Most people either know someone or is that someone who has said one night, “I’ll just get one drink…” and the rest was history, vaguely recalling the empty bottles, shot glasses and the memories that ensued. Drinking is a complex activity. Most consumers know the potential effects drinking has on the mind and body, yet still go at it with ease and vigor. It’s a common way to be social, live in the moment, and maybe leave your troubles behind for a fleeting moment.
Though no medical professional would ever explicitly tout drinking, research has been emerging on the benefits of moderate alcohol consumption, especially in the cardiovascular realm. The term “moderation” is relative, but according to the Dietary Guidelines for Americans 2015-2020, moderate alcohol consumption means one drink a day for women and two drinks a day for men. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) deems one drink as 12 fluid ounces (oz) of beer, 5 fl oz of wine, and 1.5 fl oz of distilled spirits.
As the breadth of research widens on alcohol consumption, the nascent conclusion seems to manifest the age-old idea of moderation. Too much of anything, including alcohol, is bad for you (ground-breaking, I know). Studies have shown that heavy drinking (which according to the NIAAA means five or more alcoholic drinks for males or four or more alcoholic drinks for females in the same day/night on at least one day in the past month) can increase risk of high blood pressure, alcoholic hepatitis, cirrhosis, heart muscle damage and certain cancers (including mouth, pharynx, larynx, esophagus, breast, colon and rectum). It may also cause atrial fibrillation, a cardiovascular condition that is marked by an irregular and often rapid heart beat that can cause poor blood flow and increase risk for strokes.
While the layman can guess the potentially detrimental effects of (heavy) drinking, they may not know that moderate alcohol consumption may actually decrease risk of heart disease, diabetes mellitus (DM) and ischemic strokes. A meta-analysis conducted by Harvard University looked at over 100 prospective studies, which showed an inverse association between moderate drinking and risk of heart attack, ischemic stroke, peripheral vascular disease (PVD), sudden cardiac death and overall death from cardiovascular disease (CVD). How can this be? The key player in alcoholic beverages is ethanol, which in moderate amounts may raise high-density lipoprotein (HDL) levels, aka “good cholesterol.” Higher levels of HDL are associated with greater protection against heart disease.
In another systematic review and meta-analysis conducted by Ronksley et al. (2011), alcohol consumption levels between >1 drink/day to about 5 drinks/day were cardioprotective for both cardiovascular and coronary heart disease (CHD) mortality. Also, in regard to strokes, they found a decrease or no effect on risk for stroke and stroke mortality, respectively, at > 1 drink/day and 1-2 drinks/day, and almost no overall associations of alcohol consumption with levels between 2-3 drinks/day and about 5 drinks/day. For heavier drinkers (<5 drinks/day) the risk for stroke was greater compared with those who didn’t drink, and the risk for stroke mortality was about one-and-a-half times greater. A sub-analysis of stroke subtypes revealed that when pooling the risk among current alcohol drinkers compared with nondrinkers, the risk was actually higher for incident hemorrhagic stroke than for ischemic stroke.
The Nurses’ Health Study is a series of prospective studies conducted on female nurses to examine how their lifestyle affected their health. The study examined the effects of smoking, diet, oral contraceptives and alcohol consumption on risk of developing certain cancers, CHD, hip fractures, eye disease and cognitive functioning. The study found that moderate alcohol consumption reduces risk of CHD and ischemic stroke.
The National Institute of Health (NIH) is starting a $100 million clinical trial to test whether an alcoholic drink a day can really prevent heart attacks. The study will comprise about 8,000 volunteers from all over the globe, age 50 and up with CVD or at high risk for it. Participants will be randomly assigned to either quit drinking altogether or consume 1 drink per day. Participants will be followed for about 6 years to see which cohort, either the drinkers or abstainers, will experience more heart attacks and strokes. While this study can be potentially revolutionary, there are several caveats about this study. The fact that five of the world’s largest alcoholic beverage manufacturers, Anheuser-Busch InBev, Heineken, Diageo, Pernod Ricard and Carlsberg, have pledged $67.7 million to the study can be a red flag. In a perfect world, researchers and their results would be 100 percent objective and wiped clean of corruption and fraud. However, in the real world, results can be potentially skewed in these companies’ favor, so take the results with a grain of result. Also, if results do show cardioprotective benefits of alcohol, people may misinterpret that as, “alcohol is good for you,” and start drinking more.
It’s also important to note the pattern of drinking in terms of potential benefits. There may be misinterpretation on a potential recommendation of 1-2 alcoholic drinks/day. One may assume that they can still reap the health benefits by drinking more alcohol less frequently (for example, in 1-2 days), assuming that this amount will average out to 1-2 drinks/day. Binge drinking has its own risks and dangers—potential cardiovascular benefits have no place in it. Benefits can only arise from 1-2 drinks/day!
At the end of the day, research is not 100 percent conclusive and definitive. A study does not have the power to provide a blanket statement about anything, including and especially about alcohol. One has to make an educated decision based on the facts and research given to him. Alcohol consumption may have health benefits, but it can also cause harm to its consumer and those around him if and when consumed in excess. A person’s chronic morbidities (including DM, chronic kidney disease, heart disease) have to be taken into consideration when drinking alcohol as well. While there may be potential CVD benefits to drinking alcohol in moderation, the consumer should not drink for the sole purpose of lowering their blood pressure and risk for stroke (though it may be an added bonus)!
By Melissa Papir Kolb
