on how government approaches dietary issues. They inform how government regulates sales, promotion, and taxation, and how it chooses what type of research to fund. For activists hoping to convince officials of the importance of addressing Americans’ alcohol consumption and even funding their research on the topic, changing the guidelines is a critical first step.

 

Luckily, those at USDA and HHS who make the final decision on the Dietary Guidelines saw through the advisory panel’s political agenda, rejected the recommended changes, and chose to preserve the Obama-era alcohol-intake guidelines. Some have predictably responded to this by accusing the Trump administration of bowing to alcohol-industry influence. But, as Brandon Lipps, deputy undersecretary for food, nutrition, and consumer services at the USDA, said, the new limits proposed by the advisory panel simply did not meet a “preponderance of the evidence.” In this one instance, at least, science trumped politics.