Sir, – I believe that Prof William Reville misses the policy implications of the recent Lancet alcohol article, which demonstrated the harmful effects of alcohol on life expectancy in almost 600,000 subjects in 83 prospective studies, with an analysis of 5.4 million person years ("First drinking 'protects your heart'. Then it 'shortens your life'. Who to believe?", Science, May 17th).
The key results of this powerful and reliable study clearly and robustly demonstrate that the more alcohol an individual consumes, the greater the risk of premature death.
Compared to those individuals who drink less then 10 standard drinks (SD) per week (about five pints or just over one bottle of wine), those who consume 11 to 20 SD per week live on average six months less, those who consume 21 to 30 SD per week live one to two years less, and those who consume more than 35 SD per week four to five years less.
It is true that within the analysis, there were several distinct and opposite dose-response curves for cardiovascular disease, with evidence that low levels of alcohol consumption may protect from myocardial infarction and cardiovascular death. However, this data does not detract from the key finding that here is a linear relationship between alcohol consumption and risk of death.
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Prof Reville does make a valid point in relation to the reliability of conflicting claims for various food and alcohol products. However, the safe conclusion to be drawn from the Lancet paper, and one that is consistent with the vast majority of the high-quality research and analysis, is that alcohol consumption of more than 10 SD per week is harmful and reduces life expectancy.
Adhering to an upper limit of 10 SD per week would also be consistent with the stated Government of reducing average alcohol consumption in Ireland from the current level of more than 11 to 9.1 litres of pure alcohol per individual per year by 2020.
Those of us who look after patients see the devastating and often fatal effects of alcohol on individuals. Alcohol causes more than 1,000 deaths per year in Ireland, consumes €1 in 10 in the health budget, contributes hugely to access problems in this health service such as the trolley crisis, and causes harm to family, friends and others.
The Lancet paper reinforces the urgent need to implement the Public Health Alcohol Bill, and the need to review and reduce Irish low-risk alcohol consumption guidelines. – Yours, etc,
Prof FRANK
MURRAY, MD FRCPI
Chairman,
Alcohol Health
Alliance Ireland,
and Royal College
of Physicians of Ireland
Policy Group on Alcohol,
South Frederick Street
Dublin 2.