How does a psychiatrist look at beer and health? Stan Ansoms: “The healthy aspect of beer should not turn into a preventive message.”

INTERVIEWS

Dr Stan Ansoms is psychiatrist and head of the treatment unit for drug-related diseases of the Psychiatric Centre Brothers Alexians in Tienen (Belgium). He is also chairman of the VAD, which stands for ‘Vereniging voor Alcohol- en andere Drugproblemen’ (Association for Alcohol and other Drug-related problems) (info: ). The VAD co-ordinates institutions and associations that are dealing with alcohol and other drug-related problems in Flanders and that can be considered as one big organization. It can be compared with the cogwheels of a watch. All the different cogwheels do not turn and function in the same way. Some institutions concentrate on the study of phenomena, figures and statistics. Others are doing more work in the field of prevention. Still others are taking care of assistance. Main task of the VAD is to make sure that all the cogwheels fit into each other nicely and that everything goes very smoothly. All studies, prevention, assistance concerning drugs, medication and alcohol in Flanders are steered in the right direction by the VAD. The VAD has been acknowledged by the Flemish authorities.
Everybody in Flanders can make an appeal to the VAD, either indirect via the many institutions of field workers, or direct via the Drug telephone line and the documentation centre.

What does an association such as the VAD think of the web site beer and health?
Stan Ansoms : “From the VAD there is no objection to a web site that gathers all scientific information concerning beer and health, on the condition that this happens in an honest way. There has been enough scientific research to presume that a light to moderate consumption of beer (and alcohol) is good for one’s health and mildly beneficiary for the cardiovascular system, at least for adults. As long as the healthy aspect of beer is not being used as a preventive message we have no objection to this web site.”

Why can we not consider a light to moderate consumption of beer as a preventive message?
Stan Ansoms :”Drinking too much alcohol implies also health risks. The line between light and moderate drinking on the one hand and drinking too much on the other hand is not always easy to define. Announcing within that context that a light to moderate consumption of alcohol is healthy would give the excessive drinker an argument to continue his drinking behaviour. One would think very easily that when two glasses of beer are healthy four glasses of beer would be double as healthy. This is obviously not the case. That is the reason why you have to be very careful with such messages and they should always be linked to the warning that too much alcohol is not healthy and can lead to dependence.
Moreover, there are better and safer measures to prevent cardiovascular problems than a light to moderate consumption of beer. The promotion of a low-fat diet and encouraging people to stop smoking are eg. excellent preventive messages and on top of that they are without any risk.”

The web site beer and health is frequently visited. Since its launch at the end of November 2001 more than 3,000 people visited the site. Some of them are questioning their own drinking behaviour. Maybe this web site can contribute to put problem drinkers back on the right track. Considering this, do you think a co-operation would be possible between www.beer-and-health.com and the VAD, in eg. our “frequently asked questions” section?
Stan Ansoms :”We would certainly like to co-operate on that level. The web site beer and health indeed has the possibility to identify those drinkers that are no longer drinking in a sensible way and refer them to the organizations that take care of assistance. The VAD has the knowledge available to render suitable advice or to refer to other organizations. It is, however, positive that the Belgian brewers, who support this site, have an eye for the problems alcohol can lead to and stress the fact that we should drink moderately and in a sensible way.”

Source: Dr. M.F.

 

Are there gluten in our beer?

INTERVIEWS

People with celiac disease are oversensitive to gluten. When they consume food containing gluten they could develop intestinal complaints. Gluten is a protein that can be found in wheat, rye, barley, spelt and probably also in oat. Wheat and barley are raw materials for beer, and even when only very little of these proteins remains in the final product after the brewing process, it is not to be excluded that beer still contains traces of gluten.

Prof. Dr. Martin Hiele, gastrologist UZ Leuven and spokesman of the Flemish Association of Celiac Disease:

Does beer still contain gluten?
“Beer is a subject of discussion. On the list of the Flemish Association of Celiac Disease there are many kinds of beer that are allowed. However, there are reasons to doubt the safety of beer for people with celiac disease. Most kinds of beer are made of barley. During the brewing process the barley is first germinated and then the germinated barley is fermented. As a result of the fermentation most of the carbon hydrates and proteins are split. In general the malt is removed from the beer and later on the beer will be filtered one more time. So beer certainly does not contain large lumps of protein. However, this does not alter the fact that beer can still contain traces of proteins and thus also gluten. As a matter of fact one does not know this exactly.”

Is it not possible to just measure whether or not beer contains gluten?
“That is not so obvious. Even if we dispose of good measuring methods, we have to say that they are not completely reliable. There are different kinds of protein fractions in gluten and the existing measuring methods are mainly based on the determination of one kind of protein fraction, whereas the others are not taken into consideration. That is not completely correct. When we want to trace very small quantities of gluten we have to dispose of more accurate measuring methods. In case beer contains gluten, this will in any case be in very small quantities that are probably below the standard.”

What is the standard for gluten?
“A manufacturer is allowed to call a product gluten-free when the gluten content is not beyond an internationally determined limiting value. This limiting value has been determined in the Codex Alimentarius, a bundle of guidelines concerning food stuff drawn up by a commission of the World Health Organisation. Already in 1981 it was written down in this Codex that gluten-free implies that a product contains less than 20 milligrams of protein per 100 grams of dry food. This corresponds with 20 to 30 milligrams of gliadine per 100 grams of starch. In practice this is usually expressed in p.p.m. or “parts per million”, which corresponds with milligram per kilogram. A product is per definition gluten-free when it contains no more than 200 p.p.m. of gluten.”

What is the point of view of Celiac Disease Associations concerning beer?
“Most organisations that are dealing with celiac disease put just like that that beer is not allowed in a gluten-free diet, because usually barley or wheat is used when producing beer. Others say that beer probably contains so little gluten that a beer once in a while will rarely lead to problems for a patient with celiac disease. Is there room for beer in a gluten-free diet? In scientific circles there is no consensus about this matter. Therefore you can not expect that gluten will be mentioned on the label of beer. The scientific substructure is insufficient in order to do so.”

Prof. Em. Gilbert Baetslé, University of Ghent, author of “Manual for the beer victualler; expert knowledge from the barrel to the glass”:

Which beers are gluten-free and which beers contain gluten?
“Little scientific research has been published concerning gluten in beer. In general we can say that wheat beers contain more gluten than beers that are made of barley malt that contain very little gluten. In case of barley malt the gluten are broken down to a large extent when germinating.
Beers that turned sour in a normal way (such as Rodenbach beers) contain even less gluten than beers that are made with barley malt. Particularly when they were stored for a couple of years.
Finally we can say that beers that have a secondary fermentation in the bottle contain very little gluten, because during the fermentation in the bottle those gluten that are still present are being broken down furthermore.
Especially for people with celiac disease we can say that normal lager beer is safe. Beers contain certainly not more than 200 p.p.m. gluten. But for most beers this has never been examined.”

Donald Kasarda, chemist in the “Crop Improvement and Utilisation Research Unit of the USA Departement of Agriculture”:

Does barley beer still contain gluten?
“In beer based on barley malt no gluten can be found back. Gluten from barley are broken down to smaller proteins (peptides). Whereas gluten from barley is built from a chain of about 300 amino acids, peptides that remain in beer contain at the maximum a few dozen amino acids. It is however very probable that these tiny particles do not provoke any undesired reactions among patients with celiac disease. These days, however, we do not know to what extent these peptides cause reactions among patients with celiac disease. Moreover, there are no methods available to measure this on a quantitative level.
Brewers, such as Sapporo Breweries, are right when they say that their barley beer does not contain gluten. The main problem is that today we don’t have any definite answer concerning the short peptides (the fragments of gluten) that do remain behind in beer. Are they safe for the patient with celiac disease?”

Frederik Willem Janssen, head of the chemistry department, Department of Food Inspection, Zutphen Netherlands.

Has there been any research concerning the amount of gluten in beer?
“Our department has examined about fifty kinds of beer on the presence of gluten. Most beers contain some reactive proteins between 1 and 200 p.p.m. Fifteen beers contained less than 1 p.p.m. gluten. We discovered a strong correlation between the beers made of wheat and the beers made of barley. Other research confirms that the amount of gluten in beer can vary strongly between zero and 400 p.p.m. gluten.
I wish to stress the fact that the current methods to determine gluten in beer are very unreliable. They can lead to both incorrect results on both the positive and the negative level. We ought to dispose of other and reliable measuring methods.”

 

 

Professor Isidore Pelc, Faculty of Medicine, ULB: “To forbid youngsters to drink alcohol will have an opposite effect”

INTERVIEWS

Every moralizing messaging towards alcohol, even if it comes from a doctor, will risk to cause more disadvantages than benefits and it will rather incite youngsters to break the boundaries that are imposed upon them. That is the conclusion of a debate on alcohol and health that took place in Brussels on February 12th 2002.

Professor Pelc (psychiatry, ULB): “Alcohol problems are not a result of alcohol, but of our behaviour towards alcohol. Our position towards alcohol determines whether the drink will be good or bad to us. It would be much better if we would create a feeling of responsibility among youngsters towards alcohol and to teach them how to enjoy a moderate use of alcohol rather than to act in a repressive way. Youngsters should get the possibility to experiment and to discover. Prohibitions have no sense whatsoever. However, when you teach people how to deal with alcohol and to value alcohol, it will be very unlikely they will start to abuse alcohol. The great connoisseurs of wine for example never turn into alcoholics, disregarding a few exceptions.”

“It is not to be excluded that alcohol abuse by youngsters is the result of a too strict parental prohibition. It is preferable to let youngsters discover alcohol in a progressive way in the family circle rather than to forbid them to drink along.”

“Excesses are never good, but everybody knows that a moderate consumption of alcohol has advantages for one’s health, as compared to total abstinence. For that reason it is wise to teach youngsters to deal with alcohol in a sensible way.”

Source: De Huisarts / Le Généraliste 06/03/2002

 

Henk Hendriks, scientific associate at TNO Voeding in Zeist, Netherlands:

INTERVIEWS

“Never start drinking alcohol for health reasons. But if you like to drink one or two glasses a day, that’s fine. There’s no reason to stop.”

Is moderate drinking healthy?
Henk Hendriks: “One of the interesting findings of numerous large-scale surveys of the population into the effects of alcohol consumption on health is the fact that a moderate alcohol consumption, that is to say, one or two glasses a day, results in a reduced risk of cardio-vascular diseases. That is an important conclusion, because these conditions are still cause-of-death Number One in the Western World. But we definitely wave this conclusion around and decide that alcohol is therefore necessarily healthy. Nor do we want to advocate prescribing the drinking of alcohol in moderate quantities as medicine against cardio-vascular diseases. The matter is far too complex for that.”

What are moderate, healthy amounts of alcohol?
Henk Hendriks: “That varies somewhat according to population group and individual. Men and women metabolize alcohol differently, a question of difference in body weight and a different fat-to-muscle ratio. Eating habits, lifestyle and age also have to be included in the equation. There are, in other words, a large number of factors that influence the effect of alcohol on the body. And all these factors together determine the end-effect that a given amount of alcohol will have on a specific individual. It is therefore extremely difficult to generalize.”

What is your opinion of the positive reports on alcohol consumption?
Henk Hendriks: “In all the positive reports on alcohol we must not lose sight of the fact that there are also risks attached to alcohol consumption. The combination of alcohol and driving in traffic is still as downright irresponsible as ever it was. Alcohol consumption presents risks for pregnant women, and it’s a hard fact that excessive consumption increases the risk of all sorts of conditions for everyone. Yes, we have now found a relation between moderate alcohol consumption and a reduced risk of cardio-vascular diseases. But there are also other diseases. What effect does alcohol have on them? What exactly is the ‘healthy’ dose, and where is the limit – per group or individual – between risk-reducing and risk-increasing? Is it three glasses a day, is it four? It is, in short, still too unclear. And as long as that remains the case, I would advise caution.”

Is there any difference between beer, wine and spirits as regards their effects on health?
Henk Hendriks: “As to the alleged differences of effect between wine, beer and distilled beverages, there’s still a great deal that we don’t know. I have no conclusive explanation for the different research findings, but, for the time being, I assume that the research method can be decisive. Take the Danish research; a number of factors were ignored, eating habits for example. Bearing in mind that wine is usually drunk with a meal and spirits are usually not, it’s not inconceivable that this will influence the measurements. However, our own research indicates that a very substantial part of the protective effect is caused by the alcohol in all three beverage types. But that’s still controversial. More research is still required in this field before there is clarity on all fronts. And, as long as we still have questions that go unanswered, our advice is not to start to drink alcohol ‘for medicinal reasons’. Certainly not if you’ve never drunk alcohol before. But if people enjoy a glass or two a day, that’s no cause for alarm. There’s no reason to stop.”

More information:

 

Marianne Thyssen: “A positive message has more impact on health behaviour”

INTERVIEWS

Smoking and drinking alcohol were sometimes mentioned in the same breath, and that, according to Marianne Thyssen, is absolutely unwarranted. Thyssen is a member of the European Parliament (MEP) and Chairperson of the Beer Club, set up in the European Parliament by the European brewers’ association (CBMC). “Smoking is unhealthy, right from the first cigarette,” she says, “whereas moderate alcohol drinking is actually good for the health. That is a positive and also a welcome message that we have to get across,” thinks Marianne Thyssen. Advice in connection with healthy nutrition too often have a negative complexion. They give the consumer the impression that anything that tastes nice must be avoided. In recent years our population has had to deal with a succession of food crisis that unquestionably have led to a general feeling of suspicion against our basic food. Is the meat really hormone-free? When you eat steak, isn’t there the danger of getting Creutzfeldt-Jacob Disease? Can you still buy chickens that don’t contain dioxin? What about the residues of pesticides and other sprays in fruit and vegetables? Is fish still healthy, what with all this mercury and dioxin pollution? Can we still enjoy dairy butter, or must we switch over to cholesterol-reducing spreads that protect the heart?

Beer and wine on the same line

“In that negative food climate, a positive message is a breath of fresh air and we have to emphasize it,” says Thyssen. “The message that a moderate consumption of red wine is good for the heart and blood vessels seems to have registered, thanks to the hard work of the wine lobby. What is less generally known is that beer is every bit as healthy for the heart and blood vessels as wine, and according to some research possibly even healthier. Yet the benefits of beer are less well known. And we in the Beer Club in the European Parliament intend to do something about it. Don’t forget, beer is also an important, and therefore one more reason to make extra efforts. Our objective is to spread the positive message about beer. We must place beer on a par with wine. And, needless to say, our message rests on sound scientific publications”. Marianne Thyssen makes a point of spreading information on the pro-health aspects of beer even within the European Parliament. “There’s no point laying fetters on publicity for beer in the same way as tobacco adverts are limited,” she insists. “You can’t compare beer with tobacco. The approach of adverts for tobacco and alcohol is different. This difference must be made clear to the policy-makers, in order for them to continue to make the right decisions”.

photo: MEP Marianne Thyssen talking to Dr. Marleen Finoulst

 

Hop-professor Denis De Keukeleire: “Beer is healthy”

INTERVIEWS

Beer consists of a combination of four base materials: germinated barley, hop, yeast and water. In beer there is not one single substance that exceeds the toxic threshold. It contains a lot of minerals and vitamins. Beer as a matter of fact is a fluid nutrient. It also contains little salt and a lot of magnesium which is important against heart problems and gallstones and kidney stones.

Prof. Denis De Keukeleire: “I have studied organic chemistry and although I was a diligent student I also participated in university life. Already in that time – in the sixties – the drinking of beer was an essential part of this university life. When I had to select a subject for my dissertation I was lead by my interest for beer. I chose for the research on the acrid substances in hop. It is a life’s work to get to know one single plant up to the last fibre and in my case this is hop. I think I can continue with this for the rest of my life.”

Would you, for the sake of the do-it-yourselfers among the visitors of this site, be so kind as to explain to us briefly what brewing is all about?
De Keukeleire : “Beer is made of starch, that can be found back in potatoes and all grains. The base component of beer is most of the time barley. By making the barley damp it starts germinating. The germinated barley is called malt. The brewer mixes this malt with water until it becomes a kind of pulp, which he then heats up. That way the starch in the barley will be broken down and turn into sugars. The pulp will then be filtered in such a way that all the solid substances originating from the malt disappears. The wort, the remaining substance, goes to the wort boilers and will be boiled for one and a half hour together with the hop, which will give the beer its flavour. Then the brewer filters the remainders of the hop away and the wort will be transferred to fermentation tanks, where the yeast transfers the sugars into alcohol and carbon dioxide. The beer ferments for about a week and needs to ripen for three more weeks. It is only after one month that beer will be drinkable.”

You are engaged in the research of hop?
De Keukeleire : “That is correct. Very often I am considered as the beer professor, but in fact I am a ‘hop-professor’. For the moment we are very busy with a project to make beer resistant to light. Beer will be irreparably damaged if it is exposed to light. Sulphur compounds are formed that have a very bad smell, comparable to cat piss. The cause of this is to be found in the acrid substances in hop. If you are sitting on a terrace in the sun you should not leave your glass of beer exposed to the sun too long. Drinking your beer quickly is the best thing you can do. That is also the main reason why beer is most of the times bottled in dark bottles. However, there are exceptions to everything. Corona beer eg. is bottled in a transparent bottle. This is purely for aesthetic reasons : people like to see the colour of the beer. Therefore Corona is always drunk from the bottle, with a piece of lemon in the bottleneck to disguise the bad smell. We are trying to do something about this.”

How come there are beers with different tastes?
De Keukeleire : “This has got to do with the malt that is used by the brewer. The fermentation of the malt is stopped by blowing hot air into it. This process, which is called oasting, can take place in several different ways. When it takes place at low temperatures for a short period of time you will get pale malt, which has no taste and is used for lager beer. Lager beer gets its specific taste from hop. When you blow the hot air for a longer period of time through the barley you will get caramel-like malts, that are used as an ingredient for amber beers and have their own typical taste. Finally there is very dark malt which is used for brewing the heavy beers. These beers will get an additional aroma because of the yeast.”

Could you say that beer is healthy?
De Keukeleire : “Yes. Beer consists of a combination of four natural ingredients: germinated barley, hop, yeast and water. There is not one single substance that exceeds the toxic threshold. There are a lot of minerals and vitamins in beer. Beer is actually a fluid nutrient. Beer also contains little salt and a lot of magnesium, which is important to prevent heart diseases and gallstones and kidney stones. We could say that beer is very healthy.”
“In our lab we also do some research on the medicinal characteristics of hop. In Ancient times people already knew the sedative and sleep-inducing power of hop. Apart from that it also contains female hormones, it has an oestrogenic effect. The concentration of the female hormones is low and there is no reason to panic: men will not develop female characteristics by drinking beer. We would like to apply the oestrogenic effect of hop to treat cancer and gynaecological problems.”
“We have also started a new project where we will apply our knowledge of hop on cannabis. Hop and cannabis belong to the same family and the similarities are large. In Holland cannabis is used as a painkiller and for the treatment of multiple sclerosis, but it has many possibilities that still need to studied. We use cannabis variants that contain almost no hallucinogenic substances and therefore we do enter the danger zone.”

You just said that beer is healthy. However, we do have a hangover when we drink too much of it. How is that possible?
De Keukeleire : “You get a headache because there is too much alcohol and when you start mixing different kinds of beer. Each beer has its own composition and each substance needs to be broken down in its own way. Because beer contains little salt you will have to go to the toilet quite often. That way you will develop a dry throat and the feeling of a hangover. The effect is different from persons to person. Some people will have a hangover more easily than others. Me personally never have a hangover. Also the age can play a role. Older people complain every now and then that the beer in the earlier days was better because they suffer more nowadays. That is not completely correct. Beer has become better and more consistent throughout the years. It is their condition that has slightly deteriorated.”

Why is it that Belgium is such an important beer country?
De Keukeleire : “Belgium is mainly a beer paradise where special beers are concerned. All over the world you can find a lager beer of good quality. The expert knowledge that is required for brewing special beers has historically developed in Belgium. More than hundred years there was a brewery in every village that was owned by the mayor. Due to the political struggle between the Catholics and the liberals there was a real brewery-“boom”. If the brewer was catholic, the liberal opponent for the mayor’s post could only be successful by also starting up a brewery. Many Flemish villages had two breweries that were in fierce competition with eachother and always had new and better tastes for the consumers in order to conquer the village politically. That way the absurd situation was created that a village of merely five hundred inhabitants had ten different kinds of beer. This tradition is really unique and that way the beer culture has been able to develop itself fully.”

What is your favourite kind of beer?
De Keukeleire : “When I am really thirsty I prefer one or more cool glasses of lager. However, where taste is concerned I prefer the special beers. I like drinking tripel, especially Orval. Maybe I am a little biased when choosing Orval because it is very well hopped. I like in particular the bitter beers.”

Have you ever tried to brew beer yourself?
De Keukeleire : “No, never. We work together with the brewery school of KIHO. The nice thing about this kind of research is that you can test the results yourself, although this does not apply to everybody. I have colleagues that are interested in beer but do not like beer. I just think it is a matter of combining business with pleasure.”

Source : Schamper 366, Universiteit Gent

 

Interview with Dr. Erik Skovenborg (Denmark) about the advantages of moderate alcohol consumption

INTERVIEWS

Erik Skovenborg is a general practitioner with a particular interest in the effects of moderate alcohol consumption on health. He is also co-founder of the Scandinavian Medical Alcohol Board (SMAB). Such was the capacity in which he attended the second Beer and Health symposium, held by the The Brewers of Europe on Thursday 18 October 2001 in Brussels. Skovenborg has an encyclopaedic knowledge of the scientific literature on the effects of moderate alcohol consumption on health. He is currently conducting research into the knowledge of Danish doctors concerning the health effects of alcohol; he gives lectures on the subject. Skovenborg points out that most men and women are moderate consumers of alcohol, and that a distinction should be made between moderate consumption of beer, wine or spirituous beverages on the one hand and alcohol abuse on the other. Erik Skovenborg is also the author of the book “Wine and Health, Myths and Facts”.

What does moderate drinking mean?
Skovenborg: “Moderate drinking means, in the first instance, drinking within the limits of your own health, always taking into account your family and friends. The commonly used definition: one to two units (one unit corresponding to 12 g alcohol) per day for most women and one to three units for most men. Anyone opting for beer with a low alcohol content can drink more. It is also important to know that a whole bottle of wine is equivalent to six glasses of beer.”

Why are the recommended limits different for men and women?
Skovenborg: “Women are more sensitive than men to alcohol for different reasons. In the first place, because women are usually smaller than men. Secondly, women have relatively more fat per kilo body weight than men, which means a more rapid increase of the concentration of alcohol in the blood. Men metabolize alcohol better than women. Alcohol passes faster through womens’ livers than through mens’, so the concentration in the blood is relatively higher”

Can pregnant women drink beer?
Skovenborg: “One glass of beer a day accompanying a meal has never been found to have any negative effect n the foetus. The same can be said for the breast-feeding period: one glass of beer a day won’t hurt.”

Many older people enjoy the occasional beer. What is your view of the matter?
Skovenborg: “Beer certainly has its qualities for older persons. Moderate consumption of beer improves the appetite, aids digestion and, what is more, reduced the risk of stomach ulcers caused by the bacterium Helicobacter pylori. It has also been demonstrated that one glass of beer with the evening meal improves the atmosphere and social contacts among elderly persons living in rest homes. People who drink beer (or wine) on a regular basis also appear to be less sensitive to the development of dementia. Moderate consumption of alcohol also seems to reduce the risk of old-age diabetes”

 

Is red wine better for the health than beer?
Skovenborg: “Recent research indicates that the various health effects of beer and wine issue from other lifestyle factors. In many countries, beer drinkers appear to have less healthy living habits than wine drinkers. That explains why wine drinkers often score better than beer drinkers as regards health. The fact that people who choose red wine rather than beer appear more healthy therefore has nothing to do with their choice of this or that type of drink, but rather with other aspects of their lifestyle. The beneficial effects of moderate alcohol consumption seem mainly due to ethanol. Beer therefore has just as positive an effect as wine on heart function. Moderate beer consumption reduces the number of deaths by heart attacks and strokes by approximately a third.”

 

Can a glass of beer be used as a sedative?
Skovenborg: “Beer can safely be regarded as a natural mild tranquillizer that helps you to relax after a stressful day. A glass of beer can also be useful as a nightcap to help you to sleep. Unlike sleeping pills beer is a safe sedative, on condition that consumption remains moderate.”

Is it true that beer helps to prevent gallstones and kidney stones?
Skovenborg: “Studies have shown that a moderate beer consumption significantly reduces the risk of gallstones and kidney stones.”

Is beer fattening?
Skovenberg: “There’s no certain answer to that question at present. We may assume that drinking beer, in moderation and at meal times, does not lead to weight problems.”

Should some people not drink beer at all?
Skovenberg: “Persons with an alcohol problem, persons dependent on alcoholic drink, should avoid all forms of alcohol. Persons with stomach, liver or pancreas problems should also not drink alcohol. Also, alcohol should never be consumed in combination with potentially addictive medicine, such as tranquillizers, sleeping pills, barbiturates and narcotics.”