A drink a day keeps the doctor at bay

How high is your cholestrol? You may well know, given the enthusiasm for measuring it in health food stores and doctors’ surgeries alike. Or you may not, but there are plenty of people who will help you keep it “within normal limits” by careful attention to what you eat. Animal fats and red meat are out, whilst shoals of fish and modest amounts of vegetable oils are in. The result should be a reduced risk or a heart attack for you, a rash of bankruptcies amongst butchers and a booming fishing industry.

Unfortunately for those with an interest in preventing our untimely deaths from heart disease, the story is not so simple. In most countries heart disease and animal fat consumption appear linked, but not in all. The French seem to combine a low rate of heart disease with a diet relatively high in animal fats. This ‘French paradox’ has not stopped campaigners here from trying hard to reduce our reliance on red meat, butter and full fat milk, but now it must be solved.

The explanation is simply wine, it seems.¹ A small amount of alcohol daily does protect against heart disease and offests the effects of animal fat, so the ideal and much praised “Mediterranean diet” contains more than vegetables, fish and olive oil - alcohol and meat have a place, together, as any Gallic gourmet knows. Wine may not be essential, since the Japanese have a low rate of heart disease and consume reasonable amounts of beer. Alcohol may well be one of the most efficient drugs protecting people against heart disease.

This is embarrassing to conventional medical wisdom, for a number of reasons. It strikes at the puritanism so prevalent in Britain, it promotes a drug that (just like other drugs) has adverse effects on individuals and society, and it strengthens the arguments of a profit-seeking industry that is interested in increasing the volume of alcohol sold and drunk. It also deprives many professionals of a task, since the individual counselling by health promotion nurses and doctors apparently so necessary to divert us from our bad habits may be less useful in extending our lives than moderare but frequent amounts of pleasure.

Worse still, cholestrol and other blood fats may be less powerful in promoting heart disease than once thought. Sugan may be much more of a villian, according to both epidemiological and experimental evidence,² because it promotes both greater insulin production in the body, and body resistance to the effects of insulin. The biochemistry is complicated, but the outcome is a group of illnesses that are often found together — heart disease, hypertension, gout and diabetes.

There are many lessons in this, one of which is that medical enthusiasm for doing something will not wait for evidence of effectiveness of treatment, or even for a reasonably clear picture of the problem to be solved. Lifestyles must be adjusted now, and questions asked later, when there are empires to be built!