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David Kerr: Alcohol and calories—an opportunity for public health?

22 Nov, 12 | by BMJ

David KerrMore than 200 years ago, the English artist, William Hogarth produced two prints depicting the evils of gin in contrast to the benefits of drinking beer. The inhabitants of Beer Street were portrayed as happy and healthy, nourished by English ale in contrast to the residents of Gin Lane. Gin Lane contained scenes of infanticide, starvation, madness, decay and suicide due to the overconsumption of the “foreign” gin. Its also worthwhile pointing out that the inhabitants of both Beer Street and Gin Lane are drinking rather than working—in Beer Street the workers are resting after their labours, while in Gin Lane the people drink instead of working. What has been less well appreciated is that many of the characters appearing on both prints, as well as being intoxicated, are also overweight or obese.

Recently a US National Health and Nutrition Examination Survey reported that alcoholic drinks contribute around 5% of adult daily calorie intake, with men consuming more than women. There were no differences among different races and ethnicities, but there was an age difference with young people drinking more. The report also suggested that the link between alcohol and calories is under-appreciated. The response from the alcohol industry was that this is actually a non-problem with one spokesman reported as saying “this research shows that the overwhelming majority of adults drink moderately.” However the figure of 5% is close to the 6% of average daily calorie intake contributed to by sugar-sweetened soft drinks.

In the US sweetened soft drinks are increasingly being demonised for their contribution to the obesity epidemic. For example in September, New York City Health Department approved legislation to prohibit the sale of giant sodas bigger than 16 ounces sold in bars, restaurants, sporting venues, and other establishments that fall under the jurisdiction of the city health department. It will go into effect in March 2013. However, the ban does not apply to alcoholic drinks and the Obama administration is also planning to exempt alcoholic beverages from proposed federal regulations requiring calorie labeling on all restaurant menus. As one newspaper reported “it could set up a confusing scenario in which, say, a raspberry iced tea will have a calorie count listed on the menu, while an alcohol-laden Long Island Iced Tea—with more than four times as many calories—doesn’t.”

In the UK the focus of most public health approaches has been to highlight the well established physical and psychological consequences of excessive alcohol consumption with limited emphasis on linking alcohol and calories. The forthcoming “Dry January” campaign by the charity Alcohol Concern is moving in the alcohol contributes to obesity direction with its tag line “Feel better. Save money. Make a difference. Your chance to ditch the hangover, reduce the waistline, and save the pennies.” A more radical step would be the introduction of calorie labeling on alcoholic drinks so instead of being offered the choice of a regular or large glass of wine in the pub it might be a glass of 100 or 200 calories—red or white?

See also:

David Kerr wears many hats, sometimes at the same time—diabetologist, editor of Diabetes Digest, researcher, and founder of VoyageMD.com, a free service for travellers with diabetes. You can follow him on Twiitter (@GoDiabetesMD) and Linkedin. He holds a small amount of stock in CellNovo (a new insulin pump company) and Axon Telehealth.

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  • http://twitter.com/Doonkris Donna Amey

    great article doc!

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