During the past 25 years, she has been a practicing part-time physician of Emergency Medicine in San Francisco. In addition, she is the founder of the Catena Institute of Wine, which is dedicated to preserving Malbec and elevating Argentine wine.
Throughout her career, Catena has received numerous distinctions, including the 2022 Woman of the Year Award, presented by The Drinks Business magazine. In March 2023, she was named Old Vine Hero by the Old Vine Conference and received the Meininger Outstanding Achievement Award.
JM: You are a medical doctor by training and a winemaker by passion and family history. Fundamentally, do you see any conflict between your two chosen professions?
LC: Yes, for sure. When I started my clinical rotations as a doctor, I saw many patients suffering from alcohol use disorders. I asked my father: “papá, does it not worry you to make a product that can cause harm?” He answered: “Laurita, you have nothing to worry about because we make fine wine, and there are no fine wine alcoholics.”
Of course, this is not 100% true, but it is rarer for fine wine drinkers to drink in excess because the culture of wine goes side to side with the culture of moderation and eating with meals.
All of us working with alcoholic products (which in moderation and groups at risk of cardiovascular disease have even been correlated with a reduction in cardiovascular problems) must know what moderation means. We must drink responsibly and take a few days off any alcoholic drink every week.
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JM: The World Health Organization has called alcohol “a toxic, psychoactive, and dependence-producing substance.” It has also proposed that “there is no safe level of alcohol consumption” and that “currently available evidence cannot indicate the existence of a threshold at which the carcinogenic effects of alcohol ‘switch on’ and start to manifest in the human body.” As a doctor, how do you view the WHO’s position? What advice would you advise your patients about consuming alcohol?
LC: Part of the difficulty with answering this question stems from the fact that not a single government has ever authorized a randomized controlled study of alcohol and health
The only data that exists (actually hundreds of studies) is observational. They clearly show a correlation between limited alcohol consumption and better cardiovascular health (in the over-50 age group that is susceptible) and increases in certain cancers (oral and esophageal, which are rare, and breast cancer, which is not rare).
For the over-50 age group, mortality from cardiovascular disease causes is higher than from these cancers, so I think it should be up to every individual to make their risk decision.
On the other hand, I agree that if someone has tried to reduce their drinking to the recommended guidelines (no more than two glasses per day for men, no more than one glass per day for women) and is unable to do so, as a doctor, I would have to recommend that they stop drinking alcohol.
At over-moderation levels, the risk of cardiovascular diseases and cancer is increased for alcohol drinkers. And if they don’t think they can stop drinking, I recommend reducing their intake, making the adverse effects less harmful. It is essential not to be judgmental of people. One must give all this advice with empathy and care.
A recent study out of Harvard by Dr. Ahmed Tawakol shows a reduction in the amygdala (the fight or flight location in the brain) activity for people who drink lightly (even when they are not drinking). This effect might explain why people who drink in moderation report that drinking makes them enjoy life more and why light drinking reduces cardiovascular risk. It is up to each individual to make their decision. So as a doctor, if someone drinks in moderation, and it makes them happy and improves their lifestyle, I would not tell them to stop drinking.
JM: Various studies have suggested that low to moderate consumption of alcohol can benefit human health. The most famous and most frequently cited study was an epidemiological study in France from the 1980s, popularly called the French Paradox, that found that notwithstanding high levels of dietary fat in the French diet, the incidence of heart disease in France was significantly less than in other developed countries.
Many of these findings are being dismissed by various health agencies as flawed. Do you think these studies were flawed, or are organizations like the WHO ignoring scientific evidence that doesn’t fit their preferred narrative?
LC: Because these studies are not randomized controlled, they are, in a sense, flawed. But it is rare for a pattern that makes sense biochemically (alcohol increases the good cholesterol HDL and is a blood thinner like aspirin) to be seen in hundreds of studies and not to mean something. Besides, the WHO is using these same supposedly flawed studies to reach cancer risk conclusions, and this doesn’t make any sense.
JM: Based on the WHO’s guidelines, several countries, most notably Ireland and Canada, have either implemented or have considered imposing stringent guidelines on the consumption of alcohol, bans on the advertising of any alcoholic beverage, and sharply increasing the excise taxes levied on those beverages. Is the WHO pushing its members to a de facto implementation of Prohibition 2.0?
LC: Countries should invest in education about what moderation means and how to drink in moderation. There are many tools available to do this: drinking from half bottles, marking your glass with a 3-ounce and 5-ounce line, only drinking with friends, putting alcohol in a hard-to-access location after you’ve had your daily allocation – in summary, the same things we do when we are trying to eat less chips and cookies.
Also, there should be more robust training on fostering moderation within the wine and spirits industry (I am currently working to help develop a program). We must also work on overall health: obesity, processed foods, charcuteries, etc. For example, meat consumption can increase cancer risk, while eating fruits and vegetables can decrease it. We need to improve education about food and diet.
JM: Critics of alcohol consumption have tried to draw a parallel between cigarettes and alcohol. A recent study in the UK published in the journal BMC Public Health postulated that consuming a bottle of wine per week was the equivalent of smoking ten cigarettes a week for men and five cigarettes a week for women. Do you think this is a valid comparison?
Does it make sense to look at alcohol consumption through the same paradigm we look at smoking cigarettes, or is this just a way of justifying imposing the same level of regulations and taxation on alcohol currently imposed on cigarettes?
