Buyer’s Guide to VINTAGES November 4 Release

John Szabo’s Vintage’s Preview Nov. 4: Is it Okay to Gift Alcohol?

By John Szabo, MS with notes from Michael Godel, Sara d’Amato, and Megha Jandhyala

The theme of the Vintages November 4 release is “giftable wines.” Though, I wonder, is it socially acceptable now to give alcohol as a gift in light of the Canadian Centre on Substance Use and Addiction’s recent update to its Guidance on Alcohol and Health? “There is a continuum of risk associated with weekly alcohol use,” according to the guide. And: “No matter where you are on the continuum, for your health, less alcohol is better.” Essentially, the report concludes that any more than two drinks per week increases health risks, including cancers, heart disease and strokes. It’s a simple message, and governments, politicians and marketers like simple messages. But, as you might suspect, the data on which these recommendations were made is not so straightforward. Read on to learn what the “J curve” is and how it could mean that gifting a bottle of wine is not akin to handing over a death sentence. And in anticipation of that, the WineAlign Crü has curated an enticing list from the release that will be sure to put a smile on any recipient’s face, from timeless classics such as vintage Port and Chablis to more contemporary masterpieces from regions such as Mount Etna and the Adelaide Hills.

Michael Godel wrote a special two-part report about Sicily’s en primeur wines. To read his report, please click these links: Sicilia en Primeur Part One , Sicilia en Primeur Part Two.

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Challenging the “No Safe Level of Alcohol” Claim

Canada’s new stance mirrors the World Health Organization’s policy shift announced earlier this year as well. It states, rather bluntly: “No level of alcohol consumption is safe for our health.”

The WHO’s latest report continues: “Alcohol is a toxic, psychoactive, and dependence-producing substance and has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer decades ago – this is the highest risk group, which also includes asbestos, radiation and tobacco.” The conclusions are rather bleak, and indeed the top-level takeaway is that there is no safe level of alcohol consumption. “The risks start with the first drop,” the report states.

But, as you might be hoping, there is evidence to the contrary, shoring up long-held beliefs about the health benefits of the so-called Mediterranean diet, which includes moderate alcohol consumption. Journalist Felicity Carter, reporting for Meininger’s from the International Scientific Congress in Toledo, Spain, in October, outlines some of the evidence that challenges the WHO — and Canada’s Centre on Substance Use — conclusions. It’s a subject that is understandably causing concern for the already embattled wine industry, which is seeing consumption trending downwards just about everywhere. The messaging that any alcohol consumption is harmful could see an accelerated downhill spiral, and further influence government policy, leading to even higher alcohol taxes, more restrictive advertising, and reduced availability.

The Toledo conference was entitled “Lifestyle, Diet, Wine & Health.” It was organized by The Wine Information Council (WIC) — a network of scientific, academic bodies and experts worldwide devoted to research on wine, lifestyle, and health aspects — and The Foundation for Wine and Nutrition Research (FIVIN). The purpose of FIVIN is to research, appraise, and compile scientific information on the possible health effects of moderate wine consumption in the framework of the Mediterranean Diet.

The congress convened several high-profile scientists to present the latest research on the benefits of a healthy lifestyle. “We need to spread a more balanced view of the evidence about light to moderate drinking,” said Worm Nicolai, chair of the Wine Information Council.

Prof Nicolai says the WHO’s “no safe level” recommendations are based on work done by the Global Burden of Disease collaborators, published in 2018. “They came to the conclusion that only zero alcohol is safe,” he said.

And yet, in 2020 the same authors used exactly the same data to “come to a different conclusion,” which is that the J-curve really exists. When the authors plotted the average drinks consumed per day versus relative risk of mortality from multiple studies, they discovered that the risk of dying actually goes down with a drink or two, below the baseline of teetotallers, before rising with higher consumption. The plotted line looks like the letter “J”, hence the J curve. The implication is that light-to-moderate levels of drinking actually provide a protective health effect — particularly on cardiovascular disease, the world’s leading killer. This would seem to be a rather important finding, but the WHO’s recommendations didn’t change in light of the new conclusions.

The “J Curve” from the Journal of the American College of Cardiology

One of the high-profile scientists at the congress was Professor Curtis Ellison, author of the now-famous French Paradox story that aired on an episode of 60 Minutes in 1991.

Without getting into the details of Ellison’s arguments — which he bases on certain study flaws, the inaccuracies of extrapolating data, inappropriate combinations of populations in some studies — or the faulty assumptions underlying meta-analysis and author bias when selecting studies to be included, his bottom-line message draws the same conclusions as those of the revised Global Burden of Disease collaborators. Specifically, that the scientific data clearly indicate there is a J-curve. “The dangers of moderate drinking are being exaggerated,” he concludes.

Then there’s the WHO’s failure to acknowledge the difference between relative risk and absolute risk. An extra drink per week surely does increase the relative risk of a negative health outcome, in the same way that going for a swim in the ocean increases your relative risk of getting eaten by a shark, or getting on an airplane increases your relative risk of dying in a plane crash. Stay onshore or on the ground, and your risk is zero. But going for a swim or getting on a plane are still rather safe things to do in terms of the absolute risk of dying (1 in 264.1 million for death by shark when considering only those U.S. citizens who frequent beaches, for example, according to Wikipedia). Yet the WHO’s simplistic message does not take this into account.

Identifying alcohol as a Group 1 carcinogen, up there with radiation and asbestos, is also a central point of the WHO’s position: “The risk of developing cancer increases substantially the more alcohol is consumed.” But again, this is based on relative risk. As South African oncologist Dr. Justus Apffelstaedt points out, only about four percent of cancers reported worldwide are deemed to be alcohol-related. “Of these, the vast majority were caused by heavy drinking. It is only heavy drinking that stands out for the most common cancers.” According to the U.S. Centers for Disease Control and Prevention, heavy drinking is typically defined as consuming 15 drinks or more per week for men, while for women, eight drinks or more per week is considered heavy.

So why do governments continue to demonize alcohol in a manner that resembles the attack on smoking? (NB: There are no studies to my knowledge that show that a moderate amount of smoking is good for you). The problem is that the messaging is complicated. Prof. Ellison believes that, since governments have had to deal with the fallout from alcohol abuse, talking about potential health benefits sends a mixed message. Saying “don’t drink” is just easier. But he continues at the congress: “Health policy should not be based on paternalism, but on evidence.” Four percent is not zero, so there is risk. But citizens should make their own choices about what level of risk is acceptable, and government authorities should equip them with the full range of information currently available in order to do so. Anything less becomes a “nanny state.”

Messaging is also complicated by the fact that the J-curve isn’t one-size-fits-all. “We don’t see the J-curve everywhere,” says Professor Giovanni de Gaetano, Head of the Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed Pozzilli. According to Gaetano, it exists for myocardial infarction but not for atrial fibrillation (irregular heart rhythm). “We showed that there were differences between women and men. The effect of higher doses was very different, so the beneficial effect in women disappears more quickly.”

Nationality and age also seem to matter, says Gaetano. A 40-year-old woman with no cardiovascular risk has nothing to gain from moderate drinking. And although the J curve is found everywhere, French and Italian people can apparently drink more safely than Germans or Swedes, he says, which appears to reflect consumption patterns, that is, bingeing vs. regular light drinking.

Similarly, Cancer risks are not evenly distributed either. Risk depends on who, and what type. A study presented by Dr. Apffelstaedt, for example, concluded that drinking even a small amount of alcohol could lead to a recurrence of breast cancer.

So, in short, while there’s ample evidence that shows heavy drinking is very bad for your health, there’s also plenty to support the health benefits of moderate consumption for most people, most of the time. But the messaging is deemed too complicated to reveal the nuances. Everyone should determine their own level of acceptable risks with all of the evidence at hand. The WHO, and Canada, and other governments around the world are not putting everything on the table. And while they surely have the best interests of the collective in mind, setting up wine consumption as a binary do-and-die choice is just not true.

Professor Gaetano sums it up nicely: “People who drink with moderation and regularity may continue to do it with taste, pleasure and, especially, culture.”

If the gift recipient on your list consumes wine with taste, pleasure and culture, it’s very likely okay to send them a special bottle this holiday season.

Buyer’s Guide November 4: White

Domaine Skouras Cuvée Prestige Moscofilero Alepou 2022

Domaine Skouras Cuvée Prestige White 2022, Peloponnese, Greece 
$16.95, Kolonaki Fine Wines & Spirits
John Szabo – Sharp value alert! It’s a blend of native moschofilero and the ‘alepou’, or ‘fox’ biotype of the roditis variety, fresh and fragrant, fruity and inviting, a wine to chill, crack and enjoy – no time to waste. 
Sara d’Amato – Why not add a less conventional white such as this mountain-grown blend of roditis and moscofilero to your aperitif rotation? With lemon and lanolin leading the charge on the palate, this racy and refreshing find may just give you a taste for exploring the indigenous grape varieties of Greece and beyond.

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