Science-Based Moderation: The Inconvenient Upper Limit of Alcohol and Sugar

Let’s not delude ourselves about what moderation actually means

Alcohol consumption is up especially among people prone to alcohol abuse

Covid times have brought two conflicting realizations to the fore. We’re ever more aware that our general health is key to the way our body deals with a medical challenge – such as an infection with a virus. On the other hand, it’s been hard not to double down on the very things that undermine our wellbeing, which is understandable, given the stress and isolation of the recent year, and how hard it is to change our habits. 

The Covid cocktail

As pubs and restaurants closed, people stocked up on alcohol at home. According to Neilsen, alcohol sales from stores grew 21 percent, while online alcohol sales skyrocketed and are up 234 percent. People gravitated to larger sizes and to higher alcohol content. Alcohol consumption is up especially among people prone to alcohol abuse, and binge drinking rose about 20 percent for every week on lockdown according to a recent study.

Unhealthy eating patterns also rose, especially in already at-risk populations. In a recent study about a third of participants reported that they’re eating less healthfully and have gained weight, 44 percent reported increases in unhealthy snacking, as well as increased intake of sugary drinks and candy. 

The guiding hand

Unrelated to the pandemic, the 2020-2025 Dietary Guidelines were recently published. These recommendations are developed using a report by a scientific advisory committee of 20 nationally recognized experts in the field of nutrition and health. After reviewing the relevant science, the committee’s advice, published last summer, was to cut back further on sugar and on alcohol. Alcohol intake is on the rise, the committee notes: “excessive alcohol consumption is a leading behavioral risk factor for a variety of morbidity and mortality outcomes, social harms, and economic costs”, and “consuming higher average amounts of alcohol is associated with increased mortality risk compared to drinking lower average amounts.” Men who drink alcohol, the expert panel advises, should limit their alcohol intake to 1 drink a day – matching the upper limit for women – down from the 2-a-day upper limit in the 2015 guidelines. 

Likewise, the scientific committee had new advice regarding the upper limits of added sugar. Previous dietary guidelines had the upper limit at 10 percent, a tall order by itself, as per the committee’s data, the average American consumes about 13 percent of daily calories as added sugar.  The committee’s counsel: “less than 6 percent of energy from added sugars is more consistent with a dietary pattern that is nutritionally adequate while avoiding excess energy intake from added sugars.” 

The committee’s advice regarding cutting back on alcohol and added sugar was not incorporated into the 2020 guidelines, however.

Although the 2020 guidelines state that added sugars, and especially sugary drinks, can add to our alarming obesity rates, and that alcohol is linked with certain cancers and cardiovascular disease, the guidelines remained unchanged.

Less is better

You may be asking, who’s guided by these guidelines anyway? Well, it’s true that years of recommending 5-a-day of fruits and veggies achieved the common knowledge that we should eat more veggies and fruit, but not the actual practice of doing so – only 1 in 10 Americans eat enough fruits and veggies. Most Americans don’t follow the guidelines, and the average American scores 59 out of 100 on the Healthy Eating Score.

But the Dietary Guidelines for Americans are the basis of educational materials and policies, such as the federal nutrition assistance and school lunch programs, so the guidelines do have real-world consequences. People are also aware, like never before, that poor diets are linked with chronic diseases and bad outcomes, so communicating the science matters.

And for people struggling to improve upon an unhealthy habit, vague or ambivalent advice, especially from a voice of authority, is permission to struggle less. It’s all too easy to read the current guidelines as entitling men to 14 drinks a week under the guise of moderate drinking, and shooting for a diet of 10 percent added sugar as a recipe for health – and we know we're already cheating ourselves when we count our dietary indiscretions.

So yeah, alcohol and junk food can give some comfort, and a little indulgence shouldn't be denied, especially when we’re deprived of many other things we used to enjoy. Alcohol sales have also been a bright spot for many retailers and food service businesses struggling in these hard times.

But the truth is still the truth.

The fact that health food stores like Whole Foods Market have several aisles devoted to alcohol doesn’t mean that alcohol is a whole food that nourishes you. It reflects consumers’ desire to buy and retailers' need to sell. Wine is delicious, so is cake, but these, evidence shows, should be consumed in moderation; moderation can't be defined by our desire to consume or by the wishes of those who profit from sales, but by evidence. 

I, too, wish that ice cream could become the new kale nutrition-wise, unfortunately, this is not the case.

Dr. Ayala