Alcohol: Friend or Foe?
People tend to have strong feelings and beliefs about alcohol and for good reason. Muslims, Mormons, and certain Christian churches forbid it. Buddhists disapprove of it. Other religions incorporate alcohol into rituals and take a more permissive line.
It seems that almost every day, new information is released about the dangers and/or benefits of drinking alcohol. A few years ago, a widely publicized study in the New England Journal of Medicine led a lot of drinkers to congratulate themselves, and a lot of non-drinkers to wonder if they should start. “Drinking is good for your heart,” the newspaper headlines announced, “and the more you drink, the better.”
This was a well-designed study funded by the US National Institutes of Health. It tracked the drinking habits of 38,000 men all healthy at the beginning of the study over 12 years. Men who drank at least three or four days a week had fewer heart attacks than those who drank less. It didn’t matter what they drank beer, wine, or spirits or whether they drank it with meals. The positive news didn’t end there. From the point of view of preventing heart attacks, drinking every day was better than drinking occasionally, and three drinks were better than one. So, should you say hooray and head for the nearest liquor store?
We don’t think so. Whether, when, and how much you should drink is a complex question, and the answer should be based on your current state of health, medical history, age, sex, and other factors. If ever there was a double-edged sword, it’s alcohol. It benefits people (and society) in some ways and devastates them in others. In the US, for instance, it is associated with 90,000 deaths a year but it also helps prevent thousands of deaths from heart disease later in life.
Before you embrace alcohol as heart medicine, here are some Q’s and A’s to consider.
Does alcohol protect the heart? If so, how?
Dozens of studies found that light or moderate drinkers have a lower risk of heart disease – 30 to 50 percent lower – than non-drinkers. There is hardly any argument about this now. Furthermore, researchers have found that even when moderate drinkers do have a heart attack, they have a lower risk of dying than teetotalers or heavy drinkers, and older people who live moderately have a lower risk of heart failure.
Alcohol raises blood levels of HDL (“good”) cholesterol which removes cholesterol from the blood stream and thus helps prevent hardening of the arteries (atherosclerosis). Alcohol also reduces the stickiness of platelets in the blood and thus helps prevent the blood clots that cause heart attacks. Consequently, some people compare alcohol to aspirin as a way to prevent clot formation or break up clots. And yes, both can be helpful, if taken in small doses. But unlike aspirin, alcohol is intoxicating and potentially addictive. The point is that alcohol is only one of several things that may protect your heart. You can reduce your risk of heart disease without drinking at all.
What other health benefits, if any, does alcohol have?
Even as little as one drink a week may protect against stroke (the most common type). Some research also suggests that moderate drinking may cut the risk of developing dementia, including Alzheimer’s disease, according to a new study from the University of Valencia in Spain. Alcohol drinkers had a 47-percent lower risk than abstainers, independent of genetic risk factors from Alzheimer’s with the most protection seen in women who drank lightly to moderately and in people who never smoked. This was true for all types of alcohol beer, wine, and liquor.
A study published on February 25, 2009 in the American Journal of Clinical Nutrition suggests that drinking alcohol may increase bone strength. In this study, researchers found that men who drank a glass or two of wine or beer daily had denser bones than non-drinkers, but those who drank two or more servings of hard liquor a day had significantly lower bone mineral density (BMD). The women who drank more than two glasses a day of alcohol or wine had greater BMD than the women who drank less.
The findings in men may have to do with beer’s silicon content. Silicon is a mineral that helps promote bone-building. Hard liquor is distilled, and therefore, many of the natural substances have been removed. Lastly, researchers noted that drinking alcohol boost estrogen levels, which may explain why it has been linked to better bone health but also an increased risk of breast cancer in women.
Is wine a better choice than beer or spirits?
It’s almost certainly the alcohol that’s protective, so it doesn’t matter much which beverage you drink. It’s true that wine (red or white) contains certain phytochemicals that may protect against heart disease or even cancer. Beer and spirits, made from grains and other plants, have phytochemicals of their own. Wine may simply seem healthier because wine drinkers tend to be better educated and more prosperous than other drinkers, which means they tend to have better diets and better healthcare.
What is “moderation”?
This is a tricky question, and it varies according to your age and sex. The official definition of a “drink” is 12 ounces of beer, five ounces of wine and one and a half ounce of 80-proof spirits.
Most people are surprised to learn that these all contain approximately the same amount of pure alcohol, about half an ounce (a little more in the spirits).
Why are the guidelines different for men and women? Is it the same for older people?
Alcohol affects men and women differently. A woman will get more intoxicated than a man from the same amount of alcohol. Women tend to be smaller, with a lower percentage of water and a higher percentage of body fat. Since alcohol is distributed through body water and is more soluble in water than in fat, blood alcohol concentrates (BACs) in women tend to be higher. In addition, the stomach enzyme that breaks down alcohol before it reaches the bloodstream is less active in women. Alcohol also carries additional health risks for women, since heavy drinking boosts the risk of osteoporosis. Women are also more prone to suffer liver damage from heavy drinking.
The definition of “moderate drinking” changes as you get older. Most experts think that after 65, moderation means only one drink a day for a man and half a drink for a woman. That’s because your body doesn’t process alcohol as well as you age, so you end up with a higher BAC than a younger person would.
What are the other health risks of heavy drinking?
Heavy drinking increases the risk of liver disease, damage to the brain and pancreas, and hemorrhagic stroke. It can damage heart muscle. It increases the risk of falls, injuries, car crashes (often involving pedestrians who have been drinking), workplace injuries, firearm injuries, homicides, and suicides. It contributes to domestic violence and child abuse. It has also been cited as a risk factor for cancers of the liver, rectum, upper respiratory and gastrointestinal systems besides the concern about breast cancer.
What medications can interact with alcohol?
These would include antidepressants, barbiturates, aspirin, acetaminophen, diabetes medications, drugs for gout, blood thinners, narcotics, antihistamines, NSAIDs, high blood pressure medications, drugs for ulcers, and drugs for heart failure.
Who should steer clear of alcohol?
• Anyone who is unable to drink moderately. This includes recovering alcoholics and probably those with a strong family history of alcoholism.
• Anyone taking sedatives, sleeping pills, antidepressants, or anticonvulsants should get medical advice about whether these drugs can be safely combined with alcohol.
• Don’t drink if you are planning to drive or operate machinery within the next few hours. If you had a drink, don’t get behind the wheel.
• Don’t drink if you have uncontrolled hypertension, high blood levels of triglycerides, abnormal heart rhythms, peptic ulcers, or sleep apnea. If diagnosed with any disorder, talk with your doctor about the advisability of drinking.
The bottom line
For many people, drinking alcohol is part of social, business, and family life, an enjoyable and traditional accompaniment to food and celebrations. While doctors have long recognized the harm of too much alcohol, it has been used medically for centuries. It was once the only antiseptic and anesthetic in the surgeon’s kit!
To drink or not to drink is a personal decision. At the very least, alcoholic beverages cost money and add calories to the diet. More seriously, alcohol can cause accidents, family conflicts, and medical problems. Yet, it cannot be denied that moderate alcohol intake also provides health benefits. The emphasis is on the word “moderate”!
Reyes, T. (2011, August 16). Alcohol:Friend or Foe?. The Philippine Star. P.D1-D2. Retrieved from http://www.philstar.com/health-and-family/716753/alcohol-friend-or-foe