Demon Rum
The decision by the two major soft drink companies, PepsiCo and Coca-Cola, to introduce alcoholic* drinks in soda cans was not discussed in the February 21, 2023 Business section of the New York Times; it was discussed in the Science section, with the byline “health experts raise concerns”.
The public should be aware of the life-altering, relationship-destroying and in the extreme life-destroying effects of alcohol addiction and, also, the severe liver disease, alcoholic cirrhosis, which is associated with chronic alcoholism. They may not appreciate the other health consequences of chronic alcohol use including neurological disease.
The Center for Disease Control and Prevention (CDC) performed a study of a large sample population in the United States, which concluded that alcohol use was responsible for 13% of deaths in persons aged 20 to 64 years. This represented approximately 140,000 deaths per year in this age group attributable to alcohol consumption. This exceeded the deaths from firearms and drugs in that age group. Approximately 20% of all deaths in Americans aged 20-49 years result from alcohol consumption. In another study, a disturbing fraction of pregnant women had heavy alcohol consumption or indulged in binge drinking. Alcohol results in slowed fetal growth, low birth weight, premature birth, miscarriage (losing a baby before 24 weeks of pregnancy), stillbirth (a baby being born dead after 24 weeks of pregnancy). The use of alcohol during pregnancy can cause infants to have slow growth and developmental delay, unusual facial features, irritability and brain and neurological disorders that persist through life, such as intellectual disabilities and problems with emotional attachment.
There is strong evidence that drinking alcohol increases the risk of cancers of the female breast and the liver, mouth, throat (pharynx and larynx), esophagus, stomach and bowel. Ethanol is a carcinogen. Ethanol is metabolized to acetaldehyde, which can damage DNA and that pathway is thought to account for the increase in cancer of the liver, head, neck, and esophagus in those using alcohol. Ethanol, also, increases estrogen levels, which can increase the risk of breast cancer. Alcohol impairs the absorption of nutrients whose deficiency increase the risk of cancer, including vitamins A, B1, B6, C, D, E, K, and folate, as well as iron and selenium. Alcohol can contribute to weight gain. The World Health Organization has linked obesity to the increased incidence of 13 types of cancer.
Alcohol dependence is the progression from controlled alcohol intake to compulsive alcohol consumption or a shift from alcohol intake for pleasure to compulsory alcohol-seeking behavior. Strokes and overall mortality are increased at all levels of alcohol intake. Acute ingestion of large amounts of alcohol leads to a negative effect on the heart. Chronic alcoholism is associated with the development of an alcoholic cardiomyopathy, a serious malfunction of heart muscle and, also, several disabling neurological syndromes. Twenty-five chronic disease and condition codes in the International Classification of Disease (ICD)-10 are entirely attributable to alcohol. Medical scientists have concluded that no level of alcohol use is safe. The alcohol-attributable death estimates were conservative because they were based on deaths due to alcohol-related conditions that were identified as the underlying cause of death only; contributing causes of death were not included. In addition, alcohol-attributable deaths due to partially alcohol-attributable conditions were not calculated for adults who formerly used alcohol, despite some dying of alcohol-related causes.
The soft drink Mountain Dew was first bottled in 1954 as a hillbilly soft drink. “Mountain dew” was the code name for what came out of Appalachian stills (moonshine). In 1964, PepsiCo bought Mountain Dew and in 2022 turned it into an alcoholic beverage, Hard Mtn Dew. This started the fad of ready-to-drink, flavored and packaged for ready consumption alcoholic drinks. In 2021, the sales for hard seltzer, Lipton hard iced tea and similar drinks reached 10 billion dollars; they are expected to soar going forward. A 24-ounce can is the equivalent of two standard drinks. These drinks are inexpensive, low-calorie and conveniently packaged and aimed at the over 21-year old consumer. They are designed to appeal to a young demographic and it will be a long-time, as was the case with smoking, before we establish their health impact and introduce vigorous cautions and impediments to getting hooked.
Social drinking of wine, often with meals, or social drinking of liquor, neat or mixed with diluents are deeply ingrained in most societies, except a few religious sects. It would be impossible to change this deeply ingrained (no pun intended) behavior. It is a means of socialization, relaxation, communal interactions and celebration. I am not suggesting that seniors stop having a glass of wine with dinner, although there is no safe level of alcohol use. They have made it to seniorhood despite their drinking habits. I do worry about their children and grandchildren. They should be educated, public awareness campaigns should be commonplace, as with smoking, and the life-altering effects of alcohol should be emphasized. It could lead to moderation in its use. At least those who choose other paths can understand the benefits of that decision.
Cancer societies are considering the elimination of alcoholic beverages at their social events during meetings. All medical societies should consider this approach. Non-alcoholic beers are as tasty as alcoholic beers, especially those prepared in European countries. If you prefer the taste of red wine, one can substitute pomegranate or cherry juice. Ariel has an alcohol-free cabernet sauvignon. California red blend is made by Yours. If you prefer the dryness of a glass of white wine, an alternative is apple or white grape juice. For an occasion, one can consider the alcohol free chardonnay from Fre Wines. Another substitute is the non-alcoholic sauvignon blanc by Surely. In lieu of champagne, prosecco, a sparkling juice, is a reasonable substitute. Martinelli & Company’s sparkling cider has been popular with children and adults for over 100 years. Another adult option is Töst alcohol-free sparkling beverages. Noughty dealcoholized sparkling chardonnay is also a choice.
Alcohol is more destructive to societal norms than is smoking and the health risks are as great. We know prohibition is not a functional approach to society’s wide acceptance of alcohol use. It is an integral part of socialization. It would be useful to enhance education and decrease unfettered advertising of alcoholic beverages in parallel to steps taken with smoking. More awareness should be provided by medical and paramedical organizations that have taken on smoking tobacco products in a major and sustained way. Courses in health maintenance in schools should include alcohol’s risks. Other approaches are warranted.
*There are several types of alcohol. Here the term “alcohol” refers to ethanol or ethyl alcohol, the type of alcohol in alcoholic beverages. They are synonymous in this context.