While the European Union holds back and calms down on health warning labels to be pasted on bottles of alcohol, «because everyone likes a glass of wine», the experts of our house have already taken advantage of the question and answer on the effective need for a warning similar to that of Ireland. A country where producers of wine and beer in the first place will have to, just like with cigarettes, provide labels that remind citizens of the risks they run by consuming any alcoholic drink. Realism or demonization? On the first front there is Antonella Viola, who a few days ago reaffirmed the close connection of alcohol with tumors, with the effect of brain reduction and with a dosage of alcohol that does not necessarily have to be high to cause damage. On the other Matteo Bassetti who immortalized himself with a glass of red invited his colleague not to create false alarms. A debate that needs clarity especially for the consumption of alcohol that millions of people of all ages do every day, even just at the table or during an aperitif. For this the president of the Italian Alcohol Society Gianni Testinodoctor of San Martino di Genova and coordinator of the Alcoholic Center of the Liguria region, consulted by Openis determined to re-establish the point of the speech “out of respect for the service we owe to the citizens”.
Professor, let’s get to the point: can drinking even one glass of wine a day really hurt as much as they are saying?
«In the meantime, allow me to say that the contrast between colleagues and factions is really worrying, because I am thinking of the citizens who have a different job from ours. How confusing are they in these cases? The pandemic has taught us a lot about this: the opinion of the individual scientist is not so important but the position of the scientific community. Even on vaccines there were the opposites, the community took a clear position on the fact that they would have been useful to fight the catastrophe that has rained down on us. Well, the scientific method should always be used and not intermittently. The first thing is the data, always».
And what does this data say?
«That we are facing a serious problem: alcoholic beverages represent the third cause of death and disability in the adult population and the first cause of death and destruction under the age of 24 due to road accidents, violence and acute intoxication, ethyl coma. Important numbers. But there’s more. Since 2008 the scientific community has included in group 1 dell’WHO international agency for research on canceri.e. in the list of all substances that have a relationship certain cause with cancer (120 in all), ethanol too. And that is the substance at the base of all alcoholic products: wine, beer, spirits. A choice that science does not take lightly: before inserting a substance in such a list, it thinks about 30, 40 years, precisely because of the weight of what it is also communicating to citizens. Also in the list is theacetaldehyde: a product of metabolization of ethanol in our body. In all alcoholic beverages we have the so-called free acetaldehydea flavoring molecule that if found in yogurt, would result in the immediate withdrawal from the market. And then it was decided to include drinks as well short just to make it clear there is no safe threshold level».
Does this mean that there is no “moderate” drinking that does not cause harm?
“Exactly. With this no one is saying that we must no longer sell alcohol, that we must censor those who consume, or that we are in an ascetic state but that citizens must know the truth. If Ireland has decided to write on labels that alcohol has a causal relationship with cancer, it has every right to do so. And I’ll tell you more, given the scale of the problem, we should do it too ».
What is the relationship between alcohol and cancer? Also in this case, can’t moderate consumption make you feel calm?
«In 2020 in Western Europe there were 57 thousand new cancers from alcohol. In Italy in 2020 there were 10 thousand new cases totally attributed to alcohol of which 2 thousand for very low dosages, (about 1 glass a day for women and less than 2 for men), 4.600 for intermediate dosages (from 2 glasses to 4), 3.400 new cases among alcoholics. Among the latter there are not many more than low dosages for the simple reason that it is not only the quantity that matters but also how we react to the alcoholic substance: this explains why there is no safe threshold dosage when it comes to a carcinogen. If a teenage girl consumes 1 or 2 units of alcohol per week, i.e. 12-24 grams of ethanol per week doubles and triples the risk of developing a benign breast tumor during the anatomical construction phase of the breast. Once they become a mature woman, that adolescent will instead be at greater risk of developing malignant breast cancer.
Not to mention that the only cause recognized as voluntary and therefore avoidable for breast cancer is alcohol: with an average of minus 12 grams per day, less than a glass of wine or an average beer or an aperitif, the risk of cancer in a healthy woman without predispositions 7%. A starting percentage that in the presence of genetic predisposition, with the same dosage, passes to 27%. Information that needs to be told to people. All foods can be eaten, but there are some guidelines that tell us how to do it”.
From what you are explaining, however, the guideline in the case of alcohol would be practically zero.
“As a doctor, I say yes. If a patient of mine or a citizen asked me how much he should drink to stay healthy, I would answer zero. If a citizen asks me how many Sicilian cannoli he can eat I can suggest it, but if the doubt is about how much asbestos can receive I cannot suggest it to him because I would be a criminal ».
Is ethanol like asbestos?
“In 120 substances that I mentioned earlier and that have a certified causal relationship with cancer there is also asbestos. So yes. And with it too benzene and radiation. This is why the history of DOC wine and PDO beer is a lie. There is no quality ethanol. If anything, the palatability of the product which, however, has nothing to do with the oncological point of view».
Does Drinking Make a Smaller Brain?
«Ethanol is a psychoactive substance which makes the drink attractive and enthralling. At the cerebral level it reduces the gray mass, thins it and thins the CEO of our brain, which is the frontal and prefrontal cortex. From a psychoactive substance it feeds the most archaic regions of the brain, emotions and instinctsto the detriment of a fair relationship with the most advanced areas. This is why drinking when young risks crystallizing the brain in a sort of perennial adolescence, and it happens to many adults. Do you understand how much it is not appropriate to lighten the speech?».
And that idea that a glass of wine with lunch can be good for your heart and arteries?
«It’s all lies, information born in past years used by producers in their favor. Many of the scientific works on the relationship between the heart and alcohol speak of the great beneficial effects of resveratrol, present in grape skin, tested on mice. A certainly positive substance present in blueberries, raspberries and various vegetables. But if we turn the resveratrol into wine and the rat’s body into a man, it doesn’t work anymore. To get the dose that is good for the heart through the consumption of wine we should drink more than 200 liters a day. Completely surreal. I say this having zero problems with the producers who sell and have their market. But even with regard to the heart, no, we cannot link the concept of ethanol to health. It is clear that anyone is attracted to the psychoactive substance alcohol: you don’t need to be an alcoholic. For this reason it also becomes mourning to get rid of it, we become the greatest defenders of our persecutors. And this also affects the perception of the role of the doctor. If Professor Viola and I warn of the dangers, we become obnoxious».
Does that mean that Bassetti’s is an attempt to become more likeable?
«I won’t name colleagues, I’m just saying that our job is to be honest, with ourselves and with the patients. Doctors don’t need to be liked or disliked. We have to strip ourselves in our personal opinions to fit into the so-called scientific evidence. The other thing I find absurd is that people like Sgarbi and others consider the labeling of alcohol as censorship. Absurd”.
So you don’t even drink a glass of wine for lunch?
«I never liked spirits and wine, but when I was young I liked beer. I enrolled in medicine, understood how things were and asked myself why I had to keep hurting myself so much. I assure you that one can live very well without alcohol and without cigarette smoke. I certainly don’t feel unhappy.”
No demonization in the way of communicating danger, even on labels?
“You’re just telling the truth. Ethanol is a carcinogen, the less you drink the better, if you don’t drink it for the better. No need to demonize. I don’t think there is anyone who says that there is a moderate mafia. I know what I see when I treat my patients».
What do you see in your ward?
«I see livers sick from alcohol, cirrhosis of the liver, people in need of liver transplantation and that they are not necessarily alcoholics. There are diabetics who drank moderate amounts of alcohol, patients with metabolic syndromes who developed cirrhosis with the alcohol mix. Then there are alcoholics but those who really drink enormous quantities of alcohol die first, they have other problems. Today the easy game is to address the problem alcohol or to “bad” young people (who are simply born into a society where there is alcohol everywhere) or to the alcoholic who brought it on himself. But is not so. We spend every year 25 billion euros for damages from alcohol, for every euro that producers earn we spend two on health care. He won’t tell me we’re all alcoholics.’
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