01/15/2025
An interesting read from Wine Business News:
ICCPUD Report Says Any Drinking Increases Mortality Risk
The second of two reports into alcohol and health contradicts the first one
by Felicity Carter
Jan 15, 2025
A long-awaited draft report on alcohol and health is finally out — and it’s damning. Forget the J-curve, because even small amounts of alcohol can kill.
The 81-page Scientific Findings of the Alcohol Intake & Health Study looks at the relationship between alcohol use and health in the U.S., from cancer risk to vehicle accidents. It pulls no punches.
“Among the U.S. population, the risk of dying from alcohol use begins at low levels of average use,” says the report. “Higher levels of alcohol consumption are linked with progressively higher mortality risk.”
Altogether, the report says that a mere seven drinks a week raise the risk of dying to 1 in 1,000, for both men and women.
“This risk increases to 1 in 100 if they consume more than nine drinks per week.”
Controversial from the start
The study has been mired in controversy since the beginning.
It was produced by the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD), which sits within the Department of Health and Human Services (HHS).
The report’s purpose is to help the HHS re-evaluate the Dietary Guidelines for Americans (DGAs). These guidelines, created by HHS and the U.S. Department of Agriculture (USDA), include recommendations on how much alcohol is safe to drink, and are updated every five years to reflect new scientific knowledge. HHS and the USDA are currently drafting new guidelines for 2025 to 2030 and must publish them by the end of 2025.
One of the questions hanging over the ICCPUD report is why the HHS commissioned it in the first place. Congress had already allocated $1.3 million to USDA and directed the National Academies of Sciences, Engineering and Medicine (NASEM) to write a report on the exact same topic, for the same reason — to inform the guidelines.
Lawmakers were quick to demand answers about this doubling up of effort. In October, a bipartisan group of 100 lawmakers led by Reps. Mike Thompson, D-Calif., and Dan Newhouse, R-Wash., who serve as co-chairs of the Congressional Wine Caucus, demanded that ICCPUD suspend the study.
“We question why ICCPUD would choose to redirect limited resources away from its core responsibilities,” they wrote to the Secretaries of HHS and USDA, in a letter seen by WineBusiness. “The secretive process at ICCPUD and the concept of original research on adult alcohol consumption by a committee tasked with preventing underage drinking, jeopardizes the credibility of ICCPUD and its ability to continue its primary role of helping the nation prevent underage drinking.”
That same month, Rep. James R. Comer, R-Ky., who chairs the House Committee on Oversight and Accountability, subpoenaed HHS and USDA, demanding to see the paper trail that led to this report being commissioned, citing concerns that HHS is overstepping its authority.
At the time, a spokesperson from the relevant HHS department told the media that the ICCPUD study was supposed to complement the NASEM report.
Except it doesn’t.
At present, the DGAs recommend no more than two drinks a day for men and one for women. But now the people tasked with reviewing those guidelines have two reports on their desk that contradict one another.
The NASEM report
The NASEM report was authored by 14 scientists, and peer reviewed by another 11. It was tasked with answering eight specific questions in relation to alcohol, from the relationship between alcohol and heart disease, to cancer, weight gain, pregnancy and cognition.
Their conclusion?
“On the basis of a meta-analysis of eight eligible studies, there was a 16 percent lower risk of all-cause mortality among those who consumed moderate levels of alcohol compared with those who never consumed alcohol.”
In other words, the report affirmed the J-curve; that there is a protective health effect at lower levels of consumption. As alcohol consumption rises, it becomes a health hazard.
As for cancer, the report found that there was a link between moderate consumption of alcohol and breast and colorectal cancer.
A look at the references confirms that the NASEM scientists confined themselves to studying the literature that had a direct bearing on the health questions they were told to answer.
The six-person group behind the ICCPUD report, however, drew on a much wider range of harm literature, including the role of alcohol in car accidents, suicides, violence, opioid use and tuberculosis. Although alcohol use is associated with a higher risk for tuberculosis, it should be noted that TB is not a major risk for Americans; the U.S. has one of the lowest TB rates in the world.
They also poured scorn on studies that show that moderate consumption of alcohol leads to lower all-cause mortality, saying that such studies are biased in favor of middle-classed populations.
It was almost inevitable that the ICCPUD authors would find that alcohol was dangerous to health, and not simply because they’re considering social harms as well as health harms. To find otherwise would contradict their previous work. Three of the authors—Jurgen Rehm, Kevin Shield and Tim Naimi— worked on Canada’s Guidance on Alcohol and Health. Commissioned by Health Canada, the study was undertaken by the Canadian Center on Substance Abuse and Addiction. Their conclusion was that consumers could avoid risk by consuming just two drinks a week or less.
The news caused an outcry in Canada, and the guidelines were never formally adopted.
The reaction to the ICCPUD report
America’s alcohol trade associations immediately released a joint statement in response to the latest report:
“Today’s report is the product of a flawed, opaque and unprecedented process, rife with bias and conflicts of interest. Several members of the six-member ICCPUD panel have affiliations with international anti-alcohol advocacy groups, and the panel has worked closely with others connected with these advocates. Congress never authorized or appropriated money for the panel or its work, and numerous letters from Congress and industry have voiced serious concerns over the process,” it said.
“We urge the Secretaries of Agriculture and Health & Human Services to uphold the integrity of the DGAs to promote informed and responsible decision-making around alcohol. The agencies should disregard the ICCPUD report in their final assessments for the 2025-2030 Dietary Guidelines.”
While the alcohol industry is raising questions about the affiliations of the ICCPUD authors, others are raising questions about the affiliations of those involved in the NASEM report. Politico Pro called it a “victory for the alcohol lobby” while the New York Times suggested that unnamed critics saw it as “an effort to placate the alcohol industry with a report more likely to support moderate drinking.”
As accusations fly from all sides, and with two contradictory reports in play, it’s clear that the fight over the alcohol guidelines is destined to become louder and more bitter in the months ahead.
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