Fermented Beverages, Ethanol and Health: A Critical Appraisal of Meta-Analytical Studies

The effect of alcohol on health is a controversial topic when it comes to the moderate or conscious consumption of fermented beverages. The recent claim by the World Health Organisation (WHO) and the European Heart Network (EHN) that the safe level of alcohol consumption is zero has compromised the efforts of the fermentation scientific community in developing healthier and more sustainable beverages. Therefore, the objective of this review was to assess the scientific background for such a claim that appears to be the result of recent scientific evidence. Using the meta-analytic data supporting WHO and EHN guidelines, it was possible to demonstrate that fermented beverages (e.g., wine and beer) have lower effects compared to spirits, that some population ethnicities have higher sensitivity to alcohol, and that drinking patterns influence the outcomes. Moreover, higher relative risks associated with younger individuals are mostly related to injuries (e.g., car accidents, self-inflicted injuries) and not with diseases. Sequential WHO studies produced significantly higher limits and emphasized that preventive policies should be tailored to populations at higher risk. In conclusion, the statement that “all alcohol is hazardous” has no scientific background and should be understood under the perspective that “one drink is too many and one thousand is never enough” used in alcoholism prevention. Fermentation researchers should continue their efforts on the promotion of healthier lifestyles, sustainable development and on the preservation of cultural heritage under the responsible drinking perspective.