For millennia, wine and other alcoholic beverages have been associated with health and for centuries were a part of the physician's pharmacopoeia. During the late 19th and early 20th centuries, the public focus switched primarily to the harmful effects of excessive alcohol use and alcohol abuse, and the role of alcohol in medical therapy ended.
In recent decades, however, there have begun to appear reports on possible healthful aspects of moderate drinking, with alcohol intake being especially associated with a reduced risk of coronary heart disease (CHD). There remain questions about methodology used in observational studies on alcohol and health, and of possible residual confounding by lifestyle factors. However, the general consensus, based on epidemiologic studies, short-term clinical trials of the effects of alcoholic beverages on cardiovascular disease risk factors, and basic science studies, is that moderate alcohol consumption is associated with less CHD and possibly with a lower risk of other diseases of aging.
The American public became aware of potentially beneficial effects of moderate alcohol consumption on the risk of heart disease in the early 1990s, primarily from a program on the popular television show 60 Minutes describing the “French Paradox.” The impression from that program was that the regular consumption of red wine by the French might be an important factor in explaining the lower rates of CHD in France than in the United States and Northern Europe; this led not only to an increase in the sales of red wine in the United States but has stimulated considerable research on moderate drinking by scientists around the world.
Some physicians and public health officials, only too aware of the terrible personal and social problems associated with alcohol abuse, have been reluctant to acknowledge potential beneficial effects of moderate drinking, and others have questioned the methodology of the epidemiologic studies. These concerns will be important topics of discussion at this conference.
While positive effects of alcohol on high-density lipoprotein (HDL)-cholesterol have been known for years, an immense amount of recent research has identified many other potential mechanisms by which alcoholic beverages may relate to CHD. Demonstrated have been effects of alcohol and wine polyphenolic compounds on coagulation, fibrinolysis, endothelial function, lipid oxidation, glucose metabolism, inflammation, and ventricular function, many of which will be discussed at this conference. Also to be discussed will be the adverse effects of abusive drinking on the liver, the brain, and other organs, as well as potentially favorable effects of moderate drinking on other diseases of aging, including stroke, congestive heart failure, diabetes, metabolic syndrome, dementia, and even total mortality. Further topics will include the social and cultural aspects of alcohol consumption.
The goal of this symposium is to foster free communication among the participating scientists, many of whom have made important contributions to this field over many decades. It is a closed meeting, and the emphasis will be on uninhibited dialogue, whether it be “politically correct” or not. We are encouraging all of the participants to speak freely, asking each to indicate clearly whether he or she agrees, or does not agree, with what other speakers may say—and the reasons why.
We are hoping that the end result of the meeting will be up-to-date, scientifically sound, and balanced information on moderate drinking, data that should be useful to other scientists working in the field, to physicians and other health-care providers, and to those who develop guidelines for drinking and set policy related to alcohol use. We trust that the published proceedings of this conference will indeed be as close as possible to the “truth,” as we understand it now, about the health risk and benefits of the moderate consumption of alcoholic beverages.
Statement on Conflict of Interest
The conference upon which the present publication is based was sponsored by the Institute on Lifestyle & Health, Section of Preventive Medicine & Epidemiology, Boston University School of Medicine, Boston, MA, and by the International Center for Alcohol Policies (ICAP) in Washington, DC. ICAP provided funds for the conference, including travel expenses and a modest honorarium for scientists to participate and to furnish manuscripts based on their presentations.
While ICAP is an independent organization, it does receive its major funding from companies in the beverage alcohol business. Because of this, we were careful to abide fully by the Dublin Principles (1), a set of guidelines for research principles relating to alcohol. The Dublin Principles state that while “the beverage alcohol industry should support independent scientific research which contributes to a better understanding of the use, misuse, effects and properties of alcohol and the relationships among alcohol, health, and society,” the “academic and scientific communities should adhere to the highest professional, scientific, and ethical standards in conduction and reporting on alcohol research, whatever the source of funding for such research.” Further, the Principles state specifically that while “scientific researchers should acknowledge the sources(s) of funding, (they) should be free to disseminate and publish the results of their work.”
In the present publication, the opinions expressed in each paper and discussion summary are those of the author(s) and are not necessarily those of the Guest Editor of the supplement, the Annals of Epidemiology, the Institute on Lifestyle & Health, or ICAP. Final decisions regarding the editing of each manuscript rested with the Guest Editor of this supplement and the Editor-in-Chief of Annals of Epidemiology and were uninfluenced by the source of funding.
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