Vol

wwwaim-digestcom wwwdrinkingandyoucom

Our headlines have been dominated thisyear or infact for several years by ourbinge culture whereby 18 - 25 year oldsin particular may drink very little ornothing during the week and then go outspecifically to lsquoget plasteredrsquo on a Fridayand Saturday night This culture crossesall classes income groups the sexesand most ethnic groups It is a culturethat is particularly strong in Scandinaviathe UK Ireland and to a lesser degree inthe US However even Mediterraneancountries where traditional patterns ofdrinking have been much healthier havebecome implicated with the emergenceof the lsquobotellonrsquo in Spain A botellon is aboozy party held in a public place whereoften underage participants drink in anunregulated environment

Hence bingeing and under -age drinking havebecome strongly linked in the public and officialeye as has the association of alcohol andviolence and anti-social behaviour - all of whichgive drinking alcohol a reputation the industrymust disassociate itself from The industry wasgiven an ultimatum by Commissioner DavidByrne at the WHO conference on alcohol andyoung people in Stockholm in January 2001 toshow by the end of this year that it could putstrong measures in place to prove that itsadvertising does not appeal to those under ageand that its branding does not promote a cultureof excess or of sexual prowess or legislationwill follow The WHO conference in May 2002on self regulation of alcohol advertising againcalled on governments to regulate advertisingand was heavily critical of the industry Mostrecently the British Medical Association hascalled for a ban on alcohol adverts due to lsquotheworrying increase in binge drinking among theyoungrsquo

Action from individual countries such as theUkraine and most notably the traditionally liberalIreland to stem the increase in binge-drinkingby introducing a raft of measures ( see reporton page 3) including the regulation of advertisinghas sent shockwaves around the world andprovided a much needed wake up call to somecompanies whose advertising campaigns have

been sailing close to wind over the last year Asurvey of global public opinion of differentindustries commissioned by Heineken reflectspublic suspicion of beverage alcohol companyethicsmotivation rating it at -18 below thechemical oil and pharmaceutical companiesOnly tobacco rated lower

The industry and its associations have workedhard over the last few years to emphasise theimportance of patterns of drinking and thecontext of drinking This separates the idea ofdrinking and specifically drinking in moderation- at meal times in a civilised context from thedamaging patterns of excess over the weekendResearch shows clearly that binge drinking isextremely damaging a survey carried out byFinlandrsquos national Public Health Institute tracked5000 men over 10 years and found that drinking6 or more beers in one session increased yourrisk of dying young by more than half After 10years the death rate of binge-drinkers was 75higher the main killer being heart diseasefollowed by liver disease How to change thisingrained behaviour where getting drunk israted higher than socialising or enjoyment willnot be easy However the UK and US hassucceeded in turning drink-driving into a socialtaboo over the last twenty years so there is noreason why - with imagination determinationand of course funds a current social norm canbe deemed lsquouncoolrsquo in time

Allied Domecq has paved the way for promotingmoderation as a key part of its marketing andadvertising with the launch of Tia Lusso lastyear whose sensible drinking strap line is lsquo youjust know to drink in moderationrsquo similarlyBallantynes whisky message is lsquoplay better playin moderationrsquo The tremendous success of TiaLusso leaping to number two in the creamliqueur market in 12 months showed that aresponsible approach to marketing and productlaunch has no ill effect on sales was an importantlessonThey have since extended messages toMalibu and Makers Mark

The news that Diageo have now launched asensible drinking campaign in the UK ( it hasalready run in the US) through such a mainstream brand as Smirnoff is excellent news Thewitty campaign which features a couple havingdinner to celebrate their engagement when a

lsquofriendrsquo turns up and regales Cindy with tales ofHankrsquos wild bachelor past The strapline islsquoknowing when to stop is a good thingrsquo pound2 millionfunds have been earmarked for the UK

The fact that two of the most important globalbeverage alcohol companies are putting socialresponsibility at the heart of their policy is a goodstart and combined with initiatives for betterdesign in pubs unbreakable glasses betterpublic transport at night better trained bar stafftogether with imaginative and interactiveeducation and publicity perhaps the damaging(both to the industry and the participants) patternof binge-drinking can be turned around

The Problem Drinking to get drunk

Volume 12 No2 JulyAugust 2003

In this Issue

Alcohol sponsorship and advertisingto be regulated in Ireland Page 3

Spain embodies Mediterranean dietas part of new wine law Page 4

Diet and exercise are effective incontrolling high blood pressure Page 5

Wine and the Gastrointestinal tractBy Harvey E Finkel MD Page 8

Moderate Alcohol Intake as Part of aHealthy Diet and Lifestyle byElisabeth Holmgren Page 10

2

AIM DigAIM DigAIM DigAIM DigAIM DigestestestestestPO BoPO BoPO BoPO BoPO Box 2282x 2282x 2282x 2282x 2282BBBBBAAAAATH BTH BTH BTH BTH BA1 2QA1 2QA1 2QA1 2QA1 2QYYYYY UK UK UK UK UK

TTTTTel (44) (0)1225 471444el (44) (0)1225 471444el (44) (0)1225 471444el (44) (0)1225 471444el (44) (0)1225 471444FFFFFax (44) (0)1225 427444ax (44) (0)1225 427444ax (44) (0)1225 427444ax (44) (0)1225 427444ax (44) (0)1225 427444e-maile-maile-maile-maile-mail inf inf inf inf infoAim-DigoAim-DigoAim-DigoAim-DigoAim-DigestcomestcomestcomestcomestcomWWWWWeeeeeb sites b sites b sites b sites b sites wwwwwwwwwwwwwwwaim-digaim-digaim-digaim-digaim-digestcomestcomestcomestcomestcom www www www www wwwdrinkingdrinkingdrinkingdrinkingdrinkingandandandandandyyyyyoucomoucomoucomoucomoucomAnnual Subscriptions to AIMAnnual Subscriptions to AIMAnnual Subscriptions to AIMAnnual Subscriptions to AIMAnnual Subscriptions to AIMSingle subscription to AIM Digest on-line(published bi-monthly) pound100 or $175Corporate subscription level of pound500 or $875for AIM Digest on-line and the monthlyhighlightsPlease make chequesdrafts in British poundssterling or dollars payable to AIM DigAIM DigAIM DigAIM DigAIM Digestestestestest atthe above address or emailviaSherryWebsterAim-Digestcom

PPPPPeter Dufeter Dufeter Dufeter Dufeter Duffffff ndash Executive Chairmantel (44) (0)1225 471444email PeterDuffAim-DigestcomHelena ConibearHelena ConibearHelena ConibearHelena ConibearHelena Conibear ndash Editorial Directortel (44) (0)1300 341305email HelenaConibearAim-DigestcomElisabeth HolmgElisabeth HolmgElisabeth HolmgElisabeth HolmgElisabeth Holmgrrrrrenenenenen ndash Director USOperationstel 001 925 9343226email ElisabethHolmgrenAim-DigestcomAnn HansfAnn HansfAnn HansfAnn HansfAnn Hansforororororddddd ndash Medical Research Assistanttel (44) (0)1300 341305email AnnHansfordAim-DigestcomSherSherSherSherSherrrrrry y y y y WWWWWeeeeebsterbsterbsterbsterbster ndash Communications Managertel (44) (0)1225 471444email SherryWebsterAim-DigestcomGarGarGarGarGareth Daeth Daeth Daeth Daeth Daviesviesviesviesvies ndash Website Manager

SOCIAL SCIENTIFIC AND MEDICALSOCIAL SCIENTIFIC AND MEDICALSOCIAL SCIENTIFIC AND MEDICALSOCIAL SCIENTIFIC AND MEDICALSOCIAL SCIENTIFIC AND MEDICALCOUNCILCOUNCILCOUNCILCOUNCILCOUNCILPeter Duff ndash Chairman UKUKUKUKUKHelena Conibear -Editorial Director UKUKUKUKUKElisabeth Holmgren - Director US USAUSAUSAUSAUSAMorris Chafetz MD USAUSAUSAUSAUSAProf R Curtis Ellison USAUSAUSAUSAUSADr Harvey Finkel USAUSAUSAUSAUSAProf Dwight B Heath USAUSAUSAUSAUSADr Arthur Klatsky USAUSAUSAUSAUSADr Alfred de Lorimer USAUSAUSAUSAUSAProf Oliver James UK UK UK UK UKChristopher Jarnvall SwSwSwSwSwedenedenedenedenedenDr Philip Norrie MB BS AAAAAustraliaustraliaustraliaustraliaustraliaProf Jean-Marc Orgogozo FFFFFranceranceranceranceranceStanton Peele USAUSAUSAUSAUSAHarvey Posert USAUSAUSAUSAUSADr Erik Skovenborg DenmarkDenmarkDenmarkDenmarkDenmarkCreina S Stockley AAAAAustraliaustraliaustraliaustraliaustraliaDr Thomas Stuttaford UKUKUKUKUKLilyane Weston UKUKUKUKUKDr Elizabeth Whelan USAUSAUSAUSAUSAThe publisher takes reasonable care to ensure the accuracyof quotations and other information contained herein butis not responsible for any errors or omissions Opinions andrecommendations quoted herein are usually excerpteddigested or condensed may be edited for continuity and areonly part of the opinions and recommendations expressedin the original sources which should be consulted for details

copy AIM Digest 2001 All rights reserved Material may bereproduced with attribution to AIM

Published by AIM DigestPO Box 2282 BATH BA1 2QY UK

News from around the world

UKThe UK Portman Grouprsquos independent com-plaints panel has condemned FCUK spirit fruitvodka drink for appealing to the under 18rsquos Thepanel has also asked UK retailers not to stockthe controversial Roxxoff lsquoviagrapoprsquo whichclaims to increase libido In another ruling thePanel upheld complaints against the websitewwwwkdcouk which has strong sexual con-tent and was deemed to appeal to under 18rsquos insupport of the vodka based drink WKD

UkraineThe Ukrainian parliament passed a law in Julythat bans most alcohol and tobacco advertisingon television radio and in print media The movefollows calls from deputies that both substancesare damaging to health The bill imposes a blan-ket ban on tobacco advertising and restricts al-cohol advertising on television and in printedmedia as well as on billboards and transport

FranceAs part of the public health policy currently beingdrafted for 2004-2008 the French governmentaims to reduce alcohol consumption by 20 andmake alcohol abuse less prevalent in Frenchsociety This is part of a 100- point draft billwhich was to be presented to the cabinet in July

Although any attempt at reducing alcohol misuseis laudable achieving it by seeking to enforce ablanket reduction in drinking rather than bytargeting specific areas of misuse- specificallydrink-driving in France is generally consideredto be an inefficient means to an end commentsLa Journee Vinicole

RomaniaThe Romanian Government has increasedexcise tax on alcohol cigarettes and oil Thenew rates will come into force from the first ofJuly this year Excise duties on ethyl alcohol anddistilled alcoholic beverages will rise to 150Euros (US$1728) per hectolitre of pure alcoholfrom the current 1084 Euros

Beer tax will also increase as will wine tax withsparkling wines and special wines bearingexcise duties of 280 euros per hl per alcoholdegree But excise duties on non-sparklingwines will be reduced to 030 euro per hl peralcohol degree from the current 055

Russia

Russian Brewersrsquo filed a lawsuit against taxauthorities in May for publicly advocating anexcise duty hike on beer OAO Baltika BreweryZAO Ochakovo and ZAO Vena have all filed asuit to the Moscow Court of Arbitration

Vladimir Gubanov head of department ofalcohol and tobacco taxation indicated in Aprilthat the January 25 rise in exercise duty wasneeded in order that the government canreceive more in tax revenues Baltika thecountryrsquos largest brewer is owned by BalticBeverage Holding a joint venture betweenCarlsberg AS and Scottish amp Newcastle PLCRussiarsquos second-largest brewer Sun InterbrewLtd a unit of Belgiumrsquos Interbrew SA hasnrsquotjoined the other Russian brewers

ThailandSeveral organizations and politicians are callingfor tighter controls on alcohol advertising inresponse to rising alcohol consumption in thecountry over the past 10 years Ampon Jindadirector of the National Health System ReformOffice (HSRO)expressed support in June for aproposal by Thailandrsquos Deputy Prime MinisterChaturon Chaisang to ban all radio and TV adsfor alcoholic drinks between 500am and1000pm The Thai Cabinet has now approvedplans to ban TV and radio advertising foralcoholic and energy drinks between 5am and10pm ffrom 1 October and will also include acomplete ban on cinema advertising

The proposals also include a ban on alcoholbeing promoted by actors singers andsportsmen and womenThe ban seems unlikelyto affect sports broadcasts when drinkssponsors are involved provided certainconditions are met ldquoSports sponsoring usinglogos is still allowed as long as the alcohol firmsdo not say drinking is good for peoplerdquo PrimeMinister Thaksin Shinawatra said after theCabinet meeting In addition alcohol saleswould be banned at petrol stations andconvenience stores in response to rising levelsof drink-driving HSRO statistics indicated that60 of road fatalities were drink-related Jindasaid that alcohol consumption had more thandoubled over the past 10 years to 1604 billionlitres per year

3

Alarmed that Ireland has become one of thehardest-drinking countries in Europe the Irishgovernment announced at the end of May thatit plans to require health warnings on alcoholicdrinks and limit advertising of alcoholic drinksPrime Minister Bertie Ahern insisted in a speechto European brewers in Dublin that he believedyoung people were exposed to saturationmarketing of alcohol which he said was fuellinga the ldquodrink to get drunkrdquo culture Similarly theMinister for Justice Michael McDowell Speakingat the Progressive Democrats annualconference in Galway gave warning that tighterlegislation could be introduced to tackle theproblem of public drunkenness ldquoIt is alreadyillegal for publicans to allow people to becomedrunk on their premises and I am planning astricter enforcement of this lawrdquo he said

The government plans to ban alcohol ads frombusestrains cinemas and sporting eventsinvolving young people while no ads for beeror other alcoholic beverages would be permittedbefore 10 pm on Irish television currently suchads currently face few restrictions and Guinnesssponsors the national soccer squad andHeineken the rugby Currently more than 10000pubs serve a population of 38 million Healthwarnings on beer wine and liquor would requireapproval from the European Commission butAhern said he expected the EUrsquos support intackling what he called ldquoserious social problemsarising from greatly increased levels of alcoholabuserdquo Together the commitments representas significant a shift in official attitudes to Irishtraditions as the governmentrsquos recentcommitment to outlaw smoking in pubs

Anti-alcohol campaigners and Irelandrsquos majorpub owners association welcomed the movesas well as Ahernrsquos call for pubs to stop sellingsweet heavy-alcohol ldquoslammersrdquo andldquoalcopopsrdquo which appeal to novice drinkersldquoThese drinks encourage binge drinking amongyoung people which is fast becoming the curseof modern societyrdquo said Tadh OrsquoSullivan chiefexecutive of the Vintners Federation of Irelandwhich represents 6000 pubs - many of whichsell the drinksThe Irish have long beenstereotyped as heavy drinkers but past surveyshave suggested the reputation was undeservedand Ireland was actually one of Europersquos moremoderate drinking nations In the past decadehowever figures show that this has changedWorld Drinks Trends 2002 placed Irelandsecond only to Luxembourg in the EU in per-capita volume of alcohol consumed at 285

gallons of pure alcohol each year The USaverage was 177 gallonsThe surge coincideswith Irelandrsquos quick-changing fortunes in the1990s when it went from an economicbackwater of Europe with double-digitunemployment to a booming economy andtourism

The UK government is considering a newset of regulations for alcohol advertising

Following a series of ads that breached bothgood taste and the guidelines of the industryrsquosmarketing regulator the UK government isconsidering regulating all alcohol advertisingcurrent alcohol advertising attitudes will haveto change radically to avoid a clampdown itstates

It will be difficult for some alcohol manufacturersto deny that the government has a caseRecently some advertising agencies have beenpushing the limits of the law using the loopholeof creating very sexual adverts without an overtlink to the product While this may not be atechnical infringement it has alarmedconsumers as well as groups such as AlcoholConcern The government is also beginning totake notice and is proposing a new set ofregulations including banning alcohol advertsbefore 9 pm Currently the UK has some of themost liberal alcohol advertising laws in Europe

However the industry is keen to retain itspowers of self-regulation monitored by ThePortman Group which has shown that it isprepared to take strong action to discourage thecurrent trend Recently it ruled an alcopop fromFCUK unacceptable due to the brandrsquos strongfollowing among teenagers Similarly it hascondemned the release of the controversiallsquoRoxxoffrsquo a new alcopop containing aphrodisiacherbs and which is to be marketed as ldquocreatinga generation of randy superbeingsrdquo

News that 12 alcoholics from Scotland plan tosue drinks companies for failing to warn themadequately of the dangers of consuming alcoholhas further fuelled the debate ldquoAny litigationwould have to be based on whether or not theproduct causes harm and whether or not theproducer has a duty of care to customersrdquo saidRoss Harper their solicitors The case bringsnew exposure re health warnings on alcoholcontainers in the UK The British MedicalAssociation has repeatedly called for them tobe made mandatory

Alcohol sponsorship and advertising to beregulated in Ireland

The World Cancer Report was launched in Apriland provides a global overview of the trendsand developments in cancer incidence mortalityand causality It also sheds light on WHOrsquoscancer control strategies and on a variety ofprevention measures thought to be effectiveAlcohol consumption is identified as belongingto a series of causes of cancer The WorldCancer Report said ldquoThere is an increasingrecognition of the causative role of lifestylefactors including diet physical activity andalcohol consumptionrdquo

This report together with another IARCpublication ldquoNutrition and LifestyleOpportunities for Cancer Preventionrdquo and thejoint WHOFAO Expert Report on Diet ldquoNutritionand the Prevention of Chronic Diseaserdquocontribute to the general consultative processthat will culminate with the formulation of aGlobal Strategy on Diet Physical activity andhealth to be considered by the World Healthassembly in 2004

World cancer report

Direct Wine Shipmentbreak through in US

ldquoA 139-page report released by the FederalTrade Commission will forever change the termsof debate on the direct shipment issue and willhave an extraordinary impact on statelegislatures and the federal courts in the monthsaheadrdquo states WineAmerica President DavidSloaneldquoThis report makes clear that theinterstate shipment of wine is beneficial toconsumers that states can and are effectivelyregulating such sales and that the argumentsagainst direct shipment simply do not hold upunder scrutinyrdquo he continued ldquoWine consumersand wineries all over America should know thattheir voices have finally been heard on thisissue and that the federal agency charged withsafeguarding competition and protectingconsumers has firmly come down on our siderdquohe concluded

The report entitled ldquoPossible anti-competitiveBarriers to E-Commerce Winerdquo stems from apublic workshop held last October by the FTCwhich examined state barriers to e-commercefor a number of popular consumer productsincluding wineThe FTC press release can befound at httpwwwftcgovopa200307winehtm The full report via httpwwwftcgovos200307winereport2pdf

3

4

While some research suggests alcohol drinkershave a lower risk of Parkinsonrsquos disease thanabstainers a study published in May suggestsno clear association between drinking andParkinsonrsquos disease with the exception ofmoderate beer intake which might offer someprotection Because no alcohol other than beerwas tied to a lower Parkinsonrsquos risk researcherssuspect that a beer ingredient other than alcoholmight bestow the benefit Their report ispublished in the on-line edition of the Annals ofNeurology

Over the past few decades researchers havedebated whether cigarettes coffee and alcoholcan help stave off Parkinsonrsquos disease amovement disorder that arises from the loss ofbrain cells that produce the chemical dopamineSeveral recent studies have produced strongevidence that cigarette smokers and caffeineconsumers have some protection againstParkinsonrsquos and researchers believe itrsquosbiologically plausible that tobacco smoke andcaffeine might shield brain cells from thedamage that marks the disease But there isanother possibility Some scientists havesuggested that the absence of these addictivebehaviours-caffeine consumption smoking anddrinking might be a sign of a certain kind ofpersonality according to the authors of the newstudy led by Dr Miguel A Hernan of the HarvardSchool of Public Health in Boston ldquoIt has beenhypothesized that people who are destined todevelop Parkinsonrsquos disease have acharacteristic personality- moralistic law-abiding conscientious risk averse that leadsthem to avoid novelty seeking behaviours or that

they have an underlying metabolism (geneticor as a result of a toxic insult early in life) thatmakes these behaviours particularlyunrewarding to themrdquo the researchers explainIf this hypothesis is correct then drinkingsmoking and caffeine consumption should allappear to reduce the risk of developingParkinsonrsquos Dr Alberto Ascherio a study co-author also at Harvard commentsldquoOur resultdoes not support thatrdquo Ascherio said in aninterview ldquoIndirectlyrdquo he added ldquoit supports theidea that caffeine and something in cigarettesmoke is protectiverdquo Currently there areongoing studies to look at the effects of caffeinein people who already have ParkinsonrsquosAscherio noted

The researchers looked at data from two largelong-running US studies the Nursesrsquo Healthand the Health Professionalsrsquo Follow-upStudies After examining information from nearly89000 women and 47000 men theresearchers found ldquolittle association betweentotal alcohol consumption and Parkinsonrsquosdisease incidencerdquo according to the reportWhen they broke the data down into differenttypes of alcohol people who drank moderateamounts of beer showed a 30 lower risk ofParkinsonrsquos But the authors write ldquobecausethis lower risk was not found among wine orliquor drinkers it is possible that somecomponents of beer other than (alcohol) mayreduce the risk of Parkinsonrsquos diseaserdquo

SOURCE Annals of Neurology 200354Alcoholconsumption and the incidence of Parkinsonrsquos diseaseMiguel A Hernaacuten MD DrPH 1 et al Email Miguel A

Hernaacuten (miguel_hernanpostharvardedu)

No clear link between alcohol and Parkinsonrsquosdisease

People who drink one drink a day mdash wine beeror spirits mdash show significantly better elasticityof their bodyrsquos arteries an important measureof cardiovascular health results of a new studysuggest ldquoWe thought only red wine helps butwe found if people drink one beer or one unit ofhard liquor a day they also have improvedarterial elasticity better than nondrinkersrdquo saidDr Reuven Zimlichman of Wolfson MedicalCenter and Tel Aviv University in Israel Theresearch was presented via the AmericanSociety of Hypertension

When arteries lose elasticity they fail to relaxas the heart pumps blood This causes a rise inthe systolic blood pressure somethingZimlichman calls a ldquoterrible predictorrdquo of futurestrokes cardiovascular disease and heartattacks The researchers also found thatmoderate drinkers had pulse rates that weresignificantly lower than those of nondrinkersldquoTherersquos been lots of study of pulse rates andthe risk of diseaserdquo Zimlichman said He notedthat higher pulse rates are associated with anincreased risk of disease and death

In comparing wine drinkers with drinkers whofavour other alcoholic beverages theresearchers observed that beer and spiritsdrinkers had slightly higher blood pressure thanwine drinkers But all drinkers had bloodpressure within normal ranges The researchersstudied 243 healthy people between the agesof 15 and 80 who volunteered to fill outquestionnaires and be tested at clinics in sevenEuropean countries They excluded people whodrank more than one drink a day and adjustedtheir findings for age because arterial elasticitycommonly gets worse with age

When asked if this study means non drinkersshould start drinking Zimlichman pointed outthat heavy drinking itself can cause high bloodpressureldquoWhenever you recommend drinkingyou have to consider the possibility thatsomebody will like it too much and over-drinkand cause damage to his healthrdquo he said ldquoButif someone has a high risk of cardiovasculardisease I recommend to my patients that theydrink one glass of red wine a dayrdquo Although hisstudy showed similar benefits for beer and hardliquor as for wine

A drink a day improvesoverall heart health

The wine law passed by the Spanishgovernment in June encourages the activepromotion of wine as part of a healthy dietUnder the Ley del Vino - the biggest shake-upin wine laws since Franco - the Government willprovide funds for local and national informationcampaigns which should promote wine as anintegral part of a Mediterranean diet The lawmakes it clear that wine will be promoted asdistinct from any other alcoholic beverage andshould include recommendations forresponsible consumption Growers andproducers are encouraged to use environmentaland sustainable farming methods Funds areavailable for research and development projectsat a local and national level

The law has taken eight years to agree andsweeps away the pre-democracy laws of 1970allowing more flexibility for producers There aretwo new levels of DO at the top end aboveDOCa (Denominacion de Origen Calificada) isVinos de Pagos Then below DO is Vinos deCalidad con Indicacioacuten Geograacutefica or VCIG theequivalent of the Italian IGT or French VDQSConsejos Reguladores will still make the rulesbut a new autonomous body will be created topolice their application The Federacioacuten Espantildeoldel Vino has welcomed the new law lsquoA newphase opens for a struggling sector which willpermit it to compete with rivals operating in veryderegulated environments It is an importantadvance on the law of 1970rsquo

Spanish wine laws embodies promotion of wineas part of the Mediterranean diet

5

In a study on rats a coffee and alcoholcombination know as caffeinol given within 3hours of an artery supplying blood to the brainbeing blocked was shown to reduce damageby up to 80 It delivers the potency of 2 cupsof strong coffee and an alcoholic drink althoughneither caffeine nor alcohol were protective ontheir own Treating and looking after the 140000stroke victims a year costs the NHS in Britainan estimated pound23 billion The experimental drughas been shown to be safe in a pilot study ofpatients suffering from ischaemic stroke wherea clot blocks blood going into the brain and the

Coffee and alcohol for stroke victims

New research suggests that an overhaul ofdietary and fitness habits to help prevent orcontrol high blood pressure is feasible withproper coaching contrary to the theory that toomany changes would be overwhelming andineffective for most people The best results inthe study were achieved when weight loss saltrestriction and exercise were paired with theDASH (Dietary Approaches to StopHypertension) diet which is rich in fruitsvegetables and low fat dairy products

The results of the study conducted at DukeUniversity Medical Center Johns HopkinsPennington Biomedical Research Center andthe Center for Health Research were publishedin the April 23 2003 issue of the Journal of theAmerican Medical Association The study calledPREMIER is funded by the National HeartLung and Blood Institute

Current national recommendations for loweringblood pressure include weight loss reducedsodium intake increased physical activitylimited alcohol consumption and DASH diet TheDASH diet increases fruit vegetable and low-fat dairy consumption while limiting fats redmeat sweets and beverages containing sugarNo previous study has tested the ability ofpeople to adopt DASH on their own or itseffectiveness in the lsquorealrsquo world And no previousstudy has tested all the other recommendationsfor lowering blood pressure either with orwithout DASH as an ldquoall-in-onersquointervention

The PREMIER trial enrolled 810 generallyhealthy people with above-optimal bloodpressure including those with stage onehypertension (systolic BP140-159 mmHg andor diastolic BP 90-95 mmHg None of the

participants took medications for hypertensionThose in the ldquoAdvice Onlyrdquo group each met witha registered dietitian at the beginning of the trialto discuss recommendations for weight controlreduced sodium intake physical activity and theDASH diet for lowering blood pressure plusprinted educational materials

Participants in both the ldquoEstablishedrdquo andldquoEstablished Plus DASHrdquointervention groups setgoals to lose 15 pounds within six monthsincrease physical activity lower sodium intakeand limit alcohol to one or two drinks per dayThe Established Plus DASH group also setgoals to increase fruit vegetable and low-fatdairy intake and reduce saturated fat and totalfat The Established group was given noinstructions on the DASH diet During the initialsix months of the trial both groups metfrequently to reinforce behaviour modification

During the first six months of the trial allparticipants in both the Established andEstablished Plus DASH groups significantlylowered their blood pressures in comparison tothe Advice Only group The Established PlusDASH group had the lowest prevalence ofhypertension mdash cutting group membersrsquo risk ofdeveloping hypertension by 53 percentcompared to the Advice Only group ldquoAt sixmonths we had 19 participants in the AdviceOnly group who had to begin anti-hypertensivemedication to control their blood pressurescompared to only two in the Established Groupand five in the Established Plus DASH grouprdquosaid Svetkey ldquoAnd both behaviour modificationgroups had a significant number of theparticipants reach their optimum bloodpressurerdquoAll groups had an overall reduction

Diet and exercise are effective in controlling high blood pressurein weight In the Established Plus DASH group343 percent lost 15 pounds or more while inthe Established group 286 percent lost 15pounds or more The Advice Only group hadonly 62 percent lose 15 pounds or more Whenparticipants took a treadmill exercise test thetests showed fitness increased significantly inboth the Established and Established PlusDASH groups

Those on the DASH diet also benefited fromother potential benefits prevention ofosteoporosis from the high calcium contentprevention of some cancers from the high fruitand vegetable content and the prevention ofcardiovascular disease from the low fat contentrdquo

Although the results for the Advice Only groupwere not as striking as the other two this groupdid better in losing weight and decreasingsodium intake than expected Svetkey said thiscould be because motivated people usually signon to participate in clinical trials and mayproduce better results than could be expectedin the average population

The long-term goal of the study said Svetkey isto follow all the participants for an additional 12months (18 months total) to determine whetherthe participants can stick with the diet andexercise and monitor blood pressure controlThe next phase in this series of research willfocus on weight loss mdash specifically on how tohelp people lose weight and keep the weight offlong-term This new study which is also fundedby the National Institutes of Health beganenrolling participants in May 2003 The NHLBIpress release is available at wwwnhlbinihgovnewpress03-04-22htm

findings were reported in the Stroke Journal ofthe American Heart Association

In the study on humans lead by ProfessorJames Grotta a team at the University of Texasgave the treatment to 16 females and 17 malestroke victims with an average age of 71 Theaim of this study was to see if they could safelyachieve the same blood levels of caffeinol thatwere achieved in the animal studies ProfessorGrotta said ldquoWe discovered that we could useeven lower doses than we used in the animalstudies and achieve the blood levels that were

neuro-protective in animalsrdquo Caffeinol can besafely administered to patients also receivingtraditional lsquoclot-bustingrsquo drugs used to treatstrokesProfessor Grotta said a ldquorandomisedplacebo-controlled trialrdquo was needed todetermine the extent of caffeinolrsquos protectiveeffect in humans He is planning a studycombining caffeinol with thermo-cooling instroke patients Other studies have suggestedthat cooling the brain might limit stroke damage

Source wwwstrokeahajournalsorgcgicontentabstract01STR000006817080517B

5

6

Serve Wise (formerly known as SIPS) wasdeveloped with funding and guidance from theScottish Office and enjoys continued supportfrom the Scottish Executive to deal specificallywith underage drinking drinking and drivingcriminal incidents and deathsaccidents relatedto alcohol in Scotland ServeWise is managedby Alcohol Focus Scotland a charity operatingon a non-profit basis The importance ofadequate training for all staff is increasinglybeing recognised by licensed trade licensingboards and the police Many licensing boardsare now beginning to insist on training as aprerequisite for the granting or renewal of alicence

ServeWise aims to set a National Minimumstandard for all those involved in the sale ofalcohol In order to achieve this ServeWiseoffers short courses (approx 1 day or 2 halfdays) each covering licensing law alcohol andpeople skills This is on two levels -ServeWisePlus for managers licensees and experiencedstaff (covering the law in more depth andincludes issues relating to management) andServeWise for general staff Both the coursesare available in On and Off-Licence versionsAtpresent there are just over 40 Centresthroughout Scotland that can deliver ServeWisecourses located at colleges of further educationor training organizations or other types oforganisations (including solicitors) There aretwo pilot centres in the South The University ofCardiff in conjunction with the police-basedTASC project (Targeting alcohol-Related streetCrime) have held several courses and inManchester there is a multi-agency teamincluding the licensed trade the police andAlcohol and drug services Manchester whichhas just begun to run courses

Assisting in the setting up of the centres is theServeWise Central Office All trainers undertakea 2-day Trainer rsquos Course and receive theServeWise Trainerrsquos Manual (containing coursematerial instructions on delivery and a speciallydesigned video) All trainersrsquo are subject to ongoing verification and continuous professionaldevelopment requirements

ServeWise believes that the training must berelevant user-friendly as well as assessableand affordable and is confident that there willbe a reduction in the number of accidents andcrimes resulting from the misuse of alcohol onlicensed premises and consequently a lessening

in the amount particularly in the terms of policeand accident and emergency time A numberof l icensed trade organizations supportServeWise such as the Scottish Licensed TradeAssociation Diageo UK the BritishEntertainment and Dance Association theLeisure safety and Security Association

Advice and assistance is also offered byServeWise through its Advisory and WorkingGroups which include representatives from theScottish Executive the police solicitorslicensing boards the licensed trade as well asthose from trainingfurther educationperspective These groups also assistServeWise in organising other types of trainingand events including annual events for licensingboard members

lsquoTasterrsquo ServeWise courses for the licensingboard members can be provided where licensingboards wish to encourage training amongstlicensees and staff It is recommended that alsquoFit and Proper Personrsquo policy is set up includingtraining requirements Several Boards havegone on to develop policies after attending aServeWise taster event

Both ServeWise and Alcohol Focus Scotlandare still very much organisations in growth Fromlast year ServeWise has almost doubled itstraining numbers and Alcohol Focus Scotlandis undergoing considerable expansion withseveral newly created posts - including aGender Issues Network Officer (who for the next3 years will focus on women alcohol issues) aUser Support officer (to assist thoseexperiencing alcohol problems and to set up networks) and a NetWork support officer who willassist with communications and developmentof the network of affiliated organisationsprimarily the 30 Local Councils on Alcoholthroughout Scotland which provide counsellingand related services

ServeWise Central Office 166 Buchanan StreetGlasgowG1 2LW TEL 0141 572 6703Newsletters are produced by ServeWise andinformation can also be found on the Internetservewisealcohol-focus-scotlandorguk

Serve-wise and Alcohol Focus ScotlandIn October the Swedish Spirit amp Wine Suppliers(SSWS) will launch an initiative called DrinkwiseThe aim is to get the general public to considertheir alcohol behaviourFrom the beginning Drinkwise will consist of awebsite among other with an interactive partin which the visitor by answering questionsandclaims will be told what kind of alcoholconsumerhe or she is and the character of thistype ofconsumer SSWS concludes thatDrinkwise isone example of initiatives following thepublishing of a book financed by the PublicHealth Institute written by Sam Larsson at theKarolinska Institute in Stockholm and Johan Liljaat the Academy of Turku in Finland Theyconclude that it is better to teach young peoplehow to drink than to tell them not to drink at all -it is better to discuss with them how to behavewith alcoholThe authors also say that preventionprogrammes so far have been tooldquopropagandisticrdquo The non drinking message hasbeen repeated endlessly and has not beeneffective The alcohol policy target should be toget young people to use weak alcoholic drinksand to drink in moderation Maybe it is notrealistic to believe young people will abstain butthey ought to get a more conscious view onalcohol and drugs the authors say The bookhas been financed by the Public Health Institute

Drink-wise from Sweden

The drinks giant Diageo is planning to launcha campaign aimed at reducing the problem ofbinge-drinking in the UK

Diageo has asked its principal advertisingagencies J Walter Thompson Abbott MeadVickers BBDO Bartle Bogle Hegarty Motherand Miles Calcraft Briginshaw Duffy to pitch forthe campaign

In the light of the increase in binge-drinkingdrunkenness and alcohol-related violencepolitical support for further curbs on alcoholadvertising has been growing The industry bodywhich speaks on alcohol policy The PortmanGroup has called for companies to introducecampaigns promoting responsible consumptionThe UK government has called for consultationwith a wide range of groups including alcoholcompanies on how violence in and outside pubsmight be reduced

Diageo to target bingedrinking culture

7

The long established and well supported Proofof Age Card set up by the Portman Group hasbeen accepted into the British RetailConsortiumrsquos new Proof of Age StandardsScheme (PASS) As from June 2003 the newcard complete with hologram will be incirculation

PASS is an umbrella accreditation systemaudited by the Trading Standards Institute andany card that is presented and bears the PASSlogo has met the PASS standards and containsaccurate and reliable information This will helpretailers make an informed decision on whetherto allow a purchase The Portman Group hasrelaunched the card bearing the PASS hologramand Portman Group 18+ logo The Underage

Drinking and the illegal Purchase of AlcoholReport commissioned by the NicholsonCommittee shows that 84 of 15 year oldsplaced drinking of alcohol as a common placeactivity Of the young persons questioned 49currently purchased alcohol illegally 33 fromlicensed grocers 24 from off-licences andanother 24 from pubs or bars

Proof of age standards scheme (PASS)

The subject of numerous prospective and casecontrol studies has been the possible existenceof an independent effect of alcohol use in theaetiology of lung cancer As alcohol correlatesstrongly with smoking possible residualconfounding has been a particular concernResults of several prospective studies were notadjusted for smoking therefore hampering theirinterpretation This study by De Stefani ECorrea P and Deneo-Pellegrini H et al wasundertaken to examine in detail the relationshipbetween alcohol use and the risk ofadenocarcinoma of the lung

Between July 1998 and July 2000 all incidentsof lung adenocarcinoma that were admitted tothe 4 main hospitals in Montevideo Uruguaywere considered eligible for examining the rolesof diet drinking and smoking in the aetiology ofthis malignancy Subjects for the study were 160cases with newly diagnosed adenocarcinomaof the lung with 520 hospitalised controls with acondition unrelated to drinking or smokingInformation about socio-demographic variablesoccupational history smoking history drinkinghistory height and weight 5 years before theinterview menstrual and reproductive history

(women) and a food frequency form including64 food items were obtained by use of aquestionnaire during interview

Total alcohol use was not associated with riskof adenocarcinoma of the lung (OR 12 95CI 06-21) Beer consumption did not correlatewith adenocarcinoma risk (OR 06 95 CI 03-16) In contrast wine consumption showed amarginal protective effect (OR 04 95 02-11)while the use of spirits (predominantly canaderived from sugar cane and grappa derivedfrom grapes) was associated with a 40increase in risk of lung adenocarcinoma

The results of the study suggest that wineconsumption has a protective effect against thedevelopment of adenocarcinoma of the lungwhile spirits are a moderate risk factor for thiscell type of the lung cancer

Source De Stefani E Correa P Deneo-Pellegrini Het al Alcohol intake and risk of adenocarcinoma ofthe lung a case-control study Uruguay Lung Cancer38 (2002) 9-14

Wine may protect against adenocarcinoma of thelung

International Conferenceon Alcohol Drugs andTraffic Safety T 2004

In August 2004 many of the worldrsquos experts ondrugs and alcohol will gather in Glasgow for the17th International Conference on Alcohol Drugsand Traffic Safety

The Conference will explore developments innew policies and technologies to counteractalcohol and drugs problems in the context ofroad traffic safety In particular it will explorethe following key areas of Driver CharacteristicsPharmacology and Toxicology EpidemiologyRehabilitation Prevention Driving andPerformance Police Enforcement and WorkRelated Transport IssuesTo submit an abstract or register interest inthe conference please visit the conferencewebsite at wwwICADTS2004com Tel +44 (0)141 434 1500 Fax + (00 141 434 1519 Emailicadts2004meetingmakerscouk

Conference on socialresponsibility

The Amsterdam Group (TAG) are organising aconference on Social Responsibility on the 17thSeptember at the Renaissance Hotel inBrussels The aim of the conference is topresent concrete actions undertaken by SocialAspects Organisations (SAOs) andstakeholders involved in the distribution of thealcoholic beverages to reduce the negativeimpact of alcohol consumption on individualsand society through

Education and information campaigns topromote sensible drinking in particular towardsyoung people

Responsible advertising and marketing ofalcoholic beverages by industry and retailers tocomply with the Recommendation on AlcoholDrinking by Children and Adolescents adoptedby the Commission in June 2001 For Detailsplease contact Carole Brigaudeau TheAmsterdam Group Rue Wiertz 5028 B - 1050Bruxelles T + 3224016166 F +3224016868 M + 32 (0) 486117199cbrigaudeauamsterdamgrouporg

7

8

Wine goes in at the mouth much to our delightthen trickles through other parts of the bodyLet us go then you and I to explore thetortuousness of the gastro-intestinal tract takingalong divers potables to observe their effects

Most GI adversities associated with drinkingbeverages containing alcohol come with excessand virtually all are caused by alcohol inparticular In some cases the effect of wine isdifferent from that of other drinksmdashwatch forthem The ineffable morning-after distressfollowing indiscretion is poorly understood andis transient but unpleasant consequences ofheavy drinking may be lasting and as severeas cancer

The all-too-common chief complaint of theoesophagus (gullet) is heartburn caused bywelling up of acid material from the stomachTwo major determinants of such acid reflux arethe quantity of acid secreted by the stomachand the propulsion of the stomach acid thewrong way upward into the oesophagus insteadof downward into the intestine Wine maystimulate heartburn it stimulates acid productionby the stomach Alcohol does not Here is arare example of an unfavourable effect of winersquosspecial attributes presumably polyphenolicantioxidants Alcohol however especially inheavy dose may relax the lower oesophagealvalve (sphincter) that is supposed to seal offthe oesophagus and disorder motility thereby

promoting reflux

Cirrhosis of the liver of any cause includingabuse of alcohol is often complicated byformation of oesophageal varices dilation ofveins of the lower oesophagus a distinct risk oflife-threatening haemorrhage The stomach isboth a key actor and a target in the life ofingested alcohol Alcohol dehydrogenase theenzyme that first metabolizes alcohol soneutralizing it is secreted by the gastric mucosathe lining of the stomach When ample alcoholslows the emptying of the stomach alcoholdehydrogenase has more time to attack thealcohol

Womenrsquos stomachs contain about 60 percentas much alcohol dehydrogenase as do menrsquoslikely the chief reason for the long-observedlesser tolerance of women for alcohol and therecommendation that their safe and healthyportion should be about half of menrsquos So whena couple share a bottle of wine at dinner heshould get two-thirds

Binge drinking of high-proof beverages may leadto acute gastritis inflammation of the stomachsometimes accompanied by haemorrhageWine and beer are innocent and may beprotective

The intestines large and small are not just inertpipes conveying food and the products ofdigestion to their fate Their linings activelysecrete digestive enzymes and absorb thenutrients made available by digestion Theirmuscular walls churn and propel the contentsto enhance the chemical reactions of digestionThe muscular motility of the intestine may bereduced in alcoholics thereby unpredictablyaltering function and allowing toxic bacterialovergrowth An odd converse has beenobserved recently in overweight mice whoseobesity slows intestinal motion The bacteria thatgrow to excess as a result produce alcohol andthese mice develop liver abnormalities similarto those of obese humans and to alcoholicsThe lesson may be that obesity and alcohol arecollaborators in causing liver diseasemdashtakeheed

Surprisingly light-drinking laboratory rats haveexhibited enhanced liver regeneration afterinjury compared to rats who abstained or whodrank more Heavy doses of alcohol may impairintestinal absorption of nutrients includingthiamin vitamin B12 amino acids (the building

blocks of proteins) perhaps calcium and zincleading to complex malnutrition

Iron absorption may increase with drinking notnecessarily harmless for excessive iron mayinjure the liver Excessive drinking often leadsto diarrhoea

That wine especially and other alcohol-containing beverages help prevent gastro-intestinal infections has been known for a verylong time Claret drunk in British army messesin India was held to be ldquoa sovereignpreventative against the prevalent cholerardquo justone of a number of similar observations hereand there over the years More recently andmore scientifically wine has been demonstratedto be an effective inhibitor of a trio of fearsomebacteria Escherichia coli Salmonella andShigella causes of ldquotravellerrsquos diarrhoeardquo andworse typhoid and related diseases andbacillary dysentery respectively Researcherssuspect that the operative benefactor is one ormore of winersquos polyphenols Wine and spiritsbut not beer consumed with raw oysterscontaminated with hepatitis A virus which entersvia the gastro-intestinal tract were associatedwith a reduced risk of infectionThe bacteriumHelicobacter pylori (Hpylori) looms much to theastonishment of the medical profession amalign superstar of the first magnitude It residesin the stomachs of those infected Who couldhave imagined that this organism causes muchof chronic gastritis a large majority of pepticulcers and a substantial proportion of cancersof the stomach H pylori is now being implicatedas a promoter of our most deadly diseaseatherosclerosis cause of heart attacks strokesand other catastrophes Drinking especially ofwine appears to help eliminate H pylori In adirect study less than one-third as manydrinkers as abstainers were infected

H pylori infection is also associated withreduced activity of alcohol dehydrogenase in thestomach After eradication of the infectionalcohol dehydrogenase normalizes within twomonths Alcohol is the only component of winethat has been clearly shown to increase the riskof some cancers and then only when abused

Chronic heavy drinking particularlyaccompanied by abuse of tobacco isassociated in the gastro-intestinal tract withincreased cancer risk in the mouth throatoesophagus and perhaps the upper stomach

WINE AND THE GASTROINTESTINAL TRACTBy Harvey E Finkel MD

9

Inconclusive reports have raised the questionof a slight increase in risk of cancer of thepancreas The data relating beer and spirits toa possible slight increase of risk of colorectaltumours are conflicting and confusing

Might moderate drinking protect against cancerEarly indications suggest the answer might beldquoyesrdquo A number of studies has demonstratedthat wine in particular possesses severalproperties that would tend to prevent or inhibitcancer no doubt through the actions of itsantioxidant compounds Epidemiologic researchhas revealed substantial reduction of risk ofcancers of the oesophagus and upper stomachand colon and rectum in wine drinkers ascompared to non-drinkers

In essence past experience and currentresearch indicate that abuse of alcohol risksdamaging the gastro-intestinal tract at severalpoints but moderate wine consumption risksonly a little heartburn while possibly leading tomajor health benefits not to mention gustatorypleasures

Whether wine is a poison a medicine or anourishment is a matter of dosage mdashParacelsus Harvey E Finkel MD is Clinical Professor of Medicineat Boston University Medical Centre and is a memberof AIMrsquos Social Scientific and Medical Council

a study by Dr Morten Gronbaek of the NationalInstitute of Public Health in Copenhagen hasfound that heavy drinkers (especially non-winedrinkers) significantly increase their risk ofcontracting rectal cancerThe findings are basedon a population study of over 29000 Danishmen and women aged between 23 and 95Cancers that originate in the colon and rectumare the fourth most commonly diagnosedcancers in the US and represent the second-leading cause of death from cancerApproximately one-third of the cases ofcolorectal cancer are actually cancers of therectum Gronbaek said Their weekly intake ofbeer wine and spirits was assessed as wereother factors likely to influence bowel cancerrisk such as how much they smoked weighedand took regular exercise Men were more likelythan women to be heavy drinkers and heavydrinkers were more likely to be smokers and toweigh more than light drinkers

During a monitoring period of almost 15 years411 cases of colon cancer and 202 cases ofrectal cancer were reported among thosestudied Alcohol seemed to have little influenceover the risk of colon cancer but there was aclear association between rectal cancer risk andthe amount of alcohol consumed Thosedrinking more than 41 units of alcohol a weekhad twice the risk of developing the disease as

non-drinkers But the type of alcohol consumedhad a significant bearing on rectal cancer riskThose who drank 14 or more units of beer orspirits a week were over 35 times as likely todevelop rectal cancer as non-drinkers Yet thosewho drank the same total amount of alcoholbut who included around a third or more of winein their intake were less than twice as likely todevelop the diseaseThe authors point out thatwine drinkers tended to be better educated andto take more exercise than beer or spiritdrinkers so there may be other healthier lifestylefactors at play There are no obvious reasonswhy alcohol should apparently be moredamaging to the rectum than the colon but thereasons why wine seems to exert its protectiveeffect most likely lie in resveratrol which is foundin both grapes and wine

Previous research indicates that this chemicaldamps down the cellular processes involved inthe promotion and growth of cancerous cellsThe lack of a relationship between alcoholdrinking and colon cancer risk is also somewhatof a mystery according to Gronbaek

ldquoThe tissue is rather similar in the two parts ofthe organ mdash colon and rectum mdash and one mightexpect the same mechanism in developing thediseaserdquo Gronbaek said However he addedthat previous studies have also found thatalcohol has an effect on the rectum but not thecolon SOURCE Gut 200352861-867

Alcohol colon and rectal cancer

The World Advertising Research Centre will beholding the eighth annual Alcoholic Drinksconference in central London on Tuesday 30th

September The conference will be chaired byNick Kendall Group Strategy Director BartleBogle Hegarty

This yearrsquos programme will concentrate inparticular on the urgency and importance ofsocial responsibility issues for the alcoholicdrinks industry With the UK Government in themiddle of developing a national alcohol harm-reduction strategy conducted by the PrimeMinisterrsquos own Strategy Unit and the Department

of Health self-regulation may give way to legalcontrols on the advertising of alcoholic drinksSpeakers include Rita Clifton ChairmanInterbrand Hamish Pringle Director GeneralIPAWendy Darlington Brand MarketingDirector Diageo Plc Jaspar Shelbourne GlobalCreative Director JWT Alan Mitchell JournalistMike Spurling Director The Informer A SpecialPanel on Social Responsibility features AndrewBrown The Advertising Association HughBurkitt The Marketing Society Leanne RileyScientist World Health Organisation JeanCoussins The Portman GroupHelmutWagner The Amsterdam Group Chris SearleExecutive Director Bacardi Martini

For details contact Sarah Miller World AdvertisingResearch Center Farm Road Henley-on-ThamesOxon RG9 1EJ Tel 0044 (0) 1491 418 646 Fax0044 (0) 1491 418 600 Mail sarah_millerwarccomWeb wwwwarccomconferences

30th Alcoholic Drinks 2003 - Conference Brewers of Europe 3rdBeer and health

symposiumThe Brewers of Europe are holding a conferenceon the benefits of moderate beer consumptionon the 15th October at the Residence PalaceBrussels

The event is chaired by professor Oliver Jamesof the University of Newcastle and includespresentations on alcohol and weight moderatedrinking and well being and nutritional aspects

For more information please visitwwwbrewersofeuropeorg or emailinfobrewersofeuropeorg

9

10

1Introduction

As part of cultural traditions and well balancedlifestyles wine beer and spirits consumption hasbeen a common staple in diets around the worldIn acknowledgement of such practices groupsof nutrition experts have included the moderateconsumption of alcohol as an optionalcomponent of various dietary guidelines andfood guides such as the Mediterranean AsianLatin American and Vegetarian Pyramids Herewe outline the key scientifically based nutritionmessages in these pyramids

The outlined alcohol-inclusive dietary pyramidsare part of an effort by Oldways Preservation ampExchange Trust a non- profit education groupthat is dedicated to preserving traditional eatingpatterns with the goal to improve consumerknowledge and diets around the world Oldwayshas prepared these concepts with prominentnutrition medical biomedical andcommunication experts from leading institutionssuch as the WHO Regional Office for Europeand the Harvard School of Public Health

Cardiovascular disease and cancer are leadingcauses of death in developed nations aroundthe world predominantly being associated withdiets high in animal fats With that emergingscientific consensus the Oldways pyramids allemphasize fruits vegetables cereals andpulses with litt le meat (animal fats)consumption These nutrition concepts alsoinclude wine beer and spirits which have shownto contribute to lower heart disease rates andimprove longevity

Accumulating scientific evidence suggests thatmoderate consumption of wine beer and spiritsdoes not pose a health risk to the vast majorityof consumers who choose to drink inmoderation AIMrsquos recommendations alsoemphasise that adults should enjoy alcoholbeverages in a sensible manner preferablyaround mealtimes or other responsible socialsettings Moderation is the key to a healthy dietand lifestyle and this is reflected in severaltraditional nutrition concepts

Consumers should follow moderation guidelinessuch as those in the Dietary Guidelines forAmericans which define moderation as up totwo drinks (12g) a day for men and up to onedrink a day for women further consumersshould avoid alcohol during pregnancy or when-ever it would put the individual or others at risk

To learn more about the US Dietary Guidelinesmessage on alcohol please visitwwwhealthgovdietaryguidelines and for otherauthoritative links on alcohol please also visitthe AIM links page on the gateway to sensibledrinking and health site via wwwaim-digestcom

Alcohol-Inclusive Nutrition

Concepts The

The lsquoEatwisersquo concept

The latest ldquoEat Wiserdquo Pyramid including ldquowinebeer and spirits in moderationrdquo as part of a dailybeverage recommendation was released atJanuaryrsquos 2003 Mediterranean Diet Conferencesponsored by Harvard School of Public Healthand Oldways Preservation amp Exchange TrustThis new pyramid is modelled on the originalMediterranean Diet Pyramid which initially onlyrecommended wine in moderation reflecting thecultural preference of the Mediterranean regionldquoThis Eat Wise Pyramid is a visual guide tohealthy living the Eat Wise wayrdquo theaccompanying text states ldquoIt shows thepartnership of a balanced diet plenty of waterregular physical activity and alcohol inmoderation that wise eaters know strengthenall their bodiesrsquo functionsrdquo An expert conferencediscussion emphasized the potential benefits forall three beverages Eat Wise Meal Ideasshopping tips and recipes are outlined in aspecial eating guide that can be ordered via theOldways website

Moderate Alcohol Intake as Part of a Healthy Diet and Lifestyle - A Look at Alcohol Inclusive Nutrition Concepts from Around the World by Elisabeth Holmgren

The Mediterranean Diet Pyramidwwwoldwaysptorgpyramidsmed

p_medhtml

The Mediterranean Diet Concept

Long known for its healthy lifestyles and thelongevity of its people the Mediterranean regionis also home of some of the most palatable andhealthy foods on earth Traditionally wine hasbeen included as an integral part of its mealsand cross-cultural studies have reportedsignificantly lower risk of heart disease inMediterranean regions where alcohol is a dailystaple of a healthy diet and lifestyle As thepreferred beverage in this region wine isspecified as an option on ldquoThe TraditionalHealthy Mediterranean Diet Pyramidrdquodeveloped by Oldways in cooperation withscientists from the WHO in Europe and fromthe Harvard School of Public Health Thistraditional diet is based on grains including ricepolenta bulgur and pasta as well as legumesand vegetables It also includes fruits cheesesyogurt and nuts along with the optional choiceof alcohol in moderation Olive oil is given itsown category as a major source of monounsaturated fat reflecting its importantprominence in the regionrsquos healthy cuisine Dailyphysical activity a factor contributing to healthin the Mediterranean region and elsewhere isalso included on this and all Oldways pyramids

11

The Asian Diet Concept

As Asian cuisine continues to become popularin diverse regions of the world characteristicsof Asian diets will continue to gain importanceIn Japan and China studies have found ratesfor heart disease and many types of cancer tobe lower than those in the United States andthe rest of the world The centuries-oldtraditional Asian diet of rice noodles vegetablesand fish is believed to be a significant contributorto the documented lower rates for chronicdisease in these populations The ldquoTraditionalhealthy Asian Diet Pyramidrdquo developed incooperation with scientists at Cornell Universityand the Harvard School of Public Healthincorporates these dietary patterns into thepyramid format Sake wine beer and otherbeverages with alcohol in moderation as wellas tea are included as part of the pyramidbecause studies have shown that theirconsumption may play an role in reducing heartdisease risk and overall mortality

The Asian Diet Pyramid

wwwoldwaysptorgpyramidsasianp_asianhtml

ldquoThe

The Latin American ConceptThe Traditional Healthy Latin American DietPyramidrdquo released in 1996 is based on thetraditional foods of Latin America Unlike theAmericanized versions that tend to be high insalt and fat this pyramid presents many healthyeating options It emphasizes daily consumptionof beans grains tubers and nuts along withfruits and vegetablesmdashstaples in most LatinAmerican and Caribbean regions Daily physicalactivity is integrated into the pyramid structurein recognition of the scientific consensus on theimportance of exercise in maintaining goodhealth Alcohol in moderation with meals isincluded as an option and as with other culturalpyramids meats sweets and eggs are at thevery top of the pyramid in the ldquooccasionallyrdquocategory to advocate a healthy and balancedlifestyle that can reduce the risk for several

common diseases

The Vegetarian Diet ConceptThe unique ldquoVegetarian Diet Pyramidrdquo releasedby Oldways at the end of 1997 serves as amodel for healthy eating with meals built aroundvegetables fruits whole grains and legumesThe pyramid also emphasizes daily physicalactivity water consumption and the option ofldquowine beer and other alcoholrdquo in moderationThe importance of this dietary conceptaccording to Oldways is that it reflects thegrowing number of vegetarians and

The Scientific Evidence

The nutritional and medical significance ofthe traditional Oldways Dietary Pyramidswas featured in ldquoMedical NewsPerspectivesrdquo of the Journal of the AmericanMedical Association in 2000 The authorhighlighted the importance of well-balancedand nutritious diets as a potential diseaseprevention measure that could beincreasingly conveyed by physicians andhealthcare providers to their patients Morerecently Greek and US scientists investigatedthe health effects of adherence to aMediterranean Diet reported in the New EnglandJournal of Medicine in 2003 ldquoGreater adherenceto the traditional Mediterranean diet isassociated with a significant reduction in totalmortalityrdquo Coinciding with these acknow-ledgements there is now a developing scientificconsensus that for many individuals moderatewine beer and spirits consumption is associated

acknowledges the nutritional and health benefitsof this type of diet For example the DietaryGuidelines for Americans have acknowledgedsuch a diet as able to meet RecommendedDietary Allowances (RDA) for nutrients Whilesome vegetarians are prohibited fromconsuming meat and alcohol for religiousreasons all alcohol beverages are included asa choice because of the potential risk reductionfor heart disease and its cultural role as anaccompaniment to vegetarian eating

The Latin American Diet Pyramidwwwoldwaysptorgpyramidslatin

p_latinhtml

The Vegetarian Diet Pyramidwwwoldwaysptorgpyramidsveg

p_veghtml

11

12

with a reduced risk of coronary heart diseaseand increased life expectancy which lead to theabove featured alcohol-inclusive nutritionconcepts

In 1997Sir Richard Doll Emeritis Professor ofMedicine at Oxfordoutlined in the BritishMedical Journal ldquomassiverdquo evidence for thepotential beneficial effect of alcohol in a reviewof the clinical data on alcohol and mortality Heconcluded that ldquothe consumption of small andmoderate amounts of alcoholrdquo leads to a one-third-risk reduction for vascular disease He alsoacknowledged a reduction in total mortality inmiddle-aged and elderly men and women whenthey consumed wine beer or spirits Morerecently world-renowned expert Dr ArthurKlatsky from the US outlined the overwhelmingscientific evidence in Scientific American DrKlatsky has published many research studieson alcohol and health in leading scientificjournals from the large-scale Kaiser Permanentecohort and in the recent article he wrote withrespect to the most appropriate advice to thepublic ldquoOn one hand mild to moderate drinkingseems better for heart health than abstinencefor select people On the other hand heavydrinking is clearly dangerousrdquo Merelyrecommending abstinence is inappropriatehealth advice to people such as established lightdrinkers at high risk of CHD and at low risk ofalcohol-related problemsmdashwhich describes alarge proportion of the populationrdquo Dr Klatskyalong with other experts from around the worldhas advocated that health professionals makecase-by-case evaluations based on individualand family histories They also emphasize thatthe public should be entrusted with all theinformation on use versus misuse of alcohol sothat they can make informed decisionsthemselves

Authoritative findings from cohortsinternationally lead research experts tofeature the option of moderation in eachtraditional Oldways Dietary Pyramid Manypeer-reviewed studies from Europe AsiaAustralia and the US have revealed potentialbenefits for moderately drinking adults inmulti-ethnic populations These studies findthat moderate drinkers especially consumersof 1-2 drinks (12g) daily may lower their risk ofheart disease significantly Studies reportingcertain health advantages for moderate drinkersinclude the Lyon Heart Study the CopenhagenCity Heart Study the Australian Dubbo Studyand the European Seven Country Study

The Oldways experts working with the HarvardSchool of Public Health specifically consideredfindings from the ongoing Physiciansrsquo HealthStudy and the Nursesrsquo Health Study Analyzingdata from 84000 women in the Nursesrsquo HealthStudy the effect of a combination of diet andlifestyle factors were assessed on the risk ofCHD Dr Meir Stampfer et al concludedrdquo In thispopulation of middle-aged women those whodid not smoke cigarettes were not overweightmaintained a healthful diet described aboveexercised moderately or vigorously for half anhour a day and consumed alcohol moderatelyhad an incidence of coronary events that wasmore than 80 lower than that in the rest of thepopulationrdquo At the same time based on aprospective study of more than 89000 men aspart of the Physiciansrsquo Health Study Harvardresearcher Dr Michael Gaziano et al concludedrdquoIn summary this study reveals the complexeffect of alcohol consumption on various chronicdiseases as reflected in the overall U-shapedrelationship between light-to-moderate alcoholconsumption and total mortality in menrdquoTheearlier results from the US governmentrsquos fundedNational Health and Nutrition ExaminationSurvey (NHANES) were also considered whichfound that the risk for CHD is reduced for bothmen and women who drink moderatelyPublished in 1997 in the American Journal ofEpidemiology it stated ldquoThis analysisconfirmed previous research showing thatabstainers are at a greater risk for CHD thanare most non abstainers and that a significantprotective effect may be demonstrated withsmall amounts of alcoholrdquo Along those linesresearch published in The New England Journalof Medicine from American Cancer Societyexperts concluded ldquoIn this middle-aged andelderly population moderate alcoholconsumption slightly reduced overall mortalityrdquo

At the same time there are continuingconcerns about alcohol consumption andbreast cancer and women arerecommended not to drink when pregnant in line with governmental and public healthpositions in the US Authoritative statementsfrom public health groups such as the AmericanHeart Association the National StrokeAssociation and the American DieteticAssociation acknowledge the scientific evidencepointing to potential benefits of moderation withrespect to coronary heart disease andemphasize ldquoIf you choose to drink do so inmoderationrdquo A balanced summary position is

reflected in the 1999 JAMA Patient Page onldquoBenefits and dangers of alcoholrdquo which defineslsquoModerate drinking as 1 or 2 drinks (12g) a dayfor men and 1 drink a day for women and thoseolder than 65rsquo These messages are embodiedin governmental positions in the US UKAustralia and Canada

The Oldways alcohol messages as reflectedin the pyramids are however especiallynotable in that they emphasize consumptionwith or around mealtime as research hasshown that these and related cultural normsfacilitate responsible drinking habits mayslow alcohol absorption and may counterpotential harmful effects of fatty foods Forexample Dr David Hanson author ofPreventing Alcohol Abuse Alcohol Culture andControl explains ldquoThe cross-cultural evidenceindicates that drinking abuse will be low in anygroup in which drinking customs values andsanctions are clearhellip and characterized byprescriptions for moderate drinking andproscriptions against immoderate drinkingrdquoFurthermore several biochemical studiesindicate that in addition to slowing down theabsorption process which keeps blood alcohollevels lower moderate consumption during oraround mealtime may have favourable effectson lipid profiles and atherogenesis One 1998study published in the American Journal ofClinical Nutrition suggested ldquoethanol mayreduce cardiovascular risk by modulatingvascular muscle growth during the postprandialperiodrdquo Research continues but it appears clearthat healthy dietary patterns are inverselyrelated with low rates of chronic diseases Thishas been specifically confirmed in the ongoingSeven Country Study which reported in 1999that animal-food groups were directly correlatedwith CHD mortality while vegetable-food groupsas well as fish and alcohol were inverselycorrelated

In summary in line with the developingscientific consensus public health andgovernmental positions the Oldwayspyramids stress moderation and underscorethe importance of an overall healthy mealand lifestyleConsumption is notrecommended for non-drinkers or thosewho may have any health contraindicationsand consumers are always advised toconsult with their healthcare providersFor selected references and authoritative statements onmoderate drinking and health please visit the Gateway toSensible Drinking and Health via wwwaim-digestcom

13

ORGANISATIONS INVOLVED IN ALCOHOL AFFAIRSUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOM

ALALALALALCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNWaterbridge House 32-36 Loman Street London SE10EETel (0207) 928 7377 Fax (0207) 928 4644Websitewww alcoholconcernorguk

ALALALALALCOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCATION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARCHCHCHCHCHCOUNCILCOUNCILCOUNCILCOUNCILCOUNCILAbell House John Islip Street London SW1P 4LH Tel(0207) 217 5276

ALALALALALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALTH RESEARTH RESEARTH RESEARTH RESEARTH RESEARCH CENTRECH CENTRECH CENTRECH CENTRECH CENTREUniversity of West of England Glenside CampusBlackberry Hill Stapleton Bristol BS16 1DD Tel(0131) 536 6192 Fax (0131) 5366215 E-mailmplantahrconetcouk

HEALHEALHEALHEALHEALTH EDUCATH EDUCATH EDUCATH EDUCATH EDUCATION ATION ATION ATION ATION AUTHORITYUTHORITYUTHORITYUTHORITYUTHORITYHamilton House Mabledon Place London WC1 9TXTel (020) 72985656 Fax (020) 77259031 Emailenquirieshpeorgukwebsite wwwhpeorguk and wwwwreckedcouk

THE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALCOHOLISMCOHOLISMCOHOLISMCOHOLISMCOHOLISM3 St Andrewrsquos Place London NW1 4LBTel (0207) 487 4445 Fax (0207) 9354479

THE PORTHE PORTHE PORTHE PORTHE PORTMAN GRTMAN GRTMAN GRTMAN GRTMAN GROUPOUPOUPOUPOUP7-10 Chandos Street Cavendish Square London W1G9DQTel 020 7907 3700 Fax 020 7907 3710wwwportman-grouporguk

ALALALALALCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOTLANDTLANDTLANDTLANDTLAND2nd Floor 166 Buchanan Street Glasgow G1 2NH Tel0141-572 6700 Fax 041-333 1606

BRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIATIONTIONTIONTIONTIONMarket Towers 1 Nine Elms LaneLondon SW8 5NQTel 020 7627 9191 Fax020 7627 9123E-mail jwitheridgebeerandpubcomWebsite wwwbeerandpubcom

EUREUREUREUREUROPEOPEOPEOPEOPE

ARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GROUPOUPOUPOUPOUPBrewersrsquo House 10 Grand Place B-1000 BrusselsBelgium Tel +32 2 511 49 87 Fax +32 2 511 32 59

CBMCCBMCCBMCCBMCCBMCCheacutee de la Hulpe 181 bte 20 B-1170 Bruxelles Tel(++322) 672 23 92 Fax (++322) 660 94 02Website wwwcbmcorg

FORFORFORFORFORUMUMUMUMUMLivornostraat 13 b 5 rue de Livourne ndash Brussel 1050Bruxelles BelgiumTel 32 2 539 36 64 Fax 32 2 537 81 56email forumtasteeducationskynetbe websitewwwforum-taste-educationcom

ENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTION13 Rue Monsigny 75002 Paris FranceTel 00-33-53-43-80-75E-mail enterprisewanadoofr

IREBIREBIREBIREBIREB19 avenue Trudaine 75009 ParisTel +33 (1) 48 74 82 19 Fax +33 (1) 48 78 17 56E-mail irebirebcom Website wwwirebcom

OIVOIVOIVOIVOIV18 rue drsquoAguesseau 75008 Paris FranceTel +33 (0) 1 44 94 80 94Fax +33 (0) 1 42 66 90 63E-mail oivoivintWebsite wwwoivint

STIVSTIVSTIVSTIVSTIVAAAAABenoordenhoutseweg 22-23 2596 BA The HagueTheNetherlands Tel +31 (0)70 314 2480 Fax +31(0) 70314 24 81 E-mail phoastivanl Website wwwstivanl

SCANDINSCANDINSCANDINSCANDINSCANDINAAAAAVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALALALALALALCOHOL BOCOHOL BOCOHOL BOCOHOL BOCOHOL BOARDARDARDARDARDVandvaeligrksvej 11 DK - 5690 TommerupTel 45 64 75 22 84 Fax 45 64 75 28 44E-mail smaborg Websitewwwsmaborg

DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE WEINWEINWEINWEINWEINAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHGutenbergplatz 3-5 55116 MainzTel +49 02641 977340 Fax +49 02641 977342Website wwwdeutscheweinakademiede

FIVINFIVINFIVINFIVINFIVINPlaza Penedeacutes 3 308720 Vilafranca del PenedeacutesBarcelona Spain Tel 0034 (93) 890 45 45 Fax 0034(93) 890 46 11

DIFDIFDIFDIFDIFA FORA FORA FORA FORA FORUM EVUM EVUM EVUM EVUM EVFranklinstrabe 1 10587 BerlinGermany Tel + 49 (0) 30 39 0633 60Fax +49 (0) 30 390 633 66 email infodifa-forumdeWebsite wwwdifa-forumde

GODGODGODGODGODAAAAAGode Alkoholdninger Kattesundet 9 DK-1458Koslashbenhavn K Denmark Tel 33 13 93 83Fax 33 13 03 84

FIVSFIVSFIVSFIVSFIVSInternational Federation of Wines amp Spirits20 rue drsquoAnjou - 75008 Paris Tel 33 1 42 68 82 48Fax 33 1 40 06 06 98

THE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDAM GRAM GRAM GRAM GRAM GROUPOUPOUPOUPOUPRue Wiertz 5028B-1050 Brussels BelgiumTel +32 2 401 61 35 Fax + 32 2 401 68 68 emailinfoamsterdamgrouporgwwwamsterdamgrouporg

FUNDFUNDFUNDFUNDFUNDAAAAACION ALCION ALCION ALCION ALCION ALCOHOL COHOL COHOL COHOL COHOL Y SOCIEDY SOCIEDY SOCIEDY SOCIEDY SOCIEDADADADADADDiego de Leon 442 ES 28006 MadridTel + 34 91 745 08 44 Fax + 34 91 561 8955wwwalcoholysociedadorg

USA CANUSA CANUSA CANUSA CANUSA CANADADADADADA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAAAAAAUSTRALIAUSTRALIAUSTRALIAUSTRALIAUSTRALIA

WINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICA1200 G Street NW Suite 360 Washington DC 20005Tel (800) 879 4637 Fax (202) 347 6341E-mail infoamericanwineriesorgWebsite wwwamericanwineriesorg

AMERICAN AMERICAN AMERICAN AMERICAN AMERICAN WINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARCHCHCHCHCHAND EDUCAAND EDUCAAND EDUCAAND EDUCAAND EDUCATIONTIONTIONTIONTIONVisit website at wwwalcohol-AWAREcom

AMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAND HEALAND HEALAND HEALAND HEALAND HEALTHTHTHTHTH1995 Broadway 2nd Floor New York NY 10023-5860Tel (212) 362-7044 Ext 234 Fax (212) 362-4919Email kavaacshorg Websitewwwacshorg

BEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTE122 C Street NW 750Washington DC 20001Tel(202) 737-2337 Fax (202) 737-7004E-mailinfobeerinstituteorgWebsite wwwbeerinstituteorg

PRPRPRPRPROOOOOYECTYECTYECTYECTYECTO CIENCIA O CIENCIA O CIENCIA O CIENCIA O CIENCIA VINO VINO VINO VINO VINO Y SALY SALY SALY SALY SALUDUDUDUDUDFacultad de ciencias BioloacutegicasCasilla 114 D Santiago ChileTelFax (56-23) 222 2577Email vinsaludgenesbiopuccl

EDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALCOOLCOOLCOOLCOOLCOOL606 Cathcart Suite 700 Montreacuteal Queacutebec H3B 1K9Canada Tel (514) 875-7454 E-mailhsacyeducalcoolqcca Website wwweducalcoolqcca

THE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERAGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTE1775Pennsylvania Avenue NW Suite 1200 WashingtonDC 20006 Tel 2024637110wwwamericanbeverageinstitutecom

FISAFISAFISAFISAFISACCCCC(Fundacion de Investigaciones Sociales AC) FranciscoSosa 230 coyoacan CP 04000 Mexico DF - Mexico

HEALHEALHEALHEALHEALTTTTTH EDUCAH EDUCAH EDUCAH EDUCAH EDUCATION FOUNDTION FOUNDTION FOUNDTION FOUNDTION FOUNDAAAAATIONTIONTIONTIONTION INC INC INC INC INC2600 Virginia Avenue NW Washington DC 20037Tel (202) 3383501 Fax (202) 9656520E-mail hefmonaerolscom

ICAPICAPICAPICAPICAPInternational Center for Alcohol Policies1519 New Hampshire Avenue NWWashington DC 20036Tel (202) 986-1159 Fax (202) 986-2080Website wwwicaporg

THE CENTURTHE CENTURTHE CENTURTHE CENTURTHE CENTURY COUNCILY COUNCILY COUNCILY COUNCILY COUNCIL1310 G Street NW Suite 600Washington DC 20005-3000 Tel (202) 637-0077 Fax(202) 637-0079 Email washdecenturycouncilorgWebsite wwwcenturycouncilorg

CALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIATION OF TION OF TION OF TION OF TION OF WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEGRGRGRGRGROOOOOWERS WERS WERS WERS WERS 601 University Avenue Suite 135 Sacramento CA 95825wwwcawgorg email karencawgorg

THE THE THE THE THE WINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTE425 Market Street Suite 1000 San Francisco CA94105 USA Tel (415) 512-0151 Fax (415) 442-0742

LLLLLODI -WODI -WODI -WODI -WODI -WOODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPECOMMISSIONCOMMISSIONCOMMISSIONCOMMISSIONCOMMISSION2545 West Turner Road Lodi CA 95242USAmarklodiwinecom website wwwlodiwinecom

THE NTHE NTHE NTHE NTHE NAPAPAPAPAPA A A A A VVVVVALLEY ALLEY ALLEY ALLEY ALLEY VINTNERSVINTNERSVINTNERSVINTNERSVINTNERSASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION Phone - 707-963-3388 Fax - 707-963-3488 Website wwwnapavintnerscom

OLDOLDOLDOLDOLDWWWWWAAAAAYYYYYS PRESERS PRESERS PRESERS PRESERS PRESERVVVVVAAAAATION amp EXTION amp EXTION amp EXTION amp EXTION amp EXCHANGECHANGECHANGECHANGECHANGETRTRTRTRTRUSTUSTUSTUSTUST266 Beacon Street Boston MA 02116 6174215500Fax 6174215511 website wwwoldwaysptorg

THE ATHE ATHE ATHE ATHE AUSTRALIAN USTRALIAN USTRALIAN USTRALIAN USTRALIAN WINE RESEARWINE RESEARWINE RESEARWINE RESEARWINE RESEARCHCHCHCHCHINSTITUTEINSTITUTEINSTITUTEINSTITUTEINSTITUTEP O Box 197 glen Osmond 5064 South AustraliaAustralia Tel 61 8 8303 6600 Fax 61 6 303 6601

13

3

Alarmed that Ireland has become one of thehardest-drinking countries in Europe the Irishgovernment announced at the end of May thatit plans to require health warnings on alcoholicdrinks and limit advertising of alcoholic drinksPrime Minister Bertie Ahern insisted in a speechto European brewers in Dublin that he believedyoung people were exposed to saturationmarketing of alcohol which he said was fuellinga the ldquodrink to get drunkrdquo culture Similarly theMinister for Justice Michael McDowell Speakingat the Progressive Democrats annualconference in Galway gave warning that tighterlegislation could be introduced to tackle theproblem of public drunkenness ldquoIt is alreadyillegal for publicans to allow people to becomedrunk on their premises and I am planning astricter enforcement of this lawrdquo he said

The government plans to ban alcohol ads frombusestrains cinemas and sporting eventsinvolving young people while no ads for beeror other alcoholic beverages would be permittedbefore 10 pm on Irish television currently suchads currently face few restrictions and Guinnesssponsors the national soccer squad andHeineken the rugby Currently more than 10000pubs serve a population of 38 million Healthwarnings on beer wine and liquor would requireapproval from the European Commission butAhern said he expected the EUrsquos support intackling what he called ldquoserious social problemsarising from greatly increased levels of alcoholabuserdquo Together the commitments representas significant a shift in official attitudes to Irishtraditions as the governmentrsquos recentcommitment to outlaw smoking in pubs

Anti-alcohol campaigners and Irelandrsquos majorpub owners association welcomed the movesas well as Ahernrsquos call for pubs to stop sellingsweet heavy-alcohol ldquoslammersrdquo andldquoalcopopsrdquo which appeal to novice drinkersldquoThese drinks encourage binge drinking amongyoung people which is fast becoming the curseof modern societyrdquo said Tadh OrsquoSullivan chiefexecutive of the Vintners Federation of Irelandwhich represents 6000 pubs - many of whichsell the drinksThe Irish have long beenstereotyped as heavy drinkers but past surveyshave suggested the reputation was undeservedand Ireland was actually one of Europersquos moremoderate drinking nations In the past decadehowever figures show that this has changedWorld Drinks Trends 2002 placed Irelandsecond only to Luxembourg in the EU in per-capita volume of alcohol consumed at 285

gallons of pure alcohol each year The USaverage was 177 gallonsThe surge coincideswith Irelandrsquos quick-changing fortunes in the1990s when it went from an economicbackwater of Europe with double-digitunemployment to a booming economy andtourism

The UK government is considering a newset of regulations for alcohol advertising

Following a series of ads that breached bothgood taste and the guidelines of the industryrsquosmarketing regulator the UK government isconsidering regulating all alcohol advertisingcurrent alcohol advertising attitudes will haveto change radically to avoid a clampdown itstates

It will be difficult for some alcohol manufacturersto deny that the government has a caseRecently some advertising agencies have beenpushing the limits of the law using the loopholeof creating very sexual adverts without an overtlink to the product While this may not be atechnical infringement it has alarmedconsumers as well as groups such as AlcoholConcern The government is also beginning totake notice and is proposing a new set ofregulations including banning alcohol advertsbefore 9 pm Currently the UK has some of themost liberal alcohol advertising laws in Europe

However the industry is keen to retain itspowers of self-regulation monitored by ThePortman Group which has shown that it isprepared to take strong action to discourage thecurrent trend Recently it ruled an alcopop fromFCUK unacceptable due to the brandrsquos strongfollowing among teenagers Similarly it hascondemned the release of the controversiallsquoRoxxoffrsquo a new alcopop containing aphrodisiacherbs and which is to be marketed as ldquocreatinga generation of randy superbeingsrdquo

News that 12 alcoholics from Scotland plan tosue drinks companies for failing to warn themadequately of the dangers of consuming alcoholhas further fuelled the debate ldquoAny litigationwould have to be based on whether or not theproduct causes harm and whether or not theproducer has a duty of care to customersrdquo saidRoss Harper their solicitors The case bringsnew exposure re health warnings on alcoholcontainers in the UK The British MedicalAssociation has repeatedly called for them tobe made mandatory

Alcohol sponsorship and advertising to beregulated in Ireland

The World Cancer Report was launched in Apriland provides a global overview of the trendsand developments in cancer incidence mortalityand causality It also sheds light on WHOrsquoscancer control strategies and on a variety ofprevention measures thought to be effectiveAlcohol consumption is identified as belongingto a series of causes of cancer The WorldCancer Report said ldquoThere is an increasingrecognition of the causative role of lifestylefactors including diet physical activity andalcohol consumptionrdquo

This report together with another IARCpublication ldquoNutrition and LifestyleOpportunities for Cancer Preventionrdquo and thejoint WHOFAO Expert Report on Diet ldquoNutritionand the Prevention of Chronic Diseaserdquocontribute to the general consultative processthat will culminate with the formulation of aGlobal Strategy on Diet Physical activity andhealth to be considered by the World Healthassembly in 2004

World cancer report

Direct Wine Shipmentbreak through in US

ldquoA 139-page report released by the FederalTrade Commission will forever change the termsof debate on the direct shipment issue and willhave an extraordinary impact on statelegislatures and the federal courts in the monthsaheadrdquo states WineAmerica President DavidSloaneldquoThis report makes clear that theinterstate shipment of wine is beneficial toconsumers that states can and are effectivelyregulating such sales and that the argumentsagainst direct shipment simply do not hold upunder scrutinyrdquo he continued ldquoWine consumersand wineries all over America should know thattheir voices have finally been heard on thisissue and that the federal agency charged withsafeguarding competition and protectingconsumers has firmly come down on our siderdquohe concluded

The report entitled ldquoPossible anti-competitiveBarriers to E-Commerce Winerdquo stems from apublic workshop held last October by the FTCwhich examined state barriers to e-commercefor a number of popular consumer productsincluding wineThe FTC press release can befound at httpwwwftcgovopa200307winehtm The full report via httpwwwftcgovos200307winereport2pdf

3

4

While some research suggests alcohol drinkershave a lower risk of Parkinsonrsquos disease thanabstainers a study published in May suggestsno clear association between drinking andParkinsonrsquos disease with the exception ofmoderate beer intake which might offer someprotection Because no alcohol other than beerwas tied to a lower Parkinsonrsquos risk researcherssuspect that a beer ingredient other than alcoholmight bestow the benefit Their report ispublished in the on-line edition of the Annals ofNeurology

Over the past few decades researchers havedebated whether cigarettes coffee and alcoholcan help stave off Parkinsonrsquos disease amovement disorder that arises from the loss ofbrain cells that produce the chemical dopamineSeveral recent studies have produced strongevidence that cigarette smokers and caffeineconsumers have some protection againstParkinsonrsquos and researchers believe itrsquosbiologically plausible that tobacco smoke andcaffeine might shield brain cells from thedamage that marks the disease But there isanother possibility Some scientists havesuggested that the absence of these addictivebehaviours-caffeine consumption smoking anddrinking might be a sign of a certain kind ofpersonality according to the authors of the newstudy led by Dr Miguel A Hernan of the HarvardSchool of Public Health in Boston ldquoIt has beenhypothesized that people who are destined todevelop Parkinsonrsquos disease have acharacteristic personality- moralistic law-abiding conscientious risk averse that leadsthem to avoid novelty seeking behaviours or that

they have an underlying metabolism (geneticor as a result of a toxic insult early in life) thatmakes these behaviours particularlyunrewarding to themrdquo the researchers explainIf this hypothesis is correct then drinkingsmoking and caffeine consumption should allappear to reduce the risk of developingParkinsonrsquos Dr Alberto Ascherio a study co-author also at Harvard commentsldquoOur resultdoes not support thatrdquo Ascherio said in aninterview ldquoIndirectlyrdquo he added ldquoit supports theidea that caffeine and something in cigarettesmoke is protectiverdquo Currently there areongoing studies to look at the effects of caffeinein people who already have ParkinsonrsquosAscherio noted

The researchers looked at data from two largelong-running US studies the Nursesrsquo Healthand the Health Professionalsrsquo Follow-upStudies After examining information from nearly89000 women and 47000 men theresearchers found ldquolittle association betweentotal alcohol consumption and Parkinsonrsquosdisease incidencerdquo according to the reportWhen they broke the data down into differenttypes of alcohol people who drank moderateamounts of beer showed a 30 lower risk ofParkinsonrsquos But the authors write ldquobecausethis lower risk was not found among wine orliquor drinkers it is possible that somecomponents of beer other than (alcohol) mayreduce the risk of Parkinsonrsquos diseaserdquo

SOURCE Annals of Neurology 200354Alcoholconsumption and the incidence of Parkinsonrsquos diseaseMiguel A Hernaacuten MD DrPH 1 et al Email Miguel A

Hernaacuten (miguel_hernanpostharvardedu)

No clear link between alcohol and Parkinsonrsquosdisease

People who drink one drink a day mdash wine beeror spirits mdash show significantly better elasticityof their bodyrsquos arteries an important measureof cardiovascular health results of a new studysuggest ldquoWe thought only red wine helps butwe found if people drink one beer or one unit ofhard liquor a day they also have improvedarterial elasticity better than nondrinkersrdquo saidDr Reuven Zimlichman of Wolfson MedicalCenter and Tel Aviv University in Israel Theresearch was presented via the AmericanSociety of Hypertension

When arteries lose elasticity they fail to relaxas the heart pumps blood This causes a rise inthe systolic blood pressure somethingZimlichman calls a ldquoterrible predictorrdquo of futurestrokes cardiovascular disease and heartattacks The researchers also found thatmoderate drinkers had pulse rates that weresignificantly lower than those of nondrinkersldquoTherersquos been lots of study of pulse rates andthe risk of diseaserdquo Zimlichman said He notedthat higher pulse rates are associated with anincreased risk of disease and death

In comparing wine drinkers with drinkers whofavour other alcoholic beverages theresearchers observed that beer and spiritsdrinkers had slightly higher blood pressure thanwine drinkers But all drinkers had bloodpressure within normal ranges The researchersstudied 243 healthy people between the agesof 15 and 80 who volunteered to fill outquestionnaires and be tested at clinics in sevenEuropean countries They excluded people whodrank more than one drink a day and adjustedtheir findings for age because arterial elasticitycommonly gets worse with age

When asked if this study means non drinkersshould start drinking Zimlichman pointed outthat heavy drinking itself can cause high bloodpressureldquoWhenever you recommend drinkingyou have to consider the possibility thatsomebody will like it too much and over-drinkand cause damage to his healthrdquo he said ldquoButif someone has a high risk of cardiovasculardisease I recommend to my patients that theydrink one glass of red wine a dayrdquo Although hisstudy showed similar benefits for beer and hardliquor as for wine

A drink a day improvesoverall heart health

The wine law passed by the Spanishgovernment in June encourages the activepromotion of wine as part of a healthy dietUnder the Ley del Vino - the biggest shake-upin wine laws since Franco - the Government willprovide funds for local and national informationcampaigns which should promote wine as anintegral part of a Mediterranean diet The lawmakes it clear that wine will be promoted asdistinct from any other alcoholic beverage andshould include recommendations forresponsible consumption Growers andproducers are encouraged to use environmentaland sustainable farming methods Funds areavailable for research and development projectsat a local and national level

The law has taken eight years to agree andsweeps away the pre-democracy laws of 1970allowing more flexibility for producers There aretwo new levels of DO at the top end aboveDOCa (Denominacion de Origen Calificada) isVinos de Pagos Then below DO is Vinos deCalidad con Indicacioacuten Geograacutefica or VCIG theequivalent of the Italian IGT or French VDQSConsejos Reguladores will still make the rulesbut a new autonomous body will be created topolice their application The Federacioacuten Espantildeoldel Vino has welcomed the new law lsquoA newphase opens for a struggling sector which willpermit it to compete with rivals operating in veryderegulated environments It is an importantadvance on the law of 1970rsquo

Spanish wine laws embodies promotion of wineas part of the Mediterranean diet

5

In a study on rats a coffee and alcoholcombination know as caffeinol given within 3hours of an artery supplying blood to the brainbeing blocked was shown to reduce damageby up to 80 It delivers the potency of 2 cupsof strong coffee and an alcoholic drink althoughneither caffeine nor alcohol were protective ontheir own Treating and looking after the 140000stroke victims a year costs the NHS in Britainan estimated pound23 billion The experimental drughas been shown to be safe in a pilot study ofpatients suffering from ischaemic stroke wherea clot blocks blood going into the brain and the

Coffee and alcohol for stroke victims

New research suggests that an overhaul ofdietary and fitness habits to help prevent orcontrol high blood pressure is feasible withproper coaching contrary to the theory that toomany changes would be overwhelming andineffective for most people The best results inthe study were achieved when weight loss saltrestriction and exercise were paired with theDASH (Dietary Approaches to StopHypertension) diet which is rich in fruitsvegetables and low fat dairy products

The results of the study conducted at DukeUniversity Medical Center Johns HopkinsPennington Biomedical Research Center andthe Center for Health Research were publishedin the April 23 2003 issue of the Journal of theAmerican Medical Association The study calledPREMIER is funded by the National HeartLung and Blood Institute

Current national recommendations for loweringblood pressure include weight loss reducedsodium intake increased physical activitylimited alcohol consumption and DASH diet TheDASH diet increases fruit vegetable and low-fat dairy consumption while limiting fats redmeat sweets and beverages containing sugarNo previous study has tested the ability ofpeople to adopt DASH on their own or itseffectiveness in the lsquorealrsquo world And no previousstudy has tested all the other recommendationsfor lowering blood pressure either with orwithout DASH as an ldquoall-in-onersquointervention

The PREMIER trial enrolled 810 generallyhealthy people with above-optimal bloodpressure including those with stage onehypertension (systolic BP140-159 mmHg andor diastolic BP 90-95 mmHg None of the

participants took medications for hypertensionThose in the ldquoAdvice Onlyrdquo group each met witha registered dietitian at the beginning of the trialto discuss recommendations for weight controlreduced sodium intake physical activity and theDASH diet for lowering blood pressure plusprinted educational materials

Participants in both the ldquoEstablishedrdquo andldquoEstablished Plus DASHrdquointervention groups setgoals to lose 15 pounds within six monthsincrease physical activity lower sodium intakeand limit alcohol to one or two drinks per dayThe Established Plus DASH group also setgoals to increase fruit vegetable and low-fatdairy intake and reduce saturated fat and totalfat The Established group was given noinstructions on the DASH diet During the initialsix months of the trial both groups metfrequently to reinforce behaviour modification

During the first six months of the trial allparticipants in both the Established andEstablished Plus DASH groups significantlylowered their blood pressures in comparison tothe Advice Only group The Established PlusDASH group had the lowest prevalence ofhypertension mdash cutting group membersrsquo risk ofdeveloping hypertension by 53 percentcompared to the Advice Only group ldquoAt sixmonths we had 19 participants in the AdviceOnly group who had to begin anti-hypertensivemedication to control their blood pressurescompared to only two in the Established Groupand five in the Established Plus DASH grouprdquosaid Svetkey ldquoAnd both behaviour modificationgroups had a significant number of theparticipants reach their optimum bloodpressurerdquoAll groups had an overall reduction

Diet and exercise are effective in controlling high blood pressurein weight In the Established Plus DASH group343 percent lost 15 pounds or more while inthe Established group 286 percent lost 15pounds or more The Advice Only group hadonly 62 percent lose 15 pounds or more Whenparticipants took a treadmill exercise test thetests showed fitness increased significantly inboth the Established and Established PlusDASH groups

Those on the DASH diet also benefited fromother potential benefits prevention ofosteoporosis from the high calcium contentprevention of some cancers from the high fruitand vegetable content and the prevention ofcardiovascular disease from the low fat contentrdquo

Although the results for the Advice Only groupwere not as striking as the other two this groupdid better in losing weight and decreasingsodium intake than expected Svetkey said thiscould be because motivated people usually signon to participate in clinical trials and mayproduce better results than could be expectedin the average population

The long-term goal of the study said Svetkey isto follow all the participants for an additional 12months (18 months total) to determine whetherthe participants can stick with the diet andexercise and monitor blood pressure controlThe next phase in this series of research willfocus on weight loss mdash specifically on how tohelp people lose weight and keep the weight offlong-term This new study which is also fundedby the National Institutes of Health beganenrolling participants in May 2003 The NHLBIpress release is available at wwwnhlbinihgovnewpress03-04-22htm

findings were reported in the Stroke Journal ofthe American Heart Association

In the study on humans lead by ProfessorJames Grotta a team at the University of Texasgave the treatment to 16 females and 17 malestroke victims with an average age of 71 Theaim of this study was to see if they could safelyachieve the same blood levels of caffeinol thatwere achieved in the animal studies ProfessorGrotta said ldquoWe discovered that we could useeven lower doses than we used in the animalstudies and achieve the blood levels that were

neuro-protective in animalsrdquo Caffeinol can besafely administered to patients also receivingtraditional lsquoclot-bustingrsquo drugs used to treatstrokesProfessor Grotta said a ldquorandomisedplacebo-controlled trialrdquo was needed todetermine the extent of caffeinolrsquos protectiveeffect in humans He is planning a studycombining caffeinol with thermo-cooling instroke patients Other studies have suggestedthat cooling the brain might limit stroke damage

Source wwwstrokeahajournalsorgcgicontentabstract01STR000006817080517B

5

6

Serve Wise (formerly known as SIPS) wasdeveloped with funding and guidance from theScottish Office and enjoys continued supportfrom the Scottish Executive to deal specificallywith underage drinking drinking and drivingcriminal incidents and deathsaccidents relatedto alcohol in Scotland ServeWise is managedby Alcohol Focus Scotland a charity operatingon a non-profit basis The importance ofadequate training for all staff is increasinglybeing recognised by licensed trade licensingboards and the police Many licensing boardsare now beginning to insist on training as aprerequisite for the granting or renewal of alicence

ServeWise aims to set a National Minimumstandard for all those involved in the sale ofalcohol In order to achieve this ServeWiseoffers short courses (approx 1 day or 2 halfdays) each covering licensing law alcohol andpeople skills This is on two levels -ServeWisePlus for managers licensees and experiencedstaff (covering the law in more depth andincludes issues relating to management) andServeWise for general staff Both the coursesare available in On and Off-Licence versionsAtpresent there are just over 40 Centresthroughout Scotland that can deliver ServeWisecourses located at colleges of further educationor training organizations or other types oforganisations (including solicitors) There aretwo pilot centres in the South The University ofCardiff in conjunction with the police-basedTASC project (Targeting alcohol-Related streetCrime) have held several courses and inManchester there is a multi-agency teamincluding the licensed trade the police andAlcohol and drug services Manchester whichhas just begun to run courses

Assisting in the setting up of the centres is theServeWise Central Office All trainers undertakea 2-day Trainer rsquos Course and receive theServeWise Trainerrsquos Manual (containing coursematerial instructions on delivery and a speciallydesigned video) All trainersrsquo are subject to ongoing verification and continuous professionaldevelopment requirements

ServeWise believes that the training must berelevant user-friendly as well as assessableand affordable and is confident that there willbe a reduction in the number of accidents andcrimes resulting from the misuse of alcohol onlicensed premises and consequently a lessening

in the amount particularly in the terms of policeand accident and emergency time A numberof l icensed trade organizations supportServeWise such as the Scottish Licensed TradeAssociation Diageo UK the BritishEntertainment and Dance Association theLeisure safety and Security Association

Advice and assistance is also offered byServeWise through its Advisory and WorkingGroups which include representatives from theScottish Executive the police solicitorslicensing boards the licensed trade as well asthose from trainingfurther educationperspective These groups also assistServeWise in organising other types of trainingand events including annual events for licensingboard members

lsquoTasterrsquo ServeWise courses for the licensingboard members can be provided where licensingboards wish to encourage training amongstlicensees and staff It is recommended that alsquoFit and Proper Personrsquo policy is set up includingtraining requirements Several Boards havegone on to develop policies after attending aServeWise taster event

Both ServeWise and Alcohol Focus Scotlandare still very much organisations in growth Fromlast year ServeWise has almost doubled itstraining numbers and Alcohol Focus Scotlandis undergoing considerable expansion withseveral newly created posts - including aGender Issues Network Officer (who for the next3 years will focus on women alcohol issues) aUser Support officer (to assist thoseexperiencing alcohol problems and to set up networks) and a NetWork support officer who willassist with communications and developmentof the network of affiliated organisationsprimarily the 30 Local Councils on Alcoholthroughout Scotland which provide counsellingand related services

ServeWise Central Office 166 Buchanan StreetGlasgowG1 2LW TEL 0141 572 6703Newsletters are produced by ServeWise andinformation can also be found on the Internetservewisealcohol-focus-scotlandorguk

Serve-wise and Alcohol Focus ScotlandIn October the Swedish Spirit amp Wine Suppliers(SSWS) will launch an initiative called DrinkwiseThe aim is to get the general public to considertheir alcohol behaviourFrom the beginning Drinkwise will consist of awebsite among other with an interactive partin which the visitor by answering questionsandclaims will be told what kind of alcoholconsumerhe or she is and the character of thistype ofconsumer SSWS concludes thatDrinkwise isone example of initiatives following thepublishing of a book financed by the PublicHealth Institute written by Sam Larsson at theKarolinska Institute in Stockholm and Johan Liljaat the Academy of Turku in Finland Theyconclude that it is better to teach young peoplehow to drink than to tell them not to drink at all -it is better to discuss with them how to behavewith alcoholThe authors also say that preventionprogrammes so far have been tooldquopropagandisticrdquo The non drinking message hasbeen repeated endlessly and has not beeneffective The alcohol policy target should be toget young people to use weak alcoholic drinksand to drink in moderation Maybe it is notrealistic to believe young people will abstain butthey ought to get a more conscious view onalcohol and drugs the authors say The bookhas been financed by the Public Health Institute

Drink-wise from Sweden

The drinks giant Diageo is planning to launcha campaign aimed at reducing the problem ofbinge-drinking in the UK

Diageo has asked its principal advertisingagencies J Walter Thompson Abbott MeadVickers BBDO Bartle Bogle Hegarty Motherand Miles Calcraft Briginshaw Duffy to pitch forthe campaign

In the light of the increase in binge-drinkingdrunkenness and alcohol-related violencepolitical support for further curbs on alcoholadvertising has been growing The industry bodywhich speaks on alcohol policy The PortmanGroup has called for companies to introducecampaigns promoting responsible consumptionThe UK government has called for consultationwith a wide range of groups including alcoholcompanies on how violence in and outside pubsmight be reduced

Diageo to target bingedrinking culture

7

The long established and well supported Proofof Age Card set up by the Portman Group hasbeen accepted into the British RetailConsortiumrsquos new Proof of Age StandardsScheme (PASS) As from June 2003 the newcard complete with hologram will be incirculation

PASS is an umbrella accreditation systemaudited by the Trading Standards Institute andany card that is presented and bears the PASSlogo has met the PASS standards and containsaccurate and reliable information This will helpretailers make an informed decision on whetherto allow a purchase The Portman Group hasrelaunched the card bearing the PASS hologramand Portman Group 18+ logo The Underage

Drinking and the illegal Purchase of AlcoholReport commissioned by the NicholsonCommittee shows that 84 of 15 year oldsplaced drinking of alcohol as a common placeactivity Of the young persons questioned 49currently purchased alcohol illegally 33 fromlicensed grocers 24 from off-licences andanother 24 from pubs or bars

Proof of age standards scheme (PASS)

The subject of numerous prospective and casecontrol studies has been the possible existenceof an independent effect of alcohol use in theaetiology of lung cancer As alcohol correlatesstrongly with smoking possible residualconfounding has been a particular concernResults of several prospective studies were notadjusted for smoking therefore hampering theirinterpretation This study by De Stefani ECorrea P and Deneo-Pellegrini H et al wasundertaken to examine in detail the relationshipbetween alcohol use and the risk ofadenocarcinoma of the lung

Between July 1998 and July 2000 all incidentsof lung adenocarcinoma that were admitted tothe 4 main hospitals in Montevideo Uruguaywere considered eligible for examining the rolesof diet drinking and smoking in the aetiology ofthis malignancy Subjects for the study were 160cases with newly diagnosed adenocarcinomaof the lung with 520 hospitalised controls with acondition unrelated to drinking or smokingInformation about socio-demographic variablesoccupational history smoking history drinkinghistory height and weight 5 years before theinterview menstrual and reproductive history

(women) and a food frequency form including64 food items were obtained by use of aquestionnaire during interview

Total alcohol use was not associated with riskof adenocarcinoma of the lung (OR 12 95CI 06-21) Beer consumption did not correlatewith adenocarcinoma risk (OR 06 95 CI 03-16) In contrast wine consumption showed amarginal protective effect (OR 04 95 02-11)while the use of spirits (predominantly canaderived from sugar cane and grappa derivedfrom grapes) was associated with a 40increase in risk of lung adenocarcinoma

The results of the study suggest that wineconsumption has a protective effect against thedevelopment of adenocarcinoma of the lungwhile spirits are a moderate risk factor for thiscell type of the lung cancer

Source De Stefani E Correa P Deneo-Pellegrini Het al Alcohol intake and risk of adenocarcinoma ofthe lung a case-control study Uruguay Lung Cancer38 (2002) 9-14

Wine may protect against adenocarcinoma of thelung

International Conferenceon Alcohol Drugs andTraffic Safety T 2004

In August 2004 many of the worldrsquos experts ondrugs and alcohol will gather in Glasgow for the17th International Conference on Alcohol Drugsand Traffic Safety

The Conference will explore developments innew policies and technologies to counteractalcohol and drugs problems in the context ofroad traffic safety In particular it will explorethe following key areas of Driver CharacteristicsPharmacology and Toxicology EpidemiologyRehabilitation Prevention Driving andPerformance Police Enforcement and WorkRelated Transport IssuesTo submit an abstract or register interest inthe conference please visit the conferencewebsite at wwwICADTS2004com Tel +44 (0)141 434 1500 Fax + (00 141 434 1519 Emailicadts2004meetingmakerscouk

Conference on socialresponsibility

The Amsterdam Group (TAG) are organising aconference on Social Responsibility on the 17thSeptember at the Renaissance Hotel inBrussels The aim of the conference is topresent concrete actions undertaken by SocialAspects Organisations (SAOs) andstakeholders involved in the distribution of thealcoholic beverages to reduce the negativeimpact of alcohol consumption on individualsand society through

Education and information campaigns topromote sensible drinking in particular towardsyoung people

Responsible advertising and marketing ofalcoholic beverages by industry and retailers tocomply with the Recommendation on AlcoholDrinking by Children and Adolescents adoptedby the Commission in June 2001 For Detailsplease contact Carole Brigaudeau TheAmsterdam Group Rue Wiertz 5028 B - 1050Bruxelles T + 3224016166 F +3224016868 M + 32 (0) 486117199cbrigaudeauamsterdamgrouporg

7

8

Wine goes in at the mouth much to our delightthen trickles through other parts of the bodyLet us go then you and I to explore thetortuousness of the gastro-intestinal tract takingalong divers potables to observe their effects

Most GI adversities associated with drinkingbeverages containing alcohol come with excessand virtually all are caused by alcohol inparticular In some cases the effect of wine isdifferent from that of other drinksmdashwatch forthem The ineffable morning-after distressfollowing indiscretion is poorly understood andis transient but unpleasant consequences ofheavy drinking may be lasting and as severeas cancer

The all-too-common chief complaint of theoesophagus (gullet) is heartburn caused bywelling up of acid material from the stomachTwo major determinants of such acid reflux arethe quantity of acid secreted by the stomachand the propulsion of the stomach acid thewrong way upward into the oesophagus insteadof downward into the intestine Wine maystimulate heartburn it stimulates acid productionby the stomach Alcohol does not Here is arare example of an unfavourable effect of winersquosspecial attributes presumably polyphenolicantioxidants Alcohol however especially inheavy dose may relax the lower oesophagealvalve (sphincter) that is supposed to seal offthe oesophagus and disorder motility thereby

promoting reflux

Cirrhosis of the liver of any cause includingabuse of alcohol is often complicated byformation of oesophageal varices dilation ofveins of the lower oesophagus a distinct risk oflife-threatening haemorrhage The stomach isboth a key actor and a target in the life ofingested alcohol Alcohol dehydrogenase theenzyme that first metabolizes alcohol soneutralizing it is secreted by the gastric mucosathe lining of the stomach When ample alcoholslows the emptying of the stomach alcoholdehydrogenase has more time to attack thealcohol

Womenrsquos stomachs contain about 60 percentas much alcohol dehydrogenase as do menrsquoslikely the chief reason for the long-observedlesser tolerance of women for alcohol and therecommendation that their safe and healthyportion should be about half of menrsquos So whena couple share a bottle of wine at dinner heshould get two-thirds

Binge drinking of high-proof beverages may leadto acute gastritis inflammation of the stomachsometimes accompanied by haemorrhageWine and beer are innocent and may beprotective

The intestines large and small are not just inertpipes conveying food and the products ofdigestion to their fate Their linings activelysecrete digestive enzymes and absorb thenutrients made available by digestion Theirmuscular walls churn and propel the contentsto enhance the chemical reactions of digestionThe muscular motility of the intestine may bereduced in alcoholics thereby unpredictablyaltering function and allowing toxic bacterialovergrowth An odd converse has beenobserved recently in overweight mice whoseobesity slows intestinal motion The bacteria thatgrow to excess as a result produce alcohol andthese mice develop liver abnormalities similarto those of obese humans and to alcoholicsThe lesson may be that obesity and alcohol arecollaborators in causing liver diseasemdashtakeheed

Surprisingly light-drinking laboratory rats haveexhibited enhanced liver regeneration afterinjury compared to rats who abstained or whodrank more Heavy doses of alcohol may impairintestinal absorption of nutrients includingthiamin vitamin B12 amino acids (the building

blocks of proteins) perhaps calcium and zincleading to complex malnutrition

Iron absorption may increase with drinking notnecessarily harmless for excessive iron mayinjure the liver Excessive drinking often leadsto diarrhoea

That wine especially and other alcohol-containing beverages help prevent gastro-intestinal infections has been known for a verylong time Claret drunk in British army messesin India was held to be ldquoa sovereignpreventative against the prevalent cholerardquo justone of a number of similar observations hereand there over the years More recently andmore scientifically wine has been demonstratedto be an effective inhibitor of a trio of fearsomebacteria Escherichia coli Salmonella andShigella causes of ldquotravellerrsquos diarrhoeardquo andworse typhoid and related diseases andbacillary dysentery respectively Researcherssuspect that the operative benefactor is one ormore of winersquos polyphenols Wine and spiritsbut not beer consumed with raw oysterscontaminated with hepatitis A virus which entersvia the gastro-intestinal tract were associatedwith a reduced risk of infectionThe bacteriumHelicobacter pylori (Hpylori) looms much to theastonishment of the medical profession amalign superstar of the first magnitude It residesin the stomachs of those infected Who couldhave imagined that this organism causes muchof chronic gastritis a large majority of pepticulcers and a substantial proportion of cancersof the stomach H pylori is now being implicatedas a promoter of our most deadly diseaseatherosclerosis cause of heart attacks strokesand other catastrophes Drinking especially ofwine appears to help eliminate H pylori In adirect study less than one-third as manydrinkers as abstainers were infected

H pylori infection is also associated withreduced activity of alcohol dehydrogenase in thestomach After eradication of the infectionalcohol dehydrogenase normalizes within twomonths Alcohol is the only component of winethat has been clearly shown to increase the riskof some cancers and then only when abused

Chronic heavy drinking particularlyaccompanied by abuse of tobacco isassociated in the gastro-intestinal tract withincreased cancer risk in the mouth throatoesophagus and perhaps the upper stomach

WINE AND THE GASTROINTESTINAL TRACTBy Harvey E Finkel MD

9

Inconclusive reports have raised the questionof a slight increase in risk of cancer of thepancreas The data relating beer and spirits toa possible slight increase of risk of colorectaltumours are conflicting and confusing

Might moderate drinking protect against cancerEarly indications suggest the answer might beldquoyesrdquo A number of studies has demonstratedthat wine in particular possesses severalproperties that would tend to prevent or inhibitcancer no doubt through the actions of itsantioxidant compounds Epidemiologic researchhas revealed substantial reduction of risk ofcancers of the oesophagus and upper stomachand colon and rectum in wine drinkers ascompared to non-drinkers

In essence past experience and currentresearch indicate that abuse of alcohol risksdamaging the gastro-intestinal tract at severalpoints but moderate wine consumption risksonly a little heartburn while possibly leading tomajor health benefits not to mention gustatorypleasures

Whether wine is a poison a medicine or anourishment is a matter of dosage mdashParacelsus Harvey E Finkel MD is Clinical Professor of Medicineat Boston University Medical Centre and is a memberof AIMrsquos Social Scientific and Medical Council

a study by Dr Morten Gronbaek of the NationalInstitute of Public Health in Copenhagen hasfound that heavy drinkers (especially non-winedrinkers) significantly increase their risk ofcontracting rectal cancerThe findings are basedon a population study of over 29000 Danishmen and women aged between 23 and 95Cancers that originate in the colon and rectumare the fourth most commonly diagnosedcancers in the US and represent the second-leading cause of death from cancerApproximately one-third of the cases ofcolorectal cancer are actually cancers of therectum Gronbaek said Their weekly intake ofbeer wine and spirits was assessed as wereother factors likely to influence bowel cancerrisk such as how much they smoked weighedand took regular exercise Men were more likelythan women to be heavy drinkers and heavydrinkers were more likely to be smokers and toweigh more than light drinkers

During a monitoring period of almost 15 years411 cases of colon cancer and 202 cases ofrectal cancer were reported among thosestudied Alcohol seemed to have little influenceover the risk of colon cancer but there was aclear association between rectal cancer risk andthe amount of alcohol consumed Thosedrinking more than 41 units of alcohol a weekhad twice the risk of developing the disease as

non-drinkers But the type of alcohol consumedhad a significant bearing on rectal cancer riskThose who drank 14 or more units of beer orspirits a week were over 35 times as likely todevelop rectal cancer as non-drinkers Yet thosewho drank the same total amount of alcoholbut who included around a third or more of winein their intake were less than twice as likely todevelop the diseaseThe authors point out thatwine drinkers tended to be better educated andto take more exercise than beer or spiritdrinkers so there may be other healthier lifestylefactors at play There are no obvious reasonswhy alcohol should apparently be moredamaging to the rectum than the colon but thereasons why wine seems to exert its protectiveeffect most likely lie in resveratrol which is foundin both grapes and wine

Previous research indicates that this chemicaldamps down the cellular processes involved inthe promotion and growth of cancerous cellsThe lack of a relationship between alcoholdrinking and colon cancer risk is also somewhatof a mystery according to Gronbaek

ldquoThe tissue is rather similar in the two parts ofthe organ mdash colon and rectum mdash and one mightexpect the same mechanism in developing thediseaserdquo Gronbaek said However he addedthat previous studies have also found thatalcohol has an effect on the rectum but not thecolon SOURCE Gut 200352861-867

Alcohol colon and rectal cancer

The World Advertising Research Centre will beholding the eighth annual Alcoholic Drinksconference in central London on Tuesday 30th

September The conference will be chaired byNick Kendall Group Strategy Director BartleBogle Hegarty

This yearrsquos programme will concentrate inparticular on the urgency and importance ofsocial responsibility issues for the alcoholicdrinks industry With the UK Government in themiddle of developing a national alcohol harm-reduction strategy conducted by the PrimeMinisterrsquos own Strategy Unit and the Department

of Health self-regulation may give way to legalcontrols on the advertising of alcoholic drinksSpeakers include Rita Clifton ChairmanInterbrand Hamish Pringle Director GeneralIPAWendy Darlington Brand MarketingDirector Diageo Plc Jaspar Shelbourne GlobalCreative Director JWT Alan Mitchell JournalistMike Spurling Director The Informer A SpecialPanel on Social Responsibility features AndrewBrown The Advertising Association HughBurkitt The Marketing Society Leanne RileyScientist World Health Organisation JeanCoussins The Portman GroupHelmutWagner The Amsterdam Group Chris SearleExecutive Director Bacardi Martini

For details contact Sarah Miller World AdvertisingResearch Center Farm Road Henley-on-ThamesOxon RG9 1EJ Tel 0044 (0) 1491 418 646 Fax0044 (0) 1491 418 600 Mail sarah_millerwarccomWeb wwwwarccomconferences

30th Alcoholic Drinks 2003 - Conference Brewers of Europe 3rdBeer and health

symposiumThe Brewers of Europe are holding a conferenceon the benefits of moderate beer consumptionon the 15th October at the Residence PalaceBrussels

The event is chaired by professor Oliver Jamesof the University of Newcastle and includespresentations on alcohol and weight moderatedrinking and well being and nutritional aspects

For more information please visitwwwbrewersofeuropeorg or emailinfobrewersofeuropeorg

9

10

1Introduction

As part of cultural traditions and well balancedlifestyles wine beer and spirits consumption hasbeen a common staple in diets around the worldIn acknowledgement of such practices groupsof nutrition experts have included the moderateconsumption of alcohol as an optionalcomponent of various dietary guidelines andfood guides such as the Mediterranean AsianLatin American and Vegetarian Pyramids Herewe outline the key scientifically based nutritionmessages in these pyramids

The outlined alcohol-inclusive dietary pyramidsare part of an effort by Oldways Preservation ampExchange Trust a non- profit education groupthat is dedicated to preserving traditional eatingpatterns with the goal to improve consumerknowledge and diets around the world Oldwayshas prepared these concepts with prominentnutrition medical biomedical andcommunication experts from leading institutionssuch as the WHO Regional Office for Europeand the Harvard School of Public Health

Cardiovascular disease and cancer are leadingcauses of death in developed nations aroundthe world predominantly being associated withdiets high in animal fats With that emergingscientific consensus the Oldways pyramids allemphasize fruits vegetables cereals andpulses with litt le meat (animal fats)consumption These nutrition concepts alsoinclude wine beer and spirits which have shownto contribute to lower heart disease rates andimprove longevity

Accumulating scientific evidence suggests thatmoderate consumption of wine beer and spiritsdoes not pose a health risk to the vast majorityof consumers who choose to drink inmoderation AIMrsquos recommendations alsoemphasise that adults should enjoy alcoholbeverages in a sensible manner preferablyaround mealtimes or other responsible socialsettings Moderation is the key to a healthy dietand lifestyle and this is reflected in severaltraditional nutrition concepts

Consumers should follow moderation guidelinessuch as those in the Dietary Guidelines forAmericans which define moderation as up totwo drinks (12g) a day for men and up to onedrink a day for women further consumersshould avoid alcohol during pregnancy or when-ever it would put the individual or others at risk

To learn more about the US Dietary Guidelinesmessage on alcohol please visitwwwhealthgovdietaryguidelines and for otherauthoritative links on alcohol please also visitthe AIM links page on the gateway to sensibledrinking and health site via wwwaim-digestcom

Alcohol-Inclusive Nutrition

Concepts The

The lsquoEatwisersquo concept

The latest ldquoEat Wiserdquo Pyramid including ldquowinebeer and spirits in moderationrdquo as part of a dailybeverage recommendation was released atJanuaryrsquos 2003 Mediterranean Diet Conferencesponsored by Harvard School of Public Healthand Oldways Preservation amp Exchange TrustThis new pyramid is modelled on the originalMediterranean Diet Pyramid which initially onlyrecommended wine in moderation reflecting thecultural preference of the Mediterranean regionldquoThis Eat Wise Pyramid is a visual guide tohealthy living the Eat Wise wayrdquo theaccompanying text states ldquoIt shows thepartnership of a balanced diet plenty of waterregular physical activity and alcohol inmoderation that wise eaters know strengthenall their bodiesrsquo functionsrdquo An expert conferencediscussion emphasized the potential benefits forall three beverages Eat Wise Meal Ideasshopping tips and recipes are outlined in aspecial eating guide that can be ordered via theOldways website

Moderate Alcohol Intake as Part of a Healthy Diet and Lifestyle - A Look at Alcohol Inclusive Nutrition Concepts from Around the World by Elisabeth Holmgren

The Mediterranean Diet Pyramidwwwoldwaysptorgpyramidsmed

p_medhtml

The Mediterranean Diet Concept

Long known for its healthy lifestyles and thelongevity of its people the Mediterranean regionis also home of some of the most palatable andhealthy foods on earth Traditionally wine hasbeen included as an integral part of its mealsand cross-cultural studies have reportedsignificantly lower risk of heart disease inMediterranean regions where alcohol is a dailystaple of a healthy diet and lifestyle As thepreferred beverage in this region wine isspecified as an option on ldquoThe TraditionalHealthy Mediterranean Diet Pyramidrdquodeveloped by Oldways in cooperation withscientists from the WHO in Europe and fromthe Harvard School of Public Health Thistraditional diet is based on grains including ricepolenta bulgur and pasta as well as legumesand vegetables It also includes fruits cheesesyogurt and nuts along with the optional choiceof alcohol in moderation Olive oil is given itsown category as a major source of monounsaturated fat reflecting its importantprominence in the regionrsquos healthy cuisine Dailyphysical activity a factor contributing to healthin the Mediterranean region and elsewhere isalso included on this and all Oldways pyramids

11

The Asian Diet Concept

As Asian cuisine continues to become popularin diverse regions of the world characteristicsof Asian diets will continue to gain importanceIn Japan and China studies have found ratesfor heart disease and many types of cancer tobe lower than those in the United States andthe rest of the world The centuries-oldtraditional Asian diet of rice noodles vegetablesand fish is believed to be a significant contributorto the documented lower rates for chronicdisease in these populations The ldquoTraditionalhealthy Asian Diet Pyramidrdquo developed incooperation with scientists at Cornell Universityand the Harvard School of Public Healthincorporates these dietary patterns into thepyramid format Sake wine beer and otherbeverages with alcohol in moderation as wellas tea are included as part of the pyramidbecause studies have shown that theirconsumption may play an role in reducing heartdisease risk and overall mortality

The Asian Diet Pyramid

wwwoldwaysptorgpyramidsasianp_asianhtml

ldquoThe

The Latin American ConceptThe Traditional Healthy Latin American DietPyramidrdquo released in 1996 is based on thetraditional foods of Latin America Unlike theAmericanized versions that tend to be high insalt and fat this pyramid presents many healthyeating options It emphasizes daily consumptionof beans grains tubers and nuts along withfruits and vegetablesmdashstaples in most LatinAmerican and Caribbean regions Daily physicalactivity is integrated into the pyramid structurein recognition of the scientific consensus on theimportance of exercise in maintaining goodhealth Alcohol in moderation with meals isincluded as an option and as with other culturalpyramids meats sweets and eggs are at thevery top of the pyramid in the ldquooccasionallyrdquocategory to advocate a healthy and balancedlifestyle that can reduce the risk for several

common diseases

The Vegetarian Diet ConceptThe unique ldquoVegetarian Diet Pyramidrdquo releasedby Oldways at the end of 1997 serves as amodel for healthy eating with meals built aroundvegetables fruits whole grains and legumesThe pyramid also emphasizes daily physicalactivity water consumption and the option ofldquowine beer and other alcoholrdquo in moderationThe importance of this dietary conceptaccording to Oldways is that it reflects thegrowing number of vegetarians and

The Scientific Evidence

The nutritional and medical significance ofthe traditional Oldways Dietary Pyramidswas featured in ldquoMedical NewsPerspectivesrdquo of the Journal of the AmericanMedical Association in 2000 The authorhighlighted the importance of well-balancedand nutritious diets as a potential diseaseprevention measure that could beincreasingly conveyed by physicians andhealthcare providers to their patients Morerecently Greek and US scientists investigatedthe health effects of adherence to aMediterranean Diet reported in the New EnglandJournal of Medicine in 2003 ldquoGreater adherenceto the traditional Mediterranean diet isassociated with a significant reduction in totalmortalityrdquo Coinciding with these acknow-ledgements there is now a developing scientificconsensus that for many individuals moderatewine beer and spirits consumption is associated

acknowledges the nutritional and health benefitsof this type of diet For example the DietaryGuidelines for Americans have acknowledgedsuch a diet as able to meet RecommendedDietary Allowances (RDA) for nutrients Whilesome vegetarians are prohibited fromconsuming meat and alcohol for religiousreasons all alcohol beverages are included asa choice because of the potential risk reductionfor heart disease and its cultural role as anaccompaniment to vegetarian eating

The Latin American Diet Pyramidwwwoldwaysptorgpyramidslatin

p_latinhtml

The Vegetarian Diet Pyramidwwwoldwaysptorgpyramidsveg

p_veghtml

11

12

with a reduced risk of coronary heart diseaseand increased life expectancy which lead to theabove featured alcohol-inclusive nutritionconcepts

In 1997Sir Richard Doll Emeritis Professor ofMedicine at Oxfordoutlined in the BritishMedical Journal ldquomassiverdquo evidence for thepotential beneficial effect of alcohol in a reviewof the clinical data on alcohol and mortality Heconcluded that ldquothe consumption of small andmoderate amounts of alcoholrdquo leads to a one-third-risk reduction for vascular disease He alsoacknowledged a reduction in total mortality inmiddle-aged and elderly men and women whenthey consumed wine beer or spirits Morerecently world-renowned expert Dr ArthurKlatsky from the US outlined the overwhelmingscientific evidence in Scientific American DrKlatsky has published many research studieson alcohol and health in leading scientificjournals from the large-scale Kaiser Permanentecohort and in the recent article he wrote withrespect to the most appropriate advice to thepublic ldquoOn one hand mild to moderate drinkingseems better for heart health than abstinencefor select people On the other hand heavydrinking is clearly dangerousrdquo Merelyrecommending abstinence is inappropriatehealth advice to people such as established lightdrinkers at high risk of CHD and at low risk ofalcohol-related problemsmdashwhich describes alarge proportion of the populationrdquo Dr Klatskyalong with other experts from around the worldhas advocated that health professionals makecase-by-case evaluations based on individualand family histories They also emphasize thatthe public should be entrusted with all theinformation on use versus misuse of alcohol sothat they can make informed decisionsthemselves

Authoritative findings from cohortsinternationally lead research experts tofeature the option of moderation in eachtraditional Oldways Dietary Pyramid Manypeer-reviewed studies from Europe AsiaAustralia and the US have revealed potentialbenefits for moderately drinking adults inmulti-ethnic populations These studies findthat moderate drinkers especially consumersof 1-2 drinks (12g) daily may lower their risk ofheart disease significantly Studies reportingcertain health advantages for moderate drinkersinclude the Lyon Heart Study the CopenhagenCity Heart Study the Australian Dubbo Studyand the European Seven Country Study

The Oldways experts working with the HarvardSchool of Public Health specifically consideredfindings from the ongoing Physiciansrsquo HealthStudy and the Nursesrsquo Health Study Analyzingdata from 84000 women in the Nursesrsquo HealthStudy the effect of a combination of diet andlifestyle factors were assessed on the risk ofCHD Dr Meir Stampfer et al concludedrdquo In thispopulation of middle-aged women those whodid not smoke cigarettes were not overweightmaintained a healthful diet described aboveexercised moderately or vigorously for half anhour a day and consumed alcohol moderatelyhad an incidence of coronary events that wasmore than 80 lower than that in the rest of thepopulationrdquo At the same time based on aprospective study of more than 89000 men aspart of the Physiciansrsquo Health Study Harvardresearcher Dr Michael Gaziano et al concludedrdquoIn summary this study reveals the complexeffect of alcohol consumption on various chronicdiseases as reflected in the overall U-shapedrelationship between light-to-moderate alcoholconsumption and total mortality in menrdquoTheearlier results from the US governmentrsquos fundedNational Health and Nutrition ExaminationSurvey (NHANES) were also considered whichfound that the risk for CHD is reduced for bothmen and women who drink moderatelyPublished in 1997 in the American Journal ofEpidemiology it stated ldquoThis analysisconfirmed previous research showing thatabstainers are at a greater risk for CHD thanare most non abstainers and that a significantprotective effect may be demonstrated withsmall amounts of alcoholrdquo Along those linesresearch published in The New England Journalof Medicine from American Cancer Societyexperts concluded ldquoIn this middle-aged andelderly population moderate alcoholconsumption slightly reduced overall mortalityrdquo

At the same time there are continuingconcerns about alcohol consumption andbreast cancer and women arerecommended not to drink when pregnant in line with governmental and public healthpositions in the US Authoritative statementsfrom public health groups such as the AmericanHeart Association the National StrokeAssociation and the American DieteticAssociation acknowledge the scientific evidencepointing to potential benefits of moderation withrespect to coronary heart disease andemphasize ldquoIf you choose to drink do so inmoderationrdquo A balanced summary position is

reflected in the 1999 JAMA Patient Page onldquoBenefits and dangers of alcoholrdquo which defineslsquoModerate drinking as 1 or 2 drinks (12g) a dayfor men and 1 drink a day for women and thoseolder than 65rsquo These messages are embodiedin governmental positions in the US UKAustralia and Canada

The Oldways alcohol messages as reflectedin the pyramids are however especiallynotable in that they emphasize consumptionwith or around mealtime as research hasshown that these and related cultural normsfacilitate responsible drinking habits mayslow alcohol absorption and may counterpotential harmful effects of fatty foods Forexample Dr David Hanson author ofPreventing Alcohol Abuse Alcohol Culture andControl explains ldquoThe cross-cultural evidenceindicates that drinking abuse will be low in anygroup in which drinking customs values andsanctions are clearhellip and characterized byprescriptions for moderate drinking andproscriptions against immoderate drinkingrdquoFurthermore several biochemical studiesindicate that in addition to slowing down theabsorption process which keeps blood alcohollevels lower moderate consumption during oraround mealtime may have favourable effectson lipid profiles and atherogenesis One 1998study published in the American Journal ofClinical Nutrition suggested ldquoethanol mayreduce cardiovascular risk by modulatingvascular muscle growth during the postprandialperiodrdquo Research continues but it appears clearthat healthy dietary patterns are inverselyrelated with low rates of chronic diseases Thishas been specifically confirmed in the ongoingSeven Country Study which reported in 1999that animal-food groups were directly correlatedwith CHD mortality while vegetable-food groupsas well as fish and alcohol were inverselycorrelated

In summary in line with the developingscientific consensus public health andgovernmental positions the Oldwayspyramids stress moderation and underscorethe importance of an overall healthy mealand lifestyleConsumption is notrecommended for non-drinkers or thosewho may have any health contraindicationsand consumers are always advised toconsult with their healthcare providersFor selected references and authoritative statements onmoderate drinking and health please visit the Gateway toSensible Drinking and Health via wwwaim-digestcom

13

ORGANISATIONS INVOLVED IN ALCOHOL AFFAIRSUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOM

ALALALALALCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNWaterbridge House 32-36 Loman Street London SE10EETel (0207) 928 7377 Fax (0207) 928 4644Websitewww alcoholconcernorguk

ALALALALALCOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCATION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARCHCHCHCHCHCOUNCILCOUNCILCOUNCILCOUNCILCOUNCILAbell House John Islip Street London SW1P 4LH Tel(0207) 217 5276

ALALALALALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALTH RESEARTH RESEARTH RESEARTH RESEARTH RESEARCH CENTRECH CENTRECH CENTRECH CENTRECH CENTREUniversity of West of England Glenside CampusBlackberry Hill Stapleton Bristol BS16 1DD Tel(0131) 536 6192 Fax (0131) 5366215 E-mailmplantahrconetcouk

HEALHEALHEALHEALHEALTH EDUCATH EDUCATH EDUCATH EDUCATH EDUCATION ATION ATION ATION ATION AUTHORITYUTHORITYUTHORITYUTHORITYUTHORITYHamilton House Mabledon Place London WC1 9TXTel (020) 72985656 Fax (020) 77259031 Emailenquirieshpeorgukwebsite wwwhpeorguk and wwwwreckedcouk

THE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALCOHOLISMCOHOLISMCOHOLISMCOHOLISMCOHOLISM3 St Andrewrsquos Place London NW1 4LBTel (0207) 487 4445 Fax (0207) 9354479

THE PORTHE PORTHE PORTHE PORTHE PORTMAN GRTMAN GRTMAN GRTMAN GRTMAN GROUPOUPOUPOUPOUP7-10 Chandos Street Cavendish Square London W1G9DQTel 020 7907 3700 Fax 020 7907 3710wwwportman-grouporguk

ALALALALALCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOTLANDTLANDTLANDTLANDTLAND2nd Floor 166 Buchanan Street Glasgow G1 2NH Tel0141-572 6700 Fax 041-333 1606

BRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIATIONTIONTIONTIONTIONMarket Towers 1 Nine Elms LaneLondon SW8 5NQTel 020 7627 9191 Fax020 7627 9123E-mail jwitheridgebeerandpubcomWebsite wwwbeerandpubcom

EUREUREUREUREUROPEOPEOPEOPEOPE

ARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GROUPOUPOUPOUPOUPBrewersrsquo House 10 Grand Place B-1000 BrusselsBelgium Tel +32 2 511 49 87 Fax +32 2 511 32 59

CBMCCBMCCBMCCBMCCBMCCheacutee de la Hulpe 181 bte 20 B-1170 Bruxelles Tel(++322) 672 23 92 Fax (++322) 660 94 02Website wwwcbmcorg

FORFORFORFORFORUMUMUMUMUMLivornostraat 13 b 5 rue de Livourne ndash Brussel 1050Bruxelles BelgiumTel 32 2 539 36 64 Fax 32 2 537 81 56email forumtasteeducationskynetbe websitewwwforum-taste-educationcom

ENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTION13 Rue Monsigny 75002 Paris FranceTel 00-33-53-43-80-75E-mail enterprisewanadoofr

IREBIREBIREBIREBIREB19 avenue Trudaine 75009 ParisTel +33 (1) 48 74 82 19 Fax +33 (1) 48 78 17 56E-mail irebirebcom Website wwwirebcom

OIVOIVOIVOIVOIV18 rue drsquoAguesseau 75008 Paris FranceTel +33 (0) 1 44 94 80 94Fax +33 (0) 1 42 66 90 63E-mail oivoivintWebsite wwwoivint

STIVSTIVSTIVSTIVSTIVAAAAABenoordenhoutseweg 22-23 2596 BA The HagueTheNetherlands Tel +31 (0)70 314 2480 Fax +31(0) 70314 24 81 E-mail phoastivanl Website wwwstivanl

SCANDINSCANDINSCANDINSCANDINSCANDINAAAAAVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALALALALALALCOHOL BOCOHOL BOCOHOL BOCOHOL BOCOHOL BOARDARDARDARDARDVandvaeligrksvej 11 DK - 5690 TommerupTel 45 64 75 22 84 Fax 45 64 75 28 44E-mail smaborg Websitewwwsmaborg

DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE WEINWEINWEINWEINWEINAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHGutenbergplatz 3-5 55116 MainzTel +49 02641 977340 Fax +49 02641 977342Website wwwdeutscheweinakademiede

FIVINFIVINFIVINFIVINFIVINPlaza Penedeacutes 3 308720 Vilafranca del PenedeacutesBarcelona Spain Tel 0034 (93) 890 45 45 Fax 0034(93) 890 46 11

DIFDIFDIFDIFDIFA FORA FORA FORA FORA FORUM EVUM EVUM EVUM EVUM EVFranklinstrabe 1 10587 BerlinGermany Tel + 49 (0) 30 39 0633 60Fax +49 (0) 30 390 633 66 email infodifa-forumdeWebsite wwwdifa-forumde

GODGODGODGODGODAAAAAGode Alkoholdninger Kattesundet 9 DK-1458Koslashbenhavn K Denmark Tel 33 13 93 83Fax 33 13 03 84

FIVSFIVSFIVSFIVSFIVSInternational Federation of Wines amp Spirits20 rue drsquoAnjou - 75008 Paris Tel 33 1 42 68 82 48Fax 33 1 40 06 06 98

THE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDAM GRAM GRAM GRAM GRAM GROUPOUPOUPOUPOUPRue Wiertz 5028B-1050 Brussels BelgiumTel +32 2 401 61 35 Fax + 32 2 401 68 68 emailinfoamsterdamgrouporgwwwamsterdamgrouporg

FUNDFUNDFUNDFUNDFUNDAAAAACION ALCION ALCION ALCION ALCION ALCOHOL COHOL COHOL COHOL COHOL Y SOCIEDY SOCIEDY SOCIEDY SOCIEDY SOCIEDADADADADADDiego de Leon 442 ES 28006 MadridTel + 34 91 745 08 44 Fax + 34 91 561 8955wwwalcoholysociedadorg

USA CANUSA CANUSA CANUSA CANUSA CANADADADADADA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAAAAAAUSTRALIAUSTRALIAUSTRALIAUSTRALIAUSTRALIA

WINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICA1200 G Street NW Suite 360 Washington DC 20005Tel (800) 879 4637 Fax (202) 347 6341E-mail infoamericanwineriesorgWebsite wwwamericanwineriesorg

AMERICAN AMERICAN AMERICAN AMERICAN AMERICAN WINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARCHCHCHCHCHAND EDUCAAND EDUCAAND EDUCAAND EDUCAAND EDUCATIONTIONTIONTIONTIONVisit website at wwwalcohol-AWAREcom

AMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAND HEALAND HEALAND HEALAND HEALAND HEALTHTHTHTHTH1995 Broadway 2nd Floor New York NY 10023-5860Tel (212) 362-7044 Ext 234 Fax (212) 362-4919Email kavaacshorg Websitewwwacshorg

BEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTE122 C Street NW 750Washington DC 20001Tel(202) 737-2337 Fax (202) 737-7004E-mailinfobeerinstituteorgWebsite wwwbeerinstituteorg

PRPRPRPRPROOOOOYECTYECTYECTYECTYECTO CIENCIA O CIENCIA O CIENCIA O CIENCIA O CIENCIA VINO VINO VINO VINO VINO Y SALY SALY SALY SALY SALUDUDUDUDUDFacultad de ciencias BioloacutegicasCasilla 114 D Santiago ChileTelFax (56-23) 222 2577Email vinsaludgenesbiopuccl

EDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALCOOLCOOLCOOLCOOLCOOL606 Cathcart Suite 700 Montreacuteal Queacutebec H3B 1K9Canada Tel (514) 875-7454 E-mailhsacyeducalcoolqcca Website wwweducalcoolqcca

THE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERAGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTE1775Pennsylvania Avenue NW Suite 1200 WashingtonDC 20006 Tel 2024637110wwwamericanbeverageinstitutecom

FISAFISAFISAFISAFISACCCCC(Fundacion de Investigaciones Sociales AC) FranciscoSosa 230 coyoacan CP 04000 Mexico DF - Mexico

HEALHEALHEALHEALHEALTTTTTH EDUCAH EDUCAH EDUCAH EDUCAH EDUCATION FOUNDTION FOUNDTION FOUNDTION FOUNDTION FOUNDAAAAATIONTIONTIONTIONTION INC INC INC INC INC2600 Virginia Avenue NW Washington DC 20037Tel (202) 3383501 Fax (202) 9656520E-mail hefmonaerolscom

ICAPICAPICAPICAPICAPInternational Center for Alcohol Policies1519 New Hampshire Avenue NWWashington DC 20036Tel (202) 986-1159 Fax (202) 986-2080Website wwwicaporg

THE CENTURTHE CENTURTHE CENTURTHE CENTURTHE CENTURY COUNCILY COUNCILY COUNCILY COUNCILY COUNCIL1310 G Street NW Suite 600Washington DC 20005-3000 Tel (202) 637-0077 Fax(202) 637-0079 Email washdecenturycouncilorgWebsite wwwcenturycouncilorg

CALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIATION OF TION OF TION OF TION OF TION OF WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEGRGRGRGRGROOOOOWERS WERS WERS WERS WERS 601 University Avenue Suite 135 Sacramento CA 95825wwwcawgorg email karencawgorg

THE THE THE THE THE WINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTE425 Market Street Suite 1000 San Francisco CA94105 USA Tel (415) 512-0151 Fax (415) 442-0742

LLLLLODI -WODI -WODI -WODI -WODI -WOODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPECOMMISSIONCOMMISSIONCOMMISSIONCOMMISSIONCOMMISSION2545 West Turner Road Lodi CA 95242USAmarklodiwinecom website wwwlodiwinecom

THE NTHE NTHE NTHE NTHE NAPAPAPAPAPA A A A A VVVVVALLEY ALLEY ALLEY ALLEY ALLEY VINTNERSVINTNERSVINTNERSVINTNERSVINTNERSASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION Phone - 707-963-3388 Fax - 707-963-3488 Website wwwnapavintnerscom

OLDOLDOLDOLDOLDWWWWWAAAAAYYYYYS PRESERS PRESERS PRESERS PRESERS PRESERVVVVVAAAAATION amp EXTION amp EXTION amp EXTION amp EXTION amp EXCHANGECHANGECHANGECHANGECHANGETRTRTRTRTRUSTUSTUSTUSTUST266 Beacon Street Boston MA 02116 6174215500Fax 6174215511 website wwwoldwaysptorg

THE ATHE ATHE ATHE ATHE AUSTRALIAN USTRALIAN USTRALIAN USTRALIAN USTRALIAN WINE RESEARWINE RESEARWINE RESEARWINE RESEARWINE RESEARCHCHCHCHCHINSTITUTEINSTITUTEINSTITUTEINSTITUTEINSTITUTEP O Box 197 glen Osmond 5064 South AustraliaAustralia Tel 61 8 8303 6600 Fax 61 6 303 6601

13

4

While some research suggests alcohol drinkershave a lower risk of Parkinsonrsquos disease thanabstainers a study published in May suggestsno clear association between drinking andParkinsonrsquos disease with the exception ofmoderate beer intake which might offer someprotection Because no alcohol other than beerwas tied to a lower Parkinsonrsquos risk researcherssuspect that a beer ingredient other than alcoholmight bestow the benefit Their report ispublished in the on-line edition of the Annals ofNeurology

Over the past few decades researchers havedebated whether cigarettes coffee and alcoholcan help stave off Parkinsonrsquos disease amovement disorder that arises from the loss ofbrain cells that produce the chemical dopamineSeveral recent studies have produced strongevidence that cigarette smokers and caffeineconsumers have some protection againstParkinsonrsquos and researchers believe itrsquosbiologically plausible that tobacco smoke andcaffeine might shield brain cells from thedamage that marks the disease But there isanother possibility Some scientists havesuggested that the absence of these addictivebehaviours-caffeine consumption smoking anddrinking might be a sign of a certain kind ofpersonality according to the authors of the newstudy led by Dr Miguel A Hernan of the HarvardSchool of Public Health in Boston ldquoIt has beenhypothesized that people who are destined todevelop Parkinsonrsquos disease have acharacteristic personality- moralistic law-abiding conscientious risk averse that leadsthem to avoid novelty seeking behaviours or that

they have an underlying metabolism (geneticor as a result of a toxic insult early in life) thatmakes these behaviours particularlyunrewarding to themrdquo the researchers explainIf this hypothesis is correct then drinkingsmoking and caffeine consumption should allappear to reduce the risk of developingParkinsonrsquos Dr Alberto Ascherio a study co-author also at Harvard commentsldquoOur resultdoes not support thatrdquo Ascherio said in aninterview ldquoIndirectlyrdquo he added ldquoit supports theidea that caffeine and something in cigarettesmoke is protectiverdquo Currently there areongoing studies to look at the effects of caffeinein people who already have ParkinsonrsquosAscherio noted

The researchers looked at data from two largelong-running US studies the Nursesrsquo Healthand the Health Professionalsrsquo Follow-upStudies After examining information from nearly89000 women and 47000 men theresearchers found ldquolittle association betweentotal alcohol consumption and Parkinsonrsquosdisease incidencerdquo according to the reportWhen they broke the data down into differenttypes of alcohol people who drank moderateamounts of beer showed a 30 lower risk ofParkinsonrsquos But the authors write ldquobecausethis lower risk was not found among wine orliquor drinkers it is possible that somecomponents of beer other than (alcohol) mayreduce the risk of Parkinsonrsquos diseaserdquo

SOURCE Annals of Neurology 200354Alcoholconsumption and the incidence of Parkinsonrsquos diseaseMiguel A Hernaacuten MD DrPH 1 et al Email Miguel A

Hernaacuten (miguel_hernanpostharvardedu)

No clear link between alcohol and Parkinsonrsquosdisease

People who drink one drink a day mdash wine beeror spirits mdash show significantly better elasticityof their bodyrsquos arteries an important measureof cardiovascular health results of a new studysuggest ldquoWe thought only red wine helps butwe found if people drink one beer or one unit ofhard liquor a day they also have improvedarterial elasticity better than nondrinkersrdquo saidDr Reuven Zimlichman of Wolfson MedicalCenter and Tel Aviv University in Israel Theresearch was presented via the AmericanSociety of Hypertension

When arteries lose elasticity they fail to relaxas the heart pumps blood This causes a rise inthe systolic blood pressure somethingZimlichman calls a ldquoterrible predictorrdquo of futurestrokes cardiovascular disease and heartattacks The researchers also found thatmoderate drinkers had pulse rates that weresignificantly lower than those of nondrinkersldquoTherersquos been lots of study of pulse rates andthe risk of diseaserdquo Zimlichman said He notedthat higher pulse rates are associated with anincreased risk of disease and death

In comparing wine drinkers with drinkers whofavour other alcoholic beverages theresearchers observed that beer and spiritsdrinkers had slightly higher blood pressure thanwine drinkers But all drinkers had bloodpressure within normal ranges The researchersstudied 243 healthy people between the agesof 15 and 80 who volunteered to fill outquestionnaires and be tested at clinics in sevenEuropean countries They excluded people whodrank more than one drink a day and adjustedtheir findings for age because arterial elasticitycommonly gets worse with age

When asked if this study means non drinkersshould start drinking Zimlichman pointed outthat heavy drinking itself can cause high bloodpressureldquoWhenever you recommend drinkingyou have to consider the possibility thatsomebody will like it too much and over-drinkand cause damage to his healthrdquo he said ldquoButif someone has a high risk of cardiovasculardisease I recommend to my patients that theydrink one glass of red wine a dayrdquo Although hisstudy showed similar benefits for beer and hardliquor as for wine

A drink a day improvesoverall heart health

The wine law passed by the Spanishgovernment in June encourages the activepromotion of wine as part of a healthy dietUnder the Ley del Vino - the biggest shake-upin wine laws since Franco - the Government willprovide funds for local and national informationcampaigns which should promote wine as anintegral part of a Mediterranean diet The lawmakes it clear that wine will be promoted asdistinct from any other alcoholic beverage andshould include recommendations forresponsible consumption Growers andproducers are encouraged to use environmentaland sustainable farming methods Funds areavailable for research and development projectsat a local and national level

The law has taken eight years to agree andsweeps away the pre-democracy laws of 1970allowing more flexibility for producers There aretwo new levels of DO at the top end aboveDOCa (Denominacion de Origen Calificada) isVinos de Pagos Then below DO is Vinos deCalidad con Indicacioacuten Geograacutefica or VCIG theequivalent of the Italian IGT or French VDQSConsejos Reguladores will still make the rulesbut a new autonomous body will be created topolice their application The Federacioacuten Espantildeoldel Vino has welcomed the new law lsquoA newphase opens for a struggling sector which willpermit it to compete with rivals operating in veryderegulated environments It is an importantadvance on the law of 1970rsquo

Spanish wine laws embodies promotion of wineas part of the Mediterranean diet

5

In a study on rats a coffee and alcoholcombination know as caffeinol given within 3hours of an artery supplying blood to the brainbeing blocked was shown to reduce damageby up to 80 It delivers the potency of 2 cupsof strong coffee and an alcoholic drink althoughneither caffeine nor alcohol were protective ontheir own Treating and looking after the 140000stroke victims a year costs the NHS in Britainan estimated pound23 billion The experimental drughas been shown to be safe in a pilot study ofpatients suffering from ischaemic stroke wherea clot blocks blood going into the brain and the

Coffee and alcohol for stroke victims

New research suggests that an overhaul ofdietary and fitness habits to help prevent orcontrol high blood pressure is feasible withproper coaching contrary to the theory that toomany changes would be overwhelming andineffective for most people The best results inthe study were achieved when weight loss saltrestriction and exercise were paired with theDASH (Dietary Approaches to StopHypertension) diet which is rich in fruitsvegetables and low fat dairy products

The results of the study conducted at DukeUniversity Medical Center Johns HopkinsPennington Biomedical Research Center andthe Center for Health Research were publishedin the April 23 2003 issue of the Journal of theAmerican Medical Association The study calledPREMIER is funded by the National HeartLung and Blood Institute

Current national recommendations for loweringblood pressure include weight loss reducedsodium intake increased physical activitylimited alcohol consumption and DASH diet TheDASH diet increases fruit vegetable and low-fat dairy consumption while limiting fats redmeat sweets and beverages containing sugarNo previous study has tested the ability ofpeople to adopt DASH on their own or itseffectiveness in the lsquorealrsquo world And no previousstudy has tested all the other recommendationsfor lowering blood pressure either with orwithout DASH as an ldquoall-in-onersquointervention

The PREMIER trial enrolled 810 generallyhealthy people with above-optimal bloodpressure including those with stage onehypertension (systolic BP140-159 mmHg andor diastolic BP 90-95 mmHg None of the

participants took medications for hypertensionThose in the ldquoAdvice Onlyrdquo group each met witha registered dietitian at the beginning of the trialto discuss recommendations for weight controlreduced sodium intake physical activity and theDASH diet for lowering blood pressure plusprinted educational materials

Participants in both the ldquoEstablishedrdquo andldquoEstablished Plus DASHrdquointervention groups setgoals to lose 15 pounds within six monthsincrease physical activity lower sodium intakeand limit alcohol to one or two drinks per dayThe Established Plus DASH group also setgoals to increase fruit vegetable and low-fatdairy intake and reduce saturated fat and totalfat The Established group was given noinstructions on the DASH diet During the initialsix months of the trial both groups metfrequently to reinforce behaviour modification

During the first six months of the trial allparticipants in both the Established andEstablished Plus DASH groups significantlylowered their blood pressures in comparison tothe Advice Only group The Established PlusDASH group had the lowest prevalence ofhypertension mdash cutting group membersrsquo risk ofdeveloping hypertension by 53 percentcompared to the Advice Only group ldquoAt sixmonths we had 19 participants in the AdviceOnly group who had to begin anti-hypertensivemedication to control their blood pressurescompared to only two in the Established Groupand five in the Established Plus DASH grouprdquosaid Svetkey ldquoAnd both behaviour modificationgroups had a significant number of theparticipants reach their optimum bloodpressurerdquoAll groups had an overall reduction

Diet and exercise are effective in controlling high blood pressurein weight In the Established Plus DASH group343 percent lost 15 pounds or more while inthe Established group 286 percent lost 15pounds or more The Advice Only group hadonly 62 percent lose 15 pounds or more Whenparticipants took a treadmill exercise test thetests showed fitness increased significantly inboth the Established and Established PlusDASH groups

Those on the DASH diet also benefited fromother potential benefits prevention ofosteoporosis from the high calcium contentprevention of some cancers from the high fruitand vegetable content and the prevention ofcardiovascular disease from the low fat contentrdquo

Although the results for the Advice Only groupwere not as striking as the other two this groupdid better in losing weight and decreasingsodium intake than expected Svetkey said thiscould be because motivated people usually signon to participate in clinical trials and mayproduce better results than could be expectedin the average population

The long-term goal of the study said Svetkey isto follow all the participants for an additional 12months (18 months total) to determine whetherthe participants can stick with the diet andexercise and monitor blood pressure controlThe next phase in this series of research willfocus on weight loss mdash specifically on how tohelp people lose weight and keep the weight offlong-term This new study which is also fundedby the National Institutes of Health beganenrolling participants in May 2003 The NHLBIpress release is available at wwwnhlbinihgovnewpress03-04-22htm

findings were reported in the Stroke Journal ofthe American Heart Association

In the study on humans lead by ProfessorJames Grotta a team at the University of Texasgave the treatment to 16 females and 17 malestroke victims with an average age of 71 Theaim of this study was to see if they could safelyachieve the same blood levels of caffeinol thatwere achieved in the animal studies ProfessorGrotta said ldquoWe discovered that we could useeven lower doses than we used in the animalstudies and achieve the blood levels that were

neuro-protective in animalsrdquo Caffeinol can besafely administered to patients also receivingtraditional lsquoclot-bustingrsquo drugs used to treatstrokesProfessor Grotta said a ldquorandomisedplacebo-controlled trialrdquo was needed todetermine the extent of caffeinolrsquos protectiveeffect in humans He is planning a studycombining caffeinol with thermo-cooling instroke patients Other studies have suggestedthat cooling the brain might limit stroke damage

Source wwwstrokeahajournalsorgcgicontentabstract01STR000006817080517B

5

6

Serve Wise (formerly known as SIPS) wasdeveloped with funding and guidance from theScottish Office and enjoys continued supportfrom the Scottish Executive to deal specificallywith underage drinking drinking and drivingcriminal incidents and deathsaccidents relatedto alcohol in Scotland ServeWise is managedby Alcohol Focus Scotland a charity operatingon a non-profit basis The importance ofadequate training for all staff is increasinglybeing recognised by licensed trade licensingboards and the police Many licensing boardsare now beginning to insist on training as aprerequisite for the granting or renewal of alicence

ServeWise aims to set a National Minimumstandard for all those involved in the sale ofalcohol In order to achieve this ServeWiseoffers short courses (approx 1 day or 2 halfdays) each covering licensing law alcohol andpeople skills This is on two levels -ServeWisePlus for managers licensees and experiencedstaff (covering the law in more depth andincludes issues relating to management) andServeWise for general staff Both the coursesare available in On and Off-Licence versionsAtpresent there are just over 40 Centresthroughout Scotland that can deliver ServeWisecourses located at colleges of further educationor training organizations or other types oforganisations (including solicitors) There aretwo pilot centres in the South The University ofCardiff in conjunction with the police-basedTASC project (Targeting alcohol-Related streetCrime) have held several courses and inManchester there is a multi-agency teamincluding the licensed trade the police andAlcohol and drug services Manchester whichhas just begun to run courses

Assisting in the setting up of the centres is theServeWise Central Office All trainers undertakea 2-day Trainer rsquos Course and receive theServeWise Trainerrsquos Manual (containing coursematerial instructions on delivery and a speciallydesigned video) All trainersrsquo are subject to ongoing verification and continuous professionaldevelopment requirements

ServeWise believes that the training must berelevant user-friendly as well as assessableand affordable and is confident that there willbe a reduction in the number of accidents andcrimes resulting from the misuse of alcohol onlicensed premises and consequently a lessening

in the amount particularly in the terms of policeand accident and emergency time A numberof l icensed trade organizations supportServeWise such as the Scottish Licensed TradeAssociation Diageo UK the BritishEntertainment and Dance Association theLeisure safety and Security Association

Advice and assistance is also offered byServeWise through its Advisory and WorkingGroups which include representatives from theScottish Executive the police solicitorslicensing boards the licensed trade as well asthose from trainingfurther educationperspective These groups also assistServeWise in organising other types of trainingand events including annual events for licensingboard members

lsquoTasterrsquo ServeWise courses for the licensingboard members can be provided where licensingboards wish to encourage training amongstlicensees and staff It is recommended that alsquoFit and Proper Personrsquo policy is set up includingtraining requirements Several Boards havegone on to develop policies after attending aServeWise taster event

Both ServeWise and Alcohol Focus Scotlandare still very much organisations in growth Fromlast year ServeWise has almost doubled itstraining numbers and Alcohol Focus Scotlandis undergoing considerable expansion withseveral newly created posts - including aGender Issues Network Officer (who for the next3 years will focus on women alcohol issues) aUser Support officer (to assist thoseexperiencing alcohol problems and to set up networks) and a NetWork support officer who willassist with communications and developmentof the network of affiliated organisationsprimarily the 30 Local Councils on Alcoholthroughout Scotland which provide counsellingand related services

ServeWise Central Office 166 Buchanan StreetGlasgowG1 2LW TEL 0141 572 6703Newsletters are produced by ServeWise andinformation can also be found on the Internetservewisealcohol-focus-scotlandorguk

Serve-wise and Alcohol Focus ScotlandIn October the Swedish Spirit amp Wine Suppliers(SSWS) will launch an initiative called DrinkwiseThe aim is to get the general public to considertheir alcohol behaviourFrom the beginning Drinkwise will consist of awebsite among other with an interactive partin which the visitor by answering questionsandclaims will be told what kind of alcoholconsumerhe or she is and the character of thistype ofconsumer SSWS concludes thatDrinkwise isone example of initiatives following thepublishing of a book financed by the PublicHealth Institute written by Sam Larsson at theKarolinska Institute in Stockholm and Johan Liljaat the Academy of Turku in Finland Theyconclude that it is better to teach young peoplehow to drink than to tell them not to drink at all -it is better to discuss with them how to behavewith alcoholThe authors also say that preventionprogrammes so far have been tooldquopropagandisticrdquo The non drinking message hasbeen repeated endlessly and has not beeneffective The alcohol policy target should be toget young people to use weak alcoholic drinksand to drink in moderation Maybe it is notrealistic to believe young people will abstain butthey ought to get a more conscious view onalcohol and drugs the authors say The bookhas been financed by the Public Health Institute

Drink-wise from Sweden

The drinks giant Diageo is planning to launcha campaign aimed at reducing the problem ofbinge-drinking in the UK

Diageo has asked its principal advertisingagencies J Walter Thompson Abbott MeadVickers BBDO Bartle Bogle Hegarty Motherand Miles Calcraft Briginshaw Duffy to pitch forthe campaign

In the light of the increase in binge-drinkingdrunkenness and alcohol-related violencepolitical support for further curbs on alcoholadvertising has been growing The industry bodywhich speaks on alcohol policy The PortmanGroup has called for companies to introducecampaigns promoting responsible consumptionThe UK government has called for consultationwith a wide range of groups including alcoholcompanies on how violence in and outside pubsmight be reduced

Diageo to target bingedrinking culture

7

The long established and well supported Proofof Age Card set up by the Portman Group hasbeen accepted into the British RetailConsortiumrsquos new Proof of Age StandardsScheme (PASS) As from June 2003 the newcard complete with hologram will be incirculation

PASS is an umbrella accreditation systemaudited by the Trading Standards Institute andany card that is presented and bears the PASSlogo has met the PASS standards and containsaccurate and reliable information This will helpretailers make an informed decision on whetherto allow a purchase The Portman Group hasrelaunched the card bearing the PASS hologramand Portman Group 18+ logo The Underage

Drinking and the illegal Purchase of AlcoholReport commissioned by the NicholsonCommittee shows that 84 of 15 year oldsplaced drinking of alcohol as a common placeactivity Of the young persons questioned 49currently purchased alcohol illegally 33 fromlicensed grocers 24 from off-licences andanother 24 from pubs or bars

Proof of age standards scheme (PASS)

The subject of numerous prospective and casecontrol studies has been the possible existenceof an independent effect of alcohol use in theaetiology of lung cancer As alcohol correlatesstrongly with smoking possible residualconfounding has been a particular concernResults of several prospective studies were notadjusted for smoking therefore hampering theirinterpretation This study by De Stefani ECorrea P and Deneo-Pellegrini H et al wasundertaken to examine in detail the relationshipbetween alcohol use and the risk ofadenocarcinoma of the lung

Between July 1998 and July 2000 all incidentsof lung adenocarcinoma that were admitted tothe 4 main hospitals in Montevideo Uruguaywere considered eligible for examining the rolesof diet drinking and smoking in the aetiology ofthis malignancy Subjects for the study were 160cases with newly diagnosed adenocarcinomaof the lung with 520 hospitalised controls with acondition unrelated to drinking or smokingInformation about socio-demographic variablesoccupational history smoking history drinkinghistory height and weight 5 years before theinterview menstrual and reproductive history

(women) and a food frequency form including64 food items were obtained by use of aquestionnaire during interview

Total alcohol use was not associated with riskof adenocarcinoma of the lung (OR 12 95CI 06-21) Beer consumption did not correlatewith adenocarcinoma risk (OR 06 95 CI 03-16) In contrast wine consumption showed amarginal protective effect (OR 04 95 02-11)while the use of spirits (predominantly canaderived from sugar cane and grappa derivedfrom grapes) was associated with a 40increase in risk of lung adenocarcinoma

The results of the study suggest that wineconsumption has a protective effect against thedevelopment of adenocarcinoma of the lungwhile spirits are a moderate risk factor for thiscell type of the lung cancer

Source De Stefani E Correa P Deneo-Pellegrini Het al Alcohol intake and risk of adenocarcinoma ofthe lung a case-control study Uruguay Lung Cancer38 (2002) 9-14

Wine may protect against adenocarcinoma of thelung

International Conferenceon Alcohol Drugs andTraffic Safety T 2004

In August 2004 many of the worldrsquos experts ondrugs and alcohol will gather in Glasgow for the17th International Conference on Alcohol Drugsand Traffic Safety

The Conference will explore developments innew policies and technologies to counteractalcohol and drugs problems in the context ofroad traffic safety In particular it will explorethe following key areas of Driver CharacteristicsPharmacology and Toxicology EpidemiologyRehabilitation Prevention Driving andPerformance Police Enforcement and WorkRelated Transport IssuesTo submit an abstract or register interest inthe conference please visit the conferencewebsite at wwwICADTS2004com Tel +44 (0)141 434 1500 Fax + (00 141 434 1519 Emailicadts2004meetingmakerscouk

Conference on socialresponsibility

The Amsterdam Group (TAG) are organising aconference on Social Responsibility on the 17thSeptember at the Renaissance Hotel inBrussels The aim of the conference is topresent concrete actions undertaken by SocialAspects Organisations (SAOs) andstakeholders involved in the distribution of thealcoholic beverages to reduce the negativeimpact of alcohol consumption on individualsand society through

Education and information campaigns topromote sensible drinking in particular towardsyoung people

Responsible advertising and marketing ofalcoholic beverages by industry and retailers tocomply with the Recommendation on AlcoholDrinking by Children and Adolescents adoptedby the Commission in June 2001 For Detailsplease contact Carole Brigaudeau TheAmsterdam Group Rue Wiertz 5028 B - 1050Bruxelles T + 3224016166 F +3224016868 M + 32 (0) 486117199cbrigaudeauamsterdamgrouporg

7

8

Wine goes in at the mouth much to our delightthen trickles through other parts of the bodyLet us go then you and I to explore thetortuousness of the gastro-intestinal tract takingalong divers potables to observe their effects

Most GI adversities associated with drinkingbeverages containing alcohol come with excessand virtually all are caused by alcohol inparticular In some cases the effect of wine isdifferent from that of other drinksmdashwatch forthem The ineffable morning-after distressfollowing indiscretion is poorly understood andis transient but unpleasant consequences ofheavy drinking may be lasting and as severeas cancer

The all-too-common chief complaint of theoesophagus (gullet) is heartburn caused bywelling up of acid material from the stomachTwo major determinants of such acid reflux arethe quantity of acid secreted by the stomachand the propulsion of the stomach acid thewrong way upward into the oesophagus insteadof downward into the intestine Wine maystimulate heartburn it stimulates acid productionby the stomach Alcohol does not Here is arare example of an unfavourable effect of winersquosspecial attributes presumably polyphenolicantioxidants Alcohol however especially inheavy dose may relax the lower oesophagealvalve (sphincter) that is supposed to seal offthe oesophagus and disorder motility thereby

promoting reflux

Cirrhosis of the liver of any cause includingabuse of alcohol is often complicated byformation of oesophageal varices dilation ofveins of the lower oesophagus a distinct risk oflife-threatening haemorrhage The stomach isboth a key actor and a target in the life ofingested alcohol Alcohol dehydrogenase theenzyme that first metabolizes alcohol soneutralizing it is secreted by the gastric mucosathe lining of the stomach When ample alcoholslows the emptying of the stomach alcoholdehydrogenase has more time to attack thealcohol

Womenrsquos stomachs contain about 60 percentas much alcohol dehydrogenase as do menrsquoslikely the chief reason for the long-observedlesser tolerance of women for alcohol and therecommendation that their safe and healthyportion should be about half of menrsquos So whena couple share a bottle of wine at dinner heshould get two-thirds

Binge drinking of high-proof beverages may leadto acute gastritis inflammation of the stomachsometimes accompanied by haemorrhageWine and beer are innocent and may beprotective

The intestines large and small are not just inertpipes conveying food and the products ofdigestion to their fate Their linings activelysecrete digestive enzymes and absorb thenutrients made available by digestion Theirmuscular walls churn and propel the contentsto enhance the chemical reactions of digestionThe muscular motility of the intestine may bereduced in alcoholics thereby unpredictablyaltering function and allowing toxic bacterialovergrowth An odd converse has beenobserved recently in overweight mice whoseobesity slows intestinal motion The bacteria thatgrow to excess as a result produce alcohol andthese mice develop liver abnormalities similarto those of obese humans and to alcoholicsThe lesson may be that obesity and alcohol arecollaborators in causing liver diseasemdashtakeheed

Surprisingly light-drinking laboratory rats haveexhibited enhanced liver regeneration afterinjury compared to rats who abstained or whodrank more Heavy doses of alcohol may impairintestinal absorption of nutrients includingthiamin vitamin B12 amino acids (the building

blocks of proteins) perhaps calcium and zincleading to complex malnutrition

Iron absorption may increase with drinking notnecessarily harmless for excessive iron mayinjure the liver Excessive drinking often leadsto diarrhoea

That wine especially and other alcohol-containing beverages help prevent gastro-intestinal infections has been known for a verylong time Claret drunk in British army messesin India was held to be ldquoa sovereignpreventative against the prevalent cholerardquo justone of a number of similar observations hereand there over the years More recently andmore scientifically wine has been demonstratedto be an effective inhibitor of a trio of fearsomebacteria Escherichia coli Salmonella andShigella causes of ldquotravellerrsquos diarrhoeardquo andworse typhoid and related diseases andbacillary dysentery respectively Researcherssuspect that the operative benefactor is one ormore of winersquos polyphenols Wine and spiritsbut not beer consumed with raw oysterscontaminated with hepatitis A virus which entersvia the gastro-intestinal tract were associatedwith a reduced risk of infectionThe bacteriumHelicobacter pylori (Hpylori) looms much to theastonishment of the medical profession amalign superstar of the first magnitude It residesin the stomachs of those infected Who couldhave imagined that this organism causes muchof chronic gastritis a large majority of pepticulcers and a substantial proportion of cancersof the stomach H pylori is now being implicatedas a promoter of our most deadly diseaseatherosclerosis cause of heart attacks strokesand other catastrophes Drinking especially ofwine appears to help eliminate H pylori In adirect study less than one-third as manydrinkers as abstainers were infected

H pylori infection is also associated withreduced activity of alcohol dehydrogenase in thestomach After eradication of the infectionalcohol dehydrogenase normalizes within twomonths Alcohol is the only component of winethat has been clearly shown to increase the riskof some cancers and then only when abused

Chronic heavy drinking particularlyaccompanied by abuse of tobacco isassociated in the gastro-intestinal tract withincreased cancer risk in the mouth throatoesophagus and perhaps the upper stomach

WINE AND THE GASTROINTESTINAL TRACTBy Harvey E Finkel MD

9

Inconclusive reports have raised the questionof a slight increase in risk of cancer of thepancreas The data relating beer and spirits toa possible slight increase of risk of colorectaltumours are conflicting and confusing

Might moderate drinking protect against cancerEarly indications suggest the answer might beldquoyesrdquo A number of studies has demonstratedthat wine in particular possesses severalproperties that would tend to prevent or inhibitcancer no doubt through the actions of itsantioxidant compounds Epidemiologic researchhas revealed substantial reduction of risk ofcancers of the oesophagus and upper stomachand colon and rectum in wine drinkers ascompared to non-drinkers

In essence past experience and currentresearch indicate that abuse of alcohol risksdamaging the gastro-intestinal tract at severalpoints but moderate wine consumption risksonly a little heartburn while possibly leading tomajor health benefits not to mention gustatorypleasures

Whether wine is a poison a medicine or anourishment is a matter of dosage mdashParacelsus Harvey E Finkel MD is Clinical Professor of Medicineat Boston University Medical Centre and is a memberof AIMrsquos Social Scientific and Medical Council

a study by Dr Morten Gronbaek of the NationalInstitute of Public Health in Copenhagen hasfound that heavy drinkers (especially non-winedrinkers) significantly increase their risk ofcontracting rectal cancerThe findings are basedon a population study of over 29000 Danishmen and women aged between 23 and 95Cancers that originate in the colon and rectumare the fourth most commonly diagnosedcancers in the US and represent the second-leading cause of death from cancerApproximately one-third of the cases ofcolorectal cancer are actually cancers of therectum Gronbaek said Their weekly intake ofbeer wine and spirits was assessed as wereother factors likely to influence bowel cancerrisk such as how much they smoked weighedand took regular exercise Men were more likelythan women to be heavy drinkers and heavydrinkers were more likely to be smokers and toweigh more than light drinkers

During a monitoring period of almost 15 years411 cases of colon cancer and 202 cases ofrectal cancer were reported among thosestudied Alcohol seemed to have little influenceover the risk of colon cancer but there was aclear association between rectal cancer risk andthe amount of alcohol consumed Thosedrinking more than 41 units of alcohol a weekhad twice the risk of developing the disease as

non-drinkers But the type of alcohol consumedhad a significant bearing on rectal cancer riskThose who drank 14 or more units of beer orspirits a week were over 35 times as likely todevelop rectal cancer as non-drinkers Yet thosewho drank the same total amount of alcoholbut who included around a third or more of winein their intake were less than twice as likely todevelop the diseaseThe authors point out thatwine drinkers tended to be better educated andto take more exercise than beer or spiritdrinkers so there may be other healthier lifestylefactors at play There are no obvious reasonswhy alcohol should apparently be moredamaging to the rectum than the colon but thereasons why wine seems to exert its protectiveeffect most likely lie in resveratrol which is foundin both grapes and wine

Previous research indicates that this chemicaldamps down the cellular processes involved inthe promotion and growth of cancerous cellsThe lack of a relationship between alcoholdrinking and colon cancer risk is also somewhatof a mystery according to Gronbaek

ldquoThe tissue is rather similar in the two parts ofthe organ mdash colon and rectum mdash and one mightexpect the same mechanism in developing thediseaserdquo Gronbaek said However he addedthat previous studies have also found thatalcohol has an effect on the rectum but not thecolon SOURCE Gut 200352861-867

Alcohol colon and rectal cancer

The World Advertising Research Centre will beholding the eighth annual Alcoholic Drinksconference in central London on Tuesday 30th

September The conference will be chaired byNick Kendall Group Strategy Director BartleBogle Hegarty

This yearrsquos programme will concentrate inparticular on the urgency and importance ofsocial responsibility issues for the alcoholicdrinks industry With the UK Government in themiddle of developing a national alcohol harm-reduction strategy conducted by the PrimeMinisterrsquos own Strategy Unit and the Department

of Health self-regulation may give way to legalcontrols on the advertising of alcoholic drinksSpeakers include Rita Clifton ChairmanInterbrand Hamish Pringle Director GeneralIPAWendy Darlington Brand MarketingDirector Diageo Plc Jaspar Shelbourne GlobalCreative Director JWT Alan Mitchell JournalistMike Spurling Director The Informer A SpecialPanel on Social Responsibility features AndrewBrown The Advertising Association HughBurkitt The Marketing Society Leanne RileyScientist World Health Organisation JeanCoussins The Portman GroupHelmutWagner The Amsterdam Group Chris SearleExecutive Director Bacardi Martini

For details contact Sarah Miller World AdvertisingResearch Center Farm Road Henley-on-ThamesOxon RG9 1EJ Tel 0044 (0) 1491 418 646 Fax0044 (0) 1491 418 600 Mail sarah_millerwarccomWeb wwwwarccomconferences

30th Alcoholic Drinks 2003 - Conference Brewers of Europe 3rdBeer and health

symposiumThe Brewers of Europe are holding a conferenceon the benefits of moderate beer consumptionon the 15th October at the Residence PalaceBrussels

The event is chaired by professor Oliver Jamesof the University of Newcastle and includespresentations on alcohol and weight moderatedrinking and well being and nutritional aspects

For more information please visitwwwbrewersofeuropeorg or emailinfobrewersofeuropeorg

9

10

1Introduction

As part of cultural traditions and well balancedlifestyles wine beer and spirits consumption hasbeen a common staple in diets around the worldIn acknowledgement of such practices groupsof nutrition experts have included the moderateconsumption of alcohol as an optionalcomponent of various dietary guidelines andfood guides such as the Mediterranean AsianLatin American and Vegetarian Pyramids Herewe outline the key scientifically based nutritionmessages in these pyramids

The outlined alcohol-inclusive dietary pyramidsare part of an effort by Oldways Preservation ampExchange Trust a non- profit education groupthat is dedicated to preserving traditional eatingpatterns with the goal to improve consumerknowledge and diets around the world Oldwayshas prepared these concepts with prominentnutrition medical biomedical andcommunication experts from leading institutionssuch as the WHO Regional Office for Europeand the Harvard School of Public Health

Cardiovascular disease and cancer are leadingcauses of death in developed nations aroundthe world predominantly being associated withdiets high in animal fats With that emergingscientific consensus the Oldways pyramids allemphasize fruits vegetables cereals andpulses with litt le meat (animal fats)consumption These nutrition concepts alsoinclude wine beer and spirits which have shownto contribute to lower heart disease rates andimprove longevity

Accumulating scientific evidence suggests thatmoderate consumption of wine beer and spiritsdoes not pose a health risk to the vast majorityof consumers who choose to drink inmoderation AIMrsquos recommendations alsoemphasise that adults should enjoy alcoholbeverages in a sensible manner preferablyaround mealtimes or other responsible socialsettings Moderation is the key to a healthy dietand lifestyle and this is reflected in severaltraditional nutrition concepts

Consumers should follow moderation guidelinessuch as those in the Dietary Guidelines forAmericans which define moderation as up totwo drinks (12g) a day for men and up to onedrink a day for women further consumersshould avoid alcohol during pregnancy or when-ever it would put the individual or others at risk

To learn more about the US Dietary Guidelinesmessage on alcohol please visitwwwhealthgovdietaryguidelines and for otherauthoritative links on alcohol please also visitthe AIM links page on the gateway to sensibledrinking and health site via wwwaim-digestcom

Alcohol-Inclusive Nutrition

Concepts The

The lsquoEatwisersquo concept

The latest ldquoEat Wiserdquo Pyramid including ldquowinebeer and spirits in moderationrdquo as part of a dailybeverage recommendation was released atJanuaryrsquos 2003 Mediterranean Diet Conferencesponsored by Harvard School of Public Healthand Oldways Preservation amp Exchange TrustThis new pyramid is modelled on the originalMediterranean Diet Pyramid which initially onlyrecommended wine in moderation reflecting thecultural preference of the Mediterranean regionldquoThis Eat Wise Pyramid is a visual guide tohealthy living the Eat Wise wayrdquo theaccompanying text states ldquoIt shows thepartnership of a balanced diet plenty of waterregular physical activity and alcohol inmoderation that wise eaters know strengthenall their bodiesrsquo functionsrdquo An expert conferencediscussion emphasized the potential benefits forall three beverages Eat Wise Meal Ideasshopping tips and recipes are outlined in aspecial eating guide that can be ordered via theOldways website

Moderate Alcohol Intake as Part of a Healthy Diet and Lifestyle - A Look at Alcohol Inclusive Nutrition Concepts from Around the World by Elisabeth Holmgren

The Mediterranean Diet Pyramidwwwoldwaysptorgpyramidsmed

p_medhtml

The Mediterranean Diet Concept

Long known for its healthy lifestyles and thelongevity of its people the Mediterranean regionis also home of some of the most palatable andhealthy foods on earth Traditionally wine hasbeen included as an integral part of its mealsand cross-cultural studies have reportedsignificantly lower risk of heart disease inMediterranean regions where alcohol is a dailystaple of a healthy diet and lifestyle As thepreferred beverage in this region wine isspecified as an option on ldquoThe TraditionalHealthy Mediterranean Diet Pyramidrdquodeveloped by Oldways in cooperation withscientists from the WHO in Europe and fromthe Harvard School of Public Health Thistraditional diet is based on grains including ricepolenta bulgur and pasta as well as legumesand vegetables It also includes fruits cheesesyogurt and nuts along with the optional choiceof alcohol in moderation Olive oil is given itsown category as a major source of monounsaturated fat reflecting its importantprominence in the regionrsquos healthy cuisine Dailyphysical activity a factor contributing to healthin the Mediterranean region and elsewhere isalso included on this and all Oldways pyramids

11

The Asian Diet Concept

As Asian cuisine continues to become popularin diverse regions of the world characteristicsof Asian diets will continue to gain importanceIn Japan and China studies have found ratesfor heart disease and many types of cancer tobe lower than those in the United States andthe rest of the world The centuries-oldtraditional Asian diet of rice noodles vegetablesand fish is believed to be a significant contributorto the documented lower rates for chronicdisease in these populations The ldquoTraditionalhealthy Asian Diet Pyramidrdquo developed incooperation with scientists at Cornell Universityand the Harvard School of Public Healthincorporates these dietary patterns into thepyramid format Sake wine beer and otherbeverages with alcohol in moderation as wellas tea are included as part of the pyramidbecause studies have shown that theirconsumption may play an role in reducing heartdisease risk and overall mortality

The Asian Diet Pyramid

wwwoldwaysptorgpyramidsasianp_asianhtml

ldquoThe

The Latin American ConceptThe Traditional Healthy Latin American DietPyramidrdquo released in 1996 is based on thetraditional foods of Latin America Unlike theAmericanized versions that tend to be high insalt and fat this pyramid presents many healthyeating options It emphasizes daily consumptionof beans grains tubers and nuts along withfruits and vegetablesmdashstaples in most LatinAmerican and Caribbean regions Daily physicalactivity is integrated into the pyramid structurein recognition of the scientific consensus on theimportance of exercise in maintaining goodhealth Alcohol in moderation with meals isincluded as an option and as with other culturalpyramids meats sweets and eggs are at thevery top of the pyramid in the ldquooccasionallyrdquocategory to advocate a healthy and balancedlifestyle that can reduce the risk for several

common diseases

The Vegetarian Diet ConceptThe unique ldquoVegetarian Diet Pyramidrdquo releasedby Oldways at the end of 1997 serves as amodel for healthy eating with meals built aroundvegetables fruits whole grains and legumesThe pyramid also emphasizes daily physicalactivity water consumption and the option ofldquowine beer and other alcoholrdquo in moderationThe importance of this dietary conceptaccording to Oldways is that it reflects thegrowing number of vegetarians and

The Scientific Evidence

The nutritional and medical significance ofthe traditional Oldways Dietary Pyramidswas featured in ldquoMedical NewsPerspectivesrdquo of the Journal of the AmericanMedical Association in 2000 The authorhighlighted the importance of well-balancedand nutritious diets as a potential diseaseprevention measure that could beincreasingly conveyed by physicians andhealthcare providers to their patients Morerecently Greek and US scientists investigatedthe health effects of adherence to aMediterranean Diet reported in the New EnglandJournal of Medicine in 2003 ldquoGreater adherenceto the traditional Mediterranean diet isassociated with a significant reduction in totalmortalityrdquo Coinciding with these acknow-ledgements there is now a developing scientificconsensus that for many individuals moderatewine beer and spirits consumption is associated

acknowledges the nutritional and health benefitsof this type of diet For example the DietaryGuidelines for Americans have acknowledgedsuch a diet as able to meet RecommendedDietary Allowances (RDA) for nutrients Whilesome vegetarians are prohibited fromconsuming meat and alcohol for religiousreasons all alcohol beverages are included asa choice because of the potential risk reductionfor heart disease and its cultural role as anaccompaniment to vegetarian eating

The Latin American Diet Pyramidwwwoldwaysptorgpyramidslatin

p_latinhtml

The Vegetarian Diet Pyramidwwwoldwaysptorgpyramidsveg

p_veghtml

11

12

with a reduced risk of coronary heart diseaseand increased life expectancy which lead to theabove featured alcohol-inclusive nutritionconcepts

In 1997Sir Richard Doll Emeritis Professor ofMedicine at Oxfordoutlined in the BritishMedical Journal ldquomassiverdquo evidence for thepotential beneficial effect of alcohol in a reviewof the clinical data on alcohol and mortality Heconcluded that ldquothe consumption of small andmoderate amounts of alcoholrdquo leads to a one-third-risk reduction for vascular disease He alsoacknowledged a reduction in total mortality inmiddle-aged and elderly men and women whenthey consumed wine beer or spirits Morerecently world-renowned expert Dr ArthurKlatsky from the US outlined the overwhelmingscientific evidence in Scientific American DrKlatsky has published many research studieson alcohol and health in leading scientificjournals from the large-scale Kaiser Permanentecohort and in the recent article he wrote withrespect to the most appropriate advice to thepublic ldquoOn one hand mild to moderate drinkingseems better for heart health than abstinencefor select people On the other hand heavydrinking is clearly dangerousrdquo Merelyrecommending abstinence is inappropriatehealth advice to people such as established lightdrinkers at high risk of CHD and at low risk ofalcohol-related problemsmdashwhich describes alarge proportion of the populationrdquo Dr Klatskyalong with other experts from around the worldhas advocated that health professionals makecase-by-case evaluations based on individualand family histories They also emphasize thatthe public should be entrusted with all theinformation on use versus misuse of alcohol sothat they can make informed decisionsthemselves

Authoritative findings from cohortsinternationally lead research experts tofeature the option of moderation in eachtraditional Oldways Dietary Pyramid Manypeer-reviewed studies from Europe AsiaAustralia and the US have revealed potentialbenefits for moderately drinking adults inmulti-ethnic populations These studies findthat moderate drinkers especially consumersof 1-2 drinks (12g) daily may lower their risk ofheart disease significantly Studies reportingcertain health advantages for moderate drinkersinclude the Lyon Heart Study the CopenhagenCity Heart Study the Australian Dubbo Studyand the European Seven Country Study

The Oldways experts working with the HarvardSchool of Public Health specifically consideredfindings from the ongoing Physiciansrsquo HealthStudy and the Nursesrsquo Health Study Analyzingdata from 84000 women in the Nursesrsquo HealthStudy the effect of a combination of diet andlifestyle factors were assessed on the risk ofCHD Dr Meir Stampfer et al concludedrdquo In thispopulation of middle-aged women those whodid not smoke cigarettes were not overweightmaintained a healthful diet described aboveexercised moderately or vigorously for half anhour a day and consumed alcohol moderatelyhad an incidence of coronary events that wasmore than 80 lower than that in the rest of thepopulationrdquo At the same time based on aprospective study of more than 89000 men aspart of the Physiciansrsquo Health Study Harvardresearcher Dr Michael Gaziano et al concludedrdquoIn summary this study reveals the complexeffect of alcohol consumption on various chronicdiseases as reflected in the overall U-shapedrelationship between light-to-moderate alcoholconsumption and total mortality in menrdquoTheearlier results from the US governmentrsquos fundedNational Health and Nutrition ExaminationSurvey (NHANES) were also considered whichfound that the risk for CHD is reduced for bothmen and women who drink moderatelyPublished in 1997 in the American Journal ofEpidemiology it stated ldquoThis analysisconfirmed previous research showing thatabstainers are at a greater risk for CHD thanare most non abstainers and that a significantprotective effect may be demonstrated withsmall amounts of alcoholrdquo Along those linesresearch published in The New England Journalof Medicine from American Cancer Societyexperts concluded ldquoIn this middle-aged andelderly population moderate alcoholconsumption slightly reduced overall mortalityrdquo

At the same time there are continuingconcerns about alcohol consumption andbreast cancer and women arerecommended not to drink when pregnant in line with governmental and public healthpositions in the US Authoritative statementsfrom public health groups such as the AmericanHeart Association the National StrokeAssociation and the American DieteticAssociation acknowledge the scientific evidencepointing to potential benefits of moderation withrespect to coronary heart disease andemphasize ldquoIf you choose to drink do so inmoderationrdquo A balanced summary position is

reflected in the 1999 JAMA Patient Page onldquoBenefits and dangers of alcoholrdquo which defineslsquoModerate drinking as 1 or 2 drinks (12g) a dayfor men and 1 drink a day for women and thoseolder than 65rsquo These messages are embodiedin governmental positions in the US UKAustralia and Canada

The Oldways alcohol messages as reflectedin the pyramids are however especiallynotable in that they emphasize consumptionwith or around mealtime as research hasshown that these and related cultural normsfacilitate responsible drinking habits mayslow alcohol absorption and may counterpotential harmful effects of fatty foods Forexample Dr David Hanson author ofPreventing Alcohol Abuse Alcohol Culture andControl explains ldquoThe cross-cultural evidenceindicates that drinking abuse will be low in anygroup in which drinking customs values andsanctions are clearhellip and characterized byprescriptions for moderate drinking andproscriptions against immoderate drinkingrdquoFurthermore several biochemical studiesindicate that in addition to slowing down theabsorption process which keeps blood alcohollevels lower moderate consumption during oraround mealtime may have favourable effectson lipid profiles and atherogenesis One 1998study published in the American Journal ofClinical Nutrition suggested ldquoethanol mayreduce cardiovascular risk by modulatingvascular muscle growth during the postprandialperiodrdquo Research continues but it appears clearthat healthy dietary patterns are inverselyrelated with low rates of chronic diseases Thishas been specifically confirmed in the ongoingSeven Country Study which reported in 1999that animal-food groups were directly correlatedwith CHD mortality while vegetable-food groupsas well as fish and alcohol were inverselycorrelated

In summary in line with the developingscientific consensus public health andgovernmental positions the Oldwayspyramids stress moderation and underscorethe importance of an overall healthy mealand lifestyleConsumption is notrecommended for non-drinkers or thosewho may have any health contraindicationsand consumers are always advised toconsult with their healthcare providersFor selected references and authoritative statements onmoderate drinking and health please visit the Gateway toSensible Drinking and Health via wwwaim-digestcom

13

ORGANISATIONS INVOLVED IN ALCOHOL AFFAIRSUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOM

ALALALALALCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNWaterbridge House 32-36 Loman Street London SE10EETel (0207) 928 7377 Fax (0207) 928 4644Websitewww alcoholconcernorguk

ALALALALALCOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCATION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARCHCHCHCHCHCOUNCILCOUNCILCOUNCILCOUNCILCOUNCILAbell House John Islip Street London SW1P 4LH Tel(0207) 217 5276

ALALALALALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALTH RESEARTH RESEARTH RESEARTH RESEARTH RESEARCH CENTRECH CENTRECH CENTRECH CENTRECH CENTREUniversity of West of England Glenside CampusBlackberry Hill Stapleton Bristol BS16 1DD Tel(0131) 536 6192 Fax (0131) 5366215 E-mailmplantahrconetcouk

HEALHEALHEALHEALHEALTH EDUCATH EDUCATH EDUCATH EDUCATH EDUCATION ATION ATION ATION ATION AUTHORITYUTHORITYUTHORITYUTHORITYUTHORITYHamilton House Mabledon Place London WC1 9TXTel (020) 72985656 Fax (020) 77259031 Emailenquirieshpeorgukwebsite wwwhpeorguk and wwwwreckedcouk

THE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALCOHOLISMCOHOLISMCOHOLISMCOHOLISMCOHOLISM3 St Andrewrsquos Place London NW1 4LBTel (0207) 487 4445 Fax (0207) 9354479

THE PORTHE PORTHE PORTHE PORTHE PORTMAN GRTMAN GRTMAN GRTMAN GRTMAN GROUPOUPOUPOUPOUP7-10 Chandos Street Cavendish Square London W1G9DQTel 020 7907 3700 Fax 020 7907 3710wwwportman-grouporguk

ALALALALALCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOTLANDTLANDTLANDTLANDTLAND2nd Floor 166 Buchanan Street Glasgow G1 2NH Tel0141-572 6700 Fax 041-333 1606

BRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIATIONTIONTIONTIONTIONMarket Towers 1 Nine Elms LaneLondon SW8 5NQTel 020 7627 9191 Fax020 7627 9123E-mail jwitheridgebeerandpubcomWebsite wwwbeerandpubcom

EUREUREUREUREUROPEOPEOPEOPEOPE

ARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GROUPOUPOUPOUPOUPBrewersrsquo House 10 Grand Place B-1000 BrusselsBelgium Tel +32 2 511 49 87 Fax +32 2 511 32 59

CBMCCBMCCBMCCBMCCBMCCheacutee de la Hulpe 181 bte 20 B-1170 Bruxelles Tel(++322) 672 23 92 Fax (++322) 660 94 02Website wwwcbmcorg

FORFORFORFORFORUMUMUMUMUMLivornostraat 13 b 5 rue de Livourne ndash Brussel 1050Bruxelles BelgiumTel 32 2 539 36 64 Fax 32 2 537 81 56email forumtasteeducationskynetbe websitewwwforum-taste-educationcom

ENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTION13 Rue Monsigny 75002 Paris FranceTel 00-33-53-43-80-75E-mail enterprisewanadoofr

IREBIREBIREBIREBIREB19 avenue Trudaine 75009 ParisTel +33 (1) 48 74 82 19 Fax +33 (1) 48 78 17 56E-mail irebirebcom Website wwwirebcom

OIVOIVOIVOIVOIV18 rue drsquoAguesseau 75008 Paris FranceTel +33 (0) 1 44 94 80 94Fax +33 (0) 1 42 66 90 63E-mail oivoivintWebsite wwwoivint

STIVSTIVSTIVSTIVSTIVAAAAABenoordenhoutseweg 22-23 2596 BA The HagueTheNetherlands Tel +31 (0)70 314 2480 Fax +31(0) 70314 24 81 E-mail phoastivanl Website wwwstivanl

SCANDINSCANDINSCANDINSCANDINSCANDINAAAAAVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALALALALALALCOHOL BOCOHOL BOCOHOL BOCOHOL BOCOHOL BOARDARDARDARDARDVandvaeligrksvej 11 DK - 5690 TommerupTel 45 64 75 22 84 Fax 45 64 75 28 44E-mail smaborg Websitewwwsmaborg

DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE WEINWEINWEINWEINWEINAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHGutenbergplatz 3-5 55116 MainzTel +49 02641 977340 Fax +49 02641 977342Website wwwdeutscheweinakademiede

FIVINFIVINFIVINFIVINFIVINPlaza Penedeacutes 3 308720 Vilafranca del PenedeacutesBarcelona Spain Tel 0034 (93) 890 45 45 Fax 0034(93) 890 46 11

DIFDIFDIFDIFDIFA FORA FORA FORA FORA FORUM EVUM EVUM EVUM EVUM EVFranklinstrabe 1 10587 BerlinGermany Tel + 49 (0) 30 39 0633 60Fax +49 (0) 30 390 633 66 email infodifa-forumdeWebsite wwwdifa-forumde

GODGODGODGODGODAAAAAGode Alkoholdninger Kattesundet 9 DK-1458Koslashbenhavn K Denmark Tel 33 13 93 83Fax 33 13 03 84

FIVSFIVSFIVSFIVSFIVSInternational Federation of Wines amp Spirits20 rue drsquoAnjou - 75008 Paris Tel 33 1 42 68 82 48Fax 33 1 40 06 06 98

THE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDAM GRAM GRAM GRAM GRAM GROUPOUPOUPOUPOUPRue Wiertz 5028B-1050 Brussels BelgiumTel +32 2 401 61 35 Fax + 32 2 401 68 68 emailinfoamsterdamgrouporgwwwamsterdamgrouporg

FUNDFUNDFUNDFUNDFUNDAAAAACION ALCION ALCION ALCION ALCION ALCOHOL COHOL COHOL COHOL COHOL Y SOCIEDY SOCIEDY SOCIEDY SOCIEDY SOCIEDADADADADADDiego de Leon 442 ES 28006 MadridTel + 34 91 745 08 44 Fax + 34 91 561 8955wwwalcoholysociedadorg

USA CANUSA CANUSA CANUSA CANUSA CANADADADADADA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAAAAAAUSTRALIAUSTRALIAUSTRALIAUSTRALIAUSTRALIA

WINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICA1200 G Street NW Suite 360 Washington DC 20005Tel (800) 879 4637 Fax (202) 347 6341E-mail infoamericanwineriesorgWebsite wwwamericanwineriesorg

AMERICAN AMERICAN AMERICAN AMERICAN AMERICAN WINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARCHCHCHCHCHAND EDUCAAND EDUCAAND EDUCAAND EDUCAAND EDUCATIONTIONTIONTIONTIONVisit website at wwwalcohol-AWAREcom

AMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAND HEALAND HEALAND HEALAND HEALAND HEALTHTHTHTHTH1995 Broadway 2nd Floor New York NY 10023-5860Tel (212) 362-7044 Ext 234 Fax (212) 362-4919Email kavaacshorg Websitewwwacshorg

BEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTE122 C Street NW 750Washington DC 20001Tel(202) 737-2337 Fax (202) 737-7004E-mailinfobeerinstituteorgWebsite wwwbeerinstituteorg

PRPRPRPRPROOOOOYECTYECTYECTYECTYECTO CIENCIA O CIENCIA O CIENCIA O CIENCIA O CIENCIA VINO VINO VINO VINO VINO Y SALY SALY SALY SALY SALUDUDUDUDUDFacultad de ciencias BioloacutegicasCasilla 114 D Santiago ChileTelFax (56-23) 222 2577Email vinsaludgenesbiopuccl

EDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALCOOLCOOLCOOLCOOLCOOL606 Cathcart Suite 700 Montreacuteal Queacutebec H3B 1K9Canada Tel (514) 875-7454 E-mailhsacyeducalcoolqcca Website wwweducalcoolqcca

THE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERAGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTE1775Pennsylvania Avenue NW Suite 1200 WashingtonDC 20006 Tel 2024637110wwwamericanbeverageinstitutecom

FISAFISAFISAFISAFISACCCCC(Fundacion de Investigaciones Sociales AC) FranciscoSosa 230 coyoacan CP 04000 Mexico DF - Mexico

HEALHEALHEALHEALHEALTTTTTH EDUCAH EDUCAH EDUCAH EDUCAH EDUCATION FOUNDTION FOUNDTION FOUNDTION FOUNDTION FOUNDAAAAATIONTIONTIONTIONTION INC INC INC INC INC2600 Virginia Avenue NW Washington DC 20037Tel (202) 3383501 Fax (202) 9656520E-mail hefmonaerolscom

ICAPICAPICAPICAPICAPInternational Center for Alcohol Policies1519 New Hampshire Avenue NWWashington DC 20036Tel (202) 986-1159 Fax (202) 986-2080Website wwwicaporg

THE CENTURTHE CENTURTHE CENTURTHE CENTURTHE CENTURY COUNCILY COUNCILY COUNCILY COUNCILY COUNCIL1310 G Street NW Suite 600Washington DC 20005-3000 Tel (202) 637-0077 Fax(202) 637-0079 Email washdecenturycouncilorgWebsite wwwcenturycouncilorg

CALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIATION OF TION OF TION OF TION OF TION OF WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEGRGRGRGRGROOOOOWERS WERS WERS WERS WERS 601 University Avenue Suite 135 Sacramento CA 95825wwwcawgorg email karencawgorg

THE THE THE THE THE WINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTE425 Market Street Suite 1000 San Francisco CA94105 USA Tel (415) 512-0151 Fax (415) 442-0742

LLLLLODI -WODI -WODI -WODI -WODI -WOODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPECOMMISSIONCOMMISSIONCOMMISSIONCOMMISSIONCOMMISSION2545 West Turner Road Lodi CA 95242USAmarklodiwinecom website wwwlodiwinecom

THE NTHE NTHE NTHE NTHE NAPAPAPAPAPA A A A A VVVVVALLEY ALLEY ALLEY ALLEY ALLEY VINTNERSVINTNERSVINTNERSVINTNERSVINTNERSASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION Phone - 707-963-3388 Fax - 707-963-3488 Website wwwnapavintnerscom

OLDOLDOLDOLDOLDWWWWWAAAAAYYYYYS PRESERS PRESERS PRESERS PRESERS PRESERVVVVVAAAAATION amp EXTION amp EXTION amp EXTION amp EXTION amp EXCHANGECHANGECHANGECHANGECHANGETRTRTRTRTRUSTUSTUSTUSTUST266 Beacon Street Boston MA 02116 6174215500Fax 6174215511 website wwwoldwaysptorg

THE ATHE ATHE ATHE ATHE AUSTRALIAN USTRALIAN USTRALIAN USTRALIAN USTRALIAN WINE RESEARWINE RESEARWINE RESEARWINE RESEARWINE RESEARCHCHCHCHCHINSTITUTEINSTITUTEINSTITUTEINSTITUTEINSTITUTEP O Box 197 glen Osmond 5064 South AustraliaAustralia Tel 61 8 8303 6600 Fax 61 6 303 6601

13

5

In a study on rats a coffee and alcoholcombination know as caffeinol given within 3hours of an artery supplying blood to the brainbeing blocked was shown to reduce damageby up to 80 It delivers the potency of 2 cupsof strong coffee and an alcoholic drink althoughneither caffeine nor alcohol were protective ontheir own Treating and looking after the 140000stroke victims a year costs the NHS in Britainan estimated pound23 billion The experimental drughas been shown to be safe in a pilot study ofpatients suffering from ischaemic stroke wherea clot blocks blood going into the brain and the

Coffee and alcohol for stroke victims

New research suggests that an overhaul ofdietary and fitness habits to help prevent orcontrol high blood pressure is feasible withproper coaching contrary to the theory that toomany changes would be overwhelming andineffective for most people The best results inthe study were achieved when weight loss saltrestriction and exercise were paired with theDASH (Dietary Approaches to StopHypertension) diet which is rich in fruitsvegetables and low fat dairy products

The results of the study conducted at DukeUniversity Medical Center Johns HopkinsPennington Biomedical Research Center andthe Center for Health Research were publishedin the April 23 2003 issue of the Journal of theAmerican Medical Association The study calledPREMIER is funded by the National HeartLung and Blood Institute

Current national recommendations for loweringblood pressure include weight loss reducedsodium intake increased physical activitylimited alcohol consumption and DASH diet TheDASH diet increases fruit vegetable and low-fat dairy consumption while limiting fats redmeat sweets and beverages containing sugarNo previous study has tested the ability ofpeople to adopt DASH on their own or itseffectiveness in the lsquorealrsquo world And no previousstudy has tested all the other recommendationsfor lowering blood pressure either with orwithout DASH as an ldquoall-in-onersquointervention

The PREMIER trial enrolled 810 generallyhealthy people with above-optimal bloodpressure including those with stage onehypertension (systolic BP140-159 mmHg andor diastolic BP 90-95 mmHg None of the

participants took medications for hypertensionThose in the ldquoAdvice Onlyrdquo group each met witha registered dietitian at the beginning of the trialto discuss recommendations for weight controlreduced sodium intake physical activity and theDASH diet for lowering blood pressure plusprinted educational materials

Participants in both the ldquoEstablishedrdquo andldquoEstablished Plus DASHrdquointervention groups setgoals to lose 15 pounds within six monthsincrease physical activity lower sodium intakeand limit alcohol to one or two drinks per dayThe Established Plus DASH group also setgoals to increase fruit vegetable and low-fatdairy intake and reduce saturated fat and totalfat The Established group was given noinstructions on the DASH diet During the initialsix months of the trial both groups metfrequently to reinforce behaviour modification

During the first six months of the trial allparticipants in both the Established andEstablished Plus DASH groups significantlylowered their blood pressures in comparison tothe Advice Only group The Established PlusDASH group had the lowest prevalence ofhypertension mdash cutting group membersrsquo risk ofdeveloping hypertension by 53 percentcompared to the Advice Only group ldquoAt sixmonths we had 19 participants in the AdviceOnly group who had to begin anti-hypertensivemedication to control their blood pressurescompared to only two in the Established Groupand five in the Established Plus DASH grouprdquosaid Svetkey ldquoAnd both behaviour modificationgroups had a significant number of theparticipants reach their optimum bloodpressurerdquoAll groups had an overall reduction

Diet and exercise are effective in controlling high blood pressurein weight In the Established Plus DASH group343 percent lost 15 pounds or more while inthe Established group 286 percent lost 15pounds or more The Advice Only group hadonly 62 percent lose 15 pounds or more Whenparticipants took a treadmill exercise test thetests showed fitness increased significantly inboth the Established and Established PlusDASH groups

Those on the DASH diet also benefited fromother potential benefits prevention ofosteoporosis from the high calcium contentprevention of some cancers from the high fruitand vegetable content and the prevention ofcardiovascular disease from the low fat contentrdquo

Although the results for the Advice Only groupwere not as striking as the other two this groupdid better in losing weight and decreasingsodium intake than expected Svetkey said thiscould be because motivated people usually signon to participate in clinical trials and mayproduce better results than could be expectedin the average population

The long-term goal of the study said Svetkey isto follow all the participants for an additional 12months (18 months total) to determine whetherthe participants can stick with the diet andexercise and monitor blood pressure controlThe next phase in this series of research willfocus on weight loss mdash specifically on how tohelp people lose weight and keep the weight offlong-term This new study which is also fundedby the National Institutes of Health beganenrolling participants in May 2003 The NHLBIpress release is available at wwwnhlbinihgovnewpress03-04-22htm

findings were reported in the Stroke Journal ofthe American Heart Association

In the study on humans lead by ProfessorJames Grotta a team at the University of Texasgave the treatment to 16 females and 17 malestroke victims with an average age of 71 Theaim of this study was to see if they could safelyachieve the same blood levels of caffeinol thatwere achieved in the animal studies ProfessorGrotta said ldquoWe discovered that we could useeven lower doses than we used in the animalstudies and achieve the blood levels that were

neuro-protective in animalsrdquo Caffeinol can besafely administered to patients also receivingtraditional lsquoclot-bustingrsquo drugs used to treatstrokesProfessor Grotta said a ldquorandomisedplacebo-controlled trialrdquo was needed todetermine the extent of caffeinolrsquos protectiveeffect in humans He is planning a studycombining caffeinol with thermo-cooling instroke patients Other studies have suggestedthat cooling the brain might limit stroke damage

Source wwwstrokeahajournalsorgcgicontentabstract01STR000006817080517B

5

6

Serve Wise (formerly known as SIPS) wasdeveloped with funding and guidance from theScottish Office and enjoys continued supportfrom the Scottish Executive to deal specificallywith underage drinking drinking and drivingcriminal incidents and deathsaccidents relatedto alcohol in Scotland ServeWise is managedby Alcohol Focus Scotland a charity operatingon a non-profit basis The importance ofadequate training for all staff is increasinglybeing recognised by licensed trade licensingboards and the police Many licensing boardsare now beginning to insist on training as aprerequisite for the granting or renewal of alicence

ServeWise aims to set a National Minimumstandard for all those involved in the sale ofalcohol In order to achieve this ServeWiseoffers short courses (approx 1 day or 2 halfdays) each covering licensing law alcohol andpeople skills This is on two levels -ServeWisePlus for managers licensees and experiencedstaff (covering the law in more depth andincludes issues relating to management) andServeWise for general staff Both the coursesare available in On and Off-Licence versionsAtpresent there are just over 40 Centresthroughout Scotland that can deliver ServeWisecourses located at colleges of further educationor training organizations or other types oforganisations (including solicitors) There aretwo pilot centres in the South The University ofCardiff in conjunction with the police-basedTASC project (Targeting alcohol-Related streetCrime) have held several courses and inManchester there is a multi-agency teamincluding the licensed trade the police andAlcohol and drug services Manchester whichhas just begun to run courses

Assisting in the setting up of the centres is theServeWise Central Office All trainers undertakea 2-day Trainer rsquos Course and receive theServeWise Trainerrsquos Manual (containing coursematerial instructions on delivery and a speciallydesigned video) All trainersrsquo are subject to ongoing verification and continuous professionaldevelopment requirements

ServeWise believes that the training must berelevant user-friendly as well as assessableand affordable and is confident that there willbe a reduction in the number of accidents andcrimes resulting from the misuse of alcohol onlicensed premises and consequently a lessening

in the amount particularly in the terms of policeand accident and emergency time A numberof l icensed trade organizations supportServeWise such as the Scottish Licensed TradeAssociation Diageo UK the BritishEntertainment and Dance Association theLeisure safety and Security Association

Advice and assistance is also offered byServeWise through its Advisory and WorkingGroups which include representatives from theScottish Executive the police solicitorslicensing boards the licensed trade as well asthose from trainingfurther educationperspective These groups also assistServeWise in organising other types of trainingand events including annual events for licensingboard members

lsquoTasterrsquo ServeWise courses for the licensingboard members can be provided where licensingboards wish to encourage training amongstlicensees and staff It is recommended that alsquoFit and Proper Personrsquo policy is set up includingtraining requirements Several Boards havegone on to develop policies after attending aServeWise taster event

Both ServeWise and Alcohol Focus Scotlandare still very much organisations in growth Fromlast year ServeWise has almost doubled itstraining numbers and Alcohol Focus Scotlandis undergoing considerable expansion withseveral newly created posts - including aGender Issues Network Officer (who for the next3 years will focus on women alcohol issues) aUser Support officer (to assist thoseexperiencing alcohol problems and to set up networks) and a NetWork support officer who willassist with communications and developmentof the network of affiliated organisationsprimarily the 30 Local Councils on Alcoholthroughout Scotland which provide counsellingand related services

ServeWise Central Office 166 Buchanan StreetGlasgowG1 2LW TEL 0141 572 6703Newsletters are produced by ServeWise andinformation can also be found on the Internetservewisealcohol-focus-scotlandorguk

Serve-wise and Alcohol Focus ScotlandIn October the Swedish Spirit amp Wine Suppliers(SSWS) will launch an initiative called DrinkwiseThe aim is to get the general public to considertheir alcohol behaviourFrom the beginning Drinkwise will consist of awebsite among other with an interactive partin which the visitor by answering questionsandclaims will be told what kind of alcoholconsumerhe or she is and the character of thistype ofconsumer SSWS concludes thatDrinkwise isone example of initiatives following thepublishing of a book financed by the PublicHealth Institute written by Sam Larsson at theKarolinska Institute in Stockholm and Johan Liljaat the Academy of Turku in Finland Theyconclude that it is better to teach young peoplehow to drink than to tell them not to drink at all -it is better to discuss with them how to behavewith alcoholThe authors also say that preventionprogrammes so far have been tooldquopropagandisticrdquo The non drinking message hasbeen repeated endlessly and has not beeneffective The alcohol policy target should be toget young people to use weak alcoholic drinksand to drink in moderation Maybe it is notrealistic to believe young people will abstain butthey ought to get a more conscious view onalcohol and drugs the authors say The bookhas been financed by the Public Health Institute

Drink-wise from Sweden

The drinks giant Diageo is planning to launcha campaign aimed at reducing the problem ofbinge-drinking in the UK

Diageo has asked its principal advertisingagencies J Walter Thompson Abbott MeadVickers BBDO Bartle Bogle Hegarty Motherand Miles Calcraft Briginshaw Duffy to pitch forthe campaign

In the light of the increase in binge-drinkingdrunkenness and alcohol-related violencepolitical support for further curbs on alcoholadvertising has been growing The industry bodywhich speaks on alcohol policy The PortmanGroup has called for companies to introducecampaigns promoting responsible consumptionThe UK government has called for consultationwith a wide range of groups including alcoholcompanies on how violence in and outside pubsmight be reduced

Diageo to target bingedrinking culture

7

The long established and well supported Proofof Age Card set up by the Portman Group hasbeen accepted into the British RetailConsortiumrsquos new Proof of Age StandardsScheme (PASS) As from June 2003 the newcard complete with hologram will be incirculation

PASS is an umbrella accreditation systemaudited by the Trading Standards Institute andany card that is presented and bears the PASSlogo has met the PASS standards and containsaccurate and reliable information This will helpretailers make an informed decision on whetherto allow a purchase The Portman Group hasrelaunched the card bearing the PASS hologramand Portman Group 18+ logo The Underage

Drinking and the illegal Purchase of AlcoholReport commissioned by the NicholsonCommittee shows that 84 of 15 year oldsplaced drinking of alcohol as a common placeactivity Of the young persons questioned 49currently purchased alcohol illegally 33 fromlicensed grocers 24 from off-licences andanother 24 from pubs or bars

Proof of age standards scheme (PASS)

The subject of numerous prospective and casecontrol studies has been the possible existenceof an independent effect of alcohol use in theaetiology of lung cancer As alcohol correlatesstrongly with smoking possible residualconfounding has been a particular concernResults of several prospective studies were notadjusted for smoking therefore hampering theirinterpretation This study by De Stefani ECorrea P and Deneo-Pellegrini H et al wasundertaken to examine in detail the relationshipbetween alcohol use and the risk ofadenocarcinoma of the lung

Between July 1998 and July 2000 all incidentsof lung adenocarcinoma that were admitted tothe 4 main hospitals in Montevideo Uruguaywere considered eligible for examining the rolesof diet drinking and smoking in the aetiology ofthis malignancy Subjects for the study were 160cases with newly diagnosed adenocarcinomaof the lung with 520 hospitalised controls with acondition unrelated to drinking or smokingInformation about socio-demographic variablesoccupational history smoking history drinkinghistory height and weight 5 years before theinterview menstrual and reproductive history

(women) and a food frequency form including64 food items were obtained by use of aquestionnaire during interview

Total alcohol use was not associated with riskof adenocarcinoma of the lung (OR 12 95CI 06-21) Beer consumption did not correlatewith adenocarcinoma risk (OR 06 95 CI 03-16) In contrast wine consumption showed amarginal protective effect (OR 04 95 02-11)while the use of spirits (predominantly canaderived from sugar cane and grappa derivedfrom grapes) was associated with a 40increase in risk of lung adenocarcinoma

The results of the study suggest that wineconsumption has a protective effect against thedevelopment of adenocarcinoma of the lungwhile spirits are a moderate risk factor for thiscell type of the lung cancer

Source De Stefani E Correa P Deneo-Pellegrini Het al Alcohol intake and risk of adenocarcinoma ofthe lung a case-control study Uruguay Lung Cancer38 (2002) 9-14

Wine may protect against adenocarcinoma of thelung

International Conferenceon Alcohol Drugs andTraffic Safety T 2004

In August 2004 many of the worldrsquos experts ondrugs and alcohol will gather in Glasgow for the17th International Conference on Alcohol Drugsand Traffic Safety

The Conference will explore developments innew policies and technologies to counteractalcohol and drugs problems in the context ofroad traffic safety In particular it will explorethe following key areas of Driver CharacteristicsPharmacology and Toxicology EpidemiologyRehabilitation Prevention Driving andPerformance Police Enforcement and WorkRelated Transport IssuesTo submit an abstract or register interest inthe conference please visit the conferencewebsite at wwwICADTS2004com Tel +44 (0)141 434 1500 Fax + (00 141 434 1519 Emailicadts2004meetingmakerscouk

Conference on socialresponsibility

The Amsterdam Group (TAG) are organising aconference on Social Responsibility on the 17thSeptember at the Renaissance Hotel inBrussels The aim of the conference is topresent concrete actions undertaken by SocialAspects Organisations (SAOs) andstakeholders involved in the distribution of thealcoholic beverages to reduce the negativeimpact of alcohol consumption on individualsand society through

Education and information campaigns topromote sensible drinking in particular towardsyoung people

Responsible advertising and marketing ofalcoholic beverages by industry and retailers tocomply with the Recommendation on AlcoholDrinking by Children and Adolescents adoptedby the Commission in June 2001 For Detailsplease contact Carole Brigaudeau TheAmsterdam Group Rue Wiertz 5028 B - 1050Bruxelles T + 3224016166 F +3224016868 M + 32 (0) 486117199cbrigaudeauamsterdamgrouporg

7

8

Wine goes in at the mouth much to our delightthen trickles through other parts of the bodyLet us go then you and I to explore thetortuousness of the gastro-intestinal tract takingalong divers potables to observe their effects

Most GI adversities associated with drinkingbeverages containing alcohol come with excessand virtually all are caused by alcohol inparticular In some cases the effect of wine isdifferent from that of other drinksmdashwatch forthem The ineffable morning-after distressfollowing indiscretion is poorly understood andis transient but unpleasant consequences ofheavy drinking may be lasting and as severeas cancer

The all-too-common chief complaint of theoesophagus (gullet) is heartburn caused bywelling up of acid material from the stomachTwo major determinants of such acid reflux arethe quantity of acid secreted by the stomachand the propulsion of the stomach acid thewrong way upward into the oesophagus insteadof downward into the intestine Wine maystimulate heartburn it stimulates acid productionby the stomach Alcohol does not Here is arare example of an unfavourable effect of winersquosspecial attributes presumably polyphenolicantioxidants Alcohol however especially inheavy dose may relax the lower oesophagealvalve (sphincter) that is supposed to seal offthe oesophagus and disorder motility thereby

promoting reflux

Cirrhosis of the liver of any cause includingabuse of alcohol is often complicated byformation of oesophageal varices dilation ofveins of the lower oesophagus a distinct risk oflife-threatening haemorrhage The stomach isboth a key actor and a target in the life ofingested alcohol Alcohol dehydrogenase theenzyme that first metabolizes alcohol soneutralizing it is secreted by the gastric mucosathe lining of the stomach When ample alcoholslows the emptying of the stomach alcoholdehydrogenase has more time to attack thealcohol

Womenrsquos stomachs contain about 60 percentas much alcohol dehydrogenase as do menrsquoslikely the chief reason for the long-observedlesser tolerance of women for alcohol and therecommendation that their safe and healthyportion should be about half of menrsquos So whena couple share a bottle of wine at dinner heshould get two-thirds

Binge drinking of high-proof beverages may leadto acute gastritis inflammation of the stomachsometimes accompanied by haemorrhageWine and beer are innocent and may beprotective

The intestines large and small are not just inertpipes conveying food and the products ofdigestion to their fate Their linings activelysecrete digestive enzymes and absorb thenutrients made available by digestion Theirmuscular walls churn and propel the contentsto enhance the chemical reactions of digestionThe muscular motility of the intestine may bereduced in alcoholics thereby unpredictablyaltering function and allowing toxic bacterialovergrowth An odd converse has beenobserved recently in overweight mice whoseobesity slows intestinal motion The bacteria thatgrow to excess as a result produce alcohol andthese mice develop liver abnormalities similarto those of obese humans and to alcoholicsThe lesson may be that obesity and alcohol arecollaborators in causing liver diseasemdashtakeheed

Surprisingly light-drinking laboratory rats haveexhibited enhanced liver regeneration afterinjury compared to rats who abstained or whodrank more Heavy doses of alcohol may impairintestinal absorption of nutrients includingthiamin vitamin B12 amino acids (the building

blocks of proteins) perhaps calcium and zincleading to complex malnutrition

Iron absorption may increase with drinking notnecessarily harmless for excessive iron mayinjure the liver Excessive drinking often leadsto diarrhoea

That wine especially and other alcohol-containing beverages help prevent gastro-intestinal infections has been known for a verylong time Claret drunk in British army messesin India was held to be ldquoa sovereignpreventative against the prevalent cholerardquo justone of a number of similar observations hereand there over the years More recently andmore scientifically wine has been demonstratedto be an effective inhibitor of a trio of fearsomebacteria Escherichia coli Salmonella andShigella causes of ldquotravellerrsquos diarrhoeardquo andworse typhoid and related diseases andbacillary dysentery respectively Researcherssuspect that the operative benefactor is one ormore of winersquos polyphenols Wine and spiritsbut not beer consumed with raw oysterscontaminated with hepatitis A virus which entersvia the gastro-intestinal tract were associatedwith a reduced risk of infectionThe bacteriumHelicobacter pylori (Hpylori) looms much to theastonishment of the medical profession amalign superstar of the first magnitude It residesin the stomachs of those infected Who couldhave imagined that this organism causes muchof chronic gastritis a large majority of pepticulcers and a substantial proportion of cancersof the stomach H pylori is now being implicatedas a promoter of our most deadly diseaseatherosclerosis cause of heart attacks strokesand other catastrophes Drinking especially ofwine appears to help eliminate H pylori In adirect study less than one-third as manydrinkers as abstainers were infected

H pylori infection is also associated withreduced activity of alcohol dehydrogenase in thestomach After eradication of the infectionalcohol dehydrogenase normalizes within twomonths Alcohol is the only component of winethat has been clearly shown to increase the riskof some cancers and then only when abused

Chronic heavy drinking particularlyaccompanied by abuse of tobacco isassociated in the gastro-intestinal tract withincreased cancer risk in the mouth throatoesophagus and perhaps the upper stomach

WINE AND THE GASTROINTESTINAL TRACTBy Harvey E Finkel MD

9

Inconclusive reports have raised the questionof a slight increase in risk of cancer of thepancreas The data relating beer and spirits toa possible slight increase of risk of colorectaltumours are conflicting and confusing

Might moderate drinking protect against cancerEarly indications suggest the answer might beldquoyesrdquo A number of studies has demonstratedthat wine in particular possesses severalproperties that would tend to prevent or inhibitcancer no doubt through the actions of itsantioxidant compounds Epidemiologic researchhas revealed substantial reduction of risk ofcancers of the oesophagus and upper stomachand colon and rectum in wine drinkers ascompared to non-drinkers

In essence past experience and currentresearch indicate that abuse of alcohol risksdamaging the gastro-intestinal tract at severalpoints but moderate wine consumption risksonly a little heartburn while possibly leading tomajor health benefits not to mention gustatorypleasures

Whether wine is a poison a medicine or anourishment is a matter of dosage mdashParacelsus Harvey E Finkel MD is Clinical Professor of Medicineat Boston University Medical Centre and is a memberof AIMrsquos Social Scientific and Medical Council

a study by Dr Morten Gronbaek of the NationalInstitute of Public Health in Copenhagen hasfound that heavy drinkers (especially non-winedrinkers) significantly increase their risk ofcontracting rectal cancerThe findings are basedon a population study of over 29000 Danishmen and women aged between 23 and 95Cancers that originate in the colon and rectumare the fourth most commonly diagnosedcancers in the US and represent the second-leading cause of death from cancerApproximately one-third of the cases ofcolorectal cancer are actually cancers of therectum Gronbaek said Their weekly intake ofbeer wine and spirits was assessed as wereother factors likely to influence bowel cancerrisk such as how much they smoked weighedand took regular exercise Men were more likelythan women to be heavy drinkers and heavydrinkers were more likely to be smokers and toweigh more than light drinkers

During a monitoring period of almost 15 years411 cases of colon cancer and 202 cases ofrectal cancer were reported among thosestudied Alcohol seemed to have little influenceover the risk of colon cancer but there was aclear association between rectal cancer risk andthe amount of alcohol consumed Thosedrinking more than 41 units of alcohol a weekhad twice the risk of developing the disease as

non-drinkers But the type of alcohol consumedhad a significant bearing on rectal cancer riskThose who drank 14 or more units of beer orspirits a week were over 35 times as likely todevelop rectal cancer as non-drinkers Yet thosewho drank the same total amount of alcoholbut who included around a third or more of winein their intake were less than twice as likely todevelop the diseaseThe authors point out thatwine drinkers tended to be better educated andto take more exercise than beer or spiritdrinkers so there may be other healthier lifestylefactors at play There are no obvious reasonswhy alcohol should apparently be moredamaging to the rectum than the colon but thereasons why wine seems to exert its protectiveeffect most likely lie in resveratrol which is foundin both grapes and wine

Previous research indicates that this chemicaldamps down the cellular processes involved inthe promotion and growth of cancerous cellsThe lack of a relationship between alcoholdrinking and colon cancer risk is also somewhatof a mystery according to Gronbaek

ldquoThe tissue is rather similar in the two parts ofthe organ mdash colon and rectum mdash and one mightexpect the same mechanism in developing thediseaserdquo Gronbaek said However he addedthat previous studies have also found thatalcohol has an effect on the rectum but not thecolon SOURCE Gut 200352861-867

Alcohol colon and rectal cancer

The World Advertising Research Centre will beholding the eighth annual Alcoholic Drinksconference in central London on Tuesday 30th

September The conference will be chaired byNick Kendall Group Strategy Director BartleBogle Hegarty

This yearrsquos programme will concentrate inparticular on the urgency and importance ofsocial responsibility issues for the alcoholicdrinks industry With the UK Government in themiddle of developing a national alcohol harm-reduction strategy conducted by the PrimeMinisterrsquos own Strategy Unit and the Department

of Health self-regulation may give way to legalcontrols on the advertising of alcoholic drinksSpeakers include Rita Clifton ChairmanInterbrand Hamish Pringle Director GeneralIPAWendy Darlington Brand MarketingDirector Diageo Plc Jaspar Shelbourne GlobalCreative Director JWT Alan Mitchell JournalistMike Spurling Director The Informer A SpecialPanel on Social Responsibility features AndrewBrown The Advertising Association HughBurkitt The Marketing Society Leanne RileyScientist World Health Organisation JeanCoussins The Portman GroupHelmutWagner The Amsterdam Group Chris SearleExecutive Director Bacardi Martini

For details contact Sarah Miller World AdvertisingResearch Center Farm Road Henley-on-ThamesOxon RG9 1EJ Tel 0044 (0) 1491 418 646 Fax0044 (0) 1491 418 600 Mail sarah_millerwarccomWeb wwwwarccomconferences

30th Alcoholic Drinks 2003 - Conference Brewers of Europe 3rdBeer and health

symposiumThe Brewers of Europe are holding a conferenceon the benefits of moderate beer consumptionon the 15th October at the Residence PalaceBrussels

The event is chaired by professor Oliver Jamesof the University of Newcastle and includespresentations on alcohol and weight moderatedrinking and well being and nutritional aspects

For more information please visitwwwbrewersofeuropeorg or emailinfobrewersofeuropeorg

9

10

1Introduction

As part of cultural traditions and well balancedlifestyles wine beer and spirits consumption hasbeen a common staple in diets around the worldIn acknowledgement of such practices groupsof nutrition experts have included the moderateconsumption of alcohol as an optionalcomponent of various dietary guidelines andfood guides such as the Mediterranean AsianLatin American and Vegetarian Pyramids Herewe outline the key scientifically based nutritionmessages in these pyramids

The outlined alcohol-inclusive dietary pyramidsare part of an effort by Oldways Preservation ampExchange Trust a non- profit education groupthat is dedicated to preserving traditional eatingpatterns with the goal to improve consumerknowledge and diets around the world Oldwayshas prepared these concepts with prominentnutrition medical biomedical andcommunication experts from leading institutionssuch as the WHO Regional Office for Europeand the Harvard School of Public Health

Cardiovascular disease and cancer are leadingcauses of death in developed nations aroundthe world predominantly being associated withdiets high in animal fats With that emergingscientific consensus the Oldways pyramids allemphasize fruits vegetables cereals andpulses with litt le meat (animal fats)consumption These nutrition concepts alsoinclude wine beer and spirits which have shownto contribute to lower heart disease rates andimprove longevity

Accumulating scientific evidence suggests thatmoderate consumption of wine beer and spiritsdoes not pose a health risk to the vast majorityof consumers who choose to drink inmoderation AIMrsquos recommendations alsoemphasise that adults should enjoy alcoholbeverages in a sensible manner preferablyaround mealtimes or other responsible socialsettings Moderation is the key to a healthy dietand lifestyle and this is reflected in severaltraditional nutrition concepts

Consumers should follow moderation guidelinessuch as those in the Dietary Guidelines forAmericans which define moderation as up totwo drinks (12g) a day for men and up to onedrink a day for women further consumersshould avoid alcohol during pregnancy or when-ever it would put the individual or others at risk

To learn more about the US Dietary Guidelinesmessage on alcohol please visitwwwhealthgovdietaryguidelines and for otherauthoritative links on alcohol please also visitthe AIM links page on the gateway to sensibledrinking and health site via wwwaim-digestcom

Alcohol-Inclusive Nutrition

Concepts The

The lsquoEatwisersquo concept

The latest ldquoEat Wiserdquo Pyramid including ldquowinebeer and spirits in moderationrdquo as part of a dailybeverage recommendation was released atJanuaryrsquos 2003 Mediterranean Diet Conferencesponsored by Harvard School of Public Healthand Oldways Preservation amp Exchange TrustThis new pyramid is modelled on the originalMediterranean Diet Pyramid which initially onlyrecommended wine in moderation reflecting thecultural preference of the Mediterranean regionldquoThis Eat Wise Pyramid is a visual guide tohealthy living the Eat Wise wayrdquo theaccompanying text states ldquoIt shows thepartnership of a balanced diet plenty of waterregular physical activity and alcohol inmoderation that wise eaters know strengthenall their bodiesrsquo functionsrdquo An expert conferencediscussion emphasized the potential benefits forall three beverages Eat Wise Meal Ideasshopping tips and recipes are outlined in aspecial eating guide that can be ordered via theOldways website

Moderate Alcohol Intake as Part of a Healthy Diet and Lifestyle - A Look at Alcohol Inclusive Nutrition Concepts from Around the World by Elisabeth Holmgren

The Mediterranean Diet Pyramidwwwoldwaysptorgpyramidsmed

p_medhtml

The Mediterranean Diet Concept

Long known for its healthy lifestyles and thelongevity of its people the Mediterranean regionis also home of some of the most palatable andhealthy foods on earth Traditionally wine hasbeen included as an integral part of its mealsand cross-cultural studies have reportedsignificantly lower risk of heart disease inMediterranean regions where alcohol is a dailystaple of a healthy diet and lifestyle As thepreferred beverage in this region wine isspecified as an option on ldquoThe TraditionalHealthy Mediterranean Diet Pyramidrdquodeveloped by Oldways in cooperation withscientists from the WHO in Europe and fromthe Harvard School of Public Health Thistraditional diet is based on grains including ricepolenta bulgur and pasta as well as legumesand vegetables It also includes fruits cheesesyogurt and nuts along with the optional choiceof alcohol in moderation Olive oil is given itsown category as a major source of monounsaturated fat reflecting its importantprominence in the regionrsquos healthy cuisine Dailyphysical activity a factor contributing to healthin the Mediterranean region and elsewhere isalso included on this and all Oldways pyramids

11

The Asian Diet Concept

As Asian cuisine continues to become popularin diverse regions of the world characteristicsof Asian diets will continue to gain importanceIn Japan and China studies have found ratesfor heart disease and many types of cancer tobe lower than those in the United States andthe rest of the world The centuries-oldtraditional Asian diet of rice noodles vegetablesand fish is believed to be a significant contributorto the documented lower rates for chronicdisease in these populations The ldquoTraditionalhealthy Asian Diet Pyramidrdquo developed incooperation with scientists at Cornell Universityand the Harvard School of Public Healthincorporates these dietary patterns into thepyramid format Sake wine beer and otherbeverages with alcohol in moderation as wellas tea are included as part of the pyramidbecause studies have shown that theirconsumption may play an role in reducing heartdisease risk and overall mortality

The Asian Diet Pyramid

wwwoldwaysptorgpyramidsasianp_asianhtml

ldquoThe

The Latin American ConceptThe Traditional Healthy Latin American DietPyramidrdquo released in 1996 is based on thetraditional foods of Latin America Unlike theAmericanized versions that tend to be high insalt and fat this pyramid presents many healthyeating options It emphasizes daily consumptionof beans grains tubers and nuts along withfruits and vegetablesmdashstaples in most LatinAmerican and Caribbean regions Daily physicalactivity is integrated into the pyramid structurein recognition of the scientific consensus on theimportance of exercise in maintaining goodhealth Alcohol in moderation with meals isincluded as an option and as with other culturalpyramids meats sweets and eggs are at thevery top of the pyramid in the ldquooccasionallyrdquocategory to advocate a healthy and balancedlifestyle that can reduce the risk for several

common diseases

The Vegetarian Diet ConceptThe unique ldquoVegetarian Diet Pyramidrdquo releasedby Oldways at the end of 1997 serves as amodel for healthy eating with meals built aroundvegetables fruits whole grains and legumesThe pyramid also emphasizes daily physicalactivity water consumption and the option ofldquowine beer and other alcoholrdquo in moderationThe importance of this dietary conceptaccording to Oldways is that it reflects thegrowing number of vegetarians and

The Scientific Evidence

The nutritional and medical significance ofthe traditional Oldways Dietary Pyramidswas featured in ldquoMedical NewsPerspectivesrdquo of the Journal of the AmericanMedical Association in 2000 The authorhighlighted the importance of well-balancedand nutritious diets as a potential diseaseprevention measure that could beincreasingly conveyed by physicians andhealthcare providers to their patients Morerecently Greek and US scientists investigatedthe health effects of adherence to aMediterranean Diet reported in the New EnglandJournal of Medicine in 2003 ldquoGreater adherenceto the traditional Mediterranean diet isassociated with a significant reduction in totalmortalityrdquo Coinciding with these acknow-ledgements there is now a developing scientificconsensus that for many individuals moderatewine beer and spirits consumption is associated

acknowledges the nutritional and health benefitsof this type of diet For example the DietaryGuidelines for Americans have acknowledgedsuch a diet as able to meet RecommendedDietary Allowances (RDA) for nutrients Whilesome vegetarians are prohibited fromconsuming meat and alcohol for religiousreasons all alcohol beverages are included asa choice because of the potential risk reductionfor heart disease and its cultural role as anaccompaniment to vegetarian eating

The Latin American Diet Pyramidwwwoldwaysptorgpyramidslatin

p_latinhtml

The Vegetarian Diet Pyramidwwwoldwaysptorgpyramidsveg

p_veghtml

11

12

with a reduced risk of coronary heart diseaseand increased life expectancy which lead to theabove featured alcohol-inclusive nutritionconcepts

In 1997Sir Richard Doll Emeritis Professor ofMedicine at Oxfordoutlined in the BritishMedical Journal ldquomassiverdquo evidence for thepotential beneficial effect of alcohol in a reviewof the clinical data on alcohol and mortality Heconcluded that ldquothe consumption of small andmoderate amounts of alcoholrdquo leads to a one-third-risk reduction for vascular disease He alsoacknowledged a reduction in total mortality inmiddle-aged and elderly men and women whenthey consumed wine beer or spirits Morerecently world-renowned expert Dr ArthurKlatsky from the US outlined the overwhelmingscientific evidence in Scientific American DrKlatsky has published many research studieson alcohol and health in leading scientificjournals from the large-scale Kaiser Permanentecohort and in the recent article he wrote withrespect to the most appropriate advice to thepublic ldquoOn one hand mild to moderate drinkingseems better for heart health than abstinencefor select people On the other hand heavydrinking is clearly dangerousrdquo Merelyrecommending abstinence is inappropriatehealth advice to people such as established lightdrinkers at high risk of CHD and at low risk ofalcohol-related problemsmdashwhich describes alarge proportion of the populationrdquo Dr Klatskyalong with other experts from around the worldhas advocated that health professionals makecase-by-case evaluations based on individualand family histories They also emphasize thatthe public should be entrusted with all theinformation on use versus misuse of alcohol sothat they can make informed decisionsthemselves

Authoritative findings from cohortsinternationally lead research experts tofeature the option of moderation in eachtraditional Oldways Dietary Pyramid Manypeer-reviewed studies from Europe AsiaAustralia and the US have revealed potentialbenefits for moderately drinking adults inmulti-ethnic populations These studies findthat moderate drinkers especially consumersof 1-2 drinks (12g) daily may lower their risk ofheart disease significantly Studies reportingcertain health advantages for moderate drinkersinclude the Lyon Heart Study the CopenhagenCity Heart Study the Australian Dubbo Studyand the European Seven Country Study

The Oldways experts working with the HarvardSchool of Public Health specifically consideredfindings from the ongoing Physiciansrsquo HealthStudy and the Nursesrsquo Health Study Analyzingdata from 84000 women in the Nursesrsquo HealthStudy the effect of a combination of diet andlifestyle factors were assessed on the risk ofCHD Dr Meir Stampfer et al concludedrdquo In thispopulation of middle-aged women those whodid not smoke cigarettes were not overweightmaintained a healthful diet described aboveexercised moderately or vigorously for half anhour a day and consumed alcohol moderatelyhad an incidence of coronary events that wasmore than 80 lower than that in the rest of thepopulationrdquo At the same time based on aprospective study of more than 89000 men aspart of the Physiciansrsquo Health Study Harvardresearcher Dr Michael Gaziano et al concludedrdquoIn summary this study reveals the complexeffect of alcohol consumption on various chronicdiseases as reflected in the overall U-shapedrelationship between light-to-moderate alcoholconsumption and total mortality in menrdquoTheearlier results from the US governmentrsquos fundedNational Health and Nutrition ExaminationSurvey (NHANES) were also considered whichfound that the risk for CHD is reduced for bothmen and women who drink moderatelyPublished in 1997 in the American Journal ofEpidemiology it stated ldquoThis analysisconfirmed previous research showing thatabstainers are at a greater risk for CHD thanare most non abstainers and that a significantprotective effect may be demonstrated withsmall amounts of alcoholrdquo Along those linesresearch published in The New England Journalof Medicine from American Cancer Societyexperts concluded ldquoIn this middle-aged andelderly population moderate alcoholconsumption slightly reduced overall mortalityrdquo

At the same time there are continuingconcerns about alcohol consumption andbreast cancer and women arerecommended not to drink when pregnant in line with governmental and public healthpositions in the US Authoritative statementsfrom public health groups such as the AmericanHeart Association the National StrokeAssociation and the American DieteticAssociation acknowledge the scientific evidencepointing to potential benefits of moderation withrespect to coronary heart disease andemphasize ldquoIf you choose to drink do so inmoderationrdquo A balanced summary position is

reflected in the 1999 JAMA Patient Page onldquoBenefits and dangers of alcoholrdquo which defineslsquoModerate drinking as 1 or 2 drinks (12g) a dayfor men and 1 drink a day for women and thoseolder than 65rsquo These messages are embodiedin governmental positions in the US UKAustralia and Canada

The Oldways alcohol messages as reflectedin the pyramids are however especiallynotable in that they emphasize consumptionwith or around mealtime as research hasshown that these and related cultural normsfacilitate responsible drinking habits mayslow alcohol absorption and may counterpotential harmful effects of fatty foods Forexample Dr David Hanson author ofPreventing Alcohol Abuse Alcohol Culture andControl explains ldquoThe cross-cultural evidenceindicates that drinking abuse will be low in anygroup in which drinking customs values andsanctions are clearhellip and characterized byprescriptions for moderate drinking andproscriptions against immoderate drinkingrdquoFurthermore several biochemical studiesindicate that in addition to slowing down theabsorption process which keeps blood alcohollevels lower moderate consumption during oraround mealtime may have favourable effectson lipid profiles and atherogenesis One 1998study published in the American Journal ofClinical Nutrition suggested ldquoethanol mayreduce cardiovascular risk by modulatingvascular muscle growth during the postprandialperiodrdquo Research continues but it appears clearthat healthy dietary patterns are inverselyrelated with low rates of chronic diseases Thishas been specifically confirmed in the ongoingSeven Country Study which reported in 1999that animal-food groups were directly correlatedwith CHD mortality while vegetable-food groupsas well as fish and alcohol were inverselycorrelated

In summary in line with the developingscientific consensus public health andgovernmental positions the Oldwayspyramids stress moderation and underscorethe importance of an overall healthy mealand lifestyleConsumption is notrecommended for non-drinkers or thosewho may have any health contraindicationsand consumers are always advised toconsult with their healthcare providersFor selected references and authoritative statements onmoderate drinking and health please visit the Gateway toSensible Drinking and Health via wwwaim-digestcom

13

ORGANISATIONS INVOLVED IN ALCOHOL AFFAIRSUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOM

ALALALALALCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNWaterbridge House 32-36 Loman Street London SE10EETel (0207) 928 7377 Fax (0207) 928 4644Websitewww alcoholconcernorguk

ALALALALALCOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCATION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARCHCHCHCHCHCOUNCILCOUNCILCOUNCILCOUNCILCOUNCILAbell House John Islip Street London SW1P 4LH Tel(0207) 217 5276

ALALALALALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALTH RESEARTH RESEARTH RESEARTH RESEARTH RESEARCH CENTRECH CENTRECH CENTRECH CENTRECH CENTREUniversity of West of England Glenside CampusBlackberry Hill Stapleton Bristol BS16 1DD Tel(0131) 536 6192 Fax (0131) 5366215 E-mailmplantahrconetcouk

HEALHEALHEALHEALHEALTH EDUCATH EDUCATH EDUCATH EDUCATH EDUCATION ATION ATION ATION ATION AUTHORITYUTHORITYUTHORITYUTHORITYUTHORITYHamilton House Mabledon Place London WC1 9TXTel (020) 72985656 Fax (020) 77259031 Emailenquirieshpeorgukwebsite wwwhpeorguk and wwwwreckedcouk

THE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALCOHOLISMCOHOLISMCOHOLISMCOHOLISMCOHOLISM3 St Andrewrsquos Place London NW1 4LBTel (0207) 487 4445 Fax (0207) 9354479

THE PORTHE PORTHE PORTHE PORTHE PORTMAN GRTMAN GRTMAN GRTMAN GRTMAN GROUPOUPOUPOUPOUP7-10 Chandos Street Cavendish Square London W1G9DQTel 020 7907 3700 Fax 020 7907 3710wwwportman-grouporguk

ALALALALALCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOTLANDTLANDTLANDTLANDTLAND2nd Floor 166 Buchanan Street Glasgow G1 2NH Tel0141-572 6700 Fax 041-333 1606

BRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIATIONTIONTIONTIONTIONMarket Towers 1 Nine Elms LaneLondon SW8 5NQTel 020 7627 9191 Fax020 7627 9123E-mail jwitheridgebeerandpubcomWebsite wwwbeerandpubcom

EUREUREUREUREUROPEOPEOPEOPEOPE

ARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GROUPOUPOUPOUPOUPBrewersrsquo House 10 Grand Place B-1000 BrusselsBelgium Tel +32 2 511 49 87 Fax +32 2 511 32 59

CBMCCBMCCBMCCBMCCBMCCheacutee de la Hulpe 181 bte 20 B-1170 Bruxelles Tel(++322) 672 23 92 Fax (++322) 660 94 02Website wwwcbmcorg

FORFORFORFORFORUMUMUMUMUMLivornostraat 13 b 5 rue de Livourne ndash Brussel 1050Bruxelles BelgiumTel 32 2 539 36 64 Fax 32 2 537 81 56email forumtasteeducationskynetbe websitewwwforum-taste-educationcom

ENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTION13 Rue Monsigny 75002 Paris FranceTel 00-33-53-43-80-75E-mail enterprisewanadoofr

IREBIREBIREBIREBIREB19 avenue Trudaine 75009 ParisTel +33 (1) 48 74 82 19 Fax +33 (1) 48 78 17 56E-mail irebirebcom Website wwwirebcom

OIVOIVOIVOIVOIV18 rue drsquoAguesseau 75008 Paris FranceTel +33 (0) 1 44 94 80 94Fax +33 (0) 1 42 66 90 63E-mail oivoivintWebsite wwwoivint

STIVSTIVSTIVSTIVSTIVAAAAABenoordenhoutseweg 22-23 2596 BA The HagueTheNetherlands Tel +31 (0)70 314 2480 Fax +31(0) 70314 24 81 E-mail phoastivanl Website wwwstivanl

SCANDINSCANDINSCANDINSCANDINSCANDINAAAAAVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALALALALALALCOHOL BOCOHOL BOCOHOL BOCOHOL BOCOHOL BOARDARDARDARDARDVandvaeligrksvej 11 DK - 5690 TommerupTel 45 64 75 22 84 Fax 45 64 75 28 44E-mail smaborg Websitewwwsmaborg

DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE WEINWEINWEINWEINWEINAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHGutenbergplatz 3-5 55116 MainzTel +49 02641 977340 Fax +49 02641 977342Website wwwdeutscheweinakademiede

FIVINFIVINFIVINFIVINFIVINPlaza Penedeacutes 3 308720 Vilafranca del PenedeacutesBarcelona Spain Tel 0034 (93) 890 45 45 Fax 0034(93) 890 46 11

DIFDIFDIFDIFDIFA FORA FORA FORA FORA FORUM EVUM EVUM EVUM EVUM EVFranklinstrabe 1 10587 BerlinGermany Tel + 49 (0) 30 39 0633 60Fax +49 (0) 30 390 633 66 email infodifa-forumdeWebsite wwwdifa-forumde

GODGODGODGODGODAAAAAGode Alkoholdninger Kattesundet 9 DK-1458Koslashbenhavn K Denmark Tel 33 13 93 83Fax 33 13 03 84

FIVSFIVSFIVSFIVSFIVSInternational Federation of Wines amp Spirits20 rue drsquoAnjou - 75008 Paris Tel 33 1 42 68 82 48Fax 33 1 40 06 06 98

THE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDAM GRAM GRAM GRAM GRAM GROUPOUPOUPOUPOUPRue Wiertz 5028B-1050 Brussels BelgiumTel +32 2 401 61 35 Fax + 32 2 401 68 68 emailinfoamsterdamgrouporgwwwamsterdamgrouporg

FUNDFUNDFUNDFUNDFUNDAAAAACION ALCION ALCION ALCION ALCION ALCOHOL COHOL COHOL COHOL COHOL Y SOCIEDY SOCIEDY SOCIEDY SOCIEDY SOCIEDADADADADADDiego de Leon 442 ES 28006 MadridTel + 34 91 745 08 44 Fax + 34 91 561 8955wwwalcoholysociedadorg

USA CANUSA CANUSA CANUSA CANUSA CANADADADADADA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAAAAAAUSTRALIAUSTRALIAUSTRALIAUSTRALIAUSTRALIA

WINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICA1200 G Street NW Suite 360 Washington DC 20005Tel (800) 879 4637 Fax (202) 347 6341E-mail infoamericanwineriesorgWebsite wwwamericanwineriesorg

AMERICAN AMERICAN AMERICAN AMERICAN AMERICAN WINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARCHCHCHCHCHAND EDUCAAND EDUCAAND EDUCAAND EDUCAAND EDUCATIONTIONTIONTIONTIONVisit website at wwwalcohol-AWAREcom

AMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAND HEALAND HEALAND HEALAND HEALAND HEALTHTHTHTHTH1995 Broadway 2nd Floor New York NY 10023-5860Tel (212) 362-7044 Ext 234 Fax (212) 362-4919Email kavaacshorg Websitewwwacshorg

BEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTE122 C Street NW 750Washington DC 20001Tel(202) 737-2337 Fax (202) 737-7004E-mailinfobeerinstituteorgWebsite wwwbeerinstituteorg

PRPRPRPRPROOOOOYECTYECTYECTYECTYECTO CIENCIA O CIENCIA O CIENCIA O CIENCIA O CIENCIA VINO VINO VINO VINO VINO Y SALY SALY SALY SALY SALUDUDUDUDUDFacultad de ciencias BioloacutegicasCasilla 114 D Santiago ChileTelFax (56-23) 222 2577Email vinsaludgenesbiopuccl

EDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALCOOLCOOLCOOLCOOLCOOL606 Cathcart Suite 700 Montreacuteal Queacutebec H3B 1K9Canada Tel (514) 875-7454 E-mailhsacyeducalcoolqcca Website wwweducalcoolqcca

THE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERAGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTE1775Pennsylvania Avenue NW Suite 1200 WashingtonDC 20006 Tel 2024637110wwwamericanbeverageinstitutecom

FISAFISAFISAFISAFISACCCCC(Fundacion de Investigaciones Sociales AC) FranciscoSosa 230 coyoacan CP 04000 Mexico DF - Mexico

HEALHEALHEALHEALHEALTTTTTH EDUCAH EDUCAH EDUCAH EDUCAH EDUCATION FOUNDTION FOUNDTION FOUNDTION FOUNDTION FOUNDAAAAATIONTIONTIONTIONTION INC INC INC INC INC2600 Virginia Avenue NW Washington DC 20037Tel (202) 3383501 Fax (202) 9656520E-mail hefmonaerolscom

ICAPICAPICAPICAPICAPInternational Center for Alcohol Policies1519 New Hampshire Avenue NWWashington DC 20036Tel (202) 986-1159 Fax (202) 986-2080Website wwwicaporg

THE CENTURTHE CENTURTHE CENTURTHE CENTURTHE CENTURY COUNCILY COUNCILY COUNCILY COUNCILY COUNCIL1310 G Street NW Suite 600Washington DC 20005-3000 Tel (202) 637-0077 Fax(202) 637-0079 Email washdecenturycouncilorgWebsite wwwcenturycouncilorg

CALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIATION OF TION OF TION OF TION OF TION OF WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEGRGRGRGRGROOOOOWERS WERS WERS WERS WERS 601 University Avenue Suite 135 Sacramento CA 95825wwwcawgorg email karencawgorg

THE THE THE THE THE WINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTE425 Market Street Suite 1000 San Francisco CA94105 USA Tel (415) 512-0151 Fax (415) 442-0742

LLLLLODI -WODI -WODI -WODI -WODI -WOODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPECOMMISSIONCOMMISSIONCOMMISSIONCOMMISSIONCOMMISSION2545 West Turner Road Lodi CA 95242USAmarklodiwinecom website wwwlodiwinecom

THE NTHE NTHE NTHE NTHE NAPAPAPAPAPA A A A A VVVVVALLEY ALLEY ALLEY ALLEY ALLEY VINTNERSVINTNERSVINTNERSVINTNERSVINTNERSASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION Phone - 707-963-3388 Fax - 707-963-3488 Website wwwnapavintnerscom

OLDOLDOLDOLDOLDWWWWWAAAAAYYYYYS PRESERS PRESERS PRESERS PRESERS PRESERVVVVVAAAAATION amp EXTION amp EXTION amp EXTION amp EXTION amp EXCHANGECHANGECHANGECHANGECHANGETRTRTRTRTRUSTUSTUSTUSTUST266 Beacon Street Boston MA 02116 6174215500Fax 6174215511 website wwwoldwaysptorg

THE ATHE ATHE ATHE ATHE AUSTRALIAN USTRALIAN USTRALIAN USTRALIAN USTRALIAN WINE RESEARWINE RESEARWINE RESEARWINE RESEARWINE RESEARCHCHCHCHCHINSTITUTEINSTITUTEINSTITUTEINSTITUTEINSTITUTEP O Box 197 glen Osmond 5064 South AustraliaAustralia Tel 61 8 8303 6600 Fax 61 6 303 6601

13

6

Serve Wise (formerly known as SIPS) wasdeveloped with funding and guidance from theScottish Office and enjoys continued supportfrom the Scottish Executive to deal specificallywith underage drinking drinking and drivingcriminal incidents and deathsaccidents relatedto alcohol in Scotland ServeWise is managedby Alcohol Focus Scotland a charity operatingon a non-profit basis The importance ofadequate training for all staff is increasinglybeing recognised by licensed trade licensingboards and the police Many licensing boardsare now beginning to insist on training as aprerequisite for the granting or renewal of alicence

ServeWise aims to set a National Minimumstandard for all those involved in the sale ofalcohol In order to achieve this ServeWiseoffers short courses (approx 1 day or 2 halfdays) each covering licensing law alcohol andpeople skills This is on two levels -ServeWisePlus for managers licensees and experiencedstaff (covering the law in more depth andincludes issues relating to management) andServeWise for general staff Both the coursesare available in On and Off-Licence versionsAtpresent there are just over 40 Centresthroughout Scotland that can deliver ServeWisecourses located at colleges of further educationor training organizations or other types oforganisations (including solicitors) There aretwo pilot centres in the South The University ofCardiff in conjunction with the police-basedTASC project (Targeting alcohol-Related streetCrime) have held several courses and inManchester there is a multi-agency teamincluding the licensed trade the police andAlcohol and drug services Manchester whichhas just begun to run courses

Assisting in the setting up of the centres is theServeWise Central Office All trainers undertakea 2-day Trainer rsquos Course and receive theServeWise Trainerrsquos Manual (containing coursematerial instructions on delivery and a speciallydesigned video) All trainersrsquo are subject to ongoing verification and continuous professionaldevelopment requirements

ServeWise believes that the training must berelevant user-friendly as well as assessableand affordable and is confident that there willbe a reduction in the number of accidents andcrimes resulting from the misuse of alcohol onlicensed premises and consequently a lessening

in the amount particularly in the terms of policeand accident and emergency time A numberof l icensed trade organizations supportServeWise such as the Scottish Licensed TradeAssociation Diageo UK the BritishEntertainment and Dance Association theLeisure safety and Security Association

Advice and assistance is also offered byServeWise through its Advisory and WorkingGroups which include representatives from theScottish Executive the police solicitorslicensing boards the licensed trade as well asthose from trainingfurther educationperspective These groups also assistServeWise in organising other types of trainingand events including annual events for licensingboard members

lsquoTasterrsquo ServeWise courses for the licensingboard members can be provided where licensingboards wish to encourage training amongstlicensees and staff It is recommended that alsquoFit and Proper Personrsquo policy is set up includingtraining requirements Several Boards havegone on to develop policies after attending aServeWise taster event

Both ServeWise and Alcohol Focus Scotlandare still very much organisations in growth Fromlast year ServeWise has almost doubled itstraining numbers and Alcohol Focus Scotlandis undergoing considerable expansion withseveral newly created posts - including aGender Issues Network Officer (who for the next3 years will focus on women alcohol issues) aUser Support officer (to assist thoseexperiencing alcohol problems and to set up networks) and a NetWork support officer who willassist with communications and developmentof the network of affiliated organisationsprimarily the 30 Local Councils on Alcoholthroughout Scotland which provide counsellingand related services

ServeWise Central Office 166 Buchanan StreetGlasgowG1 2LW TEL 0141 572 6703Newsletters are produced by ServeWise andinformation can also be found on the Internetservewisealcohol-focus-scotlandorguk

Serve-wise and Alcohol Focus ScotlandIn October the Swedish Spirit amp Wine Suppliers(SSWS) will launch an initiative called DrinkwiseThe aim is to get the general public to considertheir alcohol behaviourFrom the beginning Drinkwise will consist of awebsite among other with an interactive partin which the visitor by answering questionsandclaims will be told what kind of alcoholconsumerhe or she is and the character of thistype ofconsumer SSWS concludes thatDrinkwise isone example of initiatives following thepublishing of a book financed by the PublicHealth Institute written by Sam Larsson at theKarolinska Institute in Stockholm and Johan Liljaat the Academy of Turku in Finland Theyconclude that it is better to teach young peoplehow to drink than to tell them not to drink at all -it is better to discuss with them how to behavewith alcoholThe authors also say that preventionprogrammes so far have been tooldquopropagandisticrdquo The non drinking message hasbeen repeated endlessly and has not beeneffective The alcohol policy target should be toget young people to use weak alcoholic drinksand to drink in moderation Maybe it is notrealistic to believe young people will abstain butthey ought to get a more conscious view onalcohol and drugs the authors say The bookhas been financed by the Public Health Institute

Drink-wise from Sweden

The drinks giant Diageo is planning to launcha campaign aimed at reducing the problem ofbinge-drinking in the UK

Diageo has asked its principal advertisingagencies J Walter Thompson Abbott MeadVickers BBDO Bartle Bogle Hegarty Motherand Miles Calcraft Briginshaw Duffy to pitch forthe campaign

In the light of the increase in binge-drinkingdrunkenness and alcohol-related violencepolitical support for further curbs on alcoholadvertising has been growing The industry bodywhich speaks on alcohol policy The PortmanGroup has called for companies to introducecampaigns promoting responsible consumptionThe UK government has called for consultationwith a wide range of groups including alcoholcompanies on how violence in and outside pubsmight be reduced

Diageo to target bingedrinking culture

7

The long established and well supported Proofof Age Card set up by the Portman Group hasbeen accepted into the British RetailConsortiumrsquos new Proof of Age StandardsScheme (PASS) As from June 2003 the newcard complete with hologram will be incirculation

PASS is an umbrella accreditation systemaudited by the Trading Standards Institute andany card that is presented and bears the PASSlogo has met the PASS standards and containsaccurate and reliable information This will helpretailers make an informed decision on whetherto allow a purchase The Portman Group hasrelaunched the card bearing the PASS hologramand Portman Group 18+ logo The Underage

Drinking and the illegal Purchase of AlcoholReport commissioned by the NicholsonCommittee shows that 84 of 15 year oldsplaced drinking of alcohol as a common placeactivity Of the young persons questioned 49currently purchased alcohol illegally 33 fromlicensed grocers 24 from off-licences andanother 24 from pubs or bars

Proof of age standards scheme (PASS)

The subject of numerous prospective and casecontrol studies has been the possible existenceof an independent effect of alcohol use in theaetiology of lung cancer As alcohol correlatesstrongly with smoking possible residualconfounding has been a particular concernResults of several prospective studies were notadjusted for smoking therefore hampering theirinterpretation This study by De Stefani ECorrea P and Deneo-Pellegrini H et al wasundertaken to examine in detail the relationshipbetween alcohol use and the risk ofadenocarcinoma of the lung

Between July 1998 and July 2000 all incidentsof lung adenocarcinoma that were admitted tothe 4 main hospitals in Montevideo Uruguaywere considered eligible for examining the rolesof diet drinking and smoking in the aetiology ofthis malignancy Subjects for the study were 160cases with newly diagnosed adenocarcinomaof the lung with 520 hospitalised controls with acondition unrelated to drinking or smokingInformation about socio-demographic variablesoccupational history smoking history drinkinghistory height and weight 5 years before theinterview menstrual and reproductive history

(women) and a food frequency form including64 food items were obtained by use of aquestionnaire during interview

Total alcohol use was not associated with riskof adenocarcinoma of the lung (OR 12 95CI 06-21) Beer consumption did not correlatewith adenocarcinoma risk (OR 06 95 CI 03-16) In contrast wine consumption showed amarginal protective effect (OR 04 95 02-11)while the use of spirits (predominantly canaderived from sugar cane and grappa derivedfrom grapes) was associated with a 40increase in risk of lung adenocarcinoma

The results of the study suggest that wineconsumption has a protective effect against thedevelopment of adenocarcinoma of the lungwhile spirits are a moderate risk factor for thiscell type of the lung cancer

Source De Stefani E Correa P Deneo-Pellegrini Het al Alcohol intake and risk of adenocarcinoma ofthe lung a case-control study Uruguay Lung Cancer38 (2002) 9-14

Wine may protect against adenocarcinoma of thelung

International Conferenceon Alcohol Drugs andTraffic Safety T 2004

In August 2004 many of the worldrsquos experts ondrugs and alcohol will gather in Glasgow for the17th International Conference on Alcohol Drugsand Traffic Safety

The Conference will explore developments innew policies and technologies to counteractalcohol and drugs problems in the context ofroad traffic safety In particular it will explorethe following key areas of Driver CharacteristicsPharmacology and Toxicology EpidemiologyRehabilitation Prevention Driving andPerformance Police Enforcement and WorkRelated Transport IssuesTo submit an abstract or register interest inthe conference please visit the conferencewebsite at wwwICADTS2004com Tel +44 (0)141 434 1500 Fax + (00 141 434 1519 Emailicadts2004meetingmakerscouk

Conference on socialresponsibility

The Amsterdam Group (TAG) are organising aconference on Social Responsibility on the 17thSeptember at the Renaissance Hotel inBrussels The aim of the conference is topresent concrete actions undertaken by SocialAspects Organisations (SAOs) andstakeholders involved in the distribution of thealcoholic beverages to reduce the negativeimpact of alcohol consumption on individualsand society through

Education and information campaigns topromote sensible drinking in particular towardsyoung people

Responsible advertising and marketing ofalcoholic beverages by industry and retailers tocomply with the Recommendation on AlcoholDrinking by Children and Adolescents adoptedby the Commission in June 2001 For Detailsplease contact Carole Brigaudeau TheAmsterdam Group Rue Wiertz 5028 B - 1050Bruxelles T + 3224016166 F +3224016868 M + 32 (0) 486117199cbrigaudeauamsterdamgrouporg

7

8

Wine goes in at the mouth much to our delightthen trickles through other parts of the bodyLet us go then you and I to explore thetortuousness of the gastro-intestinal tract takingalong divers potables to observe their effects

Most GI adversities associated with drinkingbeverages containing alcohol come with excessand virtually all are caused by alcohol inparticular In some cases the effect of wine isdifferent from that of other drinksmdashwatch forthem The ineffable morning-after distressfollowing indiscretion is poorly understood andis transient but unpleasant consequences ofheavy drinking may be lasting and as severeas cancer

The all-too-common chief complaint of theoesophagus (gullet) is heartburn caused bywelling up of acid material from the stomachTwo major determinants of such acid reflux arethe quantity of acid secreted by the stomachand the propulsion of the stomach acid thewrong way upward into the oesophagus insteadof downward into the intestine Wine maystimulate heartburn it stimulates acid productionby the stomach Alcohol does not Here is arare example of an unfavourable effect of winersquosspecial attributes presumably polyphenolicantioxidants Alcohol however especially inheavy dose may relax the lower oesophagealvalve (sphincter) that is supposed to seal offthe oesophagus and disorder motility thereby

promoting reflux

Cirrhosis of the liver of any cause includingabuse of alcohol is often complicated byformation of oesophageal varices dilation ofveins of the lower oesophagus a distinct risk oflife-threatening haemorrhage The stomach isboth a key actor and a target in the life ofingested alcohol Alcohol dehydrogenase theenzyme that first metabolizes alcohol soneutralizing it is secreted by the gastric mucosathe lining of the stomach When ample alcoholslows the emptying of the stomach alcoholdehydrogenase has more time to attack thealcohol

Womenrsquos stomachs contain about 60 percentas much alcohol dehydrogenase as do menrsquoslikely the chief reason for the long-observedlesser tolerance of women for alcohol and therecommendation that their safe and healthyportion should be about half of menrsquos So whena couple share a bottle of wine at dinner heshould get two-thirds

Binge drinking of high-proof beverages may leadto acute gastritis inflammation of the stomachsometimes accompanied by haemorrhageWine and beer are innocent and may beprotective

The intestines large and small are not just inertpipes conveying food and the products ofdigestion to their fate Their linings activelysecrete digestive enzymes and absorb thenutrients made available by digestion Theirmuscular walls churn and propel the contentsto enhance the chemical reactions of digestionThe muscular motility of the intestine may bereduced in alcoholics thereby unpredictablyaltering function and allowing toxic bacterialovergrowth An odd converse has beenobserved recently in overweight mice whoseobesity slows intestinal motion The bacteria thatgrow to excess as a result produce alcohol andthese mice develop liver abnormalities similarto those of obese humans and to alcoholicsThe lesson may be that obesity and alcohol arecollaborators in causing liver diseasemdashtakeheed

Surprisingly light-drinking laboratory rats haveexhibited enhanced liver regeneration afterinjury compared to rats who abstained or whodrank more Heavy doses of alcohol may impairintestinal absorption of nutrients includingthiamin vitamin B12 amino acids (the building

blocks of proteins) perhaps calcium and zincleading to complex malnutrition

Iron absorption may increase with drinking notnecessarily harmless for excessive iron mayinjure the liver Excessive drinking often leadsto diarrhoea

That wine especially and other alcohol-containing beverages help prevent gastro-intestinal infections has been known for a verylong time Claret drunk in British army messesin India was held to be ldquoa sovereignpreventative against the prevalent cholerardquo justone of a number of similar observations hereand there over the years More recently andmore scientifically wine has been demonstratedto be an effective inhibitor of a trio of fearsomebacteria Escherichia coli Salmonella andShigella causes of ldquotravellerrsquos diarrhoeardquo andworse typhoid and related diseases andbacillary dysentery respectively Researcherssuspect that the operative benefactor is one ormore of winersquos polyphenols Wine and spiritsbut not beer consumed with raw oysterscontaminated with hepatitis A virus which entersvia the gastro-intestinal tract were associatedwith a reduced risk of infectionThe bacteriumHelicobacter pylori (Hpylori) looms much to theastonishment of the medical profession amalign superstar of the first magnitude It residesin the stomachs of those infected Who couldhave imagined that this organism causes muchof chronic gastritis a large majority of pepticulcers and a substantial proportion of cancersof the stomach H pylori is now being implicatedas a promoter of our most deadly diseaseatherosclerosis cause of heart attacks strokesand other catastrophes Drinking especially ofwine appears to help eliminate H pylori In adirect study less than one-third as manydrinkers as abstainers were infected

H pylori infection is also associated withreduced activity of alcohol dehydrogenase in thestomach After eradication of the infectionalcohol dehydrogenase normalizes within twomonths Alcohol is the only component of winethat has been clearly shown to increase the riskof some cancers and then only when abused

Chronic heavy drinking particularlyaccompanied by abuse of tobacco isassociated in the gastro-intestinal tract withincreased cancer risk in the mouth throatoesophagus and perhaps the upper stomach

WINE AND THE GASTROINTESTINAL TRACTBy Harvey E Finkel MD

9

Inconclusive reports have raised the questionof a slight increase in risk of cancer of thepancreas The data relating beer and spirits toa possible slight increase of risk of colorectaltumours are conflicting and confusing

Might moderate drinking protect against cancerEarly indications suggest the answer might beldquoyesrdquo A number of studies has demonstratedthat wine in particular possesses severalproperties that would tend to prevent or inhibitcancer no doubt through the actions of itsantioxidant compounds Epidemiologic researchhas revealed substantial reduction of risk ofcancers of the oesophagus and upper stomachand colon and rectum in wine drinkers ascompared to non-drinkers

In essence past experience and currentresearch indicate that abuse of alcohol risksdamaging the gastro-intestinal tract at severalpoints but moderate wine consumption risksonly a little heartburn while possibly leading tomajor health benefits not to mention gustatorypleasures

Whether wine is a poison a medicine or anourishment is a matter of dosage mdashParacelsus Harvey E Finkel MD is Clinical Professor of Medicineat Boston University Medical Centre and is a memberof AIMrsquos Social Scientific and Medical Council

a study by Dr Morten Gronbaek of the NationalInstitute of Public Health in Copenhagen hasfound that heavy drinkers (especially non-winedrinkers) significantly increase their risk ofcontracting rectal cancerThe findings are basedon a population study of over 29000 Danishmen and women aged between 23 and 95Cancers that originate in the colon and rectumare the fourth most commonly diagnosedcancers in the US and represent the second-leading cause of death from cancerApproximately one-third of the cases ofcolorectal cancer are actually cancers of therectum Gronbaek said Their weekly intake ofbeer wine and spirits was assessed as wereother factors likely to influence bowel cancerrisk such as how much they smoked weighedand took regular exercise Men were more likelythan women to be heavy drinkers and heavydrinkers were more likely to be smokers and toweigh more than light drinkers

During a monitoring period of almost 15 years411 cases of colon cancer and 202 cases ofrectal cancer were reported among thosestudied Alcohol seemed to have little influenceover the risk of colon cancer but there was aclear association between rectal cancer risk andthe amount of alcohol consumed Thosedrinking more than 41 units of alcohol a weekhad twice the risk of developing the disease as

non-drinkers But the type of alcohol consumedhad a significant bearing on rectal cancer riskThose who drank 14 or more units of beer orspirits a week were over 35 times as likely todevelop rectal cancer as non-drinkers Yet thosewho drank the same total amount of alcoholbut who included around a third or more of winein their intake were less than twice as likely todevelop the diseaseThe authors point out thatwine drinkers tended to be better educated andto take more exercise than beer or spiritdrinkers so there may be other healthier lifestylefactors at play There are no obvious reasonswhy alcohol should apparently be moredamaging to the rectum than the colon but thereasons why wine seems to exert its protectiveeffect most likely lie in resveratrol which is foundin both grapes and wine

Previous research indicates that this chemicaldamps down the cellular processes involved inthe promotion and growth of cancerous cellsThe lack of a relationship between alcoholdrinking and colon cancer risk is also somewhatof a mystery according to Gronbaek

ldquoThe tissue is rather similar in the two parts ofthe organ mdash colon and rectum mdash and one mightexpect the same mechanism in developing thediseaserdquo Gronbaek said However he addedthat previous studies have also found thatalcohol has an effect on the rectum but not thecolon SOURCE Gut 200352861-867

Alcohol colon and rectal cancer

The World Advertising Research Centre will beholding the eighth annual Alcoholic Drinksconference in central London on Tuesday 30th

September The conference will be chaired byNick Kendall Group Strategy Director BartleBogle Hegarty

This yearrsquos programme will concentrate inparticular on the urgency and importance ofsocial responsibility issues for the alcoholicdrinks industry With the UK Government in themiddle of developing a national alcohol harm-reduction strategy conducted by the PrimeMinisterrsquos own Strategy Unit and the Department

of Health self-regulation may give way to legalcontrols on the advertising of alcoholic drinksSpeakers include Rita Clifton ChairmanInterbrand Hamish Pringle Director GeneralIPAWendy Darlington Brand MarketingDirector Diageo Plc Jaspar Shelbourne GlobalCreative Director JWT Alan Mitchell JournalistMike Spurling Director The Informer A SpecialPanel on Social Responsibility features AndrewBrown The Advertising Association HughBurkitt The Marketing Society Leanne RileyScientist World Health Organisation JeanCoussins The Portman GroupHelmutWagner The Amsterdam Group Chris SearleExecutive Director Bacardi Martini

For details contact Sarah Miller World AdvertisingResearch Center Farm Road Henley-on-ThamesOxon RG9 1EJ Tel 0044 (0) 1491 418 646 Fax0044 (0) 1491 418 600 Mail sarah_millerwarccomWeb wwwwarccomconferences

30th Alcoholic Drinks 2003 - Conference Brewers of Europe 3rdBeer and health

symposiumThe Brewers of Europe are holding a conferenceon the benefits of moderate beer consumptionon the 15th October at the Residence PalaceBrussels

The event is chaired by professor Oliver Jamesof the University of Newcastle and includespresentations on alcohol and weight moderatedrinking and well being and nutritional aspects

For more information please visitwwwbrewersofeuropeorg or emailinfobrewersofeuropeorg

9

10

1Introduction

As part of cultural traditions and well balancedlifestyles wine beer and spirits consumption hasbeen a common staple in diets around the worldIn acknowledgement of such practices groupsof nutrition experts have included the moderateconsumption of alcohol as an optionalcomponent of various dietary guidelines andfood guides such as the Mediterranean AsianLatin American and Vegetarian Pyramids Herewe outline the key scientifically based nutritionmessages in these pyramids

The outlined alcohol-inclusive dietary pyramidsare part of an effort by Oldways Preservation ampExchange Trust a non- profit education groupthat is dedicated to preserving traditional eatingpatterns with the goal to improve consumerknowledge and diets around the world Oldwayshas prepared these concepts with prominentnutrition medical biomedical andcommunication experts from leading institutionssuch as the WHO Regional Office for Europeand the Harvard School of Public Health

Cardiovascular disease and cancer are leadingcauses of death in developed nations aroundthe world predominantly being associated withdiets high in animal fats With that emergingscientific consensus the Oldways pyramids allemphasize fruits vegetables cereals andpulses with litt le meat (animal fats)consumption These nutrition concepts alsoinclude wine beer and spirits which have shownto contribute to lower heart disease rates andimprove longevity

Accumulating scientific evidence suggests thatmoderate consumption of wine beer and spiritsdoes not pose a health risk to the vast majorityof consumers who choose to drink inmoderation AIMrsquos recommendations alsoemphasise that adults should enjoy alcoholbeverages in a sensible manner preferablyaround mealtimes or other responsible socialsettings Moderation is the key to a healthy dietand lifestyle and this is reflected in severaltraditional nutrition concepts

Consumers should follow moderation guidelinessuch as those in the Dietary Guidelines forAmericans which define moderation as up totwo drinks (12g) a day for men and up to onedrink a day for women further consumersshould avoid alcohol during pregnancy or when-ever it would put the individual or others at risk

To learn more about the US Dietary Guidelinesmessage on alcohol please visitwwwhealthgovdietaryguidelines and for otherauthoritative links on alcohol please also visitthe AIM links page on the gateway to sensibledrinking and health site via wwwaim-digestcom

Alcohol-Inclusive Nutrition

Concepts The

The lsquoEatwisersquo concept

The latest ldquoEat Wiserdquo Pyramid including ldquowinebeer and spirits in moderationrdquo as part of a dailybeverage recommendation was released atJanuaryrsquos 2003 Mediterranean Diet Conferencesponsored by Harvard School of Public Healthand Oldways Preservation amp Exchange TrustThis new pyramid is modelled on the originalMediterranean Diet Pyramid which initially onlyrecommended wine in moderation reflecting thecultural preference of the Mediterranean regionldquoThis Eat Wise Pyramid is a visual guide tohealthy living the Eat Wise wayrdquo theaccompanying text states ldquoIt shows thepartnership of a balanced diet plenty of waterregular physical activity and alcohol inmoderation that wise eaters know strengthenall their bodiesrsquo functionsrdquo An expert conferencediscussion emphasized the potential benefits forall three beverages Eat Wise Meal Ideasshopping tips and recipes are outlined in aspecial eating guide that can be ordered via theOldways website

Moderate Alcohol Intake as Part of a Healthy Diet and Lifestyle - A Look at Alcohol Inclusive Nutrition Concepts from Around the World by Elisabeth Holmgren

The Mediterranean Diet Pyramidwwwoldwaysptorgpyramidsmed

p_medhtml

The Mediterranean Diet Concept

Long known for its healthy lifestyles and thelongevity of its people the Mediterranean regionis also home of some of the most palatable andhealthy foods on earth Traditionally wine hasbeen included as an integral part of its mealsand cross-cultural studies have reportedsignificantly lower risk of heart disease inMediterranean regions where alcohol is a dailystaple of a healthy diet and lifestyle As thepreferred beverage in this region wine isspecified as an option on ldquoThe TraditionalHealthy Mediterranean Diet Pyramidrdquodeveloped by Oldways in cooperation withscientists from the WHO in Europe and fromthe Harvard School of Public Health Thistraditional diet is based on grains including ricepolenta bulgur and pasta as well as legumesand vegetables It also includes fruits cheesesyogurt and nuts along with the optional choiceof alcohol in moderation Olive oil is given itsown category as a major source of monounsaturated fat reflecting its importantprominence in the regionrsquos healthy cuisine Dailyphysical activity a factor contributing to healthin the Mediterranean region and elsewhere isalso included on this and all Oldways pyramids

11

The Asian Diet Concept

As Asian cuisine continues to become popularin diverse regions of the world characteristicsof Asian diets will continue to gain importanceIn Japan and China studies have found ratesfor heart disease and many types of cancer tobe lower than those in the United States andthe rest of the world The centuries-oldtraditional Asian diet of rice noodles vegetablesand fish is believed to be a significant contributorto the documented lower rates for chronicdisease in these populations The ldquoTraditionalhealthy Asian Diet Pyramidrdquo developed incooperation with scientists at Cornell Universityand the Harvard School of Public Healthincorporates these dietary patterns into thepyramid format Sake wine beer and otherbeverages with alcohol in moderation as wellas tea are included as part of the pyramidbecause studies have shown that theirconsumption may play an role in reducing heartdisease risk and overall mortality

The Asian Diet Pyramid

wwwoldwaysptorgpyramidsasianp_asianhtml

ldquoThe

The Latin American ConceptThe Traditional Healthy Latin American DietPyramidrdquo released in 1996 is based on thetraditional foods of Latin America Unlike theAmericanized versions that tend to be high insalt and fat this pyramid presents many healthyeating options It emphasizes daily consumptionof beans grains tubers and nuts along withfruits and vegetablesmdashstaples in most LatinAmerican and Caribbean regions Daily physicalactivity is integrated into the pyramid structurein recognition of the scientific consensus on theimportance of exercise in maintaining goodhealth Alcohol in moderation with meals isincluded as an option and as with other culturalpyramids meats sweets and eggs are at thevery top of the pyramid in the ldquooccasionallyrdquocategory to advocate a healthy and balancedlifestyle that can reduce the risk for several

common diseases

The Vegetarian Diet ConceptThe unique ldquoVegetarian Diet Pyramidrdquo releasedby Oldways at the end of 1997 serves as amodel for healthy eating with meals built aroundvegetables fruits whole grains and legumesThe pyramid also emphasizes daily physicalactivity water consumption and the option ofldquowine beer and other alcoholrdquo in moderationThe importance of this dietary conceptaccording to Oldways is that it reflects thegrowing number of vegetarians and

The Scientific Evidence

The nutritional and medical significance ofthe traditional Oldways Dietary Pyramidswas featured in ldquoMedical NewsPerspectivesrdquo of the Journal of the AmericanMedical Association in 2000 The authorhighlighted the importance of well-balancedand nutritious diets as a potential diseaseprevention measure that could beincreasingly conveyed by physicians andhealthcare providers to their patients Morerecently Greek and US scientists investigatedthe health effects of adherence to aMediterranean Diet reported in the New EnglandJournal of Medicine in 2003 ldquoGreater adherenceto the traditional Mediterranean diet isassociated with a significant reduction in totalmortalityrdquo Coinciding with these acknow-ledgements there is now a developing scientificconsensus that for many individuals moderatewine beer and spirits consumption is associated

acknowledges the nutritional and health benefitsof this type of diet For example the DietaryGuidelines for Americans have acknowledgedsuch a diet as able to meet RecommendedDietary Allowances (RDA) for nutrients Whilesome vegetarians are prohibited fromconsuming meat and alcohol for religiousreasons all alcohol beverages are included asa choice because of the potential risk reductionfor heart disease and its cultural role as anaccompaniment to vegetarian eating

The Latin American Diet Pyramidwwwoldwaysptorgpyramidslatin

p_latinhtml

The Vegetarian Diet Pyramidwwwoldwaysptorgpyramidsveg

p_veghtml

11

12

with a reduced risk of coronary heart diseaseand increased life expectancy which lead to theabove featured alcohol-inclusive nutritionconcepts

In 1997Sir Richard Doll Emeritis Professor ofMedicine at Oxfordoutlined in the BritishMedical Journal ldquomassiverdquo evidence for thepotential beneficial effect of alcohol in a reviewof the clinical data on alcohol and mortality Heconcluded that ldquothe consumption of small andmoderate amounts of alcoholrdquo leads to a one-third-risk reduction for vascular disease He alsoacknowledged a reduction in total mortality inmiddle-aged and elderly men and women whenthey consumed wine beer or spirits Morerecently world-renowned expert Dr ArthurKlatsky from the US outlined the overwhelmingscientific evidence in Scientific American DrKlatsky has published many research studieson alcohol and health in leading scientificjournals from the large-scale Kaiser Permanentecohort and in the recent article he wrote withrespect to the most appropriate advice to thepublic ldquoOn one hand mild to moderate drinkingseems better for heart health than abstinencefor select people On the other hand heavydrinking is clearly dangerousrdquo Merelyrecommending abstinence is inappropriatehealth advice to people such as established lightdrinkers at high risk of CHD and at low risk ofalcohol-related problemsmdashwhich describes alarge proportion of the populationrdquo Dr Klatskyalong with other experts from around the worldhas advocated that health professionals makecase-by-case evaluations based on individualand family histories They also emphasize thatthe public should be entrusted with all theinformation on use versus misuse of alcohol sothat they can make informed decisionsthemselves

Authoritative findings from cohortsinternationally lead research experts tofeature the option of moderation in eachtraditional Oldways Dietary Pyramid Manypeer-reviewed studies from Europe AsiaAustralia and the US have revealed potentialbenefits for moderately drinking adults inmulti-ethnic populations These studies findthat moderate drinkers especially consumersof 1-2 drinks (12g) daily may lower their risk ofheart disease significantly Studies reportingcertain health advantages for moderate drinkersinclude the Lyon Heart Study the CopenhagenCity Heart Study the Australian Dubbo Studyand the European Seven Country Study

The Oldways experts working with the HarvardSchool of Public Health specifically consideredfindings from the ongoing Physiciansrsquo HealthStudy and the Nursesrsquo Health Study Analyzingdata from 84000 women in the Nursesrsquo HealthStudy the effect of a combination of diet andlifestyle factors were assessed on the risk ofCHD Dr Meir Stampfer et al concludedrdquo In thispopulation of middle-aged women those whodid not smoke cigarettes were not overweightmaintained a healthful diet described aboveexercised moderately or vigorously for half anhour a day and consumed alcohol moderatelyhad an incidence of coronary events that wasmore than 80 lower than that in the rest of thepopulationrdquo At the same time based on aprospective study of more than 89000 men aspart of the Physiciansrsquo Health Study Harvardresearcher Dr Michael Gaziano et al concludedrdquoIn summary this study reveals the complexeffect of alcohol consumption on various chronicdiseases as reflected in the overall U-shapedrelationship between light-to-moderate alcoholconsumption and total mortality in menrdquoTheearlier results from the US governmentrsquos fundedNational Health and Nutrition ExaminationSurvey (NHANES) were also considered whichfound that the risk for CHD is reduced for bothmen and women who drink moderatelyPublished in 1997 in the American Journal ofEpidemiology it stated ldquoThis analysisconfirmed previous research showing thatabstainers are at a greater risk for CHD thanare most non abstainers and that a significantprotective effect may be demonstrated withsmall amounts of alcoholrdquo Along those linesresearch published in The New England Journalof Medicine from American Cancer Societyexperts concluded ldquoIn this middle-aged andelderly population moderate alcoholconsumption slightly reduced overall mortalityrdquo

At the same time there are continuingconcerns about alcohol consumption andbreast cancer and women arerecommended not to drink when pregnant in line with governmental and public healthpositions in the US Authoritative statementsfrom public health groups such as the AmericanHeart Association the National StrokeAssociation and the American DieteticAssociation acknowledge the scientific evidencepointing to potential benefits of moderation withrespect to coronary heart disease andemphasize ldquoIf you choose to drink do so inmoderationrdquo A balanced summary position is

reflected in the 1999 JAMA Patient Page onldquoBenefits and dangers of alcoholrdquo which defineslsquoModerate drinking as 1 or 2 drinks (12g) a dayfor men and 1 drink a day for women and thoseolder than 65rsquo These messages are embodiedin governmental positions in the US UKAustralia and Canada

The Oldways alcohol messages as reflectedin the pyramids are however especiallynotable in that they emphasize consumptionwith or around mealtime as research hasshown that these and related cultural normsfacilitate responsible drinking habits mayslow alcohol absorption and may counterpotential harmful effects of fatty foods Forexample Dr David Hanson author ofPreventing Alcohol Abuse Alcohol Culture andControl explains ldquoThe cross-cultural evidenceindicates that drinking abuse will be low in anygroup in which drinking customs values andsanctions are clearhellip and characterized byprescriptions for moderate drinking andproscriptions against immoderate drinkingrdquoFurthermore several biochemical studiesindicate that in addition to slowing down theabsorption process which keeps blood alcohollevels lower moderate consumption during oraround mealtime may have favourable effectson lipid profiles and atherogenesis One 1998study published in the American Journal ofClinical Nutrition suggested ldquoethanol mayreduce cardiovascular risk by modulatingvascular muscle growth during the postprandialperiodrdquo Research continues but it appears clearthat healthy dietary patterns are inverselyrelated with low rates of chronic diseases Thishas been specifically confirmed in the ongoingSeven Country Study which reported in 1999that animal-food groups were directly correlatedwith CHD mortality while vegetable-food groupsas well as fish and alcohol were inverselycorrelated

In summary in line with the developingscientific consensus public health andgovernmental positions the Oldwayspyramids stress moderation and underscorethe importance of an overall healthy mealand lifestyleConsumption is notrecommended for non-drinkers or thosewho may have any health contraindicationsand consumers are always advised toconsult with their healthcare providersFor selected references and authoritative statements onmoderate drinking and health please visit the Gateway toSensible Drinking and Health via wwwaim-digestcom

13

ORGANISATIONS INVOLVED IN ALCOHOL AFFAIRSUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOM

ALALALALALCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNWaterbridge House 32-36 Loman Street London SE10EETel (0207) 928 7377 Fax (0207) 928 4644Websitewww alcoholconcernorguk

ALALALALALCOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCATION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARCHCHCHCHCHCOUNCILCOUNCILCOUNCILCOUNCILCOUNCILAbell House John Islip Street London SW1P 4LH Tel(0207) 217 5276

ALALALALALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALTH RESEARTH RESEARTH RESEARTH RESEARTH RESEARCH CENTRECH CENTRECH CENTRECH CENTRECH CENTREUniversity of West of England Glenside CampusBlackberry Hill Stapleton Bristol BS16 1DD Tel(0131) 536 6192 Fax (0131) 5366215 E-mailmplantahrconetcouk

HEALHEALHEALHEALHEALTH EDUCATH EDUCATH EDUCATH EDUCATH EDUCATION ATION ATION ATION ATION AUTHORITYUTHORITYUTHORITYUTHORITYUTHORITYHamilton House Mabledon Place London WC1 9TXTel (020) 72985656 Fax (020) 77259031 Emailenquirieshpeorgukwebsite wwwhpeorguk and wwwwreckedcouk

THE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALCOHOLISMCOHOLISMCOHOLISMCOHOLISMCOHOLISM3 St Andrewrsquos Place London NW1 4LBTel (0207) 487 4445 Fax (0207) 9354479

THE PORTHE PORTHE PORTHE PORTHE PORTMAN GRTMAN GRTMAN GRTMAN GRTMAN GROUPOUPOUPOUPOUP7-10 Chandos Street Cavendish Square London W1G9DQTel 020 7907 3700 Fax 020 7907 3710wwwportman-grouporguk

ALALALALALCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOTLANDTLANDTLANDTLANDTLAND2nd Floor 166 Buchanan Street Glasgow G1 2NH Tel0141-572 6700 Fax 041-333 1606

BRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIATIONTIONTIONTIONTIONMarket Towers 1 Nine Elms LaneLondon SW8 5NQTel 020 7627 9191 Fax020 7627 9123E-mail jwitheridgebeerandpubcomWebsite wwwbeerandpubcom

EUREUREUREUREUROPEOPEOPEOPEOPE

ARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GROUPOUPOUPOUPOUPBrewersrsquo House 10 Grand Place B-1000 BrusselsBelgium Tel +32 2 511 49 87 Fax +32 2 511 32 59

CBMCCBMCCBMCCBMCCBMCCheacutee de la Hulpe 181 bte 20 B-1170 Bruxelles Tel(++322) 672 23 92 Fax (++322) 660 94 02Website wwwcbmcorg

FORFORFORFORFORUMUMUMUMUMLivornostraat 13 b 5 rue de Livourne ndash Brussel 1050Bruxelles BelgiumTel 32 2 539 36 64 Fax 32 2 537 81 56email forumtasteeducationskynetbe websitewwwforum-taste-educationcom

ENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTION13 Rue Monsigny 75002 Paris FranceTel 00-33-53-43-80-75E-mail enterprisewanadoofr

IREBIREBIREBIREBIREB19 avenue Trudaine 75009 ParisTel +33 (1) 48 74 82 19 Fax +33 (1) 48 78 17 56E-mail irebirebcom Website wwwirebcom

OIVOIVOIVOIVOIV18 rue drsquoAguesseau 75008 Paris FranceTel +33 (0) 1 44 94 80 94Fax +33 (0) 1 42 66 90 63E-mail oivoivintWebsite wwwoivint

STIVSTIVSTIVSTIVSTIVAAAAABenoordenhoutseweg 22-23 2596 BA The HagueTheNetherlands Tel +31 (0)70 314 2480 Fax +31(0) 70314 24 81 E-mail phoastivanl Website wwwstivanl

SCANDINSCANDINSCANDINSCANDINSCANDINAAAAAVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALALALALALALCOHOL BOCOHOL BOCOHOL BOCOHOL BOCOHOL BOARDARDARDARDARDVandvaeligrksvej 11 DK - 5690 TommerupTel 45 64 75 22 84 Fax 45 64 75 28 44E-mail smaborg Websitewwwsmaborg

DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE WEINWEINWEINWEINWEINAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHGutenbergplatz 3-5 55116 MainzTel +49 02641 977340 Fax +49 02641 977342Website wwwdeutscheweinakademiede

FIVINFIVINFIVINFIVINFIVINPlaza Penedeacutes 3 308720 Vilafranca del PenedeacutesBarcelona Spain Tel 0034 (93) 890 45 45 Fax 0034(93) 890 46 11

DIFDIFDIFDIFDIFA FORA FORA FORA FORA FORUM EVUM EVUM EVUM EVUM EVFranklinstrabe 1 10587 BerlinGermany Tel + 49 (0) 30 39 0633 60Fax +49 (0) 30 390 633 66 email infodifa-forumdeWebsite wwwdifa-forumde

GODGODGODGODGODAAAAAGode Alkoholdninger Kattesundet 9 DK-1458Koslashbenhavn K Denmark Tel 33 13 93 83Fax 33 13 03 84

FIVSFIVSFIVSFIVSFIVSInternational Federation of Wines amp Spirits20 rue drsquoAnjou - 75008 Paris Tel 33 1 42 68 82 48Fax 33 1 40 06 06 98

THE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDAM GRAM GRAM GRAM GRAM GROUPOUPOUPOUPOUPRue Wiertz 5028B-1050 Brussels BelgiumTel +32 2 401 61 35 Fax + 32 2 401 68 68 emailinfoamsterdamgrouporgwwwamsterdamgrouporg

FUNDFUNDFUNDFUNDFUNDAAAAACION ALCION ALCION ALCION ALCION ALCOHOL COHOL COHOL COHOL COHOL Y SOCIEDY SOCIEDY SOCIEDY SOCIEDY SOCIEDADADADADADDiego de Leon 442 ES 28006 MadridTel + 34 91 745 08 44 Fax + 34 91 561 8955wwwalcoholysociedadorg

USA CANUSA CANUSA CANUSA CANUSA CANADADADADADA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAAAAAAUSTRALIAUSTRALIAUSTRALIAUSTRALIAUSTRALIA

WINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICA1200 G Street NW Suite 360 Washington DC 20005Tel (800) 879 4637 Fax (202) 347 6341E-mail infoamericanwineriesorgWebsite wwwamericanwineriesorg

AMERICAN AMERICAN AMERICAN AMERICAN AMERICAN WINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARCHCHCHCHCHAND EDUCAAND EDUCAAND EDUCAAND EDUCAAND EDUCATIONTIONTIONTIONTIONVisit website at wwwalcohol-AWAREcom

AMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAND HEALAND HEALAND HEALAND HEALAND HEALTHTHTHTHTH1995 Broadway 2nd Floor New York NY 10023-5860Tel (212) 362-7044 Ext 234 Fax (212) 362-4919Email kavaacshorg Websitewwwacshorg

BEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTE122 C Street NW 750Washington DC 20001Tel(202) 737-2337 Fax (202) 737-7004E-mailinfobeerinstituteorgWebsite wwwbeerinstituteorg

PRPRPRPRPROOOOOYECTYECTYECTYECTYECTO CIENCIA O CIENCIA O CIENCIA O CIENCIA O CIENCIA VINO VINO VINO VINO VINO Y SALY SALY SALY SALY SALUDUDUDUDUDFacultad de ciencias BioloacutegicasCasilla 114 D Santiago ChileTelFax (56-23) 222 2577Email vinsaludgenesbiopuccl

EDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALCOOLCOOLCOOLCOOLCOOL606 Cathcart Suite 700 Montreacuteal Queacutebec H3B 1K9Canada Tel (514) 875-7454 E-mailhsacyeducalcoolqcca Website wwweducalcoolqcca

THE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERAGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTE1775Pennsylvania Avenue NW Suite 1200 WashingtonDC 20006 Tel 2024637110wwwamericanbeverageinstitutecom

FISAFISAFISAFISAFISACCCCC(Fundacion de Investigaciones Sociales AC) FranciscoSosa 230 coyoacan CP 04000 Mexico DF - Mexico

HEALHEALHEALHEALHEALTTTTTH EDUCAH EDUCAH EDUCAH EDUCAH EDUCATION FOUNDTION FOUNDTION FOUNDTION FOUNDTION FOUNDAAAAATIONTIONTIONTIONTION INC INC INC INC INC2600 Virginia Avenue NW Washington DC 20037Tel (202) 3383501 Fax (202) 9656520E-mail hefmonaerolscom

ICAPICAPICAPICAPICAPInternational Center for Alcohol Policies1519 New Hampshire Avenue NWWashington DC 20036Tel (202) 986-1159 Fax (202) 986-2080Website wwwicaporg

THE CENTURTHE CENTURTHE CENTURTHE CENTURTHE CENTURY COUNCILY COUNCILY COUNCILY COUNCILY COUNCIL1310 G Street NW Suite 600Washington DC 20005-3000 Tel (202) 637-0077 Fax(202) 637-0079 Email washdecenturycouncilorgWebsite wwwcenturycouncilorg

CALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIATION OF TION OF TION OF TION OF TION OF WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEGRGRGRGRGROOOOOWERS WERS WERS WERS WERS 601 University Avenue Suite 135 Sacramento CA 95825wwwcawgorg email karencawgorg

THE THE THE THE THE WINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTE425 Market Street Suite 1000 San Francisco CA94105 USA Tel (415) 512-0151 Fax (415) 442-0742

LLLLLODI -WODI -WODI -WODI -WODI -WOODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPECOMMISSIONCOMMISSIONCOMMISSIONCOMMISSIONCOMMISSION2545 West Turner Road Lodi CA 95242USAmarklodiwinecom website wwwlodiwinecom

THE NTHE NTHE NTHE NTHE NAPAPAPAPAPA A A A A VVVVVALLEY ALLEY ALLEY ALLEY ALLEY VINTNERSVINTNERSVINTNERSVINTNERSVINTNERSASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION Phone - 707-963-3388 Fax - 707-963-3488 Website wwwnapavintnerscom

OLDOLDOLDOLDOLDWWWWWAAAAAYYYYYS PRESERS PRESERS PRESERS PRESERS PRESERVVVVVAAAAATION amp EXTION amp EXTION amp EXTION amp EXTION amp EXCHANGECHANGECHANGECHANGECHANGETRTRTRTRTRUSTUSTUSTUSTUST266 Beacon Street Boston MA 02116 6174215500Fax 6174215511 website wwwoldwaysptorg

THE ATHE ATHE ATHE ATHE AUSTRALIAN USTRALIAN USTRALIAN USTRALIAN USTRALIAN WINE RESEARWINE RESEARWINE RESEARWINE RESEARWINE RESEARCHCHCHCHCHINSTITUTEINSTITUTEINSTITUTEINSTITUTEINSTITUTEP O Box 197 glen Osmond 5064 South AustraliaAustralia Tel 61 8 8303 6600 Fax 61 6 303 6601

13

7

The long established and well supported Proofof Age Card set up by the Portman Group hasbeen accepted into the British RetailConsortiumrsquos new Proof of Age StandardsScheme (PASS) As from June 2003 the newcard complete with hologram will be incirculation

PASS is an umbrella accreditation systemaudited by the Trading Standards Institute andany card that is presented and bears the PASSlogo has met the PASS standards and containsaccurate and reliable information This will helpretailers make an informed decision on whetherto allow a purchase The Portman Group hasrelaunched the card bearing the PASS hologramand Portman Group 18+ logo The Underage

Drinking and the illegal Purchase of AlcoholReport commissioned by the NicholsonCommittee shows that 84 of 15 year oldsplaced drinking of alcohol as a common placeactivity Of the young persons questioned 49currently purchased alcohol illegally 33 fromlicensed grocers 24 from off-licences andanother 24 from pubs or bars

Proof of age standards scheme (PASS)

The subject of numerous prospective and casecontrol studies has been the possible existenceof an independent effect of alcohol use in theaetiology of lung cancer As alcohol correlatesstrongly with smoking possible residualconfounding has been a particular concernResults of several prospective studies were notadjusted for smoking therefore hampering theirinterpretation This study by De Stefani ECorrea P and Deneo-Pellegrini H et al wasundertaken to examine in detail the relationshipbetween alcohol use and the risk ofadenocarcinoma of the lung

Between July 1998 and July 2000 all incidentsof lung adenocarcinoma that were admitted tothe 4 main hospitals in Montevideo Uruguaywere considered eligible for examining the rolesof diet drinking and smoking in the aetiology ofthis malignancy Subjects for the study were 160cases with newly diagnosed adenocarcinomaof the lung with 520 hospitalised controls with acondition unrelated to drinking or smokingInformation about socio-demographic variablesoccupational history smoking history drinkinghistory height and weight 5 years before theinterview menstrual and reproductive history

(women) and a food frequency form including64 food items were obtained by use of aquestionnaire during interview

Total alcohol use was not associated with riskof adenocarcinoma of the lung (OR 12 95CI 06-21) Beer consumption did not correlatewith adenocarcinoma risk (OR 06 95 CI 03-16) In contrast wine consumption showed amarginal protective effect (OR 04 95 02-11)while the use of spirits (predominantly canaderived from sugar cane and grappa derivedfrom grapes) was associated with a 40increase in risk of lung adenocarcinoma

The results of the study suggest that wineconsumption has a protective effect against thedevelopment of adenocarcinoma of the lungwhile spirits are a moderate risk factor for thiscell type of the lung cancer

Source De Stefani E Correa P Deneo-Pellegrini Het al Alcohol intake and risk of adenocarcinoma ofthe lung a case-control study Uruguay Lung Cancer38 (2002) 9-14

Wine may protect against adenocarcinoma of thelung

International Conferenceon Alcohol Drugs andTraffic Safety T 2004

In August 2004 many of the worldrsquos experts ondrugs and alcohol will gather in Glasgow for the17th International Conference on Alcohol Drugsand Traffic Safety

The Conference will explore developments innew policies and technologies to counteractalcohol and drugs problems in the context ofroad traffic safety In particular it will explorethe following key areas of Driver CharacteristicsPharmacology and Toxicology EpidemiologyRehabilitation Prevention Driving andPerformance Police Enforcement and WorkRelated Transport IssuesTo submit an abstract or register interest inthe conference please visit the conferencewebsite at wwwICADTS2004com Tel +44 (0)141 434 1500 Fax + (00 141 434 1519 Emailicadts2004meetingmakerscouk

Conference on socialresponsibility

The Amsterdam Group (TAG) are organising aconference on Social Responsibility on the 17thSeptember at the Renaissance Hotel inBrussels The aim of the conference is topresent concrete actions undertaken by SocialAspects Organisations (SAOs) andstakeholders involved in the distribution of thealcoholic beverages to reduce the negativeimpact of alcohol consumption on individualsand society through

Education and information campaigns topromote sensible drinking in particular towardsyoung people

Responsible advertising and marketing ofalcoholic beverages by industry and retailers tocomply with the Recommendation on AlcoholDrinking by Children and Adolescents adoptedby the Commission in June 2001 For Detailsplease contact Carole Brigaudeau TheAmsterdam Group Rue Wiertz 5028 B - 1050Bruxelles T + 3224016166 F +3224016868 M + 32 (0) 486117199cbrigaudeauamsterdamgrouporg

7

8

Wine goes in at the mouth much to our delightthen trickles through other parts of the bodyLet us go then you and I to explore thetortuousness of the gastro-intestinal tract takingalong divers potables to observe their effects

Most GI adversities associated with drinkingbeverages containing alcohol come with excessand virtually all are caused by alcohol inparticular In some cases the effect of wine isdifferent from that of other drinksmdashwatch forthem The ineffable morning-after distressfollowing indiscretion is poorly understood andis transient but unpleasant consequences ofheavy drinking may be lasting and as severeas cancer

The all-too-common chief complaint of theoesophagus (gullet) is heartburn caused bywelling up of acid material from the stomachTwo major determinants of such acid reflux arethe quantity of acid secreted by the stomachand the propulsion of the stomach acid thewrong way upward into the oesophagus insteadof downward into the intestine Wine maystimulate heartburn it stimulates acid productionby the stomach Alcohol does not Here is arare example of an unfavourable effect of winersquosspecial attributes presumably polyphenolicantioxidants Alcohol however especially inheavy dose may relax the lower oesophagealvalve (sphincter) that is supposed to seal offthe oesophagus and disorder motility thereby

promoting reflux

Cirrhosis of the liver of any cause includingabuse of alcohol is often complicated byformation of oesophageal varices dilation ofveins of the lower oesophagus a distinct risk oflife-threatening haemorrhage The stomach isboth a key actor and a target in the life ofingested alcohol Alcohol dehydrogenase theenzyme that first metabolizes alcohol soneutralizing it is secreted by the gastric mucosathe lining of the stomach When ample alcoholslows the emptying of the stomach alcoholdehydrogenase has more time to attack thealcohol

Womenrsquos stomachs contain about 60 percentas much alcohol dehydrogenase as do menrsquoslikely the chief reason for the long-observedlesser tolerance of women for alcohol and therecommendation that their safe and healthyportion should be about half of menrsquos So whena couple share a bottle of wine at dinner heshould get two-thirds

Binge drinking of high-proof beverages may leadto acute gastritis inflammation of the stomachsometimes accompanied by haemorrhageWine and beer are innocent and may beprotective

The intestines large and small are not just inertpipes conveying food and the products ofdigestion to their fate Their linings activelysecrete digestive enzymes and absorb thenutrients made available by digestion Theirmuscular walls churn and propel the contentsto enhance the chemical reactions of digestionThe muscular motility of the intestine may bereduced in alcoholics thereby unpredictablyaltering function and allowing toxic bacterialovergrowth An odd converse has beenobserved recently in overweight mice whoseobesity slows intestinal motion The bacteria thatgrow to excess as a result produce alcohol andthese mice develop liver abnormalities similarto those of obese humans and to alcoholicsThe lesson may be that obesity and alcohol arecollaborators in causing liver diseasemdashtakeheed

Surprisingly light-drinking laboratory rats haveexhibited enhanced liver regeneration afterinjury compared to rats who abstained or whodrank more Heavy doses of alcohol may impairintestinal absorption of nutrients includingthiamin vitamin B12 amino acids (the building

blocks of proteins) perhaps calcium and zincleading to complex malnutrition

Iron absorption may increase with drinking notnecessarily harmless for excessive iron mayinjure the liver Excessive drinking often leadsto diarrhoea

That wine especially and other alcohol-containing beverages help prevent gastro-intestinal infections has been known for a verylong time Claret drunk in British army messesin India was held to be ldquoa sovereignpreventative against the prevalent cholerardquo justone of a number of similar observations hereand there over the years More recently andmore scientifically wine has been demonstratedto be an effective inhibitor of a trio of fearsomebacteria Escherichia coli Salmonella andShigella causes of ldquotravellerrsquos diarrhoeardquo andworse typhoid and related diseases andbacillary dysentery respectively Researcherssuspect that the operative benefactor is one ormore of winersquos polyphenols Wine and spiritsbut not beer consumed with raw oysterscontaminated with hepatitis A virus which entersvia the gastro-intestinal tract were associatedwith a reduced risk of infectionThe bacteriumHelicobacter pylori (Hpylori) looms much to theastonishment of the medical profession amalign superstar of the first magnitude It residesin the stomachs of those infected Who couldhave imagined that this organism causes muchof chronic gastritis a large majority of pepticulcers and a substantial proportion of cancersof the stomach H pylori is now being implicatedas a promoter of our most deadly diseaseatherosclerosis cause of heart attacks strokesand other catastrophes Drinking especially ofwine appears to help eliminate H pylori In adirect study less than one-third as manydrinkers as abstainers were infected

H pylori infection is also associated withreduced activity of alcohol dehydrogenase in thestomach After eradication of the infectionalcohol dehydrogenase normalizes within twomonths Alcohol is the only component of winethat has been clearly shown to increase the riskof some cancers and then only when abused

Chronic heavy drinking particularlyaccompanied by abuse of tobacco isassociated in the gastro-intestinal tract withincreased cancer risk in the mouth throatoesophagus and perhaps the upper stomach

WINE AND THE GASTROINTESTINAL TRACTBy Harvey E Finkel MD

9

Inconclusive reports have raised the questionof a slight increase in risk of cancer of thepancreas The data relating beer and spirits toa possible slight increase of risk of colorectaltumours are conflicting and confusing

Might moderate drinking protect against cancerEarly indications suggest the answer might beldquoyesrdquo A number of studies has demonstratedthat wine in particular possesses severalproperties that would tend to prevent or inhibitcancer no doubt through the actions of itsantioxidant compounds Epidemiologic researchhas revealed substantial reduction of risk ofcancers of the oesophagus and upper stomachand colon and rectum in wine drinkers ascompared to non-drinkers

In essence past experience and currentresearch indicate that abuse of alcohol risksdamaging the gastro-intestinal tract at severalpoints but moderate wine consumption risksonly a little heartburn while possibly leading tomajor health benefits not to mention gustatorypleasures

Whether wine is a poison a medicine or anourishment is a matter of dosage mdashParacelsus Harvey E Finkel MD is Clinical Professor of Medicineat Boston University Medical Centre and is a memberof AIMrsquos Social Scientific and Medical Council

a study by Dr Morten Gronbaek of the NationalInstitute of Public Health in Copenhagen hasfound that heavy drinkers (especially non-winedrinkers) significantly increase their risk ofcontracting rectal cancerThe findings are basedon a population study of over 29000 Danishmen and women aged between 23 and 95Cancers that originate in the colon and rectumare the fourth most commonly diagnosedcancers in the US and represent the second-leading cause of death from cancerApproximately one-third of the cases ofcolorectal cancer are actually cancers of therectum Gronbaek said Their weekly intake ofbeer wine and spirits was assessed as wereother factors likely to influence bowel cancerrisk such as how much they smoked weighedand took regular exercise Men were more likelythan women to be heavy drinkers and heavydrinkers were more likely to be smokers and toweigh more than light drinkers

During a monitoring period of almost 15 years411 cases of colon cancer and 202 cases ofrectal cancer were reported among thosestudied Alcohol seemed to have little influenceover the risk of colon cancer but there was aclear association between rectal cancer risk andthe amount of alcohol consumed Thosedrinking more than 41 units of alcohol a weekhad twice the risk of developing the disease as

non-drinkers But the type of alcohol consumedhad a significant bearing on rectal cancer riskThose who drank 14 or more units of beer orspirits a week were over 35 times as likely todevelop rectal cancer as non-drinkers Yet thosewho drank the same total amount of alcoholbut who included around a third or more of winein their intake were less than twice as likely todevelop the diseaseThe authors point out thatwine drinkers tended to be better educated andto take more exercise than beer or spiritdrinkers so there may be other healthier lifestylefactors at play There are no obvious reasonswhy alcohol should apparently be moredamaging to the rectum than the colon but thereasons why wine seems to exert its protectiveeffect most likely lie in resveratrol which is foundin both grapes and wine

Previous research indicates that this chemicaldamps down the cellular processes involved inthe promotion and growth of cancerous cellsThe lack of a relationship between alcoholdrinking and colon cancer risk is also somewhatof a mystery according to Gronbaek

ldquoThe tissue is rather similar in the two parts ofthe organ mdash colon and rectum mdash and one mightexpect the same mechanism in developing thediseaserdquo Gronbaek said However he addedthat previous studies have also found thatalcohol has an effect on the rectum but not thecolon SOURCE Gut 200352861-867

Alcohol colon and rectal cancer

The World Advertising Research Centre will beholding the eighth annual Alcoholic Drinksconference in central London on Tuesday 30th

September The conference will be chaired byNick Kendall Group Strategy Director BartleBogle Hegarty

This yearrsquos programme will concentrate inparticular on the urgency and importance ofsocial responsibility issues for the alcoholicdrinks industry With the UK Government in themiddle of developing a national alcohol harm-reduction strategy conducted by the PrimeMinisterrsquos own Strategy Unit and the Department

of Health self-regulation may give way to legalcontrols on the advertising of alcoholic drinksSpeakers include Rita Clifton ChairmanInterbrand Hamish Pringle Director GeneralIPAWendy Darlington Brand MarketingDirector Diageo Plc Jaspar Shelbourne GlobalCreative Director JWT Alan Mitchell JournalistMike Spurling Director The Informer A SpecialPanel on Social Responsibility features AndrewBrown The Advertising Association HughBurkitt The Marketing Society Leanne RileyScientist World Health Organisation JeanCoussins The Portman GroupHelmutWagner The Amsterdam Group Chris SearleExecutive Director Bacardi Martini

For details contact Sarah Miller World AdvertisingResearch Center Farm Road Henley-on-ThamesOxon RG9 1EJ Tel 0044 (0) 1491 418 646 Fax0044 (0) 1491 418 600 Mail sarah_millerwarccomWeb wwwwarccomconferences

30th Alcoholic Drinks 2003 - Conference Brewers of Europe 3rdBeer and health

symposiumThe Brewers of Europe are holding a conferenceon the benefits of moderate beer consumptionon the 15th October at the Residence PalaceBrussels

The event is chaired by professor Oliver Jamesof the University of Newcastle and includespresentations on alcohol and weight moderatedrinking and well being and nutritional aspects

For more information please visitwwwbrewersofeuropeorg or emailinfobrewersofeuropeorg

9

10

1Introduction

As part of cultural traditions and well balancedlifestyles wine beer and spirits consumption hasbeen a common staple in diets around the worldIn acknowledgement of such practices groupsof nutrition experts have included the moderateconsumption of alcohol as an optionalcomponent of various dietary guidelines andfood guides such as the Mediterranean AsianLatin American and Vegetarian Pyramids Herewe outline the key scientifically based nutritionmessages in these pyramids

The outlined alcohol-inclusive dietary pyramidsare part of an effort by Oldways Preservation ampExchange Trust a non- profit education groupthat is dedicated to preserving traditional eatingpatterns with the goal to improve consumerknowledge and diets around the world Oldwayshas prepared these concepts with prominentnutrition medical biomedical andcommunication experts from leading institutionssuch as the WHO Regional Office for Europeand the Harvard School of Public Health

Cardiovascular disease and cancer are leadingcauses of death in developed nations aroundthe world predominantly being associated withdiets high in animal fats With that emergingscientific consensus the Oldways pyramids allemphasize fruits vegetables cereals andpulses with litt le meat (animal fats)consumption These nutrition concepts alsoinclude wine beer and spirits which have shownto contribute to lower heart disease rates andimprove longevity

Accumulating scientific evidence suggests thatmoderate consumption of wine beer and spiritsdoes not pose a health risk to the vast majorityof consumers who choose to drink inmoderation AIMrsquos recommendations alsoemphasise that adults should enjoy alcoholbeverages in a sensible manner preferablyaround mealtimes or other responsible socialsettings Moderation is the key to a healthy dietand lifestyle and this is reflected in severaltraditional nutrition concepts

Consumers should follow moderation guidelinessuch as those in the Dietary Guidelines forAmericans which define moderation as up totwo drinks (12g) a day for men and up to onedrink a day for women further consumersshould avoid alcohol during pregnancy or when-ever it would put the individual or others at risk

To learn more about the US Dietary Guidelinesmessage on alcohol please visitwwwhealthgovdietaryguidelines and for otherauthoritative links on alcohol please also visitthe AIM links page on the gateway to sensibledrinking and health site via wwwaim-digestcom

Alcohol-Inclusive Nutrition

Concepts The

The lsquoEatwisersquo concept

The latest ldquoEat Wiserdquo Pyramid including ldquowinebeer and spirits in moderationrdquo as part of a dailybeverage recommendation was released atJanuaryrsquos 2003 Mediterranean Diet Conferencesponsored by Harvard School of Public Healthand Oldways Preservation amp Exchange TrustThis new pyramid is modelled on the originalMediterranean Diet Pyramid which initially onlyrecommended wine in moderation reflecting thecultural preference of the Mediterranean regionldquoThis Eat Wise Pyramid is a visual guide tohealthy living the Eat Wise wayrdquo theaccompanying text states ldquoIt shows thepartnership of a balanced diet plenty of waterregular physical activity and alcohol inmoderation that wise eaters know strengthenall their bodiesrsquo functionsrdquo An expert conferencediscussion emphasized the potential benefits forall three beverages Eat Wise Meal Ideasshopping tips and recipes are outlined in aspecial eating guide that can be ordered via theOldways website

Moderate Alcohol Intake as Part of a Healthy Diet and Lifestyle - A Look at Alcohol Inclusive Nutrition Concepts from Around the World by Elisabeth Holmgren

The Mediterranean Diet Pyramidwwwoldwaysptorgpyramidsmed

p_medhtml

The Mediterranean Diet Concept

Long known for its healthy lifestyles and thelongevity of its people the Mediterranean regionis also home of some of the most palatable andhealthy foods on earth Traditionally wine hasbeen included as an integral part of its mealsand cross-cultural studies have reportedsignificantly lower risk of heart disease inMediterranean regions where alcohol is a dailystaple of a healthy diet and lifestyle As thepreferred beverage in this region wine isspecified as an option on ldquoThe TraditionalHealthy Mediterranean Diet Pyramidrdquodeveloped by Oldways in cooperation withscientists from the WHO in Europe and fromthe Harvard School of Public Health Thistraditional diet is based on grains including ricepolenta bulgur and pasta as well as legumesand vegetables It also includes fruits cheesesyogurt and nuts along with the optional choiceof alcohol in moderation Olive oil is given itsown category as a major source of monounsaturated fat reflecting its importantprominence in the regionrsquos healthy cuisine Dailyphysical activity a factor contributing to healthin the Mediterranean region and elsewhere isalso included on this and all Oldways pyramids

11

The Asian Diet Concept

As Asian cuisine continues to become popularin diverse regions of the world characteristicsof Asian diets will continue to gain importanceIn Japan and China studies have found ratesfor heart disease and many types of cancer tobe lower than those in the United States andthe rest of the world The centuries-oldtraditional Asian diet of rice noodles vegetablesand fish is believed to be a significant contributorto the documented lower rates for chronicdisease in these populations The ldquoTraditionalhealthy Asian Diet Pyramidrdquo developed incooperation with scientists at Cornell Universityand the Harvard School of Public Healthincorporates these dietary patterns into thepyramid format Sake wine beer and otherbeverages with alcohol in moderation as wellas tea are included as part of the pyramidbecause studies have shown that theirconsumption may play an role in reducing heartdisease risk and overall mortality

The Asian Diet Pyramid

wwwoldwaysptorgpyramidsasianp_asianhtml

ldquoThe

The Latin American ConceptThe Traditional Healthy Latin American DietPyramidrdquo released in 1996 is based on thetraditional foods of Latin America Unlike theAmericanized versions that tend to be high insalt and fat this pyramid presents many healthyeating options It emphasizes daily consumptionof beans grains tubers and nuts along withfruits and vegetablesmdashstaples in most LatinAmerican and Caribbean regions Daily physicalactivity is integrated into the pyramid structurein recognition of the scientific consensus on theimportance of exercise in maintaining goodhealth Alcohol in moderation with meals isincluded as an option and as with other culturalpyramids meats sweets and eggs are at thevery top of the pyramid in the ldquooccasionallyrdquocategory to advocate a healthy and balancedlifestyle that can reduce the risk for several

common diseases

The Vegetarian Diet ConceptThe unique ldquoVegetarian Diet Pyramidrdquo releasedby Oldways at the end of 1997 serves as amodel for healthy eating with meals built aroundvegetables fruits whole grains and legumesThe pyramid also emphasizes daily physicalactivity water consumption and the option ofldquowine beer and other alcoholrdquo in moderationThe importance of this dietary conceptaccording to Oldways is that it reflects thegrowing number of vegetarians and

The Scientific Evidence

The nutritional and medical significance ofthe traditional Oldways Dietary Pyramidswas featured in ldquoMedical NewsPerspectivesrdquo of the Journal of the AmericanMedical Association in 2000 The authorhighlighted the importance of well-balancedand nutritious diets as a potential diseaseprevention measure that could beincreasingly conveyed by physicians andhealthcare providers to their patients Morerecently Greek and US scientists investigatedthe health effects of adherence to aMediterranean Diet reported in the New EnglandJournal of Medicine in 2003 ldquoGreater adherenceto the traditional Mediterranean diet isassociated with a significant reduction in totalmortalityrdquo Coinciding with these acknow-ledgements there is now a developing scientificconsensus that for many individuals moderatewine beer and spirits consumption is associated

acknowledges the nutritional and health benefitsof this type of diet For example the DietaryGuidelines for Americans have acknowledgedsuch a diet as able to meet RecommendedDietary Allowances (RDA) for nutrients Whilesome vegetarians are prohibited fromconsuming meat and alcohol for religiousreasons all alcohol beverages are included asa choice because of the potential risk reductionfor heart disease and its cultural role as anaccompaniment to vegetarian eating

The Latin American Diet Pyramidwwwoldwaysptorgpyramidslatin

p_latinhtml

The Vegetarian Diet Pyramidwwwoldwaysptorgpyramidsveg

p_veghtml

11

12

with a reduced risk of coronary heart diseaseand increased life expectancy which lead to theabove featured alcohol-inclusive nutritionconcepts

In 1997Sir Richard Doll Emeritis Professor ofMedicine at Oxfordoutlined in the BritishMedical Journal ldquomassiverdquo evidence for thepotential beneficial effect of alcohol in a reviewof the clinical data on alcohol and mortality Heconcluded that ldquothe consumption of small andmoderate amounts of alcoholrdquo leads to a one-third-risk reduction for vascular disease He alsoacknowledged a reduction in total mortality inmiddle-aged and elderly men and women whenthey consumed wine beer or spirits Morerecently world-renowned expert Dr ArthurKlatsky from the US outlined the overwhelmingscientific evidence in Scientific American DrKlatsky has published many research studieson alcohol and health in leading scientificjournals from the large-scale Kaiser Permanentecohort and in the recent article he wrote withrespect to the most appropriate advice to thepublic ldquoOn one hand mild to moderate drinkingseems better for heart health than abstinencefor select people On the other hand heavydrinking is clearly dangerousrdquo Merelyrecommending abstinence is inappropriatehealth advice to people such as established lightdrinkers at high risk of CHD and at low risk ofalcohol-related problemsmdashwhich describes alarge proportion of the populationrdquo Dr Klatskyalong with other experts from around the worldhas advocated that health professionals makecase-by-case evaluations based on individualand family histories They also emphasize thatthe public should be entrusted with all theinformation on use versus misuse of alcohol sothat they can make informed decisionsthemselves

Authoritative findings from cohortsinternationally lead research experts tofeature the option of moderation in eachtraditional Oldways Dietary Pyramid Manypeer-reviewed studies from Europe AsiaAustralia and the US have revealed potentialbenefits for moderately drinking adults inmulti-ethnic populations These studies findthat moderate drinkers especially consumersof 1-2 drinks (12g) daily may lower their risk ofheart disease significantly Studies reportingcertain health advantages for moderate drinkersinclude the Lyon Heart Study the CopenhagenCity Heart Study the Australian Dubbo Studyand the European Seven Country Study

The Oldways experts working with the HarvardSchool of Public Health specifically consideredfindings from the ongoing Physiciansrsquo HealthStudy and the Nursesrsquo Health Study Analyzingdata from 84000 women in the Nursesrsquo HealthStudy the effect of a combination of diet andlifestyle factors were assessed on the risk ofCHD Dr Meir Stampfer et al concludedrdquo In thispopulation of middle-aged women those whodid not smoke cigarettes were not overweightmaintained a healthful diet described aboveexercised moderately or vigorously for half anhour a day and consumed alcohol moderatelyhad an incidence of coronary events that wasmore than 80 lower than that in the rest of thepopulationrdquo At the same time based on aprospective study of more than 89000 men aspart of the Physiciansrsquo Health Study Harvardresearcher Dr Michael Gaziano et al concludedrdquoIn summary this study reveals the complexeffect of alcohol consumption on various chronicdiseases as reflected in the overall U-shapedrelationship between light-to-moderate alcoholconsumption and total mortality in menrdquoTheearlier results from the US governmentrsquos fundedNational Health and Nutrition ExaminationSurvey (NHANES) were also considered whichfound that the risk for CHD is reduced for bothmen and women who drink moderatelyPublished in 1997 in the American Journal ofEpidemiology it stated ldquoThis analysisconfirmed previous research showing thatabstainers are at a greater risk for CHD thanare most non abstainers and that a significantprotective effect may be demonstrated withsmall amounts of alcoholrdquo Along those linesresearch published in The New England Journalof Medicine from American Cancer Societyexperts concluded ldquoIn this middle-aged andelderly population moderate alcoholconsumption slightly reduced overall mortalityrdquo

At the same time there are continuingconcerns about alcohol consumption andbreast cancer and women arerecommended not to drink when pregnant in line with governmental and public healthpositions in the US Authoritative statementsfrom public health groups such as the AmericanHeart Association the National StrokeAssociation and the American DieteticAssociation acknowledge the scientific evidencepointing to potential benefits of moderation withrespect to coronary heart disease andemphasize ldquoIf you choose to drink do so inmoderationrdquo A balanced summary position is

reflected in the 1999 JAMA Patient Page onldquoBenefits and dangers of alcoholrdquo which defineslsquoModerate drinking as 1 or 2 drinks (12g) a dayfor men and 1 drink a day for women and thoseolder than 65rsquo These messages are embodiedin governmental positions in the US UKAustralia and Canada

The Oldways alcohol messages as reflectedin the pyramids are however especiallynotable in that they emphasize consumptionwith or around mealtime as research hasshown that these and related cultural normsfacilitate responsible drinking habits mayslow alcohol absorption and may counterpotential harmful effects of fatty foods Forexample Dr David Hanson author ofPreventing Alcohol Abuse Alcohol Culture andControl explains ldquoThe cross-cultural evidenceindicates that drinking abuse will be low in anygroup in which drinking customs values andsanctions are clearhellip and characterized byprescriptions for moderate drinking andproscriptions against immoderate drinkingrdquoFurthermore several biochemical studiesindicate that in addition to slowing down theabsorption process which keeps blood alcohollevels lower moderate consumption during oraround mealtime may have favourable effectson lipid profiles and atherogenesis One 1998study published in the American Journal ofClinical Nutrition suggested ldquoethanol mayreduce cardiovascular risk by modulatingvascular muscle growth during the postprandialperiodrdquo Research continues but it appears clearthat healthy dietary patterns are inverselyrelated with low rates of chronic diseases Thishas been specifically confirmed in the ongoingSeven Country Study which reported in 1999that animal-food groups were directly correlatedwith CHD mortality while vegetable-food groupsas well as fish and alcohol were inverselycorrelated

In summary in line with the developingscientific consensus public health andgovernmental positions the Oldwayspyramids stress moderation and underscorethe importance of an overall healthy mealand lifestyleConsumption is notrecommended for non-drinkers or thosewho may have any health contraindicationsand consumers are always advised toconsult with their healthcare providersFor selected references and authoritative statements onmoderate drinking and health please visit the Gateway toSensible Drinking and Health via wwwaim-digestcom

13

ORGANISATIONS INVOLVED IN ALCOHOL AFFAIRSUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOM

ALALALALALCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNWaterbridge House 32-36 Loman Street London SE10EETel (0207) 928 7377 Fax (0207) 928 4644Websitewww alcoholconcernorguk

ALALALALALCOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCATION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARCHCHCHCHCHCOUNCILCOUNCILCOUNCILCOUNCILCOUNCILAbell House John Islip Street London SW1P 4LH Tel(0207) 217 5276

ALALALALALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALTH RESEARTH RESEARTH RESEARTH RESEARTH RESEARCH CENTRECH CENTRECH CENTRECH CENTRECH CENTREUniversity of West of England Glenside CampusBlackberry Hill Stapleton Bristol BS16 1DD Tel(0131) 536 6192 Fax (0131) 5366215 E-mailmplantahrconetcouk

HEALHEALHEALHEALHEALTH EDUCATH EDUCATH EDUCATH EDUCATH EDUCATION ATION ATION ATION ATION AUTHORITYUTHORITYUTHORITYUTHORITYUTHORITYHamilton House Mabledon Place London WC1 9TXTel (020) 72985656 Fax (020) 77259031 Emailenquirieshpeorgukwebsite wwwhpeorguk and wwwwreckedcouk

THE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALCOHOLISMCOHOLISMCOHOLISMCOHOLISMCOHOLISM3 St Andrewrsquos Place London NW1 4LBTel (0207) 487 4445 Fax (0207) 9354479

THE PORTHE PORTHE PORTHE PORTHE PORTMAN GRTMAN GRTMAN GRTMAN GRTMAN GROUPOUPOUPOUPOUP7-10 Chandos Street Cavendish Square London W1G9DQTel 020 7907 3700 Fax 020 7907 3710wwwportman-grouporguk

ALALALALALCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOTLANDTLANDTLANDTLANDTLAND2nd Floor 166 Buchanan Street Glasgow G1 2NH Tel0141-572 6700 Fax 041-333 1606

BRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIATIONTIONTIONTIONTIONMarket Towers 1 Nine Elms LaneLondon SW8 5NQTel 020 7627 9191 Fax020 7627 9123E-mail jwitheridgebeerandpubcomWebsite wwwbeerandpubcom

EUREUREUREUREUROPEOPEOPEOPEOPE

ARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GROUPOUPOUPOUPOUPBrewersrsquo House 10 Grand Place B-1000 BrusselsBelgium Tel +32 2 511 49 87 Fax +32 2 511 32 59

CBMCCBMCCBMCCBMCCBMCCheacutee de la Hulpe 181 bte 20 B-1170 Bruxelles Tel(++322) 672 23 92 Fax (++322) 660 94 02Website wwwcbmcorg

FORFORFORFORFORUMUMUMUMUMLivornostraat 13 b 5 rue de Livourne ndash Brussel 1050Bruxelles BelgiumTel 32 2 539 36 64 Fax 32 2 537 81 56email forumtasteeducationskynetbe websitewwwforum-taste-educationcom

ENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTION13 Rue Monsigny 75002 Paris FranceTel 00-33-53-43-80-75E-mail enterprisewanadoofr

IREBIREBIREBIREBIREB19 avenue Trudaine 75009 ParisTel +33 (1) 48 74 82 19 Fax +33 (1) 48 78 17 56E-mail irebirebcom Website wwwirebcom

OIVOIVOIVOIVOIV18 rue drsquoAguesseau 75008 Paris FranceTel +33 (0) 1 44 94 80 94Fax +33 (0) 1 42 66 90 63E-mail oivoivintWebsite wwwoivint

STIVSTIVSTIVSTIVSTIVAAAAABenoordenhoutseweg 22-23 2596 BA The HagueTheNetherlands Tel +31 (0)70 314 2480 Fax +31(0) 70314 24 81 E-mail phoastivanl Website wwwstivanl

SCANDINSCANDINSCANDINSCANDINSCANDINAAAAAVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALALALALALALCOHOL BOCOHOL BOCOHOL BOCOHOL BOCOHOL BOARDARDARDARDARDVandvaeligrksvej 11 DK - 5690 TommerupTel 45 64 75 22 84 Fax 45 64 75 28 44E-mail smaborg Websitewwwsmaborg

DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE WEINWEINWEINWEINWEINAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHGutenbergplatz 3-5 55116 MainzTel +49 02641 977340 Fax +49 02641 977342Website wwwdeutscheweinakademiede

FIVINFIVINFIVINFIVINFIVINPlaza Penedeacutes 3 308720 Vilafranca del PenedeacutesBarcelona Spain Tel 0034 (93) 890 45 45 Fax 0034(93) 890 46 11

DIFDIFDIFDIFDIFA FORA FORA FORA FORA FORUM EVUM EVUM EVUM EVUM EVFranklinstrabe 1 10587 BerlinGermany Tel + 49 (0) 30 39 0633 60Fax +49 (0) 30 390 633 66 email infodifa-forumdeWebsite wwwdifa-forumde

GODGODGODGODGODAAAAAGode Alkoholdninger Kattesundet 9 DK-1458Koslashbenhavn K Denmark Tel 33 13 93 83Fax 33 13 03 84

FIVSFIVSFIVSFIVSFIVSInternational Federation of Wines amp Spirits20 rue drsquoAnjou - 75008 Paris Tel 33 1 42 68 82 48Fax 33 1 40 06 06 98

THE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDAM GRAM GRAM GRAM GRAM GROUPOUPOUPOUPOUPRue Wiertz 5028B-1050 Brussels BelgiumTel +32 2 401 61 35 Fax + 32 2 401 68 68 emailinfoamsterdamgrouporgwwwamsterdamgrouporg

FUNDFUNDFUNDFUNDFUNDAAAAACION ALCION ALCION ALCION ALCION ALCOHOL COHOL COHOL COHOL COHOL Y SOCIEDY SOCIEDY SOCIEDY SOCIEDY SOCIEDADADADADADDiego de Leon 442 ES 28006 MadridTel + 34 91 745 08 44 Fax + 34 91 561 8955wwwalcoholysociedadorg

USA CANUSA CANUSA CANUSA CANUSA CANADADADADADA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAAAAAAUSTRALIAUSTRALIAUSTRALIAUSTRALIAUSTRALIA

WINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICA1200 G Street NW Suite 360 Washington DC 20005Tel (800) 879 4637 Fax (202) 347 6341E-mail infoamericanwineriesorgWebsite wwwamericanwineriesorg

AMERICAN AMERICAN AMERICAN AMERICAN AMERICAN WINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARCHCHCHCHCHAND EDUCAAND EDUCAAND EDUCAAND EDUCAAND EDUCATIONTIONTIONTIONTIONVisit website at wwwalcohol-AWAREcom

AMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAND HEALAND HEALAND HEALAND HEALAND HEALTHTHTHTHTH1995 Broadway 2nd Floor New York NY 10023-5860Tel (212) 362-7044 Ext 234 Fax (212) 362-4919Email kavaacshorg Websitewwwacshorg

BEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTE122 C Street NW 750Washington DC 20001Tel(202) 737-2337 Fax (202) 737-7004E-mailinfobeerinstituteorgWebsite wwwbeerinstituteorg

PRPRPRPRPROOOOOYECTYECTYECTYECTYECTO CIENCIA O CIENCIA O CIENCIA O CIENCIA O CIENCIA VINO VINO VINO VINO VINO Y SALY SALY SALY SALY SALUDUDUDUDUDFacultad de ciencias BioloacutegicasCasilla 114 D Santiago ChileTelFax (56-23) 222 2577Email vinsaludgenesbiopuccl

EDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALCOOLCOOLCOOLCOOLCOOL606 Cathcart Suite 700 Montreacuteal Queacutebec H3B 1K9Canada Tel (514) 875-7454 E-mailhsacyeducalcoolqcca Website wwweducalcoolqcca

THE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERAGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTE1775Pennsylvania Avenue NW Suite 1200 WashingtonDC 20006 Tel 2024637110wwwamericanbeverageinstitutecom

FISAFISAFISAFISAFISACCCCC(Fundacion de Investigaciones Sociales AC) FranciscoSosa 230 coyoacan CP 04000 Mexico DF - Mexico

HEALHEALHEALHEALHEALTTTTTH EDUCAH EDUCAH EDUCAH EDUCAH EDUCATION FOUNDTION FOUNDTION FOUNDTION FOUNDTION FOUNDAAAAATIONTIONTIONTIONTION INC INC INC INC INC2600 Virginia Avenue NW Washington DC 20037Tel (202) 3383501 Fax (202) 9656520E-mail hefmonaerolscom

ICAPICAPICAPICAPICAPInternational Center for Alcohol Policies1519 New Hampshire Avenue NWWashington DC 20036Tel (202) 986-1159 Fax (202) 986-2080Website wwwicaporg

THE CENTURTHE CENTURTHE CENTURTHE CENTURTHE CENTURY COUNCILY COUNCILY COUNCILY COUNCILY COUNCIL1310 G Street NW Suite 600Washington DC 20005-3000 Tel (202) 637-0077 Fax(202) 637-0079 Email washdecenturycouncilorgWebsite wwwcenturycouncilorg

CALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIATION OF TION OF TION OF TION OF TION OF WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEGRGRGRGRGROOOOOWERS WERS WERS WERS WERS 601 University Avenue Suite 135 Sacramento CA 95825wwwcawgorg email karencawgorg

THE THE THE THE THE WINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTE425 Market Street Suite 1000 San Francisco CA94105 USA Tel (415) 512-0151 Fax (415) 442-0742

LLLLLODI -WODI -WODI -WODI -WODI -WOODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPECOMMISSIONCOMMISSIONCOMMISSIONCOMMISSIONCOMMISSION2545 West Turner Road Lodi CA 95242USAmarklodiwinecom website wwwlodiwinecom

THE NTHE NTHE NTHE NTHE NAPAPAPAPAPA A A A A VVVVVALLEY ALLEY ALLEY ALLEY ALLEY VINTNERSVINTNERSVINTNERSVINTNERSVINTNERSASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION Phone - 707-963-3388 Fax - 707-963-3488 Website wwwnapavintnerscom

OLDOLDOLDOLDOLDWWWWWAAAAAYYYYYS PRESERS PRESERS PRESERS PRESERS PRESERVVVVVAAAAATION amp EXTION amp EXTION amp EXTION amp EXTION amp EXCHANGECHANGECHANGECHANGECHANGETRTRTRTRTRUSTUSTUSTUSTUST266 Beacon Street Boston MA 02116 6174215500Fax 6174215511 website wwwoldwaysptorg

THE ATHE ATHE ATHE ATHE AUSTRALIAN USTRALIAN USTRALIAN USTRALIAN USTRALIAN WINE RESEARWINE RESEARWINE RESEARWINE RESEARWINE RESEARCHCHCHCHCHINSTITUTEINSTITUTEINSTITUTEINSTITUTEINSTITUTEP O Box 197 glen Osmond 5064 South AustraliaAustralia Tel 61 8 8303 6600 Fax 61 6 303 6601

13

8

Wine goes in at the mouth much to our delightthen trickles through other parts of the bodyLet us go then you and I to explore thetortuousness of the gastro-intestinal tract takingalong divers potables to observe their effects

Most GI adversities associated with drinkingbeverages containing alcohol come with excessand virtually all are caused by alcohol inparticular In some cases the effect of wine isdifferent from that of other drinksmdashwatch forthem The ineffable morning-after distressfollowing indiscretion is poorly understood andis transient but unpleasant consequences ofheavy drinking may be lasting and as severeas cancer

The all-too-common chief complaint of theoesophagus (gullet) is heartburn caused bywelling up of acid material from the stomachTwo major determinants of such acid reflux arethe quantity of acid secreted by the stomachand the propulsion of the stomach acid thewrong way upward into the oesophagus insteadof downward into the intestine Wine maystimulate heartburn it stimulates acid productionby the stomach Alcohol does not Here is arare example of an unfavourable effect of winersquosspecial attributes presumably polyphenolicantioxidants Alcohol however especially inheavy dose may relax the lower oesophagealvalve (sphincter) that is supposed to seal offthe oesophagus and disorder motility thereby

promoting reflux

Cirrhosis of the liver of any cause includingabuse of alcohol is often complicated byformation of oesophageal varices dilation ofveins of the lower oesophagus a distinct risk oflife-threatening haemorrhage The stomach isboth a key actor and a target in the life ofingested alcohol Alcohol dehydrogenase theenzyme that first metabolizes alcohol soneutralizing it is secreted by the gastric mucosathe lining of the stomach When ample alcoholslows the emptying of the stomach alcoholdehydrogenase has more time to attack thealcohol

Womenrsquos stomachs contain about 60 percentas much alcohol dehydrogenase as do menrsquoslikely the chief reason for the long-observedlesser tolerance of women for alcohol and therecommendation that their safe and healthyportion should be about half of menrsquos So whena couple share a bottle of wine at dinner heshould get two-thirds

Binge drinking of high-proof beverages may leadto acute gastritis inflammation of the stomachsometimes accompanied by haemorrhageWine and beer are innocent and may beprotective

The intestines large and small are not just inertpipes conveying food and the products ofdigestion to their fate Their linings activelysecrete digestive enzymes and absorb thenutrients made available by digestion Theirmuscular walls churn and propel the contentsto enhance the chemical reactions of digestionThe muscular motility of the intestine may bereduced in alcoholics thereby unpredictablyaltering function and allowing toxic bacterialovergrowth An odd converse has beenobserved recently in overweight mice whoseobesity slows intestinal motion The bacteria thatgrow to excess as a result produce alcohol andthese mice develop liver abnormalities similarto those of obese humans and to alcoholicsThe lesson may be that obesity and alcohol arecollaborators in causing liver diseasemdashtakeheed

Surprisingly light-drinking laboratory rats haveexhibited enhanced liver regeneration afterinjury compared to rats who abstained or whodrank more Heavy doses of alcohol may impairintestinal absorption of nutrients includingthiamin vitamin B12 amino acids (the building

blocks of proteins) perhaps calcium and zincleading to complex malnutrition

Iron absorption may increase with drinking notnecessarily harmless for excessive iron mayinjure the liver Excessive drinking often leadsto diarrhoea

That wine especially and other alcohol-containing beverages help prevent gastro-intestinal infections has been known for a verylong time Claret drunk in British army messesin India was held to be ldquoa sovereignpreventative against the prevalent cholerardquo justone of a number of similar observations hereand there over the years More recently andmore scientifically wine has been demonstratedto be an effective inhibitor of a trio of fearsomebacteria Escherichia coli Salmonella andShigella causes of ldquotravellerrsquos diarrhoeardquo andworse typhoid and related diseases andbacillary dysentery respectively Researcherssuspect that the operative benefactor is one ormore of winersquos polyphenols Wine and spiritsbut not beer consumed with raw oysterscontaminated with hepatitis A virus which entersvia the gastro-intestinal tract were associatedwith a reduced risk of infectionThe bacteriumHelicobacter pylori (Hpylori) looms much to theastonishment of the medical profession amalign superstar of the first magnitude It residesin the stomachs of those infected Who couldhave imagined that this organism causes muchof chronic gastritis a large majority of pepticulcers and a substantial proportion of cancersof the stomach H pylori is now being implicatedas a promoter of our most deadly diseaseatherosclerosis cause of heart attacks strokesand other catastrophes Drinking especially ofwine appears to help eliminate H pylori In adirect study less than one-third as manydrinkers as abstainers were infected

H pylori infection is also associated withreduced activity of alcohol dehydrogenase in thestomach After eradication of the infectionalcohol dehydrogenase normalizes within twomonths Alcohol is the only component of winethat has been clearly shown to increase the riskof some cancers and then only when abused

Chronic heavy drinking particularlyaccompanied by abuse of tobacco isassociated in the gastro-intestinal tract withincreased cancer risk in the mouth throatoesophagus and perhaps the upper stomach

WINE AND THE GASTROINTESTINAL TRACTBy Harvey E Finkel MD

9

Inconclusive reports have raised the questionof a slight increase in risk of cancer of thepancreas The data relating beer and spirits toa possible slight increase of risk of colorectaltumours are conflicting and confusing

Might moderate drinking protect against cancerEarly indications suggest the answer might beldquoyesrdquo A number of studies has demonstratedthat wine in particular possesses severalproperties that would tend to prevent or inhibitcancer no doubt through the actions of itsantioxidant compounds Epidemiologic researchhas revealed substantial reduction of risk ofcancers of the oesophagus and upper stomachand colon and rectum in wine drinkers ascompared to non-drinkers

In essence past experience and currentresearch indicate that abuse of alcohol risksdamaging the gastro-intestinal tract at severalpoints but moderate wine consumption risksonly a little heartburn while possibly leading tomajor health benefits not to mention gustatorypleasures

Whether wine is a poison a medicine or anourishment is a matter of dosage mdashParacelsus Harvey E Finkel MD is Clinical Professor of Medicineat Boston University Medical Centre and is a memberof AIMrsquos Social Scientific and Medical Council

a study by Dr Morten Gronbaek of the NationalInstitute of Public Health in Copenhagen hasfound that heavy drinkers (especially non-winedrinkers) significantly increase their risk ofcontracting rectal cancerThe findings are basedon a population study of over 29000 Danishmen and women aged between 23 and 95Cancers that originate in the colon and rectumare the fourth most commonly diagnosedcancers in the US and represent the second-leading cause of death from cancerApproximately one-third of the cases ofcolorectal cancer are actually cancers of therectum Gronbaek said Their weekly intake ofbeer wine and spirits was assessed as wereother factors likely to influence bowel cancerrisk such as how much they smoked weighedand took regular exercise Men were more likelythan women to be heavy drinkers and heavydrinkers were more likely to be smokers and toweigh more than light drinkers

During a monitoring period of almost 15 years411 cases of colon cancer and 202 cases ofrectal cancer were reported among thosestudied Alcohol seemed to have little influenceover the risk of colon cancer but there was aclear association between rectal cancer risk andthe amount of alcohol consumed Thosedrinking more than 41 units of alcohol a weekhad twice the risk of developing the disease as

non-drinkers But the type of alcohol consumedhad a significant bearing on rectal cancer riskThose who drank 14 or more units of beer orspirits a week were over 35 times as likely todevelop rectal cancer as non-drinkers Yet thosewho drank the same total amount of alcoholbut who included around a third or more of winein their intake were less than twice as likely todevelop the diseaseThe authors point out thatwine drinkers tended to be better educated andto take more exercise than beer or spiritdrinkers so there may be other healthier lifestylefactors at play There are no obvious reasonswhy alcohol should apparently be moredamaging to the rectum than the colon but thereasons why wine seems to exert its protectiveeffect most likely lie in resveratrol which is foundin both grapes and wine

Previous research indicates that this chemicaldamps down the cellular processes involved inthe promotion and growth of cancerous cellsThe lack of a relationship between alcoholdrinking and colon cancer risk is also somewhatof a mystery according to Gronbaek

ldquoThe tissue is rather similar in the two parts ofthe organ mdash colon and rectum mdash and one mightexpect the same mechanism in developing thediseaserdquo Gronbaek said However he addedthat previous studies have also found thatalcohol has an effect on the rectum but not thecolon SOURCE Gut 200352861-867

Alcohol colon and rectal cancer

The World Advertising Research Centre will beholding the eighth annual Alcoholic Drinksconference in central London on Tuesday 30th

September The conference will be chaired byNick Kendall Group Strategy Director BartleBogle Hegarty

This yearrsquos programme will concentrate inparticular on the urgency and importance ofsocial responsibility issues for the alcoholicdrinks industry With the UK Government in themiddle of developing a national alcohol harm-reduction strategy conducted by the PrimeMinisterrsquos own Strategy Unit and the Department

of Health self-regulation may give way to legalcontrols on the advertising of alcoholic drinksSpeakers include Rita Clifton ChairmanInterbrand Hamish Pringle Director GeneralIPAWendy Darlington Brand MarketingDirector Diageo Plc Jaspar Shelbourne GlobalCreative Director JWT Alan Mitchell JournalistMike Spurling Director The Informer A SpecialPanel on Social Responsibility features AndrewBrown The Advertising Association HughBurkitt The Marketing Society Leanne RileyScientist World Health Organisation JeanCoussins The Portman GroupHelmutWagner The Amsterdam Group Chris SearleExecutive Director Bacardi Martini

For details contact Sarah Miller World AdvertisingResearch Center Farm Road Henley-on-ThamesOxon RG9 1EJ Tel 0044 (0) 1491 418 646 Fax0044 (0) 1491 418 600 Mail sarah_millerwarccomWeb wwwwarccomconferences

30th Alcoholic Drinks 2003 - Conference Brewers of Europe 3rdBeer and health

symposiumThe Brewers of Europe are holding a conferenceon the benefits of moderate beer consumptionon the 15th October at the Residence PalaceBrussels

The event is chaired by professor Oliver Jamesof the University of Newcastle and includespresentations on alcohol and weight moderatedrinking and well being and nutritional aspects

For more information please visitwwwbrewersofeuropeorg or emailinfobrewersofeuropeorg

9

10

1Introduction

As part of cultural traditions and well balancedlifestyles wine beer and spirits consumption hasbeen a common staple in diets around the worldIn acknowledgement of such practices groupsof nutrition experts have included the moderateconsumption of alcohol as an optionalcomponent of various dietary guidelines andfood guides such as the Mediterranean AsianLatin American and Vegetarian Pyramids Herewe outline the key scientifically based nutritionmessages in these pyramids

The outlined alcohol-inclusive dietary pyramidsare part of an effort by Oldways Preservation ampExchange Trust a non- profit education groupthat is dedicated to preserving traditional eatingpatterns with the goal to improve consumerknowledge and diets around the world Oldwayshas prepared these concepts with prominentnutrition medical biomedical andcommunication experts from leading institutionssuch as the WHO Regional Office for Europeand the Harvard School of Public Health

Cardiovascular disease and cancer are leadingcauses of death in developed nations aroundthe world predominantly being associated withdiets high in animal fats With that emergingscientific consensus the Oldways pyramids allemphasize fruits vegetables cereals andpulses with litt le meat (animal fats)consumption These nutrition concepts alsoinclude wine beer and spirits which have shownto contribute to lower heart disease rates andimprove longevity

Accumulating scientific evidence suggests thatmoderate consumption of wine beer and spiritsdoes not pose a health risk to the vast majorityof consumers who choose to drink inmoderation AIMrsquos recommendations alsoemphasise that adults should enjoy alcoholbeverages in a sensible manner preferablyaround mealtimes or other responsible socialsettings Moderation is the key to a healthy dietand lifestyle and this is reflected in severaltraditional nutrition concepts

Consumers should follow moderation guidelinessuch as those in the Dietary Guidelines forAmericans which define moderation as up totwo drinks (12g) a day for men and up to onedrink a day for women further consumersshould avoid alcohol during pregnancy or when-ever it would put the individual or others at risk

To learn more about the US Dietary Guidelinesmessage on alcohol please visitwwwhealthgovdietaryguidelines and for otherauthoritative links on alcohol please also visitthe AIM links page on the gateway to sensibledrinking and health site via wwwaim-digestcom

Alcohol-Inclusive Nutrition

Concepts The

The lsquoEatwisersquo concept

The latest ldquoEat Wiserdquo Pyramid including ldquowinebeer and spirits in moderationrdquo as part of a dailybeverage recommendation was released atJanuaryrsquos 2003 Mediterranean Diet Conferencesponsored by Harvard School of Public Healthand Oldways Preservation amp Exchange TrustThis new pyramid is modelled on the originalMediterranean Diet Pyramid which initially onlyrecommended wine in moderation reflecting thecultural preference of the Mediterranean regionldquoThis Eat Wise Pyramid is a visual guide tohealthy living the Eat Wise wayrdquo theaccompanying text states ldquoIt shows thepartnership of a balanced diet plenty of waterregular physical activity and alcohol inmoderation that wise eaters know strengthenall their bodiesrsquo functionsrdquo An expert conferencediscussion emphasized the potential benefits forall three beverages Eat Wise Meal Ideasshopping tips and recipes are outlined in aspecial eating guide that can be ordered via theOldways website

Moderate Alcohol Intake as Part of a Healthy Diet and Lifestyle - A Look at Alcohol Inclusive Nutrition Concepts from Around the World by Elisabeth Holmgren

The Mediterranean Diet Pyramidwwwoldwaysptorgpyramidsmed

p_medhtml

The Mediterranean Diet Concept

Long known for its healthy lifestyles and thelongevity of its people the Mediterranean regionis also home of some of the most palatable andhealthy foods on earth Traditionally wine hasbeen included as an integral part of its mealsand cross-cultural studies have reportedsignificantly lower risk of heart disease inMediterranean regions where alcohol is a dailystaple of a healthy diet and lifestyle As thepreferred beverage in this region wine isspecified as an option on ldquoThe TraditionalHealthy Mediterranean Diet Pyramidrdquodeveloped by Oldways in cooperation withscientists from the WHO in Europe and fromthe Harvard School of Public Health Thistraditional diet is based on grains including ricepolenta bulgur and pasta as well as legumesand vegetables It also includes fruits cheesesyogurt and nuts along with the optional choiceof alcohol in moderation Olive oil is given itsown category as a major source of monounsaturated fat reflecting its importantprominence in the regionrsquos healthy cuisine Dailyphysical activity a factor contributing to healthin the Mediterranean region and elsewhere isalso included on this and all Oldways pyramids

11

The Asian Diet Concept

As Asian cuisine continues to become popularin diverse regions of the world characteristicsof Asian diets will continue to gain importanceIn Japan and China studies have found ratesfor heart disease and many types of cancer tobe lower than those in the United States andthe rest of the world The centuries-oldtraditional Asian diet of rice noodles vegetablesand fish is believed to be a significant contributorto the documented lower rates for chronicdisease in these populations The ldquoTraditionalhealthy Asian Diet Pyramidrdquo developed incooperation with scientists at Cornell Universityand the Harvard School of Public Healthincorporates these dietary patterns into thepyramid format Sake wine beer and otherbeverages with alcohol in moderation as wellas tea are included as part of the pyramidbecause studies have shown that theirconsumption may play an role in reducing heartdisease risk and overall mortality

The Asian Diet Pyramid

wwwoldwaysptorgpyramidsasianp_asianhtml

ldquoThe

The Latin American ConceptThe Traditional Healthy Latin American DietPyramidrdquo released in 1996 is based on thetraditional foods of Latin America Unlike theAmericanized versions that tend to be high insalt and fat this pyramid presents many healthyeating options It emphasizes daily consumptionof beans grains tubers and nuts along withfruits and vegetablesmdashstaples in most LatinAmerican and Caribbean regions Daily physicalactivity is integrated into the pyramid structurein recognition of the scientific consensus on theimportance of exercise in maintaining goodhealth Alcohol in moderation with meals isincluded as an option and as with other culturalpyramids meats sweets and eggs are at thevery top of the pyramid in the ldquooccasionallyrdquocategory to advocate a healthy and balancedlifestyle that can reduce the risk for several

common diseases

The Vegetarian Diet ConceptThe unique ldquoVegetarian Diet Pyramidrdquo releasedby Oldways at the end of 1997 serves as amodel for healthy eating with meals built aroundvegetables fruits whole grains and legumesThe pyramid also emphasizes daily physicalactivity water consumption and the option ofldquowine beer and other alcoholrdquo in moderationThe importance of this dietary conceptaccording to Oldways is that it reflects thegrowing number of vegetarians and

The Scientific Evidence

The nutritional and medical significance ofthe traditional Oldways Dietary Pyramidswas featured in ldquoMedical NewsPerspectivesrdquo of the Journal of the AmericanMedical Association in 2000 The authorhighlighted the importance of well-balancedand nutritious diets as a potential diseaseprevention measure that could beincreasingly conveyed by physicians andhealthcare providers to their patients Morerecently Greek and US scientists investigatedthe health effects of adherence to aMediterranean Diet reported in the New EnglandJournal of Medicine in 2003 ldquoGreater adherenceto the traditional Mediterranean diet isassociated with a significant reduction in totalmortalityrdquo Coinciding with these acknow-ledgements there is now a developing scientificconsensus that for many individuals moderatewine beer and spirits consumption is associated

acknowledges the nutritional and health benefitsof this type of diet For example the DietaryGuidelines for Americans have acknowledgedsuch a diet as able to meet RecommendedDietary Allowances (RDA) for nutrients Whilesome vegetarians are prohibited fromconsuming meat and alcohol for religiousreasons all alcohol beverages are included asa choice because of the potential risk reductionfor heart disease and its cultural role as anaccompaniment to vegetarian eating

The Latin American Diet Pyramidwwwoldwaysptorgpyramidslatin

p_latinhtml

The Vegetarian Diet Pyramidwwwoldwaysptorgpyramidsveg

p_veghtml

11

12

with a reduced risk of coronary heart diseaseand increased life expectancy which lead to theabove featured alcohol-inclusive nutritionconcepts

In 1997Sir Richard Doll Emeritis Professor ofMedicine at Oxfordoutlined in the BritishMedical Journal ldquomassiverdquo evidence for thepotential beneficial effect of alcohol in a reviewof the clinical data on alcohol and mortality Heconcluded that ldquothe consumption of small andmoderate amounts of alcoholrdquo leads to a one-third-risk reduction for vascular disease He alsoacknowledged a reduction in total mortality inmiddle-aged and elderly men and women whenthey consumed wine beer or spirits Morerecently world-renowned expert Dr ArthurKlatsky from the US outlined the overwhelmingscientific evidence in Scientific American DrKlatsky has published many research studieson alcohol and health in leading scientificjournals from the large-scale Kaiser Permanentecohort and in the recent article he wrote withrespect to the most appropriate advice to thepublic ldquoOn one hand mild to moderate drinkingseems better for heart health than abstinencefor select people On the other hand heavydrinking is clearly dangerousrdquo Merelyrecommending abstinence is inappropriatehealth advice to people such as established lightdrinkers at high risk of CHD and at low risk ofalcohol-related problemsmdashwhich describes alarge proportion of the populationrdquo Dr Klatskyalong with other experts from around the worldhas advocated that health professionals makecase-by-case evaluations based on individualand family histories They also emphasize thatthe public should be entrusted with all theinformation on use versus misuse of alcohol sothat they can make informed decisionsthemselves

Authoritative findings from cohortsinternationally lead research experts tofeature the option of moderation in eachtraditional Oldways Dietary Pyramid Manypeer-reviewed studies from Europe AsiaAustralia and the US have revealed potentialbenefits for moderately drinking adults inmulti-ethnic populations These studies findthat moderate drinkers especially consumersof 1-2 drinks (12g) daily may lower their risk ofheart disease significantly Studies reportingcertain health advantages for moderate drinkersinclude the Lyon Heart Study the CopenhagenCity Heart Study the Australian Dubbo Studyand the European Seven Country Study

The Oldways experts working with the HarvardSchool of Public Health specifically consideredfindings from the ongoing Physiciansrsquo HealthStudy and the Nursesrsquo Health Study Analyzingdata from 84000 women in the Nursesrsquo HealthStudy the effect of a combination of diet andlifestyle factors were assessed on the risk ofCHD Dr Meir Stampfer et al concludedrdquo In thispopulation of middle-aged women those whodid not smoke cigarettes were not overweightmaintained a healthful diet described aboveexercised moderately or vigorously for half anhour a day and consumed alcohol moderatelyhad an incidence of coronary events that wasmore than 80 lower than that in the rest of thepopulationrdquo At the same time based on aprospective study of more than 89000 men aspart of the Physiciansrsquo Health Study Harvardresearcher Dr Michael Gaziano et al concludedrdquoIn summary this study reveals the complexeffect of alcohol consumption on various chronicdiseases as reflected in the overall U-shapedrelationship between light-to-moderate alcoholconsumption and total mortality in menrdquoTheearlier results from the US governmentrsquos fundedNational Health and Nutrition ExaminationSurvey (NHANES) were also considered whichfound that the risk for CHD is reduced for bothmen and women who drink moderatelyPublished in 1997 in the American Journal ofEpidemiology it stated ldquoThis analysisconfirmed previous research showing thatabstainers are at a greater risk for CHD thanare most non abstainers and that a significantprotective effect may be demonstrated withsmall amounts of alcoholrdquo Along those linesresearch published in The New England Journalof Medicine from American Cancer Societyexperts concluded ldquoIn this middle-aged andelderly population moderate alcoholconsumption slightly reduced overall mortalityrdquo

At the same time there are continuingconcerns about alcohol consumption andbreast cancer and women arerecommended not to drink when pregnant in line with governmental and public healthpositions in the US Authoritative statementsfrom public health groups such as the AmericanHeart Association the National StrokeAssociation and the American DieteticAssociation acknowledge the scientific evidencepointing to potential benefits of moderation withrespect to coronary heart disease andemphasize ldquoIf you choose to drink do so inmoderationrdquo A balanced summary position is

reflected in the 1999 JAMA Patient Page onldquoBenefits and dangers of alcoholrdquo which defineslsquoModerate drinking as 1 or 2 drinks (12g) a dayfor men and 1 drink a day for women and thoseolder than 65rsquo These messages are embodiedin governmental positions in the US UKAustralia and Canada

The Oldways alcohol messages as reflectedin the pyramids are however especiallynotable in that they emphasize consumptionwith or around mealtime as research hasshown that these and related cultural normsfacilitate responsible drinking habits mayslow alcohol absorption and may counterpotential harmful effects of fatty foods Forexample Dr David Hanson author ofPreventing Alcohol Abuse Alcohol Culture andControl explains ldquoThe cross-cultural evidenceindicates that drinking abuse will be low in anygroup in which drinking customs values andsanctions are clearhellip and characterized byprescriptions for moderate drinking andproscriptions against immoderate drinkingrdquoFurthermore several biochemical studiesindicate that in addition to slowing down theabsorption process which keeps blood alcohollevels lower moderate consumption during oraround mealtime may have favourable effectson lipid profiles and atherogenesis One 1998study published in the American Journal ofClinical Nutrition suggested ldquoethanol mayreduce cardiovascular risk by modulatingvascular muscle growth during the postprandialperiodrdquo Research continues but it appears clearthat healthy dietary patterns are inverselyrelated with low rates of chronic diseases Thishas been specifically confirmed in the ongoingSeven Country Study which reported in 1999that animal-food groups were directly correlatedwith CHD mortality while vegetable-food groupsas well as fish and alcohol were inverselycorrelated

In summary in line with the developingscientific consensus public health andgovernmental positions the Oldwayspyramids stress moderation and underscorethe importance of an overall healthy mealand lifestyleConsumption is notrecommended for non-drinkers or thosewho may have any health contraindicationsand consumers are always advised toconsult with their healthcare providersFor selected references and authoritative statements onmoderate drinking and health please visit the Gateway toSensible Drinking and Health via wwwaim-digestcom

13

ORGANISATIONS INVOLVED IN ALCOHOL AFFAIRSUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOM

ALALALALALCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNWaterbridge House 32-36 Loman Street London SE10EETel (0207) 928 7377 Fax (0207) 928 4644Websitewww alcoholconcernorguk

ALALALALALCOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCATION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARCHCHCHCHCHCOUNCILCOUNCILCOUNCILCOUNCILCOUNCILAbell House John Islip Street London SW1P 4LH Tel(0207) 217 5276

ALALALALALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALTH RESEARTH RESEARTH RESEARTH RESEARTH RESEARCH CENTRECH CENTRECH CENTRECH CENTRECH CENTREUniversity of West of England Glenside CampusBlackberry Hill Stapleton Bristol BS16 1DD Tel(0131) 536 6192 Fax (0131) 5366215 E-mailmplantahrconetcouk

HEALHEALHEALHEALHEALTH EDUCATH EDUCATH EDUCATH EDUCATH EDUCATION ATION ATION ATION ATION AUTHORITYUTHORITYUTHORITYUTHORITYUTHORITYHamilton House Mabledon Place London WC1 9TXTel (020) 72985656 Fax (020) 77259031 Emailenquirieshpeorgukwebsite wwwhpeorguk and wwwwreckedcouk

THE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALCOHOLISMCOHOLISMCOHOLISMCOHOLISMCOHOLISM3 St Andrewrsquos Place London NW1 4LBTel (0207) 487 4445 Fax (0207) 9354479

THE PORTHE PORTHE PORTHE PORTHE PORTMAN GRTMAN GRTMAN GRTMAN GRTMAN GROUPOUPOUPOUPOUP7-10 Chandos Street Cavendish Square London W1G9DQTel 020 7907 3700 Fax 020 7907 3710wwwportman-grouporguk

ALALALALALCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOTLANDTLANDTLANDTLANDTLAND2nd Floor 166 Buchanan Street Glasgow G1 2NH Tel0141-572 6700 Fax 041-333 1606

BRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIATIONTIONTIONTIONTIONMarket Towers 1 Nine Elms LaneLondon SW8 5NQTel 020 7627 9191 Fax020 7627 9123E-mail jwitheridgebeerandpubcomWebsite wwwbeerandpubcom

EUREUREUREUREUROPEOPEOPEOPEOPE

ARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GROUPOUPOUPOUPOUPBrewersrsquo House 10 Grand Place B-1000 BrusselsBelgium Tel +32 2 511 49 87 Fax +32 2 511 32 59

CBMCCBMCCBMCCBMCCBMCCheacutee de la Hulpe 181 bte 20 B-1170 Bruxelles Tel(++322) 672 23 92 Fax (++322) 660 94 02Website wwwcbmcorg

FORFORFORFORFORUMUMUMUMUMLivornostraat 13 b 5 rue de Livourne ndash Brussel 1050Bruxelles BelgiumTel 32 2 539 36 64 Fax 32 2 537 81 56email forumtasteeducationskynetbe websitewwwforum-taste-educationcom

ENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTION13 Rue Monsigny 75002 Paris FranceTel 00-33-53-43-80-75E-mail enterprisewanadoofr

IREBIREBIREBIREBIREB19 avenue Trudaine 75009 ParisTel +33 (1) 48 74 82 19 Fax +33 (1) 48 78 17 56E-mail irebirebcom Website wwwirebcom

OIVOIVOIVOIVOIV18 rue drsquoAguesseau 75008 Paris FranceTel +33 (0) 1 44 94 80 94Fax +33 (0) 1 42 66 90 63E-mail oivoivintWebsite wwwoivint

STIVSTIVSTIVSTIVSTIVAAAAABenoordenhoutseweg 22-23 2596 BA The HagueTheNetherlands Tel +31 (0)70 314 2480 Fax +31(0) 70314 24 81 E-mail phoastivanl Website wwwstivanl

SCANDINSCANDINSCANDINSCANDINSCANDINAAAAAVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALALALALALALCOHOL BOCOHOL BOCOHOL BOCOHOL BOCOHOL BOARDARDARDARDARDVandvaeligrksvej 11 DK - 5690 TommerupTel 45 64 75 22 84 Fax 45 64 75 28 44E-mail smaborg Websitewwwsmaborg

DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE WEINWEINWEINWEINWEINAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHGutenbergplatz 3-5 55116 MainzTel +49 02641 977340 Fax +49 02641 977342Website wwwdeutscheweinakademiede

FIVINFIVINFIVINFIVINFIVINPlaza Penedeacutes 3 308720 Vilafranca del PenedeacutesBarcelona Spain Tel 0034 (93) 890 45 45 Fax 0034(93) 890 46 11

DIFDIFDIFDIFDIFA FORA FORA FORA FORA FORUM EVUM EVUM EVUM EVUM EVFranklinstrabe 1 10587 BerlinGermany Tel + 49 (0) 30 39 0633 60Fax +49 (0) 30 390 633 66 email infodifa-forumdeWebsite wwwdifa-forumde

GODGODGODGODGODAAAAAGode Alkoholdninger Kattesundet 9 DK-1458Koslashbenhavn K Denmark Tel 33 13 93 83Fax 33 13 03 84

FIVSFIVSFIVSFIVSFIVSInternational Federation of Wines amp Spirits20 rue drsquoAnjou - 75008 Paris Tel 33 1 42 68 82 48Fax 33 1 40 06 06 98

THE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDAM GRAM GRAM GRAM GRAM GROUPOUPOUPOUPOUPRue Wiertz 5028B-1050 Brussels BelgiumTel +32 2 401 61 35 Fax + 32 2 401 68 68 emailinfoamsterdamgrouporgwwwamsterdamgrouporg

FUNDFUNDFUNDFUNDFUNDAAAAACION ALCION ALCION ALCION ALCION ALCOHOL COHOL COHOL COHOL COHOL Y SOCIEDY SOCIEDY SOCIEDY SOCIEDY SOCIEDADADADADADDiego de Leon 442 ES 28006 MadridTel + 34 91 745 08 44 Fax + 34 91 561 8955wwwalcoholysociedadorg

USA CANUSA CANUSA CANUSA CANUSA CANADADADADADA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAAAAAAUSTRALIAUSTRALIAUSTRALIAUSTRALIAUSTRALIA

WINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICA1200 G Street NW Suite 360 Washington DC 20005Tel (800) 879 4637 Fax (202) 347 6341E-mail infoamericanwineriesorgWebsite wwwamericanwineriesorg

AMERICAN AMERICAN AMERICAN AMERICAN AMERICAN WINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARCHCHCHCHCHAND EDUCAAND EDUCAAND EDUCAAND EDUCAAND EDUCATIONTIONTIONTIONTIONVisit website at wwwalcohol-AWAREcom

AMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAND HEALAND HEALAND HEALAND HEALAND HEALTHTHTHTHTH1995 Broadway 2nd Floor New York NY 10023-5860Tel (212) 362-7044 Ext 234 Fax (212) 362-4919Email kavaacshorg Websitewwwacshorg

BEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTE122 C Street NW 750Washington DC 20001Tel(202) 737-2337 Fax (202) 737-7004E-mailinfobeerinstituteorgWebsite wwwbeerinstituteorg

PRPRPRPRPROOOOOYECTYECTYECTYECTYECTO CIENCIA O CIENCIA O CIENCIA O CIENCIA O CIENCIA VINO VINO VINO VINO VINO Y SALY SALY SALY SALY SALUDUDUDUDUDFacultad de ciencias BioloacutegicasCasilla 114 D Santiago ChileTelFax (56-23) 222 2577Email vinsaludgenesbiopuccl

EDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALCOOLCOOLCOOLCOOLCOOL606 Cathcart Suite 700 Montreacuteal Queacutebec H3B 1K9Canada Tel (514) 875-7454 E-mailhsacyeducalcoolqcca Website wwweducalcoolqcca

THE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERAGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTE1775Pennsylvania Avenue NW Suite 1200 WashingtonDC 20006 Tel 2024637110wwwamericanbeverageinstitutecom

FISAFISAFISAFISAFISACCCCC(Fundacion de Investigaciones Sociales AC) FranciscoSosa 230 coyoacan CP 04000 Mexico DF - Mexico

HEALHEALHEALHEALHEALTTTTTH EDUCAH EDUCAH EDUCAH EDUCAH EDUCATION FOUNDTION FOUNDTION FOUNDTION FOUNDTION FOUNDAAAAATIONTIONTIONTIONTION INC INC INC INC INC2600 Virginia Avenue NW Washington DC 20037Tel (202) 3383501 Fax (202) 9656520E-mail hefmonaerolscom

ICAPICAPICAPICAPICAPInternational Center for Alcohol Policies1519 New Hampshire Avenue NWWashington DC 20036Tel (202) 986-1159 Fax (202) 986-2080Website wwwicaporg

THE CENTURTHE CENTURTHE CENTURTHE CENTURTHE CENTURY COUNCILY COUNCILY COUNCILY COUNCILY COUNCIL1310 G Street NW Suite 600Washington DC 20005-3000 Tel (202) 637-0077 Fax(202) 637-0079 Email washdecenturycouncilorgWebsite wwwcenturycouncilorg

CALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIATION OF TION OF TION OF TION OF TION OF WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEGRGRGRGRGROOOOOWERS WERS WERS WERS WERS 601 University Avenue Suite 135 Sacramento CA 95825wwwcawgorg email karencawgorg

THE THE THE THE THE WINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTE425 Market Street Suite 1000 San Francisco CA94105 USA Tel (415) 512-0151 Fax (415) 442-0742

LLLLLODI -WODI -WODI -WODI -WODI -WOODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPECOMMISSIONCOMMISSIONCOMMISSIONCOMMISSIONCOMMISSION2545 West Turner Road Lodi CA 95242USAmarklodiwinecom website wwwlodiwinecom

THE NTHE NTHE NTHE NTHE NAPAPAPAPAPA A A A A VVVVVALLEY ALLEY ALLEY ALLEY ALLEY VINTNERSVINTNERSVINTNERSVINTNERSVINTNERSASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION Phone - 707-963-3388 Fax - 707-963-3488 Website wwwnapavintnerscom

OLDOLDOLDOLDOLDWWWWWAAAAAYYYYYS PRESERS PRESERS PRESERS PRESERS PRESERVVVVVAAAAATION amp EXTION amp EXTION amp EXTION amp EXTION amp EXCHANGECHANGECHANGECHANGECHANGETRTRTRTRTRUSTUSTUSTUSTUST266 Beacon Street Boston MA 02116 6174215500Fax 6174215511 website wwwoldwaysptorg

THE ATHE ATHE ATHE ATHE AUSTRALIAN USTRALIAN USTRALIAN USTRALIAN USTRALIAN WINE RESEARWINE RESEARWINE RESEARWINE RESEARWINE RESEARCHCHCHCHCHINSTITUTEINSTITUTEINSTITUTEINSTITUTEINSTITUTEP O Box 197 glen Osmond 5064 South AustraliaAustralia Tel 61 8 8303 6600 Fax 61 6 303 6601

13

9

Inconclusive reports have raised the questionof a slight increase in risk of cancer of thepancreas The data relating beer and spirits toa possible slight increase of risk of colorectaltumours are conflicting and confusing

Might moderate drinking protect against cancerEarly indications suggest the answer might beldquoyesrdquo A number of studies has demonstratedthat wine in particular possesses severalproperties that would tend to prevent or inhibitcancer no doubt through the actions of itsantioxidant compounds Epidemiologic researchhas revealed substantial reduction of risk ofcancers of the oesophagus and upper stomachand colon and rectum in wine drinkers ascompared to non-drinkers

In essence past experience and currentresearch indicate that abuse of alcohol risksdamaging the gastro-intestinal tract at severalpoints but moderate wine consumption risksonly a little heartburn while possibly leading tomajor health benefits not to mention gustatorypleasures

Whether wine is a poison a medicine or anourishment is a matter of dosage mdashParacelsus Harvey E Finkel MD is Clinical Professor of Medicineat Boston University Medical Centre and is a memberof AIMrsquos Social Scientific and Medical Council

a study by Dr Morten Gronbaek of the NationalInstitute of Public Health in Copenhagen hasfound that heavy drinkers (especially non-winedrinkers) significantly increase their risk ofcontracting rectal cancerThe findings are basedon a population study of over 29000 Danishmen and women aged between 23 and 95Cancers that originate in the colon and rectumare the fourth most commonly diagnosedcancers in the US and represent the second-leading cause of death from cancerApproximately one-third of the cases ofcolorectal cancer are actually cancers of therectum Gronbaek said Their weekly intake ofbeer wine and spirits was assessed as wereother factors likely to influence bowel cancerrisk such as how much they smoked weighedand took regular exercise Men were more likelythan women to be heavy drinkers and heavydrinkers were more likely to be smokers and toweigh more than light drinkers

During a monitoring period of almost 15 years411 cases of colon cancer and 202 cases ofrectal cancer were reported among thosestudied Alcohol seemed to have little influenceover the risk of colon cancer but there was aclear association between rectal cancer risk andthe amount of alcohol consumed Thosedrinking more than 41 units of alcohol a weekhad twice the risk of developing the disease as

non-drinkers But the type of alcohol consumedhad a significant bearing on rectal cancer riskThose who drank 14 or more units of beer orspirits a week were over 35 times as likely todevelop rectal cancer as non-drinkers Yet thosewho drank the same total amount of alcoholbut who included around a third or more of winein their intake were less than twice as likely todevelop the diseaseThe authors point out thatwine drinkers tended to be better educated andto take more exercise than beer or spiritdrinkers so there may be other healthier lifestylefactors at play There are no obvious reasonswhy alcohol should apparently be moredamaging to the rectum than the colon but thereasons why wine seems to exert its protectiveeffect most likely lie in resveratrol which is foundin both grapes and wine

Previous research indicates that this chemicaldamps down the cellular processes involved inthe promotion and growth of cancerous cellsThe lack of a relationship between alcoholdrinking and colon cancer risk is also somewhatof a mystery according to Gronbaek

ldquoThe tissue is rather similar in the two parts ofthe organ mdash colon and rectum mdash and one mightexpect the same mechanism in developing thediseaserdquo Gronbaek said However he addedthat previous studies have also found thatalcohol has an effect on the rectum but not thecolon SOURCE Gut 200352861-867

Alcohol colon and rectal cancer

The World Advertising Research Centre will beholding the eighth annual Alcoholic Drinksconference in central London on Tuesday 30th

September The conference will be chaired byNick Kendall Group Strategy Director BartleBogle Hegarty

This yearrsquos programme will concentrate inparticular on the urgency and importance ofsocial responsibility issues for the alcoholicdrinks industry With the UK Government in themiddle of developing a national alcohol harm-reduction strategy conducted by the PrimeMinisterrsquos own Strategy Unit and the Department

of Health self-regulation may give way to legalcontrols on the advertising of alcoholic drinksSpeakers include Rita Clifton ChairmanInterbrand Hamish Pringle Director GeneralIPAWendy Darlington Brand MarketingDirector Diageo Plc Jaspar Shelbourne GlobalCreative Director JWT Alan Mitchell JournalistMike Spurling Director The Informer A SpecialPanel on Social Responsibility features AndrewBrown The Advertising Association HughBurkitt The Marketing Society Leanne RileyScientist World Health Organisation JeanCoussins The Portman GroupHelmutWagner The Amsterdam Group Chris SearleExecutive Director Bacardi Martini

For details contact Sarah Miller World AdvertisingResearch Center Farm Road Henley-on-ThamesOxon RG9 1EJ Tel 0044 (0) 1491 418 646 Fax0044 (0) 1491 418 600 Mail sarah_millerwarccomWeb wwwwarccomconferences

30th Alcoholic Drinks 2003 - Conference Brewers of Europe 3rdBeer and health

symposiumThe Brewers of Europe are holding a conferenceon the benefits of moderate beer consumptionon the 15th October at the Residence PalaceBrussels

The event is chaired by professor Oliver Jamesof the University of Newcastle and includespresentations on alcohol and weight moderatedrinking and well being and nutritional aspects

For more information please visitwwwbrewersofeuropeorg or emailinfobrewersofeuropeorg

9

10

1Introduction

As part of cultural traditions and well balancedlifestyles wine beer and spirits consumption hasbeen a common staple in diets around the worldIn acknowledgement of such practices groupsof nutrition experts have included the moderateconsumption of alcohol as an optionalcomponent of various dietary guidelines andfood guides such as the Mediterranean AsianLatin American and Vegetarian Pyramids Herewe outline the key scientifically based nutritionmessages in these pyramids

The outlined alcohol-inclusive dietary pyramidsare part of an effort by Oldways Preservation ampExchange Trust a non- profit education groupthat is dedicated to preserving traditional eatingpatterns with the goal to improve consumerknowledge and diets around the world Oldwayshas prepared these concepts with prominentnutrition medical biomedical andcommunication experts from leading institutionssuch as the WHO Regional Office for Europeand the Harvard School of Public Health

Cardiovascular disease and cancer are leadingcauses of death in developed nations aroundthe world predominantly being associated withdiets high in animal fats With that emergingscientific consensus the Oldways pyramids allemphasize fruits vegetables cereals andpulses with litt le meat (animal fats)consumption These nutrition concepts alsoinclude wine beer and spirits which have shownto contribute to lower heart disease rates andimprove longevity

Accumulating scientific evidence suggests thatmoderate consumption of wine beer and spiritsdoes not pose a health risk to the vast majorityof consumers who choose to drink inmoderation AIMrsquos recommendations alsoemphasise that adults should enjoy alcoholbeverages in a sensible manner preferablyaround mealtimes or other responsible socialsettings Moderation is the key to a healthy dietand lifestyle and this is reflected in severaltraditional nutrition concepts

Consumers should follow moderation guidelinessuch as those in the Dietary Guidelines forAmericans which define moderation as up totwo drinks (12g) a day for men and up to onedrink a day for women further consumersshould avoid alcohol during pregnancy or when-ever it would put the individual or others at risk

To learn more about the US Dietary Guidelinesmessage on alcohol please visitwwwhealthgovdietaryguidelines and for otherauthoritative links on alcohol please also visitthe AIM links page on the gateway to sensibledrinking and health site via wwwaim-digestcom

Alcohol-Inclusive Nutrition

Concepts The

The lsquoEatwisersquo concept

The latest ldquoEat Wiserdquo Pyramid including ldquowinebeer and spirits in moderationrdquo as part of a dailybeverage recommendation was released atJanuaryrsquos 2003 Mediterranean Diet Conferencesponsored by Harvard School of Public Healthand Oldways Preservation amp Exchange TrustThis new pyramid is modelled on the originalMediterranean Diet Pyramid which initially onlyrecommended wine in moderation reflecting thecultural preference of the Mediterranean regionldquoThis Eat Wise Pyramid is a visual guide tohealthy living the Eat Wise wayrdquo theaccompanying text states ldquoIt shows thepartnership of a balanced diet plenty of waterregular physical activity and alcohol inmoderation that wise eaters know strengthenall their bodiesrsquo functionsrdquo An expert conferencediscussion emphasized the potential benefits forall three beverages Eat Wise Meal Ideasshopping tips and recipes are outlined in aspecial eating guide that can be ordered via theOldways website

Moderate Alcohol Intake as Part of a Healthy Diet and Lifestyle - A Look at Alcohol Inclusive Nutrition Concepts from Around the World by Elisabeth Holmgren

The Mediterranean Diet Pyramidwwwoldwaysptorgpyramidsmed

p_medhtml

The Mediterranean Diet Concept

Long known for its healthy lifestyles and thelongevity of its people the Mediterranean regionis also home of some of the most palatable andhealthy foods on earth Traditionally wine hasbeen included as an integral part of its mealsand cross-cultural studies have reportedsignificantly lower risk of heart disease inMediterranean regions where alcohol is a dailystaple of a healthy diet and lifestyle As thepreferred beverage in this region wine isspecified as an option on ldquoThe TraditionalHealthy Mediterranean Diet Pyramidrdquodeveloped by Oldways in cooperation withscientists from the WHO in Europe and fromthe Harvard School of Public Health Thistraditional diet is based on grains including ricepolenta bulgur and pasta as well as legumesand vegetables It also includes fruits cheesesyogurt and nuts along with the optional choiceof alcohol in moderation Olive oil is given itsown category as a major source of monounsaturated fat reflecting its importantprominence in the regionrsquos healthy cuisine Dailyphysical activity a factor contributing to healthin the Mediterranean region and elsewhere isalso included on this and all Oldways pyramids

11

The Asian Diet Concept

As Asian cuisine continues to become popularin diverse regions of the world characteristicsof Asian diets will continue to gain importanceIn Japan and China studies have found ratesfor heart disease and many types of cancer tobe lower than those in the United States andthe rest of the world The centuries-oldtraditional Asian diet of rice noodles vegetablesand fish is believed to be a significant contributorto the documented lower rates for chronicdisease in these populations The ldquoTraditionalhealthy Asian Diet Pyramidrdquo developed incooperation with scientists at Cornell Universityand the Harvard School of Public Healthincorporates these dietary patterns into thepyramid format Sake wine beer and otherbeverages with alcohol in moderation as wellas tea are included as part of the pyramidbecause studies have shown that theirconsumption may play an role in reducing heartdisease risk and overall mortality

The Asian Diet Pyramid

wwwoldwaysptorgpyramidsasianp_asianhtml

ldquoThe

The Latin American ConceptThe Traditional Healthy Latin American DietPyramidrdquo released in 1996 is based on thetraditional foods of Latin America Unlike theAmericanized versions that tend to be high insalt and fat this pyramid presents many healthyeating options It emphasizes daily consumptionof beans grains tubers and nuts along withfruits and vegetablesmdashstaples in most LatinAmerican and Caribbean regions Daily physicalactivity is integrated into the pyramid structurein recognition of the scientific consensus on theimportance of exercise in maintaining goodhealth Alcohol in moderation with meals isincluded as an option and as with other culturalpyramids meats sweets and eggs are at thevery top of the pyramid in the ldquooccasionallyrdquocategory to advocate a healthy and balancedlifestyle that can reduce the risk for several

common diseases

The Vegetarian Diet ConceptThe unique ldquoVegetarian Diet Pyramidrdquo releasedby Oldways at the end of 1997 serves as amodel for healthy eating with meals built aroundvegetables fruits whole grains and legumesThe pyramid also emphasizes daily physicalactivity water consumption and the option ofldquowine beer and other alcoholrdquo in moderationThe importance of this dietary conceptaccording to Oldways is that it reflects thegrowing number of vegetarians and

The Scientific Evidence

The nutritional and medical significance ofthe traditional Oldways Dietary Pyramidswas featured in ldquoMedical NewsPerspectivesrdquo of the Journal of the AmericanMedical Association in 2000 The authorhighlighted the importance of well-balancedand nutritious diets as a potential diseaseprevention measure that could beincreasingly conveyed by physicians andhealthcare providers to their patients Morerecently Greek and US scientists investigatedthe health effects of adherence to aMediterranean Diet reported in the New EnglandJournal of Medicine in 2003 ldquoGreater adherenceto the traditional Mediterranean diet isassociated with a significant reduction in totalmortalityrdquo Coinciding with these acknow-ledgements there is now a developing scientificconsensus that for many individuals moderatewine beer and spirits consumption is associated

acknowledges the nutritional and health benefitsof this type of diet For example the DietaryGuidelines for Americans have acknowledgedsuch a diet as able to meet RecommendedDietary Allowances (RDA) for nutrients Whilesome vegetarians are prohibited fromconsuming meat and alcohol for religiousreasons all alcohol beverages are included asa choice because of the potential risk reductionfor heart disease and its cultural role as anaccompaniment to vegetarian eating

The Latin American Diet Pyramidwwwoldwaysptorgpyramidslatin

p_latinhtml

The Vegetarian Diet Pyramidwwwoldwaysptorgpyramidsveg

p_veghtml

11

12

with a reduced risk of coronary heart diseaseand increased life expectancy which lead to theabove featured alcohol-inclusive nutritionconcepts

In 1997Sir Richard Doll Emeritis Professor ofMedicine at Oxfordoutlined in the BritishMedical Journal ldquomassiverdquo evidence for thepotential beneficial effect of alcohol in a reviewof the clinical data on alcohol and mortality Heconcluded that ldquothe consumption of small andmoderate amounts of alcoholrdquo leads to a one-third-risk reduction for vascular disease He alsoacknowledged a reduction in total mortality inmiddle-aged and elderly men and women whenthey consumed wine beer or spirits Morerecently world-renowned expert Dr ArthurKlatsky from the US outlined the overwhelmingscientific evidence in Scientific American DrKlatsky has published many research studieson alcohol and health in leading scientificjournals from the large-scale Kaiser Permanentecohort and in the recent article he wrote withrespect to the most appropriate advice to thepublic ldquoOn one hand mild to moderate drinkingseems better for heart health than abstinencefor select people On the other hand heavydrinking is clearly dangerousrdquo Merelyrecommending abstinence is inappropriatehealth advice to people such as established lightdrinkers at high risk of CHD and at low risk ofalcohol-related problemsmdashwhich describes alarge proportion of the populationrdquo Dr Klatskyalong with other experts from around the worldhas advocated that health professionals makecase-by-case evaluations based on individualand family histories They also emphasize thatthe public should be entrusted with all theinformation on use versus misuse of alcohol sothat they can make informed decisionsthemselves

Authoritative findings from cohortsinternationally lead research experts tofeature the option of moderation in eachtraditional Oldways Dietary Pyramid Manypeer-reviewed studies from Europe AsiaAustralia and the US have revealed potentialbenefits for moderately drinking adults inmulti-ethnic populations These studies findthat moderate drinkers especially consumersof 1-2 drinks (12g) daily may lower their risk ofheart disease significantly Studies reportingcertain health advantages for moderate drinkersinclude the Lyon Heart Study the CopenhagenCity Heart Study the Australian Dubbo Studyand the European Seven Country Study

The Oldways experts working with the HarvardSchool of Public Health specifically consideredfindings from the ongoing Physiciansrsquo HealthStudy and the Nursesrsquo Health Study Analyzingdata from 84000 women in the Nursesrsquo HealthStudy the effect of a combination of diet andlifestyle factors were assessed on the risk ofCHD Dr Meir Stampfer et al concludedrdquo In thispopulation of middle-aged women those whodid not smoke cigarettes were not overweightmaintained a healthful diet described aboveexercised moderately or vigorously for half anhour a day and consumed alcohol moderatelyhad an incidence of coronary events that wasmore than 80 lower than that in the rest of thepopulationrdquo At the same time based on aprospective study of more than 89000 men aspart of the Physiciansrsquo Health Study Harvardresearcher Dr Michael Gaziano et al concludedrdquoIn summary this study reveals the complexeffect of alcohol consumption on various chronicdiseases as reflected in the overall U-shapedrelationship between light-to-moderate alcoholconsumption and total mortality in menrdquoTheearlier results from the US governmentrsquos fundedNational Health and Nutrition ExaminationSurvey (NHANES) were also considered whichfound that the risk for CHD is reduced for bothmen and women who drink moderatelyPublished in 1997 in the American Journal ofEpidemiology it stated ldquoThis analysisconfirmed previous research showing thatabstainers are at a greater risk for CHD thanare most non abstainers and that a significantprotective effect may be demonstrated withsmall amounts of alcoholrdquo Along those linesresearch published in The New England Journalof Medicine from American Cancer Societyexperts concluded ldquoIn this middle-aged andelderly population moderate alcoholconsumption slightly reduced overall mortalityrdquo

At the same time there are continuingconcerns about alcohol consumption andbreast cancer and women arerecommended not to drink when pregnant in line with governmental and public healthpositions in the US Authoritative statementsfrom public health groups such as the AmericanHeart Association the National StrokeAssociation and the American DieteticAssociation acknowledge the scientific evidencepointing to potential benefits of moderation withrespect to coronary heart disease andemphasize ldquoIf you choose to drink do so inmoderationrdquo A balanced summary position is

reflected in the 1999 JAMA Patient Page onldquoBenefits and dangers of alcoholrdquo which defineslsquoModerate drinking as 1 or 2 drinks (12g) a dayfor men and 1 drink a day for women and thoseolder than 65rsquo These messages are embodiedin governmental positions in the US UKAustralia and Canada

The Oldways alcohol messages as reflectedin the pyramids are however especiallynotable in that they emphasize consumptionwith or around mealtime as research hasshown that these and related cultural normsfacilitate responsible drinking habits mayslow alcohol absorption and may counterpotential harmful effects of fatty foods Forexample Dr David Hanson author ofPreventing Alcohol Abuse Alcohol Culture andControl explains ldquoThe cross-cultural evidenceindicates that drinking abuse will be low in anygroup in which drinking customs values andsanctions are clearhellip and characterized byprescriptions for moderate drinking andproscriptions against immoderate drinkingrdquoFurthermore several biochemical studiesindicate that in addition to slowing down theabsorption process which keeps blood alcohollevels lower moderate consumption during oraround mealtime may have favourable effectson lipid profiles and atherogenesis One 1998study published in the American Journal ofClinical Nutrition suggested ldquoethanol mayreduce cardiovascular risk by modulatingvascular muscle growth during the postprandialperiodrdquo Research continues but it appears clearthat healthy dietary patterns are inverselyrelated with low rates of chronic diseases Thishas been specifically confirmed in the ongoingSeven Country Study which reported in 1999that animal-food groups were directly correlatedwith CHD mortality while vegetable-food groupsas well as fish and alcohol were inverselycorrelated

In summary in line with the developingscientific consensus public health andgovernmental positions the Oldwayspyramids stress moderation and underscorethe importance of an overall healthy mealand lifestyleConsumption is notrecommended for non-drinkers or thosewho may have any health contraindicationsand consumers are always advised toconsult with their healthcare providersFor selected references and authoritative statements onmoderate drinking and health please visit the Gateway toSensible Drinking and Health via wwwaim-digestcom

13

ORGANISATIONS INVOLVED IN ALCOHOL AFFAIRSUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOM

ALALALALALCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNWaterbridge House 32-36 Loman Street London SE10EETel (0207) 928 7377 Fax (0207) 928 4644Websitewww alcoholconcernorguk

ALALALALALCOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCATION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARCHCHCHCHCHCOUNCILCOUNCILCOUNCILCOUNCILCOUNCILAbell House John Islip Street London SW1P 4LH Tel(0207) 217 5276

ALALALALALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALTH RESEARTH RESEARTH RESEARTH RESEARTH RESEARCH CENTRECH CENTRECH CENTRECH CENTRECH CENTREUniversity of West of England Glenside CampusBlackberry Hill Stapleton Bristol BS16 1DD Tel(0131) 536 6192 Fax (0131) 5366215 E-mailmplantahrconetcouk

HEALHEALHEALHEALHEALTH EDUCATH EDUCATH EDUCATH EDUCATH EDUCATION ATION ATION ATION ATION AUTHORITYUTHORITYUTHORITYUTHORITYUTHORITYHamilton House Mabledon Place London WC1 9TXTel (020) 72985656 Fax (020) 77259031 Emailenquirieshpeorgukwebsite wwwhpeorguk and wwwwreckedcouk

THE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALCOHOLISMCOHOLISMCOHOLISMCOHOLISMCOHOLISM3 St Andrewrsquos Place London NW1 4LBTel (0207) 487 4445 Fax (0207) 9354479

THE PORTHE PORTHE PORTHE PORTHE PORTMAN GRTMAN GRTMAN GRTMAN GRTMAN GROUPOUPOUPOUPOUP7-10 Chandos Street Cavendish Square London W1G9DQTel 020 7907 3700 Fax 020 7907 3710wwwportman-grouporguk

ALALALALALCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOTLANDTLANDTLANDTLANDTLAND2nd Floor 166 Buchanan Street Glasgow G1 2NH Tel0141-572 6700 Fax 041-333 1606

BRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIATIONTIONTIONTIONTIONMarket Towers 1 Nine Elms LaneLondon SW8 5NQTel 020 7627 9191 Fax020 7627 9123E-mail jwitheridgebeerandpubcomWebsite wwwbeerandpubcom

EUREUREUREUREUROPEOPEOPEOPEOPE

ARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GROUPOUPOUPOUPOUPBrewersrsquo House 10 Grand Place B-1000 BrusselsBelgium Tel +32 2 511 49 87 Fax +32 2 511 32 59

CBMCCBMCCBMCCBMCCBMCCheacutee de la Hulpe 181 bte 20 B-1170 Bruxelles Tel(++322) 672 23 92 Fax (++322) 660 94 02Website wwwcbmcorg

FORFORFORFORFORUMUMUMUMUMLivornostraat 13 b 5 rue de Livourne ndash Brussel 1050Bruxelles BelgiumTel 32 2 539 36 64 Fax 32 2 537 81 56email forumtasteeducationskynetbe websitewwwforum-taste-educationcom

ENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTION13 Rue Monsigny 75002 Paris FranceTel 00-33-53-43-80-75E-mail enterprisewanadoofr

IREBIREBIREBIREBIREB19 avenue Trudaine 75009 ParisTel +33 (1) 48 74 82 19 Fax +33 (1) 48 78 17 56E-mail irebirebcom Website wwwirebcom

OIVOIVOIVOIVOIV18 rue drsquoAguesseau 75008 Paris FranceTel +33 (0) 1 44 94 80 94Fax +33 (0) 1 42 66 90 63E-mail oivoivintWebsite wwwoivint

STIVSTIVSTIVSTIVSTIVAAAAABenoordenhoutseweg 22-23 2596 BA The HagueTheNetherlands Tel +31 (0)70 314 2480 Fax +31(0) 70314 24 81 E-mail phoastivanl Website wwwstivanl

SCANDINSCANDINSCANDINSCANDINSCANDINAAAAAVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALALALALALALCOHOL BOCOHOL BOCOHOL BOCOHOL BOCOHOL BOARDARDARDARDARDVandvaeligrksvej 11 DK - 5690 TommerupTel 45 64 75 22 84 Fax 45 64 75 28 44E-mail smaborg Websitewwwsmaborg

DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE WEINWEINWEINWEINWEINAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHGutenbergplatz 3-5 55116 MainzTel +49 02641 977340 Fax +49 02641 977342Website wwwdeutscheweinakademiede

FIVINFIVINFIVINFIVINFIVINPlaza Penedeacutes 3 308720 Vilafranca del PenedeacutesBarcelona Spain Tel 0034 (93) 890 45 45 Fax 0034(93) 890 46 11

DIFDIFDIFDIFDIFA FORA FORA FORA FORA FORUM EVUM EVUM EVUM EVUM EVFranklinstrabe 1 10587 BerlinGermany Tel + 49 (0) 30 39 0633 60Fax +49 (0) 30 390 633 66 email infodifa-forumdeWebsite wwwdifa-forumde

GODGODGODGODGODAAAAAGode Alkoholdninger Kattesundet 9 DK-1458Koslashbenhavn K Denmark Tel 33 13 93 83Fax 33 13 03 84

FIVSFIVSFIVSFIVSFIVSInternational Federation of Wines amp Spirits20 rue drsquoAnjou - 75008 Paris Tel 33 1 42 68 82 48Fax 33 1 40 06 06 98

THE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDAM GRAM GRAM GRAM GRAM GROUPOUPOUPOUPOUPRue Wiertz 5028B-1050 Brussels BelgiumTel +32 2 401 61 35 Fax + 32 2 401 68 68 emailinfoamsterdamgrouporgwwwamsterdamgrouporg

FUNDFUNDFUNDFUNDFUNDAAAAACION ALCION ALCION ALCION ALCION ALCOHOL COHOL COHOL COHOL COHOL Y SOCIEDY SOCIEDY SOCIEDY SOCIEDY SOCIEDADADADADADDiego de Leon 442 ES 28006 MadridTel + 34 91 745 08 44 Fax + 34 91 561 8955wwwalcoholysociedadorg

USA CANUSA CANUSA CANUSA CANUSA CANADADADADADA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAAAAAAUSTRALIAUSTRALIAUSTRALIAUSTRALIAUSTRALIA

WINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICA1200 G Street NW Suite 360 Washington DC 20005Tel (800) 879 4637 Fax (202) 347 6341E-mail infoamericanwineriesorgWebsite wwwamericanwineriesorg

AMERICAN AMERICAN AMERICAN AMERICAN AMERICAN WINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARCHCHCHCHCHAND EDUCAAND EDUCAAND EDUCAAND EDUCAAND EDUCATIONTIONTIONTIONTIONVisit website at wwwalcohol-AWAREcom

AMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAND HEALAND HEALAND HEALAND HEALAND HEALTHTHTHTHTH1995 Broadway 2nd Floor New York NY 10023-5860Tel (212) 362-7044 Ext 234 Fax (212) 362-4919Email kavaacshorg Websitewwwacshorg

BEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTE122 C Street NW 750Washington DC 20001Tel(202) 737-2337 Fax (202) 737-7004E-mailinfobeerinstituteorgWebsite wwwbeerinstituteorg

PRPRPRPRPROOOOOYECTYECTYECTYECTYECTO CIENCIA O CIENCIA O CIENCIA O CIENCIA O CIENCIA VINO VINO VINO VINO VINO Y SALY SALY SALY SALY SALUDUDUDUDUDFacultad de ciencias BioloacutegicasCasilla 114 D Santiago ChileTelFax (56-23) 222 2577Email vinsaludgenesbiopuccl

EDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALCOOLCOOLCOOLCOOLCOOL606 Cathcart Suite 700 Montreacuteal Queacutebec H3B 1K9Canada Tel (514) 875-7454 E-mailhsacyeducalcoolqcca Website wwweducalcoolqcca

THE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERAGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTE1775Pennsylvania Avenue NW Suite 1200 WashingtonDC 20006 Tel 2024637110wwwamericanbeverageinstitutecom

FISAFISAFISAFISAFISACCCCC(Fundacion de Investigaciones Sociales AC) FranciscoSosa 230 coyoacan CP 04000 Mexico DF - Mexico

HEALHEALHEALHEALHEALTTTTTH EDUCAH EDUCAH EDUCAH EDUCAH EDUCATION FOUNDTION FOUNDTION FOUNDTION FOUNDTION FOUNDAAAAATIONTIONTIONTIONTION INC INC INC INC INC2600 Virginia Avenue NW Washington DC 20037Tel (202) 3383501 Fax (202) 9656520E-mail hefmonaerolscom

ICAPICAPICAPICAPICAPInternational Center for Alcohol Policies1519 New Hampshire Avenue NWWashington DC 20036Tel (202) 986-1159 Fax (202) 986-2080Website wwwicaporg

THE CENTURTHE CENTURTHE CENTURTHE CENTURTHE CENTURY COUNCILY COUNCILY COUNCILY COUNCILY COUNCIL1310 G Street NW Suite 600Washington DC 20005-3000 Tel (202) 637-0077 Fax(202) 637-0079 Email washdecenturycouncilorgWebsite wwwcenturycouncilorg

CALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIATION OF TION OF TION OF TION OF TION OF WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEGRGRGRGRGROOOOOWERS WERS WERS WERS WERS 601 University Avenue Suite 135 Sacramento CA 95825wwwcawgorg email karencawgorg

THE THE THE THE THE WINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTE425 Market Street Suite 1000 San Francisco CA94105 USA Tel (415) 512-0151 Fax (415) 442-0742

LLLLLODI -WODI -WODI -WODI -WODI -WOODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPECOMMISSIONCOMMISSIONCOMMISSIONCOMMISSIONCOMMISSION2545 West Turner Road Lodi CA 95242USAmarklodiwinecom website wwwlodiwinecom

THE NTHE NTHE NTHE NTHE NAPAPAPAPAPA A A A A VVVVVALLEY ALLEY ALLEY ALLEY ALLEY VINTNERSVINTNERSVINTNERSVINTNERSVINTNERSASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION Phone - 707-963-3388 Fax - 707-963-3488 Website wwwnapavintnerscom

OLDOLDOLDOLDOLDWWWWWAAAAAYYYYYS PRESERS PRESERS PRESERS PRESERS PRESERVVVVVAAAAATION amp EXTION amp EXTION amp EXTION amp EXTION amp EXCHANGECHANGECHANGECHANGECHANGETRTRTRTRTRUSTUSTUSTUSTUST266 Beacon Street Boston MA 02116 6174215500Fax 6174215511 website wwwoldwaysptorg

THE ATHE ATHE ATHE ATHE AUSTRALIAN USTRALIAN USTRALIAN USTRALIAN USTRALIAN WINE RESEARWINE RESEARWINE RESEARWINE RESEARWINE RESEARCHCHCHCHCHINSTITUTEINSTITUTEINSTITUTEINSTITUTEINSTITUTEP O Box 197 glen Osmond 5064 South AustraliaAustralia Tel 61 8 8303 6600 Fax 61 6 303 6601

13

10

1Introduction

As part of cultural traditions and well balancedlifestyles wine beer and spirits consumption hasbeen a common staple in diets around the worldIn acknowledgement of such practices groupsof nutrition experts have included the moderateconsumption of alcohol as an optionalcomponent of various dietary guidelines andfood guides such as the Mediterranean AsianLatin American and Vegetarian Pyramids Herewe outline the key scientifically based nutritionmessages in these pyramids

The outlined alcohol-inclusive dietary pyramidsare part of an effort by Oldways Preservation ampExchange Trust a non- profit education groupthat is dedicated to preserving traditional eatingpatterns with the goal to improve consumerknowledge and diets around the world Oldwayshas prepared these concepts with prominentnutrition medical biomedical andcommunication experts from leading institutionssuch as the WHO Regional Office for Europeand the Harvard School of Public Health

Cardiovascular disease and cancer are leadingcauses of death in developed nations aroundthe world predominantly being associated withdiets high in animal fats With that emergingscientific consensus the Oldways pyramids allemphasize fruits vegetables cereals andpulses with litt le meat (animal fats)consumption These nutrition concepts alsoinclude wine beer and spirits which have shownto contribute to lower heart disease rates andimprove longevity

Accumulating scientific evidence suggests thatmoderate consumption of wine beer and spiritsdoes not pose a health risk to the vast majorityof consumers who choose to drink inmoderation AIMrsquos recommendations alsoemphasise that adults should enjoy alcoholbeverages in a sensible manner preferablyaround mealtimes or other responsible socialsettings Moderation is the key to a healthy dietand lifestyle and this is reflected in severaltraditional nutrition concepts

Consumers should follow moderation guidelinessuch as those in the Dietary Guidelines forAmericans which define moderation as up totwo drinks (12g) a day for men and up to onedrink a day for women further consumersshould avoid alcohol during pregnancy or when-ever it would put the individual or others at risk

To learn more about the US Dietary Guidelinesmessage on alcohol please visitwwwhealthgovdietaryguidelines and for otherauthoritative links on alcohol please also visitthe AIM links page on the gateway to sensibledrinking and health site via wwwaim-digestcom

Alcohol-Inclusive Nutrition

Concepts The

The lsquoEatwisersquo concept

The latest ldquoEat Wiserdquo Pyramid including ldquowinebeer and spirits in moderationrdquo as part of a dailybeverage recommendation was released atJanuaryrsquos 2003 Mediterranean Diet Conferencesponsored by Harvard School of Public Healthand Oldways Preservation amp Exchange TrustThis new pyramid is modelled on the originalMediterranean Diet Pyramid which initially onlyrecommended wine in moderation reflecting thecultural preference of the Mediterranean regionldquoThis Eat Wise Pyramid is a visual guide tohealthy living the Eat Wise wayrdquo theaccompanying text states ldquoIt shows thepartnership of a balanced diet plenty of waterregular physical activity and alcohol inmoderation that wise eaters know strengthenall their bodiesrsquo functionsrdquo An expert conferencediscussion emphasized the potential benefits forall three beverages Eat Wise Meal Ideasshopping tips and recipes are outlined in aspecial eating guide that can be ordered via theOldways website

Moderate Alcohol Intake as Part of a Healthy Diet and Lifestyle - A Look at Alcohol Inclusive Nutrition Concepts from Around the World by Elisabeth Holmgren

The Mediterranean Diet Pyramidwwwoldwaysptorgpyramidsmed

p_medhtml

The Mediterranean Diet Concept

Long known for its healthy lifestyles and thelongevity of its people the Mediterranean regionis also home of some of the most palatable andhealthy foods on earth Traditionally wine hasbeen included as an integral part of its mealsand cross-cultural studies have reportedsignificantly lower risk of heart disease inMediterranean regions where alcohol is a dailystaple of a healthy diet and lifestyle As thepreferred beverage in this region wine isspecified as an option on ldquoThe TraditionalHealthy Mediterranean Diet Pyramidrdquodeveloped by Oldways in cooperation withscientists from the WHO in Europe and fromthe Harvard School of Public Health Thistraditional diet is based on grains including ricepolenta bulgur and pasta as well as legumesand vegetables It also includes fruits cheesesyogurt and nuts along with the optional choiceof alcohol in moderation Olive oil is given itsown category as a major source of monounsaturated fat reflecting its importantprominence in the regionrsquos healthy cuisine Dailyphysical activity a factor contributing to healthin the Mediterranean region and elsewhere isalso included on this and all Oldways pyramids

11

The Asian Diet Concept

As Asian cuisine continues to become popularin diverse regions of the world characteristicsof Asian diets will continue to gain importanceIn Japan and China studies have found ratesfor heart disease and many types of cancer tobe lower than those in the United States andthe rest of the world The centuries-oldtraditional Asian diet of rice noodles vegetablesand fish is believed to be a significant contributorto the documented lower rates for chronicdisease in these populations The ldquoTraditionalhealthy Asian Diet Pyramidrdquo developed incooperation with scientists at Cornell Universityand the Harvard School of Public Healthincorporates these dietary patterns into thepyramid format Sake wine beer and otherbeverages with alcohol in moderation as wellas tea are included as part of the pyramidbecause studies have shown that theirconsumption may play an role in reducing heartdisease risk and overall mortality

The Asian Diet Pyramid

wwwoldwaysptorgpyramidsasianp_asianhtml

ldquoThe

The Latin American ConceptThe Traditional Healthy Latin American DietPyramidrdquo released in 1996 is based on thetraditional foods of Latin America Unlike theAmericanized versions that tend to be high insalt and fat this pyramid presents many healthyeating options It emphasizes daily consumptionof beans grains tubers and nuts along withfruits and vegetablesmdashstaples in most LatinAmerican and Caribbean regions Daily physicalactivity is integrated into the pyramid structurein recognition of the scientific consensus on theimportance of exercise in maintaining goodhealth Alcohol in moderation with meals isincluded as an option and as with other culturalpyramids meats sweets and eggs are at thevery top of the pyramid in the ldquooccasionallyrdquocategory to advocate a healthy and balancedlifestyle that can reduce the risk for several

common diseases

The Vegetarian Diet ConceptThe unique ldquoVegetarian Diet Pyramidrdquo releasedby Oldways at the end of 1997 serves as amodel for healthy eating with meals built aroundvegetables fruits whole grains and legumesThe pyramid also emphasizes daily physicalactivity water consumption and the option ofldquowine beer and other alcoholrdquo in moderationThe importance of this dietary conceptaccording to Oldways is that it reflects thegrowing number of vegetarians and

The Scientific Evidence

The nutritional and medical significance ofthe traditional Oldways Dietary Pyramidswas featured in ldquoMedical NewsPerspectivesrdquo of the Journal of the AmericanMedical Association in 2000 The authorhighlighted the importance of well-balancedand nutritious diets as a potential diseaseprevention measure that could beincreasingly conveyed by physicians andhealthcare providers to their patients Morerecently Greek and US scientists investigatedthe health effects of adherence to aMediterranean Diet reported in the New EnglandJournal of Medicine in 2003 ldquoGreater adherenceto the traditional Mediterranean diet isassociated with a significant reduction in totalmortalityrdquo Coinciding with these acknow-ledgements there is now a developing scientificconsensus that for many individuals moderatewine beer and spirits consumption is associated

acknowledges the nutritional and health benefitsof this type of diet For example the DietaryGuidelines for Americans have acknowledgedsuch a diet as able to meet RecommendedDietary Allowances (RDA) for nutrients Whilesome vegetarians are prohibited fromconsuming meat and alcohol for religiousreasons all alcohol beverages are included asa choice because of the potential risk reductionfor heart disease and its cultural role as anaccompaniment to vegetarian eating

The Latin American Diet Pyramidwwwoldwaysptorgpyramidslatin

p_latinhtml

The Vegetarian Diet Pyramidwwwoldwaysptorgpyramidsveg

p_veghtml

11

12

with a reduced risk of coronary heart diseaseand increased life expectancy which lead to theabove featured alcohol-inclusive nutritionconcepts

In 1997Sir Richard Doll Emeritis Professor ofMedicine at Oxfordoutlined in the BritishMedical Journal ldquomassiverdquo evidence for thepotential beneficial effect of alcohol in a reviewof the clinical data on alcohol and mortality Heconcluded that ldquothe consumption of small andmoderate amounts of alcoholrdquo leads to a one-third-risk reduction for vascular disease He alsoacknowledged a reduction in total mortality inmiddle-aged and elderly men and women whenthey consumed wine beer or spirits Morerecently world-renowned expert Dr ArthurKlatsky from the US outlined the overwhelmingscientific evidence in Scientific American DrKlatsky has published many research studieson alcohol and health in leading scientificjournals from the large-scale Kaiser Permanentecohort and in the recent article he wrote withrespect to the most appropriate advice to thepublic ldquoOn one hand mild to moderate drinkingseems better for heart health than abstinencefor select people On the other hand heavydrinking is clearly dangerousrdquo Merelyrecommending abstinence is inappropriatehealth advice to people such as established lightdrinkers at high risk of CHD and at low risk ofalcohol-related problemsmdashwhich describes alarge proportion of the populationrdquo Dr Klatskyalong with other experts from around the worldhas advocated that health professionals makecase-by-case evaluations based on individualand family histories They also emphasize thatthe public should be entrusted with all theinformation on use versus misuse of alcohol sothat they can make informed decisionsthemselves

Authoritative findings from cohortsinternationally lead research experts tofeature the option of moderation in eachtraditional Oldways Dietary Pyramid Manypeer-reviewed studies from Europe AsiaAustralia and the US have revealed potentialbenefits for moderately drinking adults inmulti-ethnic populations These studies findthat moderate drinkers especially consumersof 1-2 drinks (12g) daily may lower their risk ofheart disease significantly Studies reportingcertain health advantages for moderate drinkersinclude the Lyon Heart Study the CopenhagenCity Heart Study the Australian Dubbo Studyand the European Seven Country Study

The Oldways experts working with the HarvardSchool of Public Health specifically consideredfindings from the ongoing Physiciansrsquo HealthStudy and the Nursesrsquo Health Study Analyzingdata from 84000 women in the Nursesrsquo HealthStudy the effect of a combination of diet andlifestyle factors were assessed on the risk ofCHD Dr Meir Stampfer et al concludedrdquo In thispopulation of middle-aged women those whodid not smoke cigarettes were not overweightmaintained a healthful diet described aboveexercised moderately or vigorously for half anhour a day and consumed alcohol moderatelyhad an incidence of coronary events that wasmore than 80 lower than that in the rest of thepopulationrdquo At the same time based on aprospective study of more than 89000 men aspart of the Physiciansrsquo Health Study Harvardresearcher Dr Michael Gaziano et al concludedrdquoIn summary this study reveals the complexeffect of alcohol consumption on various chronicdiseases as reflected in the overall U-shapedrelationship between light-to-moderate alcoholconsumption and total mortality in menrdquoTheearlier results from the US governmentrsquos fundedNational Health and Nutrition ExaminationSurvey (NHANES) were also considered whichfound that the risk for CHD is reduced for bothmen and women who drink moderatelyPublished in 1997 in the American Journal ofEpidemiology it stated ldquoThis analysisconfirmed previous research showing thatabstainers are at a greater risk for CHD thanare most non abstainers and that a significantprotective effect may be demonstrated withsmall amounts of alcoholrdquo Along those linesresearch published in The New England Journalof Medicine from American Cancer Societyexperts concluded ldquoIn this middle-aged andelderly population moderate alcoholconsumption slightly reduced overall mortalityrdquo

At the same time there are continuingconcerns about alcohol consumption andbreast cancer and women arerecommended not to drink when pregnant in line with governmental and public healthpositions in the US Authoritative statementsfrom public health groups such as the AmericanHeart Association the National StrokeAssociation and the American DieteticAssociation acknowledge the scientific evidencepointing to potential benefits of moderation withrespect to coronary heart disease andemphasize ldquoIf you choose to drink do so inmoderationrdquo A balanced summary position is

reflected in the 1999 JAMA Patient Page onldquoBenefits and dangers of alcoholrdquo which defineslsquoModerate drinking as 1 or 2 drinks (12g) a dayfor men and 1 drink a day for women and thoseolder than 65rsquo These messages are embodiedin governmental positions in the US UKAustralia and Canada

The Oldways alcohol messages as reflectedin the pyramids are however especiallynotable in that they emphasize consumptionwith or around mealtime as research hasshown that these and related cultural normsfacilitate responsible drinking habits mayslow alcohol absorption and may counterpotential harmful effects of fatty foods Forexample Dr David Hanson author ofPreventing Alcohol Abuse Alcohol Culture andControl explains ldquoThe cross-cultural evidenceindicates that drinking abuse will be low in anygroup in which drinking customs values andsanctions are clearhellip and characterized byprescriptions for moderate drinking andproscriptions against immoderate drinkingrdquoFurthermore several biochemical studiesindicate that in addition to slowing down theabsorption process which keeps blood alcohollevels lower moderate consumption during oraround mealtime may have favourable effectson lipid profiles and atherogenesis One 1998study published in the American Journal ofClinical Nutrition suggested ldquoethanol mayreduce cardiovascular risk by modulatingvascular muscle growth during the postprandialperiodrdquo Research continues but it appears clearthat healthy dietary patterns are inverselyrelated with low rates of chronic diseases Thishas been specifically confirmed in the ongoingSeven Country Study which reported in 1999that animal-food groups were directly correlatedwith CHD mortality while vegetable-food groupsas well as fish and alcohol were inverselycorrelated

In summary in line with the developingscientific consensus public health andgovernmental positions the Oldwayspyramids stress moderation and underscorethe importance of an overall healthy mealand lifestyleConsumption is notrecommended for non-drinkers or thosewho may have any health contraindicationsand consumers are always advised toconsult with their healthcare providersFor selected references and authoritative statements onmoderate drinking and health please visit the Gateway toSensible Drinking and Health via wwwaim-digestcom

13

ORGANISATIONS INVOLVED IN ALCOHOL AFFAIRSUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOM

ALALALALALCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNWaterbridge House 32-36 Loman Street London SE10EETel (0207) 928 7377 Fax (0207) 928 4644Websitewww alcoholconcernorguk

ALALALALALCOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCATION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARCHCHCHCHCHCOUNCILCOUNCILCOUNCILCOUNCILCOUNCILAbell House John Islip Street London SW1P 4LH Tel(0207) 217 5276

ALALALALALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALTH RESEARTH RESEARTH RESEARTH RESEARTH RESEARCH CENTRECH CENTRECH CENTRECH CENTRECH CENTREUniversity of West of England Glenside CampusBlackberry Hill Stapleton Bristol BS16 1DD Tel(0131) 536 6192 Fax (0131) 5366215 E-mailmplantahrconetcouk

HEALHEALHEALHEALHEALTH EDUCATH EDUCATH EDUCATH EDUCATH EDUCATION ATION ATION ATION ATION AUTHORITYUTHORITYUTHORITYUTHORITYUTHORITYHamilton House Mabledon Place London WC1 9TXTel (020) 72985656 Fax (020) 77259031 Emailenquirieshpeorgukwebsite wwwhpeorguk and wwwwreckedcouk

THE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALCOHOLISMCOHOLISMCOHOLISMCOHOLISMCOHOLISM3 St Andrewrsquos Place London NW1 4LBTel (0207) 487 4445 Fax (0207) 9354479

THE PORTHE PORTHE PORTHE PORTHE PORTMAN GRTMAN GRTMAN GRTMAN GRTMAN GROUPOUPOUPOUPOUP7-10 Chandos Street Cavendish Square London W1G9DQTel 020 7907 3700 Fax 020 7907 3710wwwportman-grouporguk

ALALALALALCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOTLANDTLANDTLANDTLANDTLAND2nd Floor 166 Buchanan Street Glasgow G1 2NH Tel0141-572 6700 Fax 041-333 1606

BRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIATIONTIONTIONTIONTIONMarket Towers 1 Nine Elms LaneLondon SW8 5NQTel 020 7627 9191 Fax020 7627 9123E-mail jwitheridgebeerandpubcomWebsite wwwbeerandpubcom

EUREUREUREUREUROPEOPEOPEOPEOPE

ARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GROUPOUPOUPOUPOUPBrewersrsquo House 10 Grand Place B-1000 BrusselsBelgium Tel +32 2 511 49 87 Fax +32 2 511 32 59

CBMCCBMCCBMCCBMCCBMCCheacutee de la Hulpe 181 bte 20 B-1170 Bruxelles Tel(++322) 672 23 92 Fax (++322) 660 94 02Website wwwcbmcorg

FORFORFORFORFORUMUMUMUMUMLivornostraat 13 b 5 rue de Livourne ndash Brussel 1050Bruxelles BelgiumTel 32 2 539 36 64 Fax 32 2 537 81 56email forumtasteeducationskynetbe websitewwwforum-taste-educationcom

ENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTION13 Rue Monsigny 75002 Paris FranceTel 00-33-53-43-80-75E-mail enterprisewanadoofr

IREBIREBIREBIREBIREB19 avenue Trudaine 75009 ParisTel +33 (1) 48 74 82 19 Fax +33 (1) 48 78 17 56E-mail irebirebcom Website wwwirebcom

OIVOIVOIVOIVOIV18 rue drsquoAguesseau 75008 Paris FranceTel +33 (0) 1 44 94 80 94Fax +33 (0) 1 42 66 90 63E-mail oivoivintWebsite wwwoivint

STIVSTIVSTIVSTIVSTIVAAAAABenoordenhoutseweg 22-23 2596 BA The HagueTheNetherlands Tel +31 (0)70 314 2480 Fax +31(0) 70314 24 81 E-mail phoastivanl Website wwwstivanl

SCANDINSCANDINSCANDINSCANDINSCANDINAAAAAVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALALALALALALCOHOL BOCOHOL BOCOHOL BOCOHOL BOCOHOL BOARDARDARDARDARDVandvaeligrksvej 11 DK - 5690 TommerupTel 45 64 75 22 84 Fax 45 64 75 28 44E-mail smaborg Websitewwwsmaborg

DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE WEINWEINWEINWEINWEINAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHGutenbergplatz 3-5 55116 MainzTel +49 02641 977340 Fax +49 02641 977342Website wwwdeutscheweinakademiede

FIVINFIVINFIVINFIVINFIVINPlaza Penedeacutes 3 308720 Vilafranca del PenedeacutesBarcelona Spain Tel 0034 (93) 890 45 45 Fax 0034(93) 890 46 11

DIFDIFDIFDIFDIFA FORA FORA FORA FORA FORUM EVUM EVUM EVUM EVUM EVFranklinstrabe 1 10587 BerlinGermany Tel + 49 (0) 30 39 0633 60Fax +49 (0) 30 390 633 66 email infodifa-forumdeWebsite wwwdifa-forumde

GODGODGODGODGODAAAAAGode Alkoholdninger Kattesundet 9 DK-1458Koslashbenhavn K Denmark Tel 33 13 93 83Fax 33 13 03 84

FIVSFIVSFIVSFIVSFIVSInternational Federation of Wines amp Spirits20 rue drsquoAnjou - 75008 Paris Tel 33 1 42 68 82 48Fax 33 1 40 06 06 98

THE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDAM GRAM GRAM GRAM GRAM GROUPOUPOUPOUPOUPRue Wiertz 5028B-1050 Brussels BelgiumTel +32 2 401 61 35 Fax + 32 2 401 68 68 emailinfoamsterdamgrouporgwwwamsterdamgrouporg

FUNDFUNDFUNDFUNDFUNDAAAAACION ALCION ALCION ALCION ALCION ALCOHOL COHOL COHOL COHOL COHOL Y SOCIEDY SOCIEDY SOCIEDY SOCIEDY SOCIEDADADADADADDiego de Leon 442 ES 28006 MadridTel + 34 91 745 08 44 Fax + 34 91 561 8955wwwalcoholysociedadorg

USA CANUSA CANUSA CANUSA CANUSA CANADADADADADA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAAAAAAUSTRALIAUSTRALIAUSTRALIAUSTRALIAUSTRALIA

WINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICA1200 G Street NW Suite 360 Washington DC 20005Tel (800) 879 4637 Fax (202) 347 6341E-mail infoamericanwineriesorgWebsite wwwamericanwineriesorg

AMERICAN AMERICAN AMERICAN AMERICAN AMERICAN WINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARCHCHCHCHCHAND EDUCAAND EDUCAAND EDUCAAND EDUCAAND EDUCATIONTIONTIONTIONTIONVisit website at wwwalcohol-AWAREcom

AMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAND HEALAND HEALAND HEALAND HEALAND HEALTHTHTHTHTH1995 Broadway 2nd Floor New York NY 10023-5860Tel (212) 362-7044 Ext 234 Fax (212) 362-4919Email kavaacshorg Websitewwwacshorg

BEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTE122 C Street NW 750Washington DC 20001Tel(202) 737-2337 Fax (202) 737-7004E-mailinfobeerinstituteorgWebsite wwwbeerinstituteorg

PRPRPRPRPROOOOOYECTYECTYECTYECTYECTO CIENCIA O CIENCIA O CIENCIA O CIENCIA O CIENCIA VINO VINO VINO VINO VINO Y SALY SALY SALY SALY SALUDUDUDUDUDFacultad de ciencias BioloacutegicasCasilla 114 D Santiago ChileTelFax (56-23) 222 2577Email vinsaludgenesbiopuccl

EDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALCOOLCOOLCOOLCOOLCOOL606 Cathcart Suite 700 Montreacuteal Queacutebec H3B 1K9Canada Tel (514) 875-7454 E-mailhsacyeducalcoolqcca Website wwweducalcoolqcca

THE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERAGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTE1775Pennsylvania Avenue NW Suite 1200 WashingtonDC 20006 Tel 2024637110wwwamericanbeverageinstitutecom

FISAFISAFISAFISAFISACCCCC(Fundacion de Investigaciones Sociales AC) FranciscoSosa 230 coyoacan CP 04000 Mexico DF - Mexico

HEALHEALHEALHEALHEALTTTTTH EDUCAH EDUCAH EDUCAH EDUCAH EDUCATION FOUNDTION FOUNDTION FOUNDTION FOUNDTION FOUNDAAAAATIONTIONTIONTIONTION INC INC INC INC INC2600 Virginia Avenue NW Washington DC 20037Tel (202) 3383501 Fax (202) 9656520E-mail hefmonaerolscom

ICAPICAPICAPICAPICAPInternational Center for Alcohol Policies1519 New Hampshire Avenue NWWashington DC 20036Tel (202) 986-1159 Fax (202) 986-2080Website wwwicaporg

THE CENTURTHE CENTURTHE CENTURTHE CENTURTHE CENTURY COUNCILY COUNCILY COUNCILY COUNCILY COUNCIL1310 G Street NW Suite 600Washington DC 20005-3000 Tel (202) 637-0077 Fax(202) 637-0079 Email washdecenturycouncilorgWebsite wwwcenturycouncilorg

CALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIATION OF TION OF TION OF TION OF TION OF WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEGRGRGRGRGROOOOOWERS WERS WERS WERS WERS 601 University Avenue Suite 135 Sacramento CA 95825wwwcawgorg email karencawgorg

THE THE THE THE THE WINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTE425 Market Street Suite 1000 San Francisco CA94105 USA Tel (415) 512-0151 Fax (415) 442-0742

LLLLLODI -WODI -WODI -WODI -WODI -WOODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPECOMMISSIONCOMMISSIONCOMMISSIONCOMMISSIONCOMMISSION2545 West Turner Road Lodi CA 95242USAmarklodiwinecom website wwwlodiwinecom

THE NTHE NTHE NTHE NTHE NAPAPAPAPAPA A A A A VVVVVALLEY ALLEY ALLEY ALLEY ALLEY VINTNERSVINTNERSVINTNERSVINTNERSVINTNERSASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION Phone - 707-963-3388 Fax - 707-963-3488 Website wwwnapavintnerscom

OLDOLDOLDOLDOLDWWWWWAAAAAYYYYYS PRESERS PRESERS PRESERS PRESERS PRESERVVVVVAAAAATION amp EXTION amp EXTION amp EXTION amp EXTION amp EXCHANGECHANGECHANGECHANGECHANGETRTRTRTRTRUSTUSTUSTUSTUST266 Beacon Street Boston MA 02116 6174215500Fax 6174215511 website wwwoldwaysptorg

THE ATHE ATHE ATHE ATHE AUSTRALIAN USTRALIAN USTRALIAN USTRALIAN USTRALIAN WINE RESEARWINE RESEARWINE RESEARWINE RESEARWINE RESEARCHCHCHCHCHINSTITUTEINSTITUTEINSTITUTEINSTITUTEINSTITUTEP O Box 197 glen Osmond 5064 South AustraliaAustralia Tel 61 8 8303 6600 Fax 61 6 303 6601

13

11

The Asian Diet Concept

As Asian cuisine continues to become popularin diverse regions of the world characteristicsof Asian diets will continue to gain importanceIn Japan and China studies have found ratesfor heart disease and many types of cancer tobe lower than those in the United States andthe rest of the world The centuries-oldtraditional Asian diet of rice noodles vegetablesand fish is believed to be a significant contributorto the documented lower rates for chronicdisease in these populations The ldquoTraditionalhealthy Asian Diet Pyramidrdquo developed incooperation with scientists at Cornell Universityand the Harvard School of Public Healthincorporates these dietary patterns into thepyramid format Sake wine beer and otherbeverages with alcohol in moderation as wellas tea are included as part of the pyramidbecause studies have shown that theirconsumption may play an role in reducing heartdisease risk and overall mortality

The Asian Diet Pyramid

wwwoldwaysptorgpyramidsasianp_asianhtml

ldquoThe

The Latin American ConceptThe Traditional Healthy Latin American DietPyramidrdquo released in 1996 is based on thetraditional foods of Latin America Unlike theAmericanized versions that tend to be high insalt and fat this pyramid presents many healthyeating options It emphasizes daily consumptionof beans grains tubers and nuts along withfruits and vegetablesmdashstaples in most LatinAmerican and Caribbean regions Daily physicalactivity is integrated into the pyramid structurein recognition of the scientific consensus on theimportance of exercise in maintaining goodhealth Alcohol in moderation with meals isincluded as an option and as with other culturalpyramids meats sweets and eggs are at thevery top of the pyramid in the ldquooccasionallyrdquocategory to advocate a healthy and balancedlifestyle that can reduce the risk for several

common diseases

The Vegetarian Diet ConceptThe unique ldquoVegetarian Diet Pyramidrdquo releasedby Oldways at the end of 1997 serves as amodel for healthy eating with meals built aroundvegetables fruits whole grains and legumesThe pyramid also emphasizes daily physicalactivity water consumption and the option ofldquowine beer and other alcoholrdquo in moderationThe importance of this dietary conceptaccording to Oldways is that it reflects thegrowing number of vegetarians and

The Scientific Evidence

The nutritional and medical significance ofthe traditional Oldways Dietary Pyramidswas featured in ldquoMedical NewsPerspectivesrdquo of the Journal of the AmericanMedical Association in 2000 The authorhighlighted the importance of well-balancedand nutritious diets as a potential diseaseprevention measure that could beincreasingly conveyed by physicians andhealthcare providers to their patients Morerecently Greek and US scientists investigatedthe health effects of adherence to aMediterranean Diet reported in the New EnglandJournal of Medicine in 2003 ldquoGreater adherenceto the traditional Mediterranean diet isassociated with a significant reduction in totalmortalityrdquo Coinciding with these acknow-ledgements there is now a developing scientificconsensus that for many individuals moderatewine beer and spirits consumption is associated

acknowledges the nutritional and health benefitsof this type of diet For example the DietaryGuidelines for Americans have acknowledgedsuch a diet as able to meet RecommendedDietary Allowances (RDA) for nutrients Whilesome vegetarians are prohibited fromconsuming meat and alcohol for religiousreasons all alcohol beverages are included asa choice because of the potential risk reductionfor heart disease and its cultural role as anaccompaniment to vegetarian eating

The Latin American Diet Pyramidwwwoldwaysptorgpyramidslatin

p_latinhtml

The Vegetarian Diet Pyramidwwwoldwaysptorgpyramidsveg

p_veghtml

11

12

with a reduced risk of coronary heart diseaseand increased life expectancy which lead to theabove featured alcohol-inclusive nutritionconcepts

In 1997Sir Richard Doll Emeritis Professor ofMedicine at Oxfordoutlined in the BritishMedical Journal ldquomassiverdquo evidence for thepotential beneficial effect of alcohol in a reviewof the clinical data on alcohol and mortality Heconcluded that ldquothe consumption of small andmoderate amounts of alcoholrdquo leads to a one-third-risk reduction for vascular disease He alsoacknowledged a reduction in total mortality inmiddle-aged and elderly men and women whenthey consumed wine beer or spirits Morerecently world-renowned expert Dr ArthurKlatsky from the US outlined the overwhelmingscientific evidence in Scientific American DrKlatsky has published many research studieson alcohol and health in leading scientificjournals from the large-scale Kaiser Permanentecohort and in the recent article he wrote withrespect to the most appropriate advice to thepublic ldquoOn one hand mild to moderate drinkingseems better for heart health than abstinencefor select people On the other hand heavydrinking is clearly dangerousrdquo Merelyrecommending abstinence is inappropriatehealth advice to people such as established lightdrinkers at high risk of CHD and at low risk ofalcohol-related problemsmdashwhich describes alarge proportion of the populationrdquo Dr Klatskyalong with other experts from around the worldhas advocated that health professionals makecase-by-case evaluations based on individualand family histories They also emphasize thatthe public should be entrusted with all theinformation on use versus misuse of alcohol sothat they can make informed decisionsthemselves

Authoritative findings from cohortsinternationally lead research experts tofeature the option of moderation in eachtraditional Oldways Dietary Pyramid Manypeer-reviewed studies from Europe AsiaAustralia and the US have revealed potentialbenefits for moderately drinking adults inmulti-ethnic populations These studies findthat moderate drinkers especially consumersof 1-2 drinks (12g) daily may lower their risk ofheart disease significantly Studies reportingcertain health advantages for moderate drinkersinclude the Lyon Heart Study the CopenhagenCity Heart Study the Australian Dubbo Studyand the European Seven Country Study

The Oldways experts working with the HarvardSchool of Public Health specifically consideredfindings from the ongoing Physiciansrsquo HealthStudy and the Nursesrsquo Health Study Analyzingdata from 84000 women in the Nursesrsquo HealthStudy the effect of a combination of diet andlifestyle factors were assessed on the risk ofCHD Dr Meir Stampfer et al concludedrdquo In thispopulation of middle-aged women those whodid not smoke cigarettes were not overweightmaintained a healthful diet described aboveexercised moderately or vigorously for half anhour a day and consumed alcohol moderatelyhad an incidence of coronary events that wasmore than 80 lower than that in the rest of thepopulationrdquo At the same time based on aprospective study of more than 89000 men aspart of the Physiciansrsquo Health Study Harvardresearcher Dr Michael Gaziano et al concludedrdquoIn summary this study reveals the complexeffect of alcohol consumption on various chronicdiseases as reflected in the overall U-shapedrelationship between light-to-moderate alcoholconsumption and total mortality in menrdquoTheearlier results from the US governmentrsquos fundedNational Health and Nutrition ExaminationSurvey (NHANES) were also considered whichfound that the risk for CHD is reduced for bothmen and women who drink moderatelyPublished in 1997 in the American Journal ofEpidemiology it stated ldquoThis analysisconfirmed previous research showing thatabstainers are at a greater risk for CHD thanare most non abstainers and that a significantprotective effect may be demonstrated withsmall amounts of alcoholrdquo Along those linesresearch published in The New England Journalof Medicine from American Cancer Societyexperts concluded ldquoIn this middle-aged andelderly population moderate alcoholconsumption slightly reduced overall mortalityrdquo

At the same time there are continuingconcerns about alcohol consumption andbreast cancer and women arerecommended not to drink when pregnant in line with governmental and public healthpositions in the US Authoritative statementsfrom public health groups such as the AmericanHeart Association the National StrokeAssociation and the American DieteticAssociation acknowledge the scientific evidencepointing to potential benefits of moderation withrespect to coronary heart disease andemphasize ldquoIf you choose to drink do so inmoderationrdquo A balanced summary position is

reflected in the 1999 JAMA Patient Page onldquoBenefits and dangers of alcoholrdquo which defineslsquoModerate drinking as 1 or 2 drinks (12g) a dayfor men and 1 drink a day for women and thoseolder than 65rsquo These messages are embodiedin governmental positions in the US UKAustralia and Canada

The Oldways alcohol messages as reflectedin the pyramids are however especiallynotable in that they emphasize consumptionwith or around mealtime as research hasshown that these and related cultural normsfacilitate responsible drinking habits mayslow alcohol absorption and may counterpotential harmful effects of fatty foods Forexample Dr David Hanson author ofPreventing Alcohol Abuse Alcohol Culture andControl explains ldquoThe cross-cultural evidenceindicates that drinking abuse will be low in anygroup in which drinking customs values andsanctions are clearhellip and characterized byprescriptions for moderate drinking andproscriptions against immoderate drinkingrdquoFurthermore several biochemical studiesindicate that in addition to slowing down theabsorption process which keeps blood alcohollevels lower moderate consumption during oraround mealtime may have favourable effectson lipid profiles and atherogenesis One 1998study published in the American Journal ofClinical Nutrition suggested ldquoethanol mayreduce cardiovascular risk by modulatingvascular muscle growth during the postprandialperiodrdquo Research continues but it appears clearthat healthy dietary patterns are inverselyrelated with low rates of chronic diseases Thishas been specifically confirmed in the ongoingSeven Country Study which reported in 1999that animal-food groups were directly correlatedwith CHD mortality while vegetable-food groupsas well as fish and alcohol were inverselycorrelated

In summary in line with the developingscientific consensus public health andgovernmental positions the Oldwayspyramids stress moderation and underscorethe importance of an overall healthy mealand lifestyleConsumption is notrecommended for non-drinkers or thosewho may have any health contraindicationsand consumers are always advised toconsult with their healthcare providersFor selected references and authoritative statements onmoderate drinking and health please visit the Gateway toSensible Drinking and Health via wwwaim-digestcom

13

ORGANISATIONS INVOLVED IN ALCOHOL AFFAIRSUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOM

ALALALALALCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNWaterbridge House 32-36 Loman Street London SE10EETel (0207) 928 7377 Fax (0207) 928 4644Websitewww alcoholconcernorguk

ALALALALALCOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCATION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARCHCHCHCHCHCOUNCILCOUNCILCOUNCILCOUNCILCOUNCILAbell House John Islip Street London SW1P 4LH Tel(0207) 217 5276

ALALALALALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALTH RESEARTH RESEARTH RESEARTH RESEARTH RESEARCH CENTRECH CENTRECH CENTRECH CENTRECH CENTREUniversity of West of England Glenside CampusBlackberry Hill Stapleton Bristol BS16 1DD Tel(0131) 536 6192 Fax (0131) 5366215 E-mailmplantahrconetcouk

HEALHEALHEALHEALHEALTH EDUCATH EDUCATH EDUCATH EDUCATH EDUCATION ATION ATION ATION ATION AUTHORITYUTHORITYUTHORITYUTHORITYUTHORITYHamilton House Mabledon Place London WC1 9TXTel (020) 72985656 Fax (020) 77259031 Emailenquirieshpeorgukwebsite wwwhpeorguk and wwwwreckedcouk

THE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALCOHOLISMCOHOLISMCOHOLISMCOHOLISMCOHOLISM3 St Andrewrsquos Place London NW1 4LBTel (0207) 487 4445 Fax (0207) 9354479

THE PORTHE PORTHE PORTHE PORTHE PORTMAN GRTMAN GRTMAN GRTMAN GRTMAN GROUPOUPOUPOUPOUP7-10 Chandos Street Cavendish Square London W1G9DQTel 020 7907 3700 Fax 020 7907 3710wwwportman-grouporguk

ALALALALALCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOTLANDTLANDTLANDTLANDTLAND2nd Floor 166 Buchanan Street Glasgow G1 2NH Tel0141-572 6700 Fax 041-333 1606

BRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIATIONTIONTIONTIONTIONMarket Towers 1 Nine Elms LaneLondon SW8 5NQTel 020 7627 9191 Fax020 7627 9123E-mail jwitheridgebeerandpubcomWebsite wwwbeerandpubcom

EUREUREUREUREUROPEOPEOPEOPEOPE

ARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GROUPOUPOUPOUPOUPBrewersrsquo House 10 Grand Place B-1000 BrusselsBelgium Tel +32 2 511 49 87 Fax +32 2 511 32 59

CBMCCBMCCBMCCBMCCBMCCheacutee de la Hulpe 181 bte 20 B-1170 Bruxelles Tel(++322) 672 23 92 Fax (++322) 660 94 02Website wwwcbmcorg

FORFORFORFORFORUMUMUMUMUMLivornostraat 13 b 5 rue de Livourne ndash Brussel 1050Bruxelles BelgiumTel 32 2 539 36 64 Fax 32 2 537 81 56email forumtasteeducationskynetbe websitewwwforum-taste-educationcom

ENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTION13 Rue Monsigny 75002 Paris FranceTel 00-33-53-43-80-75E-mail enterprisewanadoofr

IREBIREBIREBIREBIREB19 avenue Trudaine 75009 ParisTel +33 (1) 48 74 82 19 Fax +33 (1) 48 78 17 56E-mail irebirebcom Website wwwirebcom

OIVOIVOIVOIVOIV18 rue drsquoAguesseau 75008 Paris FranceTel +33 (0) 1 44 94 80 94Fax +33 (0) 1 42 66 90 63E-mail oivoivintWebsite wwwoivint

STIVSTIVSTIVSTIVSTIVAAAAABenoordenhoutseweg 22-23 2596 BA The HagueTheNetherlands Tel +31 (0)70 314 2480 Fax +31(0) 70314 24 81 E-mail phoastivanl Website wwwstivanl

SCANDINSCANDINSCANDINSCANDINSCANDINAAAAAVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALALALALALALCOHOL BOCOHOL BOCOHOL BOCOHOL BOCOHOL BOARDARDARDARDARDVandvaeligrksvej 11 DK - 5690 TommerupTel 45 64 75 22 84 Fax 45 64 75 28 44E-mail smaborg Websitewwwsmaborg

DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE WEINWEINWEINWEINWEINAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHGutenbergplatz 3-5 55116 MainzTel +49 02641 977340 Fax +49 02641 977342Website wwwdeutscheweinakademiede

FIVINFIVINFIVINFIVINFIVINPlaza Penedeacutes 3 308720 Vilafranca del PenedeacutesBarcelona Spain Tel 0034 (93) 890 45 45 Fax 0034(93) 890 46 11

DIFDIFDIFDIFDIFA FORA FORA FORA FORA FORUM EVUM EVUM EVUM EVUM EVFranklinstrabe 1 10587 BerlinGermany Tel + 49 (0) 30 39 0633 60Fax +49 (0) 30 390 633 66 email infodifa-forumdeWebsite wwwdifa-forumde

GODGODGODGODGODAAAAAGode Alkoholdninger Kattesundet 9 DK-1458Koslashbenhavn K Denmark Tel 33 13 93 83Fax 33 13 03 84

FIVSFIVSFIVSFIVSFIVSInternational Federation of Wines amp Spirits20 rue drsquoAnjou - 75008 Paris Tel 33 1 42 68 82 48Fax 33 1 40 06 06 98

THE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDAM GRAM GRAM GRAM GRAM GROUPOUPOUPOUPOUPRue Wiertz 5028B-1050 Brussels BelgiumTel +32 2 401 61 35 Fax + 32 2 401 68 68 emailinfoamsterdamgrouporgwwwamsterdamgrouporg

FUNDFUNDFUNDFUNDFUNDAAAAACION ALCION ALCION ALCION ALCION ALCOHOL COHOL COHOL COHOL COHOL Y SOCIEDY SOCIEDY SOCIEDY SOCIEDY SOCIEDADADADADADDiego de Leon 442 ES 28006 MadridTel + 34 91 745 08 44 Fax + 34 91 561 8955wwwalcoholysociedadorg

USA CANUSA CANUSA CANUSA CANUSA CANADADADADADA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAAAAAAUSTRALIAUSTRALIAUSTRALIAUSTRALIAUSTRALIA

WINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICA1200 G Street NW Suite 360 Washington DC 20005Tel (800) 879 4637 Fax (202) 347 6341E-mail infoamericanwineriesorgWebsite wwwamericanwineriesorg

AMERICAN AMERICAN AMERICAN AMERICAN AMERICAN WINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARCHCHCHCHCHAND EDUCAAND EDUCAAND EDUCAAND EDUCAAND EDUCATIONTIONTIONTIONTIONVisit website at wwwalcohol-AWAREcom

AMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAND HEALAND HEALAND HEALAND HEALAND HEALTHTHTHTHTH1995 Broadway 2nd Floor New York NY 10023-5860Tel (212) 362-7044 Ext 234 Fax (212) 362-4919Email kavaacshorg Websitewwwacshorg

BEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTE122 C Street NW 750Washington DC 20001Tel(202) 737-2337 Fax (202) 737-7004E-mailinfobeerinstituteorgWebsite wwwbeerinstituteorg

PRPRPRPRPROOOOOYECTYECTYECTYECTYECTO CIENCIA O CIENCIA O CIENCIA O CIENCIA O CIENCIA VINO VINO VINO VINO VINO Y SALY SALY SALY SALY SALUDUDUDUDUDFacultad de ciencias BioloacutegicasCasilla 114 D Santiago ChileTelFax (56-23) 222 2577Email vinsaludgenesbiopuccl

EDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALCOOLCOOLCOOLCOOLCOOL606 Cathcart Suite 700 Montreacuteal Queacutebec H3B 1K9Canada Tel (514) 875-7454 E-mailhsacyeducalcoolqcca Website wwweducalcoolqcca

THE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERAGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTE1775Pennsylvania Avenue NW Suite 1200 WashingtonDC 20006 Tel 2024637110wwwamericanbeverageinstitutecom

FISAFISAFISAFISAFISACCCCC(Fundacion de Investigaciones Sociales AC) FranciscoSosa 230 coyoacan CP 04000 Mexico DF - Mexico

HEALHEALHEALHEALHEALTTTTTH EDUCAH EDUCAH EDUCAH EDUCAH EDUCATION FOUNDTION FOUNDTION FOUNDTION FOUNDTION FOUNDAAAAATIONTIONTIONTIONTION INC INC INC INC INC2600 Virginia Avenue NW Washington DC 20037Tel (202) 3383501 Fax (202) 9656520E-mail hefmonaerolscom

ICAPICAPICAPICAPICAPInternational Center for Alcohol Policies1519 New Hampshire Avenue NWWashington DC 20036Tel (202) 986-1159 Fax (202) 986-2080Website wwwicaporg

THE CENTURTHE CENTURTHE CENTURTHE CENTURTHE CENTURY COUNCILY COUNCILY COUNCILY COUNCILY COUNCIL1310 G Street NW Suite 600Washington DC 20005-3000 Tel (202) 637-0077 Fax(202) 637-0079 Email washdecenturycouncilorgWebsite wwwcenturycouncilorg

CALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIATION OF TION OF TION OF TION OF TION OF WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEGRGRGRGRGROOOOOWERS WERS WERS WERS WERS 601 University Avenue Suite 135 Sacramento CA 95825wwwcawgorg email karencawgorg

THE THE THE THE THE WINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTE425 Market Street Suite 1000 San Francisco CA94105 USA Tel (415) 512-0151 Fax (415) 442-0742

LLLLLODI -WODI -WODI -WODI -WODI -WOODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPECOMMISSIONCOMMISSIONCOMMISSIONCOMMISSIONCOMMISSION2545 West Turner Road Lodi CA 95242USAmarklodiwinecom website wwwlodiwinecom

THE NTHE NTHE NTHE NTHE NAPAPAPAPAPA A A A A VVVVVALLEY ALLEY ALLEY ALLEY ALLEY VINTNERSVINTNERSVINTNERSVINTNERSVINTNERSASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION Phone - 707-963-3388 Fax - 707-963-3488 Website wwwnapavintnerscom

OLDOLDOLDOLDOLDWWWWWAAAAAYYYYYS PRESERS PRESERS PRESERS PRESERS PRESERVVVVVAAAAATION amp EXTION amp EXTION amp EXTION amp EXTION amp EXCHANGECHANGECHANGECHANGECHANGETRTRTRTRTRUSTUSTUSTUSTUST266 Beacon Street Boston MA 02116 6174215500Fax 6174215511 website wwwoldwaysptorg

THE ATHE ATHE ATHE ATHE AUSTRALIAN USTRALIAN USTRALIAN USTRALIAN USTRALIAN WINE RESEARWINE RESEARWINE RESEARWINE RESEARWINE RESEARCHCHCHCHCHINSTITUTEINSTITUTEINSTITUTEINSTITUTEINSTITUTEP O Box 197 glen Osmond 5064 South AustraliaAustralia Tel 61 8 8303 6600 Fax 61 6 303 6601

13

12

with a reduced risk of coronary heart diseaseand increased life expectancy which lead to theabove featured alcohol-inclusive nutritionconcepts

In 1997Sir Richard Doll Emeritis Professor ofMedicine at Oxfordoutlined in the BritishMedical Journal ldquomassiverdquo evidence for thepotential beneficial effect of alcohol in a reviewof the clinical data on alcohol and mortality Heconcluded that ldquothe consumption of small andmoderate amounts of alcoholrdquo leads to a one-third-risk reduction for vascular disease He alsoacknowledged a reduction in total mortality inmiddle-aged and elderly men and women whenthey consumed wine beer or spirits Morerecently world-renowned expert Dr ArthurKlatsky from the US outlined the overwhelmingscientific evidence in Scientific American DrKlatsky has published many research studieson alcohol and health in leading scientificjournals from the large-scale Kaiser Permanentecohort and in the recent article he wrote withrespect to the most appropriate advice to thepublic ldquoOn one hand mild to moderate drinkingseems better for heart health than abstinencefor select people On the other hand heavydrinking is clearly dangerousrdquo Merelyrecommending abstinence is inappropriatehealth advice to people such as established lightdrinkers at high risk of CHD and at low risk ofalcohol-related problemsmdashwhich describes alarge proportion of the populationrdquo Dr Klatskyalong with other experts from around the worldhas advocated that health professionals makecase-by-case evaluations based on individualand family histories They also emphasize thatthe public should be entrusted with all theinformation on use versus misuse of alcohol sothat they can make informed decisionsthemselves

Authoritative findings from cohortsinternationally lead research experts tofeature the option of moderation in eachtraditional Oldways Dietary Pyramid Manypeer-reviewed studies from Europe AsiaAustralia and the US have revealed potentialbenefits for moderately drinking adults inmulti-ethnic populations These studies findthat moderate drinkers especially consumersof 1-2 drinks (12g) daily may lower their risk ofheart disease significantly Studies reportingcertain health advantages for moderate drinkersinclude the Lyon Heart Study the CopenhagenCity Heart Study the Australian Dubbo Studyand the European Seven Country Study

The Oldways experts working with the HarvardSchool of Public Health specifically consideredfindings from the ongoing Physiciansrsquo HealthStudy and the Nursesrsquo Health Study Analyzingdata from 84000 women in the Nursesrsquo HealthStudy the effect of a combination of diet andlifestyle factors were assessed on the risk ofCHD Dr Meir Stampfer et al concludedrdquo In thispopulation of middle-aged women those whodid not smoke cigarettes were not overweightmaintained a healthful diet described aboveexercised moderately or vigorously for half anhour a day and consumed alcohol moderatelyhad an incidence of coronary events that wasmore than 80 lower than that in the rest of thepopulationrdquo At the same time based on aprospective study of more than 89000 men aspart of the Physiciansrsquo Health Study Harvardresearcher Dr Michael Gaziano et al concludedrdquoIn summary this study reveals the complexeffect of alcohol consumption on various chronicdiseases as reflected in the overall U-shapedrelationship between light-to-moderate alcoholconsumption and total mortality in menrdquoTheearlier results from the US governmentrsquos fundedNational Health and Nutrition ExaminationSurvey (NHANES) were also considered whichfound that the risk for CHD is reduced for bothmen and women who drink moderatelyPublished in 1997 in the American Journal ofEpidemiology it stated ldquoThis analysisconfirmed previous research showing thatabstainers are at a greater risk for CHD thanare most non abstainers and that a significantprotective effect may be demonstrated withsmall amounts of alcoholrdquo Along those linesresearch published in The New England Journalof Medicine from American Cancer Societyexperts concluded ldquoIn this middle-aged andelderly population moderate alcoholconsumption slightly reduced overall mortalityrdquo

At the same time there are continuingconcerns about alcohol consumption andbreast cancer and women arerecommended not to drink when pregnant in line with governmental and public healthpositions in the US Authoritative statementsfrom public health groups such as the AmericanHeart Association the National StrokeAssociation and the American DieteticAssociation acknowledge the scientific evidencepointing to potential benefits of moderation withrespect to coronary heart disease andemphasize ldquoIf you choose to drink do so inmoderationrdquo A balanced summary position is

reflected in the 1999 JAMA Patient Page onldquoBenefits and dangers of alcoholrdquo which defineslsquoModerate drinking as 1 or 2 drinks (12g) a dayfor men and 1 drink a day for women and thoseolder than 65rsquo These messages are embodiedin governmental positions in the US UKAustralia and Canada

The Oldways alcohol messages as reflectedin the pyramids are however especiallynotable in that they emphasize consumptionwith or around mealtime as research hasshown that these and related cultural normsfacilitate responsible drinking habits mayslow alcohol absorption and may counterpotential harmful effects of fatty foods Forexample Dr David Hanson author ofPreventing Alcohol Abuse Alcohol Culture andControl explains ldquoThe cross-cultural evidenceindicates that drinking abuse will be low in anygroup in which drinking customs values andsanctions are clearhellip and characterized byprescriptions for moderate drinking andproscriptions against immoderate drinkingrdquoFurthermore several biochemical studiesindicate that in addition to slowing down theabsorption process which keeps blood alcohollevels lower moderate consumption during oraround mealtime may have favourable effectson lipid profiles and atherogenesis One 1998study published in the American Journal ofClinical Nutrition suggested ldquoethanol mayreduce cardiovascular risk by modulatingvascular muscle growth during the postprandialperiodrdquo Research continues but it appears clearthat healthy dietary patterns are inverselyrelated with low rates of chronic diseases Thishas been specifically confirmed in the ongoingSeven Country Study which reported in 1999that animal-food groups were directly correlatedwith CHD mortality while vegetable-food groupsas well as fish and alcohol were inverselycorrelated

In summary in line with the developingscientific consensus public health andgovernmental positions the Oldwayspyramids stress moderation and underscorethe importance of an overall healthy mealand lifestyleConsumption is notrecommended for non-drinkers or thosewho may have any health contraindicationsand consumers are always advised toconsult with their healthcare providersFor selected references and authoritative statements onmoderate drinking and health please visit the Gateway toSensible Drinking and Health via wwwaim-digestcom

13

ORGANISATIONS INVOLVED IN ALCOHOL AFFAIRSUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOM

ALALALALALCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNWaterbridge House 32-36 Loman Street London SE10EETel (0207) 928 7377 Fax (0207) 928 4644Websitewww alcoholconcernorguk

ALALALALALCOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCATION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARCHCHCHCHCHCOUNCILCOUNCILCOUNCILCOUNCILCOUNCILAbell House John Islip Street London SW1P 4LH Tel(0207) 217 5276

ALALALALALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALTH RESEARTH RESEARTH RESEARTH RESEARTH RESEARCH CENTRECH CENTRECH CENTRECH CENTRECH CENTREUniversity of West of England Glenside CampusBlackberry Hill Stapleton Bristol BS16 1DD Tel(0131) 536 6192 Fax (0131) 5366215 E-mailmplantahrconetcouk

HEALHEALHEALHEALHEALTH EDUCATH EDUCATH EDUCATH EDUCATH EDUCATION ATION ATION ATION ATION AUTHORITYUTHORITYUTHORITYUTHORITYUTHORITYHamilton House Mabledon Place London WC1 9TXTel (020) 72985656 Fax (020) 77259031 Emailenquirieshpeorgukwebsite wwwhpeorguk and wwwwreckedcouk

THE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALCOHOLISMCOHOLISMCOHOLISMCOHOLISMCOHOLISM3 St Andrewrsquos Place London NW1 4LBTel (0207) 487 4445 Fax (0207) 9354479

THE PORTHE PORTHE PORTHE PORTHE PORTMAN GRTMAN GRTMAN GRTMAN GRTMAN GROUPOUPOUPOUPOUP7-10 Chandos Street Cavendish Square London W1G9DQTel 020 7907 3700 Fax 020 7907 3710wwwportman-grouporguk

ALALALALALCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOTLANDTLANDTLANDTLANDTLAND2nd Floor 166 Buchanan Street Glasgow G1 2NH Tel0141-572 6700 Fax 041-333 1606

BRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIATIONTIONTIONTIONTIONMarket Towers 1 Nine Elms LaneLondon SW8 5NQTel 020 7627 9191 Fax020 7627 9123E-mail jwitheridgebeerandpubcomWebsite wwwbeerandpubcom

EUREUREUREUREUROPEOPEOPEOPEOPE

ARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GROUPOUPOUPOUPOUPBrewersrsquo House 10 Grand Place B-1000 BrusselsBelgium Tel +32 2 511 49 87 Fax +32 2 511 32 59

CBMCCBMCCBMCCBMCCBMCCheacutee de la Hulpe 181 bte 20 B-1170 Bruxelles Tel(++322) 672 23 92 Fax (++322) 660 94 02Website wwwcbmcorg

FORFORFORFORFORUMUMUMUMUMLivornostraat 13 b 5 rue de Livourne ndash Brussel 1050Bruxelles BelgiumTel 32 2 539 36 64 Fax 32 2 537 81 56email forumtasteeducationskynetbe websitewwwforum-taste-educationcom

ENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTION13 Rue Monsigny 75002 Paris FranceTel 00-33-53-43-80-75E-mail enterprisewanadoofr

IREBIREBIREBIREBIREB19 avenue Trudaine 75009 ParisTel +33 (1) 48 74 82 19 Fax +33 (1) 48 78 17 56E-mail irebirebcom Website wwwirebcom

OIVOIVOIVOIVOIV18 rue drsquoAguesseau 75008 Paris FranceTel +33 (0) 1 44 94 80 94Fax +33 (0) 1 42 66 90 63E-mail oivoivintWebsite wwwoivint

STIVSTIVSTIVSTIVSTIVAAAAABenoordenhoutseweg 22-23 2596 BA The HagueTheNetherlands Tel +31 (0)70 314 2480 Fax +31(0) 70314 24 81 E-mail phoastivanl Website wwwstivanl

SCANDINSCANDINSCANDINSCANDINSCANDINAAAAAVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALALALALALALCOHOL BOCOHOL BOCOHOL BOCOHOL BOCOHOL BOARDARDARDARDARDVandvaeligrksvej 11 DK - 5690 TommerupTel 45 64 75 22 84 Fax 45 64 75 28 44E-mail smaborg Websitewwwsmaborg

DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE WEINWEINWEINWEINWEINAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHGutenbergplatz 3-5 55116 MainzTel +49 02641 977340 Fax +49 02641 977342Website wwwdeutscheweinakademiede

FIVINFIVINFIVINFIVINFIVINPlaza Penedeacutes 3 308720 Vilafranca del PenedeacutesBarcelona Spain Tel 0034 (93) 890 45 45 Fax 0034(93) 890 46 11

DIFDIFDIFDIFDIFA FORA FORA FORA FORA FORUM EVUM EVUM EVUM EVUM EVFranklinstrabe 1 10587 BerlinGermany Tel + 49 (0) 30 39 0633 60Fax +49 (0) 30 390 633 66 email infodifa-forumdeWebsite wwwdifa-forumde

GODGODGODGODGODAAAAAGode Alkoholdninger Kattesundet 9 DK-1458Koslashbenhavn K Denmark Tel 33 13 93 83Fax 33 13 03 84

FIVSFIVSFIVSFIVSFIVSInternational Federation of Wines amp Spirits20 rue drsquoAnjou - 75008 Paris Tel 33 1 42 68 82 48Fax 33 1 40 06 06 98

THE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDAM GRAM GRAM GRAM GRAM GROUPOUPOUPOUPOUPRue Wiertz 5028B-1050 Brussels BelgiumTel +32 2 401 61 35 Fax + 32 2 401 68 68 emailinfoamsterdamgrouporgwwwamsterdamgrouporg

FUNDFUNDFUNDFUNDFUNDAAAAACION ALCION ALCION ALCION ALCION ALCOHOL COHOL COHOL COHOL COHOL Y SOCIEDY SOCIEDY SOCIEDY SOCIEDY SOCIEDADADADADADDiego de Leon 442 ES 28006 MadridTel + 34 91 745 08 44 Fax + 34 91 561 8955wwwalcoholysociedadorg

USA CANUSA CANUSA CANUSA CANUSA CANADADADADADA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAAAAAAUSTRALIAUSTRALIAUSTRALIAUSTRALIAUSTRALIA

WINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICA1200 G Street NW Suite 360 Washington DC 20005Tel (800) 879 4637 Fax (202) 347 6341E-mail infoamericanwineriesorgWebsite wwwamericanwineriesorg

AMERICAN AMERICAN AMERICAN AMERICAN AMERICAN WINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARCHCHCHCHCHAND EDUCAAND EDUCAAND EDUCAAND EDUCAAND EDUCATIONTIONTIONTIONTIONVisit website at wwwalcohol-AWAREcom

AMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAND HEALAND HEALAND HEALAND HEALAND HEALTHTHTHTHTH1995 Broadway 2nd Floor New York NY 10023-5860Tel (212) 362-7044 Ext 234 Fax (212) 362-4919Email kavaacshorg Websitewwwacshorg

BEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTE122 C Street NW 750Washington DC 20001Tel(202) 737-2337 Fax (202) 737-7004E-mailinfobeerinstituteorgWebsite wwwbeerinstituteorg

PRPRPRPRPROOOOOYECTYECTYECTYECTYECTO CIENCIA O CIENCIA O CIENCIA O CIENCIA O CIENCIA VINO VINO VINO VINO VINO Y SALY SALY SALY SALY SALUDUDUDUDUDFacultad de ciencias BioloacutegicasCasilla 114 D Santiago ChileTelFax (56-23) 222 2577Email vinsaludgenesbiopuccl

EDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALCOOLCOOLCOOLCOOLCOOL606 Cathcart Suite 700 Montreacuteal Queacutebec H3B 1K9Canada Tel (514) 875-7454 E-mailhsacyeducalcoolqcca Website wwweducalcoolqcca

THE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERAGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTE1775Pennsylvania Avenue NW Suite 1200 WashingtonDC 20006 Tel 2024637110wwwamericanbeverageinstitutecom

FISAFISAFISAFISAFISACCCCC(Fundacion de Investigaciones Sociales AC) FranciscoSosa 230 coyoacan CP 04000 Mexico DF - Mexico

HEALHEALHEALHEALHEALTTTTTH EDUCAH EDUCAH EDUCAH EDUCAH EDUCATION FOUNDTION FOUNDTION FOUNDTION FOUNDTION FOUNDAAAAATIONTIONTIONTIONTION INC INC INC INC INC2600 Virginia Avenue NW Washington DC 20037Tel (202) 3383501 Fax (202) 9656520E-mail hefmonaerolscom

ICAPICAPICAPICAPICAPInternational Center for Alcohol Policies1519 New Hampshire Avenue NWWashington DC 20036Tel (202) 986-1159 Fax (202) 986-2080Website wwwicaporg

THE CENTURTHE CENTURTHE CENTURTHE CENTURTHE CENTURY COUNCILY COUNCILY COUNCILY COUNCILY COUNCIL1310 G Street NW Suite 600Washington DC 20005-3000 Tel (202) 637-0077 Fax(202) 637-0079 Email washdecenturycouncilorgWebsite wwwcenturycouncilorg

CALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIATION OF TION OF TION OF TION OF TION OF WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEGRGRGRGRGROOOOOWERS WERS WERS WERS WERS 601 University Avenue Suite 135 Sacramento CA 95825wwwcawgorg email karencawgorg

THE THE THE THE THE WINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTE425 Market Street Suite 1000 San Francisco CA94105 USA Tel (415) 512-0151 Fax (415) 442-0742

LLLLLODI -WODI -WODI -WODI -WODI -WOODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPECOMMISSIONCOMMISSIONCOMMISSIONCOMMISSIONCOMMISSION2545 West Turner Road Lodi CA 95242USAmarklodiwinecom website wwwlodiwinecom

THE NTHE NTHE NTHE NTHE NAPAPAPAPAPA A A A A VVVVVALLEY ALLEY ALLEY ALLEY ALLEY VINTNERSVINTNERSVINTNERSVINTNERSVINTNERSASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION Phone - 707-963-3388 Fax - 707-963-3488 Website wwwnapavintnerscom

OLDOLDOLDOLDOLDWWWWWAAAAAYYYYYS PRESERS PRESERS PRESERS PRESERS PRESERVVVVVAAAAATION amp EXTION amp EXTION amp EXTION amp EXTION amp EXCHANGECHANGECHANGECHANGECHANGETRTRTRTRTRUSTUSTUSTUSTUST266 Beacon Street Boston MA 02116 6174215500Fax 6174215511 website wwwoldwaysptorg

THE ATHE ATHE ATHE ATHE AUSTRALIAN USTRALIAN USTRALIAN USTRALIAN USTRALIAN WINE RESEARWINE RESEARWINE RESEARWINE RESEARWINE RESEARCHCHCHCHCHINSTITUTEINSTITUTEINSTITUTEINSTITUTEINSTITUTEP O Box 197 glen Osmond 5064 South AustraliaAustralia Tel 61 8 8303 6600 Fax 61 6 303 6601

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ORGANISATIONS INVOLVED IN ALCOHOL AFFAIRSUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOMUNITED KINGDOM

ALALALALALCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNCOHOL CONCERNWaterbridge House 32-36 Loman Street London SE10EETel (0207) 928 7377 Fax (0207) 928 4644Websitewww alcoholconcernorguk

ALALALALALCOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCACOHOL EDUCATION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARTION AND RESEARCHCHCHCHCHCOUNCILCOUNCILCOUNCILCOUNCILCOUNCILAbell House John Islip Street London SW1P 4LH Tel(0207) 217 5276

ALALALALALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALCOHOL AND HEALTH RESEARTH RESEARTH RESEARTH RESEARTH RESEARCH CENTRECH CENTRECH CENTRECH CENTRECH CENTREUniversity of West of England Glenside CampusBlackberry Hill Stapleton Bristol BS16 1DD Tel(0131) 536 6192 Fax (0131) 5366215 E-mailmplantahrconetcouk

HEALHEALHEALHEALHEALTH EDUCATH EDUCATH EDUCATH EDUCATH EDUCATION ATION ATION ATION ATION AUTHORITYUTHORITYUTHORITYUTHORITYUTHORITYHamilton House Mabledon Place London WC1 9TXTel (020) 72985656 Fax (020) 77259031 Emailenquirieshpeorgukwebsite wwwhpeorguk and wwwwreckedcouk

THE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALTHE MEDICAL COUNCIL ON ALCOHOLISMCOHOLISMCOHOLISMCOHOLISMCOHOLISM3 St Andrewrsquos Place London NW1 4LBTel (0207) 487 4445 Fax (0207) 9354479

THE PORTHE PORTHE PORTHE PORTHE PORTMAN GRTMAN GRTMAN GRTMAN GRTMAN GROUPOUPOUPOUPOUP7-10 Chandos Street Cavendish Square London W1G9DQTel 020 7907 3700 Fax 020 7907 3710wwwportman-grouporguk

ALALALALALCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOCOHOL FOCUS SCOTLANDTLANDTLANDTLANDTLAND2nd Floor 166 Buchanan Street Glasgow G1 2NH Tel0141-572 6700 Fax 041-333 1606

BRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIABRITISH BEER AND PUB ASSOCIATIONTIONTIONTIONTIONMarket Towers 1 Nine Elms LaneLondon SW8 5NQTel 020 7627 9191 Fax020 7627 9123E-mail jwitheridgebeerandpubcomWebsite wwwbeerandpubcom

EUREUREUREUREUROPEOPEOPEOPEOPE

ARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GRARNOLDOUS GROUPOUPOUPOUPOUPBrewersrsquo House 10 Grand Place B-1000 BrusselsBelgium Tel +32 2 511 49 87 Fax +32 2 511 32 59

CBMCCBMCCBMCCBMCCBMCCheacutee de la Hulpe 181 bte 20 B-1170 Bruxelles Tel(++322) 672 23 92 Fax (++322) 660 94 02Website wwwcbmcorg

FORFORFORFORFORUMUMUMUMUMLivornostraat 13 b 5 rue de Livourne ndash Brussel 1050Bruxelles BelgiumTel 32 2 539 36 64 Fax 32 2 537 81 56email forumtasteeducationskynetbe websitewwwforum-taste-educationcom

ENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTIONENTREPRISE ET PREVENTION13 Rue Monsigny 75002 Paris FranceTel 00-33-53-43-80-75E-mail enterprisewanadoofr

IREBIREBIREBIREBIREB19 avenue Trudaine 75009 ParisTel +33 (1) 48 74 82 19 Fax +33 (1) 48 78 17 56E-mail irebirebcom Website wwwirebcom

OIVOIVOIVOIVOIV18 rue drsquoAguesseau 75008 Paris FranceTel +33 (0) 1 44 94 80 94Fax +33 (0) 1 42 66 90 63E-mail oivoivintWebsite wwwoivint

STIVSTIVSTIVSTIVSTIVAAAAABenoordenhoutseweg 22-23 2596 BA The HagueTheNetherlands Tel +31 (0)70 314 2480 Fax +31(0) 70314 24 81 E-mail phoastivanl Website wwwstivanl

SCANDINSCANDINSCANDINSCANDINSCANDINAAAAAVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALVIAN MEDICALALALALALALCOHOL BOCOHOL BOCOHOL BOCOHOL BOCOHOL BOARDARDARDARDARDVandvaeligrksvej 11 DK - 5690 TommerupTel 45 64 75 22 84 Fax 45 64 75 28 44E-mail smaborg Websitewwwsmaborg

DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE DEUTSCHE WEINWEINWEINWEINWEINAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHAKADEMIE GMBHGutenbergplatz 3-5 55116 MainzTel +49 02641 977340 Fax +49 02641 977342Website wwwdeutscheweinakademiede

FIVINFIVINFIVINFIVINFIVINPlaza Penedeacutes 3 308720 Vilafranca del PenedeacutesBarcelona Spain Tel 0034 (93) 890 45 45 Fax 0034(93) 890 46 11

DIFDIFDIFDIFDIFA FORA FORA FORA FORA FORUM EVUM EVUM EVUM EVUM EVFranklinstrabe 1 10587 BerlinGermany Tel + 49 (0) 30 39 0633 60Fax +49 (0) 30 390 633 66 email infodifa-forumdeWebsite wwwdifa-forumde

GODGODGODGODGODAAAAAGode Alkoholdninger Kattesundet 9 DK-1458Koslashbenhavn K Denmark Tel 33 13 93 83Fax 33 13 03 84

FIVSFIVSFIVSFIVSFIVSInternational Federation of Wines amp Spirits20 rue drsquoAnjou - 75008 Paris Tel 33 1 42 68 82 48Fax 33 1 40 06 06 98

THE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDTHE AMSTERDAM GRAM GRAM GRAM GRAM GROUPOUPOUPOUPOUPRue Wiertz 5028B-1050 Brussels BelgiumTel +32 2 401 61 35 Fax + 32 2 401 68 68 emailinfoamsterdamgrouporgwwwamsterdamgrouporg

FUNDFUNDFUNDFUNDFUNDAAAAACION ALCION ALCION ALCION ALCION ALCOHOL COHOL COHOL COHOL COHOL Y SOCIEDY SOCIEDY SOCIEDY SOCIEDY SOCIEDADADADADADDiego de Leon 442 ES 28006 MadridTel + 34 91 745 08 44 Fax + 34 91 561 8955wwwalcoholysociedadorg

USA CANUSA CANUSA CANUSA CANUSA CANADADADADADA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAA SOUTH AMERICAAAAAAUSTRALIAUSTRALIAUSTRALIAUSTRALIAUSTRALIA

WINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICAWINE AMERICA1200 G Street NW Suite 360 Washington DC 20005Tel (800) 879 4637 Fax (202) 347 6341E-mail infoamericanwineriesorgWebsite wwwamericanwineriesorg

AMERICAN AMERICAN AMERICAN AMERICAN AMERICAN WINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARWINE ALLIANCE FOR RESEARCHCHCHCHCHAND EDUCAAND EDUCAAND EDUCAAND EDUCAAND EDUCATIONTIONTIONTIONTIONVisit website at wwwalcohol-AWAREcom

AMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAMERICAN COUNCIL ON SCIENCEAND HEALAND HEALAND HEALAND HEALAND HEALTHTHTHTHTH1995 Broadway 2nd Floor New York NY 10023-5860Tel (212) 362-7044 Ext 234 Fax (212) 362-4919Email kavaacshorg Websitewwwacshorg

BEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTEBEER INSTITUTE122 C Street NW 750Washington DC 20001Tel(202) 737-2337 Fax (202) 737-7004E-mailinfobeerinstituteorgWebsite wwwbeerinstituteorg

PRPRPRPRPROOOOOYECTYECTYECTYECTYECTO CIENCIA O CIENCIA O CIENCIA O CIENCIA O CIENCIA VINO VINO VINO VINO VINO Y SALY SALY SALY SALY SALUDUDUDUDUDFacultad de ciencias BioloacutegicasCasilla 114 D Santiago ChileTelFax (56-23) 222 2577Email vinsaludgenesbiopuccl

EDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALEDUCrsquoALCOOLCOOLCOOLCOOLCOOL606 Cathcart Suite 700 Montreacuteal Queacutebec H3B 1K9Canada Tel (514) 875-7454 E-mailhsacyeducalcoolqcca Website wwweducalcoolqcca

THE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERATHE AMERICAN BEVERAGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTEGE INSTIUTE1775Pennsylvania Avenue NW Suite 1200 WashingtonDC 20006 Tel 2024637110wwwamericanbeverageinstitutecom

FISAFISAFISAFISAFISACCCCC(Fundacion de Investigaciones Sociales AC) FranciscoSosa 230 coyoacan CP 04000 Mexico DF - Mexico

HEALHEALHEALHEALHEALTTTTTH EDUCAH EDUCAH EDUCAH EDUCAH EDUCATION FOUNDTION FOUNDTION FOUNDTION FOUNDTION FOUNDAAAAATIONTIONTIONTIONTION INC INC INC INC INC2600 Virginia Avenue NW Washington DC 20037Tel (202) 3383501 Fax (202) 9656520E-mail hefmonaerolscom

ICAPICAPICAPICAPICAPInternational Center for Alcohol Policies1519 New Hampshire Avenue NWWashington DC 20036Tel (202) 986-1159 Fax (202) 986-2080Website wwwicaporg

THE CENTURTHE CENTURTHE CENTURTHE CENTURTHE CENTURY COUNCILY COUNCILY COUNCILY COUNCILY COUNCIL1310 G Street NW Suite 600Washington DC 20005-3000 Tel (202) 637-0077 Fax(202) 637-0079 Email washdecenturycouncilorgWebsite wwwcenturycouncilorg

CALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIACALIFORNIA ASSOCIATION OF TION OF TION OF TION OF TION OF WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEGRGRGRGRGROOOOOWERS WERS WERS WERS WERS 601 University Avenue Suite 135 Sacramento CA 95825wwwcawgorg email karencawgorg

THE THE THE THE THE WINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTEWINE INSTITUTE425 Market Street Suite 1000 San Francisco CA94105 USA Tel (415) 512-0151 Fax (415) 442-0742

LLLLLODI -WODI -WODI -WODI -WODI -WOODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE OODBRIDGE WINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPEWINEGRAPECOMMISSIONCOMMISSIONCOMMISSIONCOMMISSIONCOMMISSION2545 West Turner Road Lodi CA 95242USAmarklodiwinecom website wwwlodiwinecom

THE NTHE NTHE NTHE NTHE NAPAPAPAPAPA A A A A VVVVVALLEY ALLEY ALLEY ALLEY ALLEY VINTNERSVINTNERSVINTNERSVINTNERSVINTNERSASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION ASSOCIAITION Phone - 707-963-3388 Fax - 707-963-3488 Website wwwnapavintnerscom

OLDOLDOLDOLDOLDWWWWWAAAAAYYYYYS PRESERS PRESERS PRESERS PRESERS PRESERVVVVVAAAAATION amp EXTION amp EXTION amp EXTION amp EXTION amp EXCHANGECHANGECHANGECHANGECHANGETRTRTRTRTRUSTUSTUSTUSTUST266 Beacon Street Boston MA 02116 6174215500Fax 6174215511 website wwwoldwaysptorg

THE ATHE ATHE ATHE ATHE AUSTRALIAN USTRALIAN USTRALIAN USTRALIAN USTRALIAN WINE RESEARWINE RESEARWINE RESEARWINE RESEARWINE RESEARCHCHCHCHCHINSTITUTEINSTITUTEINSTITUTEINSTITUTEINSTITUTEP O Box 197 glen Osmond 5064 South AustraliaAustralia Tel 61 8 8303 6600 Fax 61 6 303 6601

13