Health: Battle of the booze

You may think you drink very

little. But research shows that

more and more people are

binge drinking, and the effects

can be disastrous.

It's been a bad summer for alcohol. Along with the public "battles with booze" fought by Caroline "Mrs Merton" Aherne and Coronation Street's Curly Watts, there's also been the really tragic cases; the fatal drinking sessions for actor Kevin Lloyd from The Bill and, more recently, David Cheek, Paul Gascoigne's friend.

On the night of David's death, the 43-year-old had drunk five pints of lager, some wine and a strong Italian spirit, grappa, while dining with Gasgoigne and friends.

It's hardly surprising that binge drinking remains popular, considering the positive press alcohol has enjoyed in recent years. Drinkers throughout the land have had a number of opportunities to raise a glass and celebrate: the relaxation of pub licensing laws, the launch of youth-friendly alcopops and an increasing number of high-strength brands and the Government's raising of recommended units we can consume.

True, evidence suggests that moderate amounts of alcohol raise levels of HDL cholesterol, the "good" kind. Alcohol also seems to protect against blood clots by making platelets less sticky. Any alcohol does this, whether it's in wine, beer or spirits, but some drinks benefit the body in other ways, too. Red wine and beer contain flavinoids, which act as antioxidants, but you'd get a far better dose from a plate of fresh vegetables.

Yet the euphoria of highlighting alcohol's good points has also meant that studies exposing groups which may not benefit, such as pregnant women and nursing mothers, have sometimes been overlooked. Some studies have indicated that drinking alcohol increases a woman's risk of developing breast cancer. The Harvard School of Public Health concluded recently that two drinks a day can raise a woman's risk of contracting the disease by as much as a quarter.

Often the problem with alcohol lies more in the way we drink rather than the amount we knock back, according to a report in this month's Journal of the Royal Society of Medicine. "In southern European countries the whole culture is of families drinking moderately while the culture of men drinking on their own in a pub in, say, northern England or Ireland leads to situations where people may drink heavily and irregularly," says Professor Martin McKee who, with Annie Britton, at the London School of Hygiene and Tropical Medicine, published the findings. "It's much more difficult to get blind drunk if you've got a wife and family with you."

The study compares drinking patterns in different countries to discover why some are more fatal than others. The Russians, for instance, are far more likely to die of an alcohol-related death than their French counterparts, even if those in both countries were drinking the same quantity of alcohol in a week. This is because Russians tend to binge on vodka while the French usually consume red wine, drinking a little each day with an evening meal.

The research also shows that the day after a binge, heart-beat patterns can be dangerously irregular and the heart is more likely to be damaged by a high concentration of alcohol in the blood. In addition, binge drinking was found to raise levels of HDLS, lipids associated with heart attacks.

A Finnish study published in the British Medical Journal in October last year supports Professor McKee's work. It discovered that men who binge on beer (defined as six or more bottles in a session) have a much higher risk of early death, regardless of their total average consumption. Other risks are also increased, including poisoning, injuries, violence and suicide.

The problem of the unexpected death of healthy people caused by binge drinking is unlikely to be improved as long as we continue to receive mixed "facts" about alcohol. Professor McKee believes that policymakers seeking to promote "sensible drinking" need to present a clear message that recognises the benefits but also the dangers.

"Now, people either say doctors can't make up their minds about alcohol, or they think they're just drinking a little amount when of course they are drinking more," says Professor McKee. "People's recollections of what they have drunk is often inaccurate. They forget what they've drunk, they often think it is less than it really is."

One explanation of why people find it hard to pin down their drinking habits is the complicated process involved in working it out. The strength of wine varies from under 9 to over 13 per cent for example, and a pub wine glass varies greatly from a goblet given by the host of a generous dinner party. Ciders also vary greatly in strength, beers even more. And, needless to say, when talking about recommended units for a man or a woman, people vary greatly in size and tolerance also.

The Health Education Authority released research last year to illustrate the problems of one-off binges. These include accidents and injuries, blackouts and memory loss, alcohol poisoning, sickness and hangovers, crime and violence and doing something you later regret, such as having unprotected sex.

The research found that 16- to 24-year-olds are the most likely group to binge drink, but also that risky drink behaviour is common among all adult drinkers. Six out of ten of the men taking part in the survey said they'd drunk the equivalent of at least four pints of beer in one session (over eight units) in the last year while more than a third of women had drunk the equivalent of at least three pints (six units), many at least once a week.

It is worth remembering the following tips: that drinking with food slows alcohol absorption time; that a small glass of wine of 9 per cent alcohol by volume constitutes one unit of alcohol - but many wines are stronger; and that a healthy liver takes an hour to break down a unit of alcohol, so after a binge you may be over the legal drink drive limit the next morning.

According to Alcohol Concern, the money spent on educating and warning the public about alcohol is tiny compared to that spent on the spread of information about Aids, drugs and cigarettes. Considering that alcohol is such a deadly drug, can we really afford to spend so little?

Alcohol concern (0171 928 777) can refer people to local agencies; local Alcoholics Anonymous helplines are listed in the telephone directory; Drinkline (from 1 Oct): 0500 801802