SOME years ago we were advised that research proved drinking modest amounts of red wine was good for preventing heart disease. We now know that the researchers failed to control for lifestyle factors. Red wine is favoured by middle-class people and it is a healthier diet that produces the beneficial effect rather than the alcohol.

It seems that the UK’s chief medical officers (CMOs) are making exactly the same mistake with regard to their recent draft guidelines and the suggested link between alcohol and cancer (“Men advised to massively cut alcohol intake”, The Herald, January 8). Their comments are based on international research, with statistics “reverse engineered” to give estimates for the UK.

Go into any Scottish bar 10 years ago and the air would be blue with smoke. In many countries, that is still the case. So if research shows a higher than normal incidence of squamous cell carcinoma of the mouth among drinkers can we be sure that it is alcohol that is the cause? Or is it more likely that the researchers are failing to control for a lifestyle factor, namely smoking while drinking? Similarly, the rise of “women-friendly” bars and social drinking over the last 40 years matches a rise in the incidence of breast cancer. But is alcohol the cause? During the same period of time, we can see a rise in the use of hormone replacement therapy and birth control pills which are known to carry a slightly higher risk of breast cancer.

The main mistake of the CMOs, though, is allowing themselves to get mazed in population statistics. The purpose of the guidelines is not to advise populations but to advise you and me. Fascinating though academics might find mortality and morbidity “J” curves in population statistical projections, this departs from physiology – the known science of the body. And sound advice can be given here based on sound science.

The effect of alcohol on you and me first of all depends on size – a small, slight person will be affected more than a large, heavily-built person. An obese person will be affected much more than a thin person because the fat-to-water ratio inhibits the body processing alcohol. Most importantly, women are much more at risk from alcohol effects, so for the CMOs to suggest that there should be no difference between men and women in the new guidelines shows how far they are straying from the science base.

The alcohol issue with women is not a matter of sexism – women are much more vulnerable to the effects of alcohol both short-term and long-term. First, they are physically smaller than men. Second, they have a higher proportion of body fat than men. Third, women produce around half the enzymes (ADH & ALDH) necessary for the liver to process alcohol compared to men. Fourth, the capacity of women to process alcohol varies according to hormone fluctuations during the month. Men can have greater social problems with alcohol – for example, there is an entrenched tradition of hard drinking among East European men – but that is a matter of social campaigning rather than physiology.

Perhaps, then, the Chief Medical Officers should stick to offering medical advice based on physiological science and leave social campaigning to others.

Russell Vallance,

4, West Douglas Drive, Helensburgh.

OBVIOUSLY drinking an excess of alcohol is bad for us and at times society is plagued by the anti-social behaviour of some. Knowledge of what harm may befall us, if we continue to imbibe heedlessly, is useful in planning our lifestyle choices. However ,there are many different areas of advice which surround us: for example, red wine helps to prevent Alzheimer’s, drinking coffee can be bad for us, eggs cause cholesterol problems, eggs do not cause problems. The list is endless and sometimes the conflicting information is published within the same week. It is therefore no surprise that we stop listening because articles giving balance advice are rare.

With the dire warnings on alcohol we are not given statistics of the number of cancer diagnoses per 1,000 of the population caused by its consumption, nor are we given information on the areas of the body most commonly affected. When numbers are mentioned it is usually unclear whether they are factual or projected.

Will the drop in revenue from taxation of ex-smokers and soon to be ex-drinkers eventually have its shortfall made up by the taxation of those who exercise too vigorously and require ankle, knee and hip joint replacements after following the "perceived" wisdom and advice that exercise can only do you good?

JAC McNally,

Kennoch House, St Quivox, Ayr.