Does moderate alcohol consumption protect against CHD?
Even in 1984 there was substantial literature to suggest that moderate alcohol consumption lowered risk of CHD. Professor Marmot wrestled with the issue of sick quitters , an idea later carefully examined in detail.7 In most prospective studies, non-drinkers include a percentage of individuals who were sick and subsequently stopped drinking alcohol; however, this potential bias still cannot explain the strong inverse association between moderate alcohol consumption and CHD.8,9 Inaccuracy in reporting of alcohol consumption has and always will be a problem with observational studies. However, if the goal is to assess moderate alcohol consumption, then many of our current assessment tools are adequate and can differentiate moderate drinkers at lowest risk of CHD from those who abstain. A recent review in this area concluded that methods that inquire about both the frequency and amount consumed for beer, wine, and liquor separately yield the most realistic levels of intake.10 Marmot also
