Your How To Source: Issues of Value, Ethics, Human Needs and Deeds Edited by Heinz Dinter, PhD
Light drinking could help you live longer (2006-09-14)
By now, it’s part of the national consciousness: Drinking, in moderation, is good for you. Still, as with all things scientific, it’s far more complicated than that. And there’s hardly a doctor in the country who will advise a teetotaling patient to start tippling.
Dozens of questions remain: Who should drink, who shouldn’t? Is wine better than beer or liquor? Red wine better than white? Grape-extract pills? Grape juice? Grape jelly?
But a broad consensus has evolved: “People who drink light to moderate amounts of alcohol have the lowest mortality — even lower than nondrinkers,” says Dr. J. Michael Gaziano, a cardiologist and epidemiologist at the Veterans Administration Hospital and Brigham and Women’s Hospital in Boston.
Yet he adds: “I don’t advocate that people drink. I say if you drink, be light to moderate. If you don’t, it’s your choice.”
Alcohol’s health effects are well documented. In 2003, researchers at the National Institute on Alcohol Abuse and Alcoholism surveyed 217 scientific studies done over 30 years, and came to these positive — and negative — conclusions:
· Light to moderate drinking prevents 80,000 deaths a year in the United States from coronary heart disease, the illness that accounts for 45 percent of all deaths among men over 35 and 37 percent of all deaths among women that age.
· Heavy drinking causes 100,000 deaths a year in the United States including 16,000 traffic fatalities plus injuries, violence, suicide, poisoning, cirrhosis and some cancers. In women it increases the risk of breast cancer. In pregnant women, heavy drinking can contribute to “fetal alcohol syndrome” — babies stillborn, with physical malformation, cognitive deficits.
· How much drinking is good varies by age, gender, genetic susceptibility, metabolic rate, co-morbid conditions, lifestyle factors and patterns of consumption. The new USDA Dietary Pyramid says one drink a day for women, two for men. Other studies say one to two for women, two to three for men. Drink sizes vary, too; the USDA says one drink is 1.5 ounces of liquor, 12 ounces of beer or five ounces of wine.
· Alcohol fights heart disease by increasing high-density lipoprotein, the “good” cholesterol and decreasing low-density lipoprotein, the “bad” cholesterol. It reduces blood clotting and platelet aggregation. Relaxes blood vessels. Lowers the risk of Type II diabetes by decreasing insulin resistance. It may reduce the risk of vascular dementia, maybe not of Alzheimer’s dementia or macular degeneration.
Taken together, the studies form the well-known “J-Curve” of alcohol’s effects. The risk of mortality from all causes starts at one point on a graph for those who never drink, dips sharply for moderate drinkers, then soars even more sharply for heavy drinkers, forming the letter “J.”
Studies had hinted at this since the 1970s and earlier. But the first big news break about the benefits of alcohol hit the United States like a bomb in November 1991, when 33.7 million Americans learned about “The French Paradox” from the avuncular Morley Safer on CBS’s 60 Minutes.
The paradox: The French ate four times as much butter, twice as much cheese as Americans — but only 142 in 100,000 French men died annually from heart disease, compared with 315 in 100,000 Americans.
“Obviously, they’re doing something right — something Americans are not doing,” said Safer, a longtime wine aficionado. “Now it’s all but confirmed: Alcohol — in particular red wine — reduces the risk of heart disease.”
Americans believed their Uncle Morley, increasing red wine consumption by 42 percent the following year. And while red wine made up only 17 percent of U.S. wine consumption in 1990, it had surpassed white wine by 2004.
The idea that red wine is better than alcohol in general also came from France, where heart disease in the South, around Toulouse, where most people drink red wine, was lower than in the North, around Strasbourg, where they favored the apple brandy called calvados.
Why would red wine be better? A review of 30 years of studies by vascular surgeons from the Yale University School of Medicine, printed in 2005 in the Journal of the American College of Surgeons, looked into that.
It concluded that red wine has a variety of polyphenolic substances derived from the grapeskins and seeds — one a flavenoid called quercitin, another a nonflavenoid called resveratrol — that have powerful anti-oxidant qualities. White wine has little of either. And red wine was better than red grapes, grape juice and such because the substances are brought out by fermentation.
Animal trials backed it up: Scientists at the University of Cologne in 1998 fed Chateauneuf du Pape, a red wine, to some rats and Riesling, a white wine, to others. They found the big Rhne red did more to relax the rats’ aortas.
Gaziano isn’t convinced: “I think the totality of evidence is that at least part of the benefits of light to moderate drinking are due to the alcohol itself. My study said there is not a preferred kind of alcoholic beverage that is better than others. Drinkers of beer, wine or spirits get the same effect.”
The NIAAA survey took Gaziano’s caveat a big step further: “While there is an association between moderate drinking and lower coronary heart disease risk, science has not confirmed that alcohol itself causes the lower risk. It also is plausible that the lower risk might result from some as-yet-unidentified factor or surrogate associated both with alcohol use and lower coronary heart disease risk, such as lifestyle, diet and exercise or additives to alcoholic beverages.”
The dietary angle was explored in The British Medical Journal by researchers who conducted a grocery-buying survey and concluded that customers who bought wine also bought more olives, fruit and vegetables, while those who bought beer bought more cold cuts, sugar, chips and pork.
And wine-drinkers exercised more and smoked less than non-drinkers.
Ironically, when Safer was touting the French Paradox, the French were staging a major crackdown on drinking with 1991’s “Loi Evin.” The law banned alcohol ads from TV and at national sporting events, prohibited the use of “beautiful people” in beer, wine or liquor ads and lowered the blood-alcohol level for drivers to 0.5 grams per liter — compared to 0.8 in most parts of the United States.
Said Dominique Gillot, France’s secretary of state for health: “There is no scientific consensus today over the protective effect of alcohol.”
Gaziano says the existence of so many seemingly conflicting studies and viewpoints does not justify simply throwing up one’s hands and doing what feels good.
“There have been hundreds of studies,” he says. “If you look at them all together, I think it’s clear that light to moderate drinkers have a lower risk.”
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