Drink (72 page)

Pearl’s findings—that moderate drinkers lived longer—were confirmed again and again over the next seven decades. However, and unlike his discovery that smokers died younger, they had little impact in the sphere of public health during the same period. No matter how much evidence was heaped up in favor of booze, the federal government refused to recommend it to the people. Sadly, those most in need of learning about the life-sustaining properties of drink were the least likely to have come across the issue before it appeared on TV. Abstinence was most common among Americans “with less than a high school degree,” 51 percent of whom were dry, compared to only 20 percent of college graduates. The category who’d spent fewer years in education already had a shorter life expectancy than their better-educated peers—why hold back from helping them toward equality?

Once the health benefits of alcohol were well and truly in the public domain, California’s winemakers explored ways of keeping them there by reminding drinkers of the salutary properties of their product. Since they were compelled to warn drinkers about the dangers of DUI and FAS, might they not also warn them wine was good for their hearts? Despite the evidence in favor, they were not hopeful. The federal regulator, the Bureau of Alcohol, Tobacco, and Firearms (BATF), did not allow alcohol manufacturers to make “therapeutic or curative claims” about their products. Past attempts by people in the wine trade to add positive statements to their labels had been rejected, notably in the case of Kermit Lynch, an importer, who had sought and been refused permission to quote Thomas Jefferson (“Wine from long habit has become an indispensable for my health”), Louis Pasteur (“Wine is the healthiest, most hygienic beverage known to man”), and 1 Timothy (“Drink no longer water, but use a little wine for thy stomach’s sake”) on his merchandise.
⁷³

Initial attempts to incorporate quotations from or references to
60 Minutes
into publicity material were rebuffed by the BATF. The Leeward Winery of Ventura, California, which summarized the program and the benefits of drinking in its March 1992 newsletter, was told to stop distributing it. Mondavi, which had added neck hangers to its bottles referring to
60 Minutes,
was also ordered to desist. However, in October of the same year, Beringer Estates of St. Helena succeeded in getting approval for a neck hanger with quotes from the program, one of which was Dr. Ellison’s reference to the “tremendous problem of alcohol abuse.” Despite being given the go-ahead, Beringer decided not to proceed, fearful of inflaming the ire of federal agencies other than BATF, among whom antipathy toward alcohol was universal, no matter how much evidence had piled up in favor of moderate drinking. By 1993, studies involving a total of more than half a million subjects of “varying ages, both genders, and different economic and racial backgrounds,” adjusted “for concurrent risk factors—including diet, smoking, age, high blood pressure, and other medical conditions—and to allow for separate analyses of lifetime abstainers and ex-drinkers, drinkers who reduced their consumption for health reasons, all nondrinkers, and coronary-artery-disease-risk candidates” had “consistently found coronary artery disease risk is reduced by drinking.” Indeed, when taken together, the studies made “the risk-reduction link between alcohol and coronary artery disease close to irrefutable.”

Notwithstanding such persuasive numbers, numerous official and independent bodies in the health care industry continued to attack alcohol and lobbied for a “sin tax” on the fluid to pay for the Medicaid reforms proposed by the new Democrat administration under Presi-dentWilliam Jefferson Clinton. The liquor industry lobbied back, and both sides watched anxiously to see which one of them he would believe. Their mutual curiosity was satisfied in February 1993, when a delegation from the Wine Institute met with the president at the White House. According to a reporter at the scene: “With flash bulbs popping, Wine Institute President John A. De Luca told the forty-six-year-old Clinton about recent medical research revealing potential health benefits from moderate alcohol consumption. Clinton interrupted, noting appreciatively that he had reached the age that when all this health data comes out, I want to take another glass of wine. . . . Before Clinton could even finish his sentence, the group erupted in applause. The president grinned, beating his chest, thump, thump, thump, like a healthy heart.”

36 SINGLETONS, WINE LAKES, AND THE MOSCOW EXPRESS

The numerous studies which had concluded that alcohol could enhance longevity all noted that its benefits were greatest for moderate drinkers. But what constituted moderate drinking? Not finishing the bottle every night? A sip of champagne on New Year’s Eve? Raymond Pearl had chosen vernacular definitions in his pioneering study: “Surely it is in accord with common usage to call a person who gets drunk a heavy drinker. Also it is common usage to call a person who drinks a little but never gets drunk a moderate drinker.” While perfectly intelligible to the average drinker, such definitions were too imprecise to issue to individuals wishing to take up alcohol or cut down their consumption. Numerical guidelines were required, so that people might count their drinks as they did their calories. Moreover, such guidelines needed to provide for the different strengths of spirits, wine, and beer. The solution to the latter problem was the
standard drink,
a hypothetical measure of alcohol that could be equated to a glass of wine, a beer, or a shot of spirits. The issue was addressed by governments worldwide, resulting in a variety of standards. The most generous definition was made in Japan, where a splendid twenty-eight grams of pure alcohol was chosen as being a representative drink. The meanest was poured in Austria, where a mere 5 grams counted as a measure. America came to rest in the middle: standard serving sizes of beer (12 ounces), wine (5 ounces), and spirits (1.5 ounces) were all officially defined as containing the equivalent of 14 grams of ethanol.

But how many of these standard drinks could people consume and protect their hearts without compromising their livers? In Great Britain, which had settled on an austere measure called the
unit
— containing only 0.8 grams of pure alcohol, equivalent to a little glass of 11 percent wine, a small measure of spirits, or a half pint of weak beer—the Royal College of Physicians (RCP) had a stab at the task of quantifying safe limits. In 1982 it settled on fifty-six units per week, or roughly nine bottles of wine, for an adult male. This wonderfully liberal allowance, construed by some as an invitation to drunkenness, was reviewed in 1987 when the RCP published
A Great and Growing Evil: The Medical Consequences of Alcohol Abuse
, which cut it by more than half. The new report set the maximum recommended weekly intake at twenty-one units for men, and fourteen for women .
⁷⁴
A member of the working party responsible for the cuts later described how they had been calculated: “Those limits were really plucked out of the air. They were not based on any firm evidence at all. It was a sort of intelligent guess by a Committee.” Better that people were made to veer in favor of caution on the basis of false figures than be allowed to make up their own minds on the best available evidence. Although statistics suggested, and some doctors protested, that up to forty-two weekly units of alcohol were better than none at all in terms of protecting against heart attacks, the invented limits were nonetheless confirmed as government gospel.

Twenty-one units a week, although a mere three and a half bottles of wine, or only half a bottle a day, could, however, still cause problems if a drinker decided to knock it all back at once. Many tried: Britons did not consume alcohol at a uniform rate—they tended to drink most at the end of a working week, and (unlike their ancestors) very little on Monday mornings. On their weekend sprees they clogged up the country’s emergency wards to have their stomachs pumped, their bones set, their burns treated, and their cuts stitched. This style of drinking was particularly common in northeast England, where the principal function of alcohol was considered to be to produce drunkenness. The culture of the age and the place was reflected in the pages of
Viz,
a Newcastle-based adult comic, whose readers competed in its letters columns as to which of them had wasted most of their pay on booze.

Curious to relate, the episodic style of drinking that was commonplace in Newcastle had not been considered as a factor in determining safe limits until the 1990s, when health care professionals and statisticians decided to look at drinking occasions, and at people’s reasons for drinking, as opposed to weekly or annual averages. They found that in the real world, a third of the people might drink two-thirds of the alcohol in one country, whereas in another, two-thirds drank seven-tenths—on Friday and Saturday nights. In extreme cases, such as the Feria de San Fermín in Pamplona, the scene for Hemingway’s
Sun Also Rises
, almost the whole town, and people from miles around, got drunk for an entire week every July. Such sporadic excess was labeled
binge
drinking, and the concept of safe limits was modified to take account of the phenomenon.

A strip from
Viz
magazine

In 1995, the British government refined its guidelines in accordance with the new thinking. Instead of suggesting no more than twenty-one units per week, it advised that men should drink no more than three to four units each day, and women only one or two. It emphasized that a man downing more than ten units in one sitting, and a woman more than seven, were, technically, on a binge with a capital
B.
Bingers were advised to detoxify themselves at once by abstaining from alcohol for at least the next forty-eight hours. However, while the ten-unit definition of bingeing for men had seemed plausible when it represented ten separate drinks, the average strength of these had been rising, especially in the case of beer.

British brewing underwent radical changes in the last quarter of the twentieth century. In the 1970s, the market had been dominated by large brewers and their tied pubs. In order to maximize profits, the brewers had attempted to replace traditional “live” beers, so-called because they continued to ferment in their casks after delivery to pub cellars, with “nitrokeg.” This latter style, of which Watney’s infamous
Red Barrel
was the exemplar, was pasteurized, filtered, then packaged in steel or aluminum kegs and delivered to the tap by forcing compressed nitrogen into the beer. Nitrokeg was a modern, stable beverage, less wasteful than real ale, and easier to transport and store. It lacked, however, the delicate and changing flavor of traditional living beers. Its introduction prompted howls of outrage from purists, who formed the
Campaign for Real Ale
(CAMRA), whose mission was to protect the quality and diversity of British beer. CAMRA became the most successful single-issue consumer group in the country, and through its efforts real ale was rescued from the edge of extinction. Diversity was also protected by the Thatcher administration, which issued legislation known as the
Beer Orders
in 1989, whose purpose was to end the cartel in tied houses run by a handful of large brewers. The orders forced any brewer owning more than a thousand pubs to sell down to that limit. It also required tied houses to offer guest beers. It inspired a renaissance in craft brewing and also, as Britons revived the beer recipes of their ancestors, a return of the alcoholic strength of the average brew to pre-World War II levels.

The increase in potency was also prompted by the growth in lager sales. This once-alien beverage had gained market share from both real ale and nitrokeg at an explosive rate. Whereas in 1970 only 7 percent of pints drunk in English pubs were lager, by 1996 it accounted for more than half of all beer sold. Although early British lagers were weak, rising demand inspired foreign brewers to enter the market, and their products were, to a nation used to 3.2 percent beer, very strong.
Holsten Pils,
the pioneer in this new sector, weighed in at 5.5 percent ABV. While Germans drank it for breakfast by the liter, in Britain Holsten Pils was sold in 275-milliliter bottles in deference to its relative kick. Incidentally, it was also marketed as a lite drink, in the sense of being low in calories: “Holsten Pils, the beer where more of the sugar turns to alcohol.” Bottled lagers, which eventually settled around 5 percent ABV for taxation reasons, pushed up the strength of draft lager, which pulled up the strength of bitter.