A great deal of popular media coverage over the past decade has given rise to a common conception that alcohol, when consumed in moderation, conveys certain health benefits, especially for the heart and cardiovascular system. This idea is not new, and was first introduced to the medical literature hundreds of years ago by a doctor who noticed that French people suffered chest pain less often than Irish people and speculated that this may be because of French habits and mode of living. 1
Does the Type of Alcohol Matter?:
Consistent with this centuries old French Connection, modern interest in the possible health benefits of alcohol always seems to come back specifically to red wine. While this preoccupation with wine was initially fueled by some original research 2 , later studies have found that the vehicle (wine vs. beer vs. spirits) does not matter. 3 Rather, the health benefits of moderate alcohol consumption seem to be independent of type of drink consumed.
A large problem in the research done on alcohol is that no universal definition exists for what constitutes moderate alcohol consumption. The term moderate has been interpreted to mean anything from less than one drink per day up to three or four drinks per day. In a general sense, moderate drinking can be defined as the point where any potential health benefits are stronger than any potential negative effects.
Recently, the Dietary Guidelines for Americans has defined moderate drinking as no more than one to two drinks per day for the average male, and no more than one drink per day for the average female.
Literally hundreds of research studies have demonstrated a relationship between moderate alcohol consumption and lowered risk of cardiovascular diseases such as
- clot related stroke
- vascular disease
- death from all cardiovascular causes4
Many of these benefits are likely due to
- Increased HDL (good cholesterol), which protects against cardiovascular disease5
- Effects on the clotting system, which prevent the formation of small clots that are the cause of many heart attacks and strokes6
Possible Negative Effects:
The flip side to this situation is that alcohol is also strongly associated with several negative outcomes. These include
- Potential for dependence
- Potential for abuse
- Increased risk of breast cancer in women7
- Possible interference with the absorption and utilization of certain vitamins and minerals
Changing Risk Profiles:
Because risks for certain diseases and events change with age, life situation, and other factors, it is difficult to flatly declare that moderate alcohol consumption is healthy. For example, while a 60 year old man likely does derive significant cardiac benefit from moderate alcohol consumption, the same is not true for a 30 year old man. This is because the 30 year old man is much less likely, overall, to suffer from cardiac ailments, but is much more likely to be involved in an alcohol related accident. In general, then, a single overlying guideline regarding the moderate consumption of alcohol cannot be given.
The real bottom line is that there is no reason to start drinking alcohol if you dont right now. None of the health benefits are unique to the consumption of alcohol. The same changes in HDL levels and clotting profiles can be obtained from regular exercise, a good diet, and overall healthy living patterns.
2 St Leger AS, Cochrane AL, Moore F. Factors associated with cardiac mortality in developed countries with particular reference to the consumption of wine. Lancet 1979; 1:1017-20.
3 Rimm EB, Klatsky A, Grobbee D, Stampfer MJ. Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits. BMJ 1996; 312:731-6.
4 Goldberg IJ, Mosca L, Piano MR, Fisher EA. AHA Science Advisory: Wine and your heart: a science advisory for healthcare professionals from the Nutrition Committee, Council on Epidemiology and Prevention, and Council on Cardiovascular Nursing of the American Heart Association. Circulation 2001; 103:472-5
5 Ajani UA, Hennekens CH, Spelsberg A, Manson JE. Alcohol consumption and risk of type 2 diabetes mellitus among US male physicians. Arch Intern Med 2000; 160:1025-30.
6 Camargo CA, Jr., Stampfer MJ, Glynn RJ, et al. Moderate alcohol consumption and risk for angina pectoris or myocardial infarction in U.S. male physicians. Ann Intern Med 1997; 126:372-5.
7 Chen WY, Colditz GA, Rosner B, et al. Use of postmenopausal hormones, alcohol, and risk for invasive breast cancer. Ann Intern Med 2002; 137:798-804.