## Monday, June 11, 2018

### Actual wine consumption versus the recommended maximum

Many, if not most, countries have an "official" recommended maximum level of wine consumption per week for adults. However, the recommended value differs rather a lot between the countries. Moreover, the observed weekly consumption of wine also differs between countries. I have therefore wondered how these two values compare — the actual consumption versus the recommended maximum one.

For the recommended wine-intake values for each country, I have used the data from the International Alliance for Responsible Drinking (IARD), which were last updated in January 2018. The values given are in grams of alcohol per week (for each adult), with separate values for males and females, if they differ. We know that one 750 ml bottle of 12.5% wine equals 74 g alcohol, so we can use this to convert the values to bottles of wine per week.

For the actual wine-intake values for each country, I have used the Annual Per Capita Wine Consumption 2014-16 list from the AAWE facebook page. The values given are liters of wine per person per year. To convert these to "per adult", I have used the World Bank data for the percent of each population aged 15-64 years (this is apparently a standard age group for "adults"). I then converted these new values to bottles of wine per week.

This means that I now have two figures for bottles of wine per week per adult, one estimating actual consumption and one describing the recommended maximum, for a range of countries. Clearly, the value for actual consumption does not take into account what proportion of the population actually drinks wine.

The only complication is that the observed consumption values combine both males and females, whereas the recommendations for the sexes sometimes differ — where they do differ, the value for females is typically one-half or two-thirds of the value for males. Interestingly, there has been a recent trend for countries to lower the recommended limit for wine consumption by men to the same value used for women. Apparently, we are moving away from the James Bond / Humphrey Bogart hard-drinking lifestyle, at least as a medical recommendation for men (see my blog post James Bond, alcoholic).

Anyway, the data in the table show the actual consumption (bottles of wine per week per adult) as a percentage of the recommended limit for men. Most countries have a recommended limit for men of 1.9-2.3 bottles per week.

 Croatia France Netherlands Switzerland Portugal UK Belgium-Lux. Italy Denmark Austria Australia Sweden New Zealand Uruguay Germany Georgia Chile Greece Bulgaria Ireland Argentina Romania Finland Canada USA Spain 90% 90% 88% 83% 75% 74% 63% 60% 53% 49% 47% 45% 45% 44% 39% 39% 36% 36% 31% 31% 30% 27% 26% 20% 16% 15%

Note that most of the countries have wine intake that is less than 50% of the recommended maximum wine consumption. In theory, this should make the medical people happy. However, there are two ways to be at the top of this list: (i) have a high consumption, and (ii) have a low recommended maximum consumption.

The countries with lower limits than 1.9 bottles per week include Bulgaria and the United Kingdom (1.5 bottles), Chile (1.3), and the Netherlands (1.0). This explains why the UK and the Netherlands are near the top of the list, even though their consumption is not particularly high.

The other top countries are there because of their high wine consumption. Indeed, Croatia, Portugal, France and Switzerland each consume 25% more wine per adult than does their nearest rival (Italy).

The countries with the highest recommended limits include Argentina, Canada and the USA (2.7 bottles per week), Greece (2.8), Romania (3.0), and Spain (3.8). This explains why these countries occupy the bottom places on the list — they set high limits, and so their people's consumption gets nowhere near that limit.

Note that Chile and Bulgaria have low recommended limits but even lower wine consumption.

Finally, it is worth noting that those countries with wine-consumption values exceeding 50% are likely to have average consumptions that exceed the recommended value for females, since these are often half that of the values for males. This is true for Croatia, Switzerland and Portugal. Also, since the value for actual consumption does not take into account what proportion of the population actually drinks wine, there will be many people of both sexes who exceed the recommended limit, possibly by a great margin.

1. Demographic stats:

40% of U.S. adults do not drink wine (or any alcoholic beverages).

Of the remaining 60% who do drink wine, it subdivides this way:

~~ 16% of those 60% of U.S. adults who drink wine are responsible for purchasing and consuming 96% of it.
~~ The remaining 84% of those 60% of U.S. adults who drink wine are responsible for purchasing and consuming the remaining 4% of it.

The 40% non-drinkers demographic group will never convert to becoming a member of the 84% infrequent wine drinkers demographic group.

The 84% infrequent drinkers demographic group "might" increase their wine consumption over time -- perhaps one or two percentage points of them becoming members of the 16% high unit volume wine drinkers demographic group. But the conversion would represent an insignificant unit volume of wine.

Marketers have to keep their eyes on the prize: the 16% high unit volume wine drinkers who consume one or more bottles a week. Drink 96% of all the wines.

Source of some of these stats:

(May 12, 2010, 2012):

“The Market for Fine Wine in the United States”
[Fine Wine 2010 Conference in Ribera del Duero (Spain)]

By Graham Holter
Associate Director – Publishing
Wine Intelligence market research firm (United Kingdom)

Excerpt from The Guardian Newspaper Online
(April 12, 2018):

"Extra glass of wine a day 'will shorten your life by 30 minutes';
Drinking is as harmful as smoking, and more than five drinks a week lowers life expectancy, say researchers"

"Drinking will shorten your life, according to a study that suggests every glass of wine or pint of beer over the daily recommended limit will cut half an hour from the expected lifespan of a 40-year-old.

"Those who think a glass of red wine every evening will help keep the heart healthy will be dismayed. The paper, published in the Lancet medical journal, says five standard 175ml glasses of wine or five pints a week is the upper safe limit – about 100g of alcohol, or 12.5 units in total. More than that raises the risk of stroke, fatal aneurysm (a ruptured artery in the chest), heart failure and death.

"The risks for a 40-year-old of drinking over the recommended daily limit were comparable to smoking, said one leading scientist. 'Above two units a day, the death rates steadily climb,' said David Spiegelhalter, Winton professor for the public understanding of risk at the University of Cambridge."

3. For example, this advice . . .

From the Harvard [Medical School] Health Letter
(Published January, 2015):

"Mediterranean Diet Linked to Longevity, say Harvard Researchers"

"We often write in these pages that the Mediterranean diet is good for your heart and brain. Now it appears that the Mediterranean diet may also help protect your telomeres, according to a Harvard study published in the December 2, 2014 BMJ (a.k.a. British Medical Journal).

"Telomeres sit at the ends of your chromosomes and help protect the ends from fraying. Telomere length is considered to be a biomarker of aging: shorter telomeres are associated with a lower life expectancy and higher rates of developing chronic diseases.

"After analyzing the detailed food questionnaires and telomere measurements of more than 4,600 women, Harvard researchers concluded that a greater adherence to the Mediterranean diet was associated with longer telomeres, and that even small changes in diet made a difference.

"The Mediterranean diet is rich in olive oil, fruits, vegetables, nuts, and fish; minimizes red meats and processed meats; and includes a moderate amount of cheese and WINE."

[CAPITALIZATION added for emphasis. ~~ Bob]

So how much wine are we talking about?

See next comment.

4. From The BMJ
(Published

"The Benefits of Moderate Wine Consumption"

The dominant conclusion of the Lancet study [footnote 1], widely reported in the media, is that current alcohol guidelines may not be low enough. But the data in the Appendices to the Lancet article reveal a far more nuanced picture. Applying a one size fits all public health statement to alcohol is risking throwing the baby out with the bath water.

Most striking is the huge difference in mortality risk when frequency of drinking is taken into consideration. Drinking on no more than 2 days per week was associated with an increased risk of mortality when weekly intake was 125 g alcohol or more (about 16 units in the UK). But when alcohol intake was spread out over more than 2 days per week there was a reduced mortality risk even with levels up to 200 g/week (eFig. 17). This is equivalent to 25 units of alcohol - far more than the current recommended limit of 14 units.

Secondly, risk of mortality from wine was far lower than for beer or spirits, with no adverse effects on mortality up to at least 150 g/week (9 glasses) (eFig. 17 ). In addition, wine did not have the adverse effects on cardiovascular outcomes associated with spirits (eFig. 18). Combining the benefits of wine with the benefits of spreading out intake over several days would probably produce an even greater benefit. These findings are consistent with the significantly reduced risk of total mortality associated with following a Mediterranean diet drinking pattern - moderate alcohol intake spread out over the week, a preference for red wine drunk with meals, little intake of spirits, and an avoidance of binge drinking [footnote 2].

It would be rather odd if paracetamol was prescribed without making clear that only a few tablets should be taken each day, not all consumed on a Friday night. Failing to adequately communicate the huge difference, between on the one hand binge drinking on spirits, and on the other moderate wine intake with meals, is to miss out on conveying a crucial public health message.

Footnote 1: Wood AM, Kaptoge S, Butterworth AS, et al. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. Lancet 2018;391(10129):1513-23.
Footnote 2: Gea A, Bes-Rastrollo M, Toledo E, et al. Mediterranean alcohol-drinking pattern and mortality in the SUN (Seguimiento Universidad de Navarra) Project: a prospective cohort study. The British journal of nutrition 2014;111(10):1871-80.

[Erratum. Let me provide the link to the article titled "Mediterranean Diet Linked to Longevity, say Harvard Researchers."