Alcohol Warning Labels Make No Distinctions

In two days, on Saturday, the federal government’s mandatory warning label will begin appearing on bottles of wine, beer and distilled spirits.

Ordered by Congress last fall, the warning will state: “Government Warning. (1) According to the Surgeon General, women should not drink alcoholic beverages during pregnancy because of the risk of birth defects. (2) Consumption of alcoholic beverages impairs your ability to drive a car or operate machinery and may cause health problems.”

Alcohol, it is clear, is a drug that if misused can cause damage to the human body, including cirrhosis of the liver, fetal alcohol syndrome and other maladies.

Wine contains alcohol, and thus can be abused, just like any other drug. Yet the warning statement mandated for wine has a number of wine lovers, including producers and those in wine and gourmet societies, upset.

They say studies show that wine reacts differently in the body from other alcoholic beverages and that there are actually benefits from regular, moderate amounts of wine that may not be obtained by consuming other alcoholic beverages. They say an otherwise benign beverage is being tarred with the same “booze” brush by irresponsible anti-alcohol groups.

Most of the health groups that speak out against alcohol abuse usually ignore the scientific evidence that shows wine to be less deleterious than some of the other alcoholic beverages. They lump all alcoholic beverages into the same pot.

And this reluctance on the part of the anti-alcohol forces to mention the positive aspects of wine has prompted a number of prominent physicians to come forward more vocally than they have in the past, to set the record straight. Another reason these doctors have come forward with a defense of moderate wine consumption is the new warning label that seems to tell only one side of the story.

Among those doctors are three San Francisco physicians--Dr. Paul Scholten, associate clinical professor of obstetrics and gynecology at the University of California School of Medicine; Dr. Keith Marton, chairman of the Department of Medicine at Pacific Presbyterian Medical Center, and Dr. David Whitten, chief of the Emergency Department at Kaiser Permanente Medical Center

“The beneficial effects of moderate consumption of wine, both in nutrition and in satisfactory living, far outweigh any of the dangers of acute alcoholism,” said Scholten.

He said one of the two warnings listed on the new label addresses Fetal Alcohol Syndrome (FAS), a subject he has researched. FAS occurs when a woman consumes large amounts of alcohol during pregnancy. It can produce babies with symptoms that include slow growth, central nervous system impairment and mental retardation.

Scholten explored FAS extensively a decade ago and said, “There is enormous publicity given to Fetal Alcohol Syndrome. And while no respectable obstetrician would advise his or her pregnant patients to consume any alcohol at all, small amounts of wine consumed with meals during pregnancy have not been shown to cause any fetal damage.”

Scholten, referring to a scientific paper he wrote in 1982, said, “For women who consume two glasses of wine with meals, no evidence exists that the full syndrome develops. We see that only in true drunkards and binge drinkers. Two glasses of wine per day has not been shown to have any deleterious effect. That would be two four-ounce glasses of dry table wine of no more than 12% alcohol.”

More than a year ago, a widely reported study indicated that women who were even moderate drinkers of alcoholic beverages ran a higher risk of breast cancer. Then, subsequent studies cast doubt on that report.

In a recent speech, Marton said that studies linking breast cancer and alcohol consumption were inconclusive, but even if they were directly linked, he said, the cancer risk in moderate consumers of wine would rise from a 10% chance to a 16% chance that a woman would get breast cancer sometime in her life.

And he said that the evidence shows that moderate consumers of alcoholic beverages run “a nearly 50% lower risk of heart disease, which is this nation’s No. 1 killer.” He asked rhetorically if abstention was better than moderate consumption in moderation.

Curiously, wine may also contain at least two anti-cancer compounds.

Health and nutrition author Jean Carper, in her book “The Food Pharmacy,” quotes Dr. Hans Stich, a cancer expert, as saying that red wine contains Gallic acid and that in research he conducted, Gallic acid “prevented different carcinogens from inducing chromosome aberrations.”

Another benefit for wine was announced earlier this year when Terrance Leighton, professor of microbiology at the University of California at Berkeley, said he had discovered in some red wines the compound called quercetin, which is known to be a potent anti-cancer agent.

It should be noted that quercetin also is found, in much higher doses than in wine, in such foods as garlic, onions, broccoli and squash.

Anti-drunken driving groups have sought to limit consumption of alcoholic beverages, and wine is equated with the other beverages. This, say wine lovers, ignores the fact that wine in typical use simply isn’t a major cause of drunken driving.

That was shown in a 1988 Department of Justice study of people sentenced to jail for drunk driving. That survey showed that just 2% of those arrested said they had consumed only wine before their arrest. By contrast, 54% said they had consumed only beer; 28% said they had consumed only distilled spirits and 21% said they had mixed more than one type of alcoholic beverage. Most of the “drink mixing” was beer with spirits, the survey said.

As for fears consumption of wine can lead to alcoholism, Scholten said: “In Italy, which has the second highest rate of total alcohol consumption in Europe, wine as a food is introduced into the home very early in life, yet alcoholism is one-seventh of that in the United States.”

He said there are 500 alcoholics per 100,000 residents in Italy, but 2,950 alcoholics per 100,000 population in the United States. “And they (Italians) consume 10 times as much wine as we do in the United States.” (Americans consume a bit less than 2.4 gallons of wine per person per year. In Italy, the annual per-capita consumption rate is more than 22 gallons.)

Wine wasn’t always linked with distilled spirits and beer. There are numerous biblical references to wine as a curative, and although such suggestions were not usually based on scientific evidence, some doctors over the decades believed them to be correct.

During Prohibition, wine was the only alcoholic beverage that could be legally obtained: it could be prescribed by doctors for its medicinal value, and it was used by many religions in traditional ceremonies.

After Prohibition ended, doctors knew little about the benefits of wine in moderation, so Leon Adams, then with the California Wine Institute’s defunct Wine Advisory Board, founded the Society of the Medical Friends of Wine in 1939.

Adams, who now lives in Sausalito and is completing the fourth edition of his book “The Wines of America,” wrote the statement of purpose of the group: “The object of the society is to stimulate scientific research on wine, develop an understanding of its beneficial effects, and encourage an appreciation of the conviviality and good fellowship that are a part of the relaxed and deliberate manner of living that follows its proper use.”

The society, which has remained active for 50 years, honored Adams at a testimonial dinner last Thursday.

By the mid-1940s, research funded by the Wine Advisory Board began to show that the biblical recommendations for wine use were correct, Adams said, but the Wine Advisory Board did not publish results of this work widely, except to the medical profession, usually in medical journals.

Funding of scientific research to prove the healthful benefits of wine was halted in the mid 1950s by the California Wine Institute, which was under pressure from large wineries, according to a source familiar with the situation. Funding for research resumed at a later date.

Subsequently, the late Dr. Salvatore Lucia of the University of California Medical Center at San Francisco saw a vacuum in public awareness of the healthful benefits of wine and he decided to compile and publish some of the research funded by the Wine Advisory Board.

In his books “A History of Wine as Therapy” and “Wine and Your Good Health,” published in the early 1960s, Lucia listed some of wine’s healthful benefits. However, wine consumption in America was so small in those days (less than one gallon of wine per capita per year) that the books raised little attention. Both books are long out of print.

In recent years, wine has been equated with other alcoholic beverages, especially in the demands by a number of consumer groups who argue that alcohol is alcohol is alcohol. They have lobbied for more stringent warning labels, higher taxation and other limitations on the sale of all alcoholic beverages, to limit consumption. It was that lobbying that, in part, led to Congress seeking the new warning label.

Meanwhile, scientific studies have shown benefits from moderate consumption of alcoholic beverages, especially wine. Such reports often appear in medical jargon in medical journals and receive far less publicity than have the anti-drinking forces.

One reason for the lack of publicity on the health benefits of wine is that researchers who have discovered such benefits fear being misunderstood.

Elizabeth Whelan, executive director of the New York-based American Council on Science and Health, said scientists are to blame for not mentioning the positive aspects of moderate consumption of wine.

“They think Americans are so stupid that they would drink a case of wine if told two or three drinks were safe,” said Whelan.

And journalists were taken to task for not mentioning the benefits of moderate consumption by Dr. Meir Stampfer of Harvard Medical School: “A lot of journalists are loath to talk about it (the benefits of moderate consumption) for fear of stimulating drinking and (giving) comfort to heavy drinking.”

Scientists say there are almost no known health risks from moderate consumption of wine with meals and that there are specific benefits.

One new finding is that the use of wine in the diet may help the body retain calcium.

Wine contains trace amounts of boron, which has recently been shown to help the body retain normal levels of calcium. Women tend to lose calcium from their systems as they age, which could lead to osteoporosis and other bone ailments. The use of calcium supplements is an imprecise way to maintain proper calcium levels, say doctors.

However, a recent study by the Human Nutrition Research Center at Grand Forks, N.D., shows that small amounts of boron added daily to the diet play a key role in greater use of calcium by the body. The study showed that in women past menopause, boron may stimulate hormones, which acts like estrogen replacement therapy.

Dr. Forrest Nielsen, director of the center, said his study showed that the addition of a small amount of boron to the diet--he added three milligrams per day--produced a significant decline in the loss of both calcium and magnesium, minerals used to help form new bone.

Nielsen said that in large doses, boron is toxic, but in small doses such as found in grapes, apples and pears, as well as wine, it is not only safe but appears to be beneficial in greater absorption of calcium.

Textbooks on wine making show that wine contains between a trace amount to as much as four milligrams in a 3.4-ounce serving. Nielsen said a glass of wine combined with fruits and vegetables in the daily diet would provide enough boron to help retain calcium.

One of the key studies regarding alcoholic beverage consumption and longevity was announced in 1979 in England. A team of researchers found that moderate daily consumption of alcohol led to a lower rate of heart attacks than was found in either abstainers or heavy drinkers. The survey showed that alcohol consumption raises the level of high-density lipoproteins, which reduces the likelihood of coronary artery disease.

That study was confirmed in 1980 when Drs. Ronald LaPorte, James Cresanta and Louis Kuller at the University of Pittsburgh said that moderate alcohol consumption lowers mortality from heart disease. Their analysis of 20 countries suggested that moderate alcohol consumption appeared to be negatively related to rates of heart disease mortality and that the lowest rates of mortality appeared in Portugal, Italy, France and Spain.

That study didn’t draw a connection to wine specifically, discussing only alcohol in general, but Marton, in a recent presentation to the Society of Wine Educators, showed a chart with the lowest and highest mortality rates in Europe.

He noted that the lowest mortality rates from all causes were in counties in which wine consumption was very high--more than 20 gallons per person per year. These were the Mediterranean countries mentioned by the University of Pittsburgh team. Mortality rates were highest in Scandinavian countries, where wine consumption is low, but where consumption of distilled spirits was high.

Marton’s comments included remarks culled from the 1987 book “The Mediterranean Diet” by Carol and Malcolm McConnell, which quoted from a World Health Organization study that noted that despite high smoking rates, Greeks and Italians have slightly longer life expectancies than do much wealthier Americans because of large consumption of red wine, garlic and olive oil.

Whitten, in a 1988 speech, said, “The studies . . . show pretty clearly that the chances of suffering sudden cardiac death are dramatically reduced by drinking one or two glasses of wine a day or equivalent amounts of alcohol. We don’t have any drugs that are as good as alcohol.”

Then last February, in an article in the American Journal of Public Health, Drs. Matthew Longnecker and Brian Mahon extended the benefits of moderate consumption of wine, beer and spirits to all ailments. In a study of 17,600 individuals, the doctors concluded, the rate of hospitalization for all reasons was less for those people who drink 29 to 42 alcoholic beverages over a two-week period than for abstainers. That averages two to three drinks per day.

Another benefit from wine is the relaxation factor. An amino acid found in wine, gamma-amino-butyric acid (known as GABA), helps to calm the nervous system, making the individual drowsy. GABA is not found in distilled spirits or beer.

In tests on older adults, Dr. Robert Kastenbaum, professor of gerontology at Arizona State University, found that persons who have insomnia have an easier time getting to sleep after a glass of wine. He said GABA and tryptophan act similarly in the system to help calm the individual.

“Wherever we did our research in a nursing home, the home continued to keep wine available (to patients) after the study was over,” said Kastenbaum. (There is a greater concentration of GABA in Pinot Noir and Cabernet Sauvignon than in other wines, Kastenbaum said.)

Another discovery of a benefit from wine was announced recently by the U.S. Department of Agriculture.

Chemist Richard Anderson, a chromium expert with the USDA’s Agricultural Research Service, said that chromium helps keep blood sugar levels from rising too high or dipping too low because it makes insulin more efficient. Anderson said most Americans get less chromium than the suggested minimum intake.

Anderson said a good source of chromium was fresh fruits, vegetables, dairy and whole-wheat products and meat, and he added that beer and wine are rich in chromium.

In addition, wine contains small amounts of potassium, calcium, magnesium, zinc, iron and many other minerals, as well as a complex of B vitamins.

The advent of the warning label by itself hasn’t been a momentous event, but it has elicited comment from numerous people who feel it will be ignored by most buyers of alcoholic beverages and isn’t specific enough to be of help to those who need the information most.

One of those who is aware of the warning label and who feels it is only one brief and not comprehensive statement is Dr. Herbert Fingarette, a professor of philosophy at UC Santa Barbara and the author of “Heavy Drinking: The Myth of Alcoholism as a Disease.”

Fingarette looked at the recent broadside attacks on all alcoholic beverages, and the new warning label and commented: “The moderate use of wine and other spirits is a very valuable adjunct to social, civilized life for millions of people in the present, just as it was for people in the past.”

“We shouldn’t minimize that, just as we shouldn’t be down on driving automobiles just because a certain minority uses them destructively.”