Los Angeles Times, Friday, March 1, 1996
Tell children the truth about drinking
After years of debate, the U.S. government has finally decided that alcohol can be beneficial. Federal dietary recommendations, revised every five years, now indicate that moderate drinking lowers the risk of heart disease. The dietary guidelines note that such "beverages have been used to enhance the enjoyment of meals throughout human history.
There is both old and new information in this statement. We all know that many Americans drink only occasionally or lightly at meals and social occasions. They know when to quit, don't misbehave when they drink and enjoy the taste and sensations of alcohol without going overboard.
Most of us are also aware that people in different cultures handle alcohol differently. In Mediterranean societies Italy, Spain, Portugal alcohol is consumed in the form of wine, usually at meals, by family members of all ages. Even small children are served wine on special occasion& Many European countries permit adolescents to drink with their families at restaurants.
To many Americans, the idea of offering children alcohol is reprehensible. Yet, this approach to drinking seems to inoculate children against alcohol abuse later in life. A study conducted by Harvard psychiatrist George Vaillant followed a group of men in Boston for more than four decades. The Italian, Greek and Jewish men were only one-seventh as likely as Irish Americans in the study to become alcoholic.
In contemporary America, we are taught that alcoholics are born, not made. Yet no gene determines that any individual will become an alcoholic. Rather, development of adult alcoholism is a long-term, interactive process. Despite our claim to advanced medical knowledge about alcoholism, America produces many more problem drinkers than do many traditional cultures.
The groups in the Vaillant study that had few alcoholics actually teach children responsible drinking at home. The problem with a blanket disapproval of drinking is that many children develop drinking habits on their own that are very different from sipping wine at a religious feast or family meal. National surveys show that up to half of college students and high school seniors have drunk five or more drinks at one sitting in the prior two weeks. Among fraternity and sorority members, this figure is 80%.
Ironically, in the United States today, we follow the method of alcohol education found least successful in the Vaillant study. That is, alcohol is grouped with illicit drugs, and children are taught that abstinence is the only answer. Yet children are aware that most adults drink, and many drink alcohol themselves on the sly. Moreover, drinking will be legal and widely available to them within a few short years. Clearly, many young people find the abstinence message confusing and hypocritical.
Studies that examine health outcomes among groups of adults who have been tracked for years find that moderate drinkers live longer than abstainers. What is moderate drinking? The government defined this as no more than two drinks daily for men and one for women. Britain has defined higher sensible drinking limits-two to three drinks for women and three to four for men.
These standards apply to adult men and post-menopausal women, or to any adult with one or more coronary risk factors (such as having a parent with premature heart disease, being overweight, having high cholesterol or blood pressure). Three-quarters of all Americans have such risk factors. These adults show significant reduction in mortality when they drink moderately.
The lower death rate among moderate drinkers is due to the reduction in heart disease, specifically atherosclerosis or clogging of the arteries. Alcohol enhances high density-or good-cholesterol production. However, when people average more than two drinks daily, they are more likely to suffer from such diseases as cancer and cirrhosis. At five to six drinks daily for men and four drinks for women, these risks distinctly outweigh the benefits of drinking.
What are people to make of these complications in the message about alcohol? Like most things in life, sound judgment and moderation are the bywords. After all, there are many things people consume occasionally such as meat, desserts or cigars that if done to excess become health problems.
Even adolescents can define the difference between healthy and unhealthy drinking. I recommend holding such open discussions among teenagers in place of the standard temperance lecture that passes for alcohol education. After all, even the government confirms that all drinking is not bad.