Beer : Health and Nutrition

The Impact of Alcohol on Health 129
psychological performance. On the other hand, and perhaps unsurprisingly, those engaging
in team sports (presumably leading to increased tness) consume more beer and
spirits (Watten 1995).
An additional criticism of studies that are based on surveys is the reliability of individuals’
reporting of alcohol intake (Dawson 1998; McCann et al. 1999). As Klatsky
(2001) says: ‘In data based upon surveys, systematic ‘underestimation’ (lying) probably
tends to lower the apparent threshold for harmful alcohol effects.’
Rimm et al. (1996) highlight the greater reliability of case-control studies, in which
controlled observations are made relating consumption of a speci c alcoholic beverage
to ailments such as coronary heart disease. From such investigations (see also Cleophas
1999) it is clear that wine, beer and spirits all confer a reduction in coronary heart disease.
As Rimm and co-workers (1996) say:
We conclude that if any type of drink does provide extra cardiovascular bene t
apart from its alcohol content, the bene t is likely to be modest at best or possibly
restricted to certain sub-populations.
Barefoot et al. (2002) concur entirely, highlighting the signi cance of confounding factors
as establishing the apparent difference in health impact of wine and beer. Wine drinkers
had healthier diets than did those drinking beer (or spirits) and they were less likely
to smoke. They reported that they ate more servings of fruit and vegetables and fewer
servings of red or fried meats. The diets of wine drinkers contained less cholesterol and
saturated fat, but more bre. Non-drinkers consumed fewer vegetables and more bre, and
they were less likely to exercise regularly. They had a higher mean body mass index.
Nonetheless, there have been several reports suggesting that one type of alcoholic
beverage is superior to another on a health basis. Rimm et al. (1996) insist that this
relates to aspects of lifestyle associated with consuming drinks of a certain type. Klatsky
et al. (1997) observed that wine consumers were less likely, and beer drinkers more
likely, to develop coronary heart disease than spirit drinkers were, but that when the data
was corrected for parameters such as sex, race, cigarette smoking and consumption of
coffee, the correlations were eliminated. To emphasise the point: differences in bene t
or risk associated with beer, wine or spirits are probably associated with other lifestyle
parameters and not due to the different drinks themselves.
It seems that, if there is a preference for one type of drink within a population, then
studies within that populace relating moderate alcohol consumption to health bene ts
tend to highlight the advantages of that particular beverage. For instance, a study in
Honolulu where a minority of the population consumes wine showed a signi cant
inverse population between coronary heart disease and beer drinking (Yano et al. 1977).
Similar results were obtained in countries noted for the popularity of beer, namely
Germany (Keil et al. 1997) and the Czech Republic (Bobak et al. 2000). Hoffmeister