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Keywords:

  • Alcohol abuse;
  • binge eating disorders;
  • drinking behaviour;
  • Europe;
  • France;
  • US;
  • wine

In the United States, the 1976–1985 birth cohorts report higher alcohol consumption than that of previous and following ones [1]. These cohorts matured during the peak of average consumption of 2.7 gallons/year in the 1980s, before a drop to 2.14 gallons in 1998 [2], close to 2.1 gallons, the goal of the US Healthy People 2020 report [3]. Permissive social norms during the maturation of these cohorts could, possibly, explain their propensity to alcohol use [4] compared to their younger peers. However, in 2010, US average consumption rose to 2.26 gallons/year [2]. In fact, Kerr shows a non-significant increase in both volume [incidence rate ratio (IRR) = 1.268] and binge drinking days (IRR = 1.569) in the 1991–1992 birth cohort, consistent with the US National Institute on Alcohol Abuse and Alcoholism (NIAAA) report [5], due possibly to promotion of the health benefits of alcohol.

Is the real issue the average quantity consumed within the population, or the drinking habits of some groups of individuals? Indeed, two ways of drinking seven to 14 drinks/week were imported into the United States: the French/Latin way of a glass of wine at mealtimes, and the Scandinavian–northern-European way of seven to 14 servings of spirits at one time.

Kerr highlights the regular increase from the mid-1990s of only one alcoholic beverage: wine. The Gomberg Fredrikson consulting firm attributed this mainly to the interview of Serge Renaud and Curtis Ellison in the 60 Minutes programme aired in 1991 about the ‘French Paradox’ [6], watched by more than 50 million Americans. Serge Renaud, from France, proposed that the habit of drinking moderate amounts of wine with meals could be one of the explanations for this French Paradox, defined as follows [7]: for a level of risk factors higher than or similar to those of the United Kingdom and the United States (cholesterol, saturated fat consumption, blood pressure, smoking), France had a lower coronary heart disease mortality rate. In the same paper, he proposed the hypothesis of a haemostatic mechanism, rather than an interaction with the atherosclerosis process, following his life-long work on platelet reactivity. Two years later, the US Surgeon General suggested that a moderate intake of alcohol could be beneficial to health. This French Paradox is still observable today through the 2008 World Health Organization (WHO) data [8], with the second lowest mortality in the world from cardiovascular disease and diabetes after Japan, despite passable risk factors such as higher cholesterol levels, smoking habits and higher saturated fat consumption than in the United States (33.4 g/day versus 25.9 g/day) [9]. At the same time, the French are still first on the list of primary wine drinkers globally [10], but 24th in the ranking of alcohol drinkers [11]. Wine is a fermented grape juice naturally enriched in polyphenols. However, the increase of average alcohol levels in French wine (about 2% alcohol by volume) and around the world during the last three decades is to be deplored.

Whether or not a moderate regular intake of wine is associated with healthier outcomes [12-14], by cause or consequence [15], is still debated. Conversely, binge drinking is certainly associated with harmful middle and long-term outcomes such as increased risk of cardiovascular disease [16, 17] and obesity [18], not to mention the obvious short-term dangers. There may be a disturbing trend towards binge drinking, particularly involving spirits, in younger European adults and, as stated by Kerr et al. in their conclusion, in the United States as well.

Declaration of interests

Dr Lanzmann-Petithory is a member of the International Scientific Forum on Alcohol Research (ISFAR), disclosure statement available at: http://www.bu.edu/alcohol-forum/disclosure-statement/. This entity has never supplied her or her institution with any financial support. Dr Lanzmann-Petithory is a member of the Renaud Society, which provided her travel funds (low-cost plane tickets) in 2007 and 2009 for scientific meetings; http://www.renaudsociety.org/membership.html.

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