Drinking It In

THE BALTIMORE SUN

Clad in leotards and a T-shirt and accompanied by her 12-year-old daughter, Cary Black jogs up to the counter at Wells Discount Liquors on a sunny weekday morning to purchase a bottle of red wine. Shopping for wine is a ritual as sure as her thrice-weekly workout at the Towson Y.

"I believe that having a glass of wine with dinner is one of the healthier things I do," says the Towson mother of two.

In the past three years, wine sales have skyrocketed 65 percent at Wells and nearly 40 percent nationally. A host of wine industry experts attribute the dramatic rise to growing medical evidence that moderate amounts of alcoholic beverages, especially red wine, may reduce heart disease.

Wine groups armed with these studies have convinced Congress to fund research on the benefits of liquor and asked the government to pass along health news about liquor to doctors for distribution to patients. The Wine Institute, a group of California wine growers, is lobbying to change a mostly negative message about alcohol in U.S. Dietary Guidelines to one that says alcohol can be healthy.

Now, under pressure from a conservative business group that calls current government labeling of alcohol unfair, the federal Bureau of Alcohol, Tobacco and Firearms is asking for medical evidence of the benefits of alcohol to decide whether the industry can make such health claims.

They are strongly opposed by some public health watchdogs, who say promoting alcohol could lead to more abuse in a society where at least one in 10 drinkers is an abuser.

"Alcohol is America's leading and most costly drug problem," says George Hacker, director of the alcohol policies project for the Center for Science in the Public Interest, which has challenged advertising and marketing campaigns of the alcoholic beverage industry since 1982.

"Our position is, if you drink moderately, one or so a day, no problem with that," he says. "But to suggest that people start drinking for their health, which is the agenda of the wine industry, is dangerous."

The alcohol industry probably doesn't need to make health claims on its labels to sell its products. The relentless drumbeat of one study after another -- frequently publicized by the industry -- has left many people with the perception that drinking wine, particularly red wine, is good for their health.

"I can't tell you how many times in a week a customer will come in and say 'I want to drink a bottle of red wine because I hear it is good for me,' " says Michael D. Hyatt, Wells' president. In the past few years, he says, studies publicized by the media have made red wine "not only OK, but also, by golly, therapeutic!"

The growing perception of wine as healthy, and the discussion of whether to tout its health benefits after nearly two decades of preaching its evils, can be traced directly to a "60 Minutes" broadcast in November 1991 on the so-called "French Paradox."

The paradox is that the French, despite a regular diet of such artery cloggers as cheese, pate, buttery croissants and cream-based sauces, have one of the lowest heart disease rates in the world. In an interview with Morley Safer, French researcher Serge Renaud attributed the country's relatively good health to another French habit -- daily doses of red table wine.

After the broadcast, U.S. wine sales shot up 40 percent, according to Impact magazine, a trade journal for the wine industry. The phenomenon set off calls from the industry to recognize the health benefits of liquor and sparked additional research, some of it funded by the federal government, notes Thomas Matthews, senior editor of the Wine Spectator, a magazine devoted to wine lovers.

For example, the National Institute of Alcohol Abuse and Alcoholism, which largely funds research into the consequences of problem drinking, now is funding research on the risks and benefits of moderate drinking. "That has an enormous ripple effect," Mr. Matthews says.

Other studies

The French Paradox is the most famous study of the health benefits of alcohol and helped focus attention on red wine, which appears to offer the most protection against heart disease. But there are dozens of others that focus on the advantages of moderate amounts of wine, beer or liquor.

More recent studies, including those in the New England Journal of Medicine and other prestigious journals, conclude that moderate alcohol consumption -- one to two drinks a day for women and two to three drinks for men -- reduces the risk of heart attacks by 25 percent to 40 percent. People who drink moderately also appear to live two to three years longer than those who abstain.

Now chemists and other scientists are trying to find reasons why alcohol may have this effect. Research to date shows that it increases the level of "good cholesterol" in the blood, thus preventing a buildup of fats that can lead to heart attacks.

* A 1993 study by Michael Gaziano of Brigham and Women's Hospital in Boston showed that moderate alcohol may account for half of the reduced risk of heart disease he found among moderate drinkers. He found that alcohol increases high density lipoprotein, the good cholesterol in the bloodstream, which helps keep arteries from becoming clogged with fat.

* The same year, Dr. Arthur Klatsky, a California cardiologist, reported that the wine drinkers among Kaiser Permanente's 80,000 members had a lower risk of cardiovascular disease than those who drank beer or hard liquor.

* In 1993, University of California at Davis researchers found a non-alcoholic chemical component in red wine that protects against heart disease. The study in the British medical journal Lancet found a class of chemicals known as phenolic flavonoids, which also exist in grape juice and in many fruits and vegetables. Essentially these are anti-oxidants -- chemicals that prevent fats from blocking the blood stream to the heart.

* The Copenhagen Heart Study, published last month in the British Medical Journal, found that people who drank wine had half the risk of dying of those who abstained. The gains came for those who drank one to two glasses a day but increased for people who drank between three and five glasses of wine a day. Researchers there also attributed a 30 percent drop in coronary heart disease in Denmark in the past 15 years to an increase in wine consumption.

Undeniable

"Even the most ardent anti-alcohol scientists can no longer deny that moderate drinking affords protection against coronary heart disease," says Wells Schoemaker, a pediatrician and San Francisco winemaker who gives advice on health issues to the Wine Institute, a group of the largest California vineyards.

"The ongoing debate, which is both scientific and political, is, 'At what price can that information be displayed to the public?'" he says.

"If a health claim is allowed on wine labels, will it encourage moderate drinkers to become alcoholics? Everyone agrees alcohol abuse is already a terrible problem," Dr. Schoemaker says.

Indeed, the National Institute of Alcohol Abuse and Alcoholism says one in 10 drinkers is an abuser. Alcohol is linked to liver disease, high blood pressure and cancer, and drunk driving is responsible for about half of all traffic fatalities, according to Dorothy P. Rice, economist at the University of California San Francisco. Alcoholism will cost an estimated $100 billion this year, up from $70 billion in 1985, according to her widely cited research.

The Center for Science in the Public Interest doesn't disagree with the scientific studies on alcohol. But it opposes any general message that alcohol is good -- a message Mr. Hacker says could lead to broader, deeper drinking patterns in society and encourage more people to abuse alcohol.

Health claims on alcohol "would tend to overwhelm the information out there about the negatives. People don't want to hear the negatives. They want to be indulged in their drinking. They want to be enabled. This is the greatest excuse: 'It is good for me,' " Mr. Hacker says.

The government allows health claims for broccoli, but not when it is part of a cream and egg quiche, he notes. Wine that is healthy for some is dangerous for others, including pregnant women, young people and people taking a wide range of medications, he says.

The untapped market

Mr. Hacker says the wine industry's goal is to use health claims to reach this country's huge, untapped market for wine.

Per capita drinking in the United States is only about 10 percent jTC of what it is in France and other European countries, studies show. About 90 percent of the American public consumes no more than one or two drinks a week.

But Dr. Schoemaker of the Wine Institute says the industry as a whole has never tried to use health as a marketing tool. His own group, concerned about exaggerated health claims, opposes the labeling effort or promoting wine as a health food.

At the same time, the Wine Institute believes people should know about the health benefits. "It validates what we've known to be true," he says.

For now, the industry is trying to win widespread acceptance of wine by providing information to public policy experts and doctors that shows alcohol to be helpful in combating disease.

Some health professionals say doctors shouldn't be encouraged to prescribe wine, because they don't have all the facts about alcoholism and drug abuse. And changing the mostly negative message about alcohol has many public health experts outraged. The deans of many of the nation's top public health schools, including Johns Hopkins, have signed a petition opposing any change to the current drink-in-moderation advice on U.S. Dietary Guidelines.

Though moderate amounts of alcohol may reduce the risk of heart disease, it increases the risk of breast cancer and is associated with high blood pressure in some people.

Public health experts note that the same lowered risk of heart attack can be achieved if people quit smoking, exercise regularly and stick to a low-fat diet, as many doctors suggest.

Moreover, as UC-Davis researchers noted in their studies of the anti-oxidants in wine, these chemicals also are found naturally in many plants and vegetables. That's the reason the National Academy of Sciences recommends eating fruits and vegetables five times a day.

"My philosophy has always been that alcohol is more dangerous than beneficial," says Katrina Armstrong, 30, a doctor at Johns Hopkins who shops at Wells. The risks don't stop her from drinking a glass a day -- or buying a case of R.H. Philips for a party at Hopkins.

With or without a health claim on the label, wine continues to be regarded highly by the consumer.

Mrs. Black, like other shoppers, has heard the claims. "Sure, why not?" she says when asked if she believes it. "It behooves me to believe it as long as I'm doing it anyway."

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