According to the experts at the U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS) — the authors of the Dietary Guidelines for Americans 2005 — people who drink in moderation have the lowest all-cause mortality (science speak for d-e-a-t-h from all causes).
The guidelines define moderation as one drink a day for a woman and two drinks a day for a man. One drink is equal to 1.5 ounces of 80 proof spirits, or 5 ounces of wine, or 12 ounces of regular (as opposed to low-cal) beer.
Government stats, in the U.S. and around the world, show that people who stick to these guidelines not only live longer, but they also live healthier than people who either drink too much or avoid alcohol altogether. Those in the Moderate Middle have fewer heart attacks and strokes. They’re less likely to suffer from high blood pressure, Alzheimer’s disease, diabetes, rheumatoid arthritis, broken or weakened bones, Parkinson’s disease, hepatitis A, pancreatic cancer, macular degeneration (a major cause of blindness), duodenal ulcer, erectile dysfunction, hearing loss, gallstones, liver disease, and — believe it or not — the common cold.
In addition, just feeling good may not be up there with avoiding a heart attack or broken bones, but it’s nothing to sneeze at either. One drink before or with a meal may improve digestion or offer a soothing respite at the end of a stressful day, and the occasional drink with friends can be a social pleasure. In other words, the physical and psychological effects of moderate drinking are components of a comfortable life.
Best of all, unlike some of life’s other pleasures, the health benefits of moderate drinking actually seem to get more beneficial as a person gets older. The British Medical Journal reports that among men younger than 35 and women younger than 55, nondrinkers have a lower risk of death than do moderate drinkers. But hit the magic 65, and things change. Among senior citizens, moderate drinking may save as many as 5,000 older lives a year, perhaps because older drinkers have learned to avoid the risky behavior that trips younger drinkers into potentially fatal accidents.
And remember: When one drinker toasts another with the words, “To your health,” he or she is right on the mark.
Heartening News
The evidence that moderate drinking benefits the heart comes from reliable studies funded and/or run by reliable organizations like the American Cancer Society (ACS) and the American Heart Association (AHA).
The best known study may be the ACS Cancer Prevention Study 1, a research project that followed more than one million Americans in 25 states for 12 years. Analyzing the lifestyles of 276,802 middleaged men and the circumstances of those who died during the study period, the researchers concluded that moderate alcohol intake had an “apparent protective effect on coronary heart disease.” Translation: Men who drink moderately lower their risk of heart attack. The risk is 21 percent lower for men who have one drink a day than for men who never drink.
A similar analysis of the data for nearly 600,000 women in the same study showed that, like men, women who drink occasionally or have one drink a day are less likely to die of heart attack than women who don’t drink at all.
The two most likely explanations for these facts are alcohol’s ability to make blood less sticky, reducing the risk of an artery-clogging blood clot, and its tendency to raise the level of HDL, the “good” fat and protein particles that ferry cholesterol out of the body.
Lowering Bad Cholesterol, Raising Good Cholesterol
Moderate amounts of any type of beverage alcohol lower blood levels of low density lipoproteins (LDL), the “bad” fat and protein particles that carry cholesterol into arteries, while raising the blood levels of high-density lipoproteins (HDL), the “good” fat and protein particles that ferry cholesterol out of the body.
To counter the idea that wine is the only alcohol beverage that accomplishes this phenomenon, researchers at Hebrew University Hadassah Medical School in Jerusalem divided 48 men with coronary artery disease in two groups. The first got 12 ounces of Pale Lager a day for a month; the second got mineral water. Both groups ate a fruit-and-veggie-rich diet.
The results, released in 2003, showed that 21 of the 24 beer drinkers had lowered their bad cholesterol, raised their good cholesterol, and reduced the activity of fibrinogen, a natural clotmaker in blood. None of these changes occurred among those drinking mineral water, but, on the other hand, nobody in either group had a heart attack during the study.
Busting Blood Clots
Cut yourself and you’ll bleed, but soon tiny particles in blood, called platelets, glom onto a sticky net made of a naturally occurring substance, called fibrinogen, to form a scab. This series of events, most visible when skin is cut, also occurs when the inside surface of a blood vessel is injured, perhaps by a passing piece of cholesterol.
Forming a scab over a cut on the skin is good. Building a scab over an injury inside a blood vessel isn’t. Inside an artery, the “scab” can catch more particles that stick on, eventually creating a pile of gunk that may be large enough to block the artery and cause a heart attack.
Alcohol beverages reduce the risk of forming that pile of gunk by temporarily lessening the stickiness of fibrinogen and other naturally occurring clotting factors that normally make platelets stick together.
As a result, blood clots are less likely to form in an artery, another reason why moderate drinking appears to protect the heart.
Lowering the Pressure
When the alcohol from a (moderate) drink flows through the bloodstream into the heart, the heart muscles relax, reducing the force of their contractions (or beats). As a result, your heart pumps out slightly less blood for a few minutes, blood vessels all over your body relax, and your blood pressure goes down.
The contractions of your heart muscle soon return to normal, but your blood vessels may remain relaxed and your blood pressure may stay lower for as long as half an hour. How important is this lowered blood pressure?
In 2002, researchers at the Nurses’ Health Study issued a new report on 70,891 women who had been 25 to 42 years old when the study began in 1989. According to this report, women in the study who took one quarter to one half of a drink a day — in real life, two or three drinks a week — were 15 percent less likely to develop high blood pressure than were women who never drink. The results applied to all kinds of alcohol — that is, beer, wine, and spirits.
The inevitable bad news — sorry about this — is that women who take more than 10 drinks a week are 30 percent more likely to have high blood pressure. Once again, moderation is the key.
Staving Off Stroke
In 2006, scientists at Johns Hopkins University in Maryland fed laboratory mice a moderate dose of resveratrol, a naturally occurring compound in red grape skins and seeds. Then they induced stroke in the mice and found that animals given the resveratrol experienced about 40 percent less brain damage than mice that weren’t treated with resveratrol before a stroke.
The suspicion is that resveratrol increases levels of heme oxygenase, an enzyme in the brain that protects nerve cells. Naturally, more studies are required before anyone can say that drinking red wine prevents stroke damage, but, hey, it’s a start.
Beer and distilled spirits have no resveratrol, so right now this particular good news may (or may not) apply only to red wine. But an any-type-of-alcohol-plus-caffeine cocktail may prevent additional brain damage after a stroke strikes.
In 2004, neurologist James C. Grotta and a team of researchers at the University of Texas-Houston Medical School whipped up an experimental drug they named caffeinol. They designed one dose to deliver as much caffeine as two cups of strong coffee plus the alcohol in one drink of any type of alcohol.
The Texans induced stroke in laboratory rats and gave caffeinol to half the injured rats within two hours of the stroke. The treated animals had up to 80 percent less brain damage than the untreated ones. Human tests say caffeinol is safe; future studies will tell whether it’s effective. If so, look for Irish coffee on the menu in every ER. Just kidding.
Deterring Diabetes
In 2002, the Journal of the American Medical Association reported the results of a study at the U.S. Department of Agriculture’s Agricultural Research Service (ARS) Lab in Beltsville, Maryland, designed to evaluate the effects of moderate drinking alcohol on insulin resistance, a risk factor for both diabetes and heart disease.
The scientists randomly assigned 53 healthy, post-menopausal, women volunteers to one of three once-a-day drink plans: Plain orange juice or orange juice with half an ounce of alcohol (the equivalent of one standard drink), or orange juice with one ounce of alcohol (the equivalent of two standard drinks).
Yes, the Dietary Guidelines for Americans say that one standard drink is 1.5 ounces of distilled spirits, 5 ounces of wine, or 12 ounces of beer. But the actual amount of pure alcohol in that amount of beer, wine, or spirits is 0.5 ounces of alcohol. Remember: When spirits are distilled, and when wine and beer are fermented and bottled, the alcohol is diluted with water.
The 51 women who completed the study took blood tests to measure their fasting insulin levels (the level of insulin in the blood after 12 hours without food or drink).
Among women who drank orange juice with one ounce of alcohol each day, fasting insulin levels went down 19 percent versus no change for those drinking less alcohol or none at all. Levels of triglycerides, a form of fat found in blood that’s a risk factor for both heart disease and diabetes, also fell among the women who drank either one half or one ounce of alcohol a day.
Protecting Intelligence
MRI (magnetic resonance imaging) studies of the brain have clearly shown that even moderate drinking knocks off some brain cells. The surprise is that this loss may not correlate with a loss of intellect.
Typically, a human being’s score on tests for memory, reasoning, and decision-making declines about one point per decade before age 60 and two to three points every ten years after that.
But data from a 12-year, 1,488-person survey at Johns Hopkins University in Maryland strongly suggests that moderate drinkers score better than teetotalers over time on the Mini-Mental State Examination (MMSE), a standard test of intelligence and cognition. (In addition, a recent study among French senior citizens pinpointed a 75 percent lower risk for Alzheimer’s disease and an 80 percent lower risk for senile dementia among moderate drinkers versus teetotalers. Vive la France.)
What makes this news fascinating is that MRI studies showing alcohol-related brain shrinkage and the new alcohol-and-intelligence survey were both done at Johns Hopkins.
Talk about your left hand (or brain) not knowing what your right hand (or brain) is doing.
Preserving the Brain
Can it be? Yes, it can. According to Monique M.B. Breteler and her colleagues at the Erasmus Medical Centre in Rotterdam, the Netherlands, people who drink moderately as they grow older are less likely than abstainers or heavy drinkers to develop Alzheimer’s and other forms of dementia, including dementia triggered by repeated small blood-clot-related strokes.
To reach that conclusion, from 1990 to 1999, the Dutch team collected data for 5,395 healthy people age 55 and older with no signs of dementia. After adjusting the data to account for gender, age, weight, blood pressure, smoking, and all the other nasty factors that affect the risk of dementia, the researchers discovered that the people in the survey who took one to three drinks a day of any kind of beverage alcohol were only half as likely as those who drank more (or less) to develop dementia.
Anyone here know how to say “to your health” in Dutch?
Boosting Bones
Alcohol abuse is linked to an increased risk of fractures, not simply to an intoxicated person’s higher risk of falling, but also to a documented alcohol-related loss of bone density (the concentration of minerals such as calcium in bones), particularly in postmenopausal women, a group at high risk of weakened bones.
But moderate drinkers don’t have the same problem. When researchers at the Bone Metabolism Unit and the Cardiac Center of Creighton University School of Medicine in Omaha, Nebraska, measured bone density among 445 women ages 65 to 77, they found that the women who drank moderately (about an ounce a day) had higher total bone density, higher spinal bone density, and higher forearm bone density than the women who drank more or less or none at all.
How come? The body destroys old bone and builds new bone every day. With age, the body continues to break down old bone at the same rate but builds new bone more slowly. Hence, the characteristic loss of bone called age-related osteoporosis.
The Creighton researchers suggest that alcohol may lower the concentration of anti-bone hormones, thus preserving existing bone. Worth another study, doncha think?
Enhancing Appetite
Appetite is the desire for food, a psychological reaction (looks good! smells good!) that stimulates hunger pangs, the involuntary contractions triggered by the secretion of gastric acids in an empty stomach that say, “Time to eat.” In America, as any casual observer of bulging bodies knows, most people have no trouble shoveling in the food even in the absence of hunger pangs.
But for those whose weight is under control, a moderate drink before dinner can enhance the pleasure of dining. In addition, appetite declines with age so that older people often eat less than they should, raising the possibility of malnutrition. Luckily, several studies in nursing homes and hospitals have suggested that a moderate amount of alcohol at dinnertime may benefit healthy seniors who aren’t physically or mentally impaired or taking any medication that can interact with the alcohol.
Controlling Weight
Yes, a balanced diet is important. But so is balanced consumption of beverage alcohol.
The figure comes from researchers at Texas Tech University Health Sciences Center and the Mayo Clinic. Based on a detailed analysis of the drinking habits and body mass index (BMI) for 8,236 nonsmokers, they concluded that moderate drinkers (up to five drinks per week) are 46 percent less likely than either abstainers or alcohol abusers to end up obese.
Their final word, in their report in BMC Public Health, an online medical journal that publishes original peer-reviewed research articles, is this: “The evidence reported here argues against a strategy of promoting complete abstention at least among those who regularly consume alcohol.”
People who don’t already drink shouldn’t start drinking to control their weight. But you know that.
Countering the Common Cold
Sometimes you have to wonder whether researchers really have enough to do. With all the health problems humans face, did they actually need to study the relationship between beverage alcohol and the common cold?
Heck, why not.
Seeking to test the idea that smoking and/or drinking makes a person more susceptible to viral infections, five scientists at the Department of Psychology at Carnegie Mellon University in Pittsburgh, Pennsylvania, exposed 391 volunteers to one of five different respiratory viruses (a control group of 26 volunteers was exposed to plain saltwater). Then the researchers sat back to see who got a cold.
Soon enough, they discovered that smokers had a higher risk of getting a cold than did nonsmokers. But nonsmokers who drank were less likely than smokers to end up sneezing. In the words of the researchers, “moderate drinkers have been found to be more resistant than abstainers to five strains of the common cold virus.” Compared to abstainers, the resistance was lowered:
a. 85 percent for people who consumed two to three drinks a day
b. 65 percent for people who consumed one to two drinks a day
c. 30 percent for people who consumed less than one drink a day.
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Riding the curve
When scientists talk about the relationship between alcohol and heart health, the term “J-curve” often pops up. What’s a J-curve? A statistical graph in the shape of a J.
In terms of alcohol and your risk of heart attack, the lower peak on the left of the J shows the risk among teetotalers, the high spike on the right shows the risk among those who drink too much, and the curve in the center shows the risk in the moderate middle. In other words, the J-curve says that people who drink moderately have a lower risk of heart attack than do either people who drink too much or not at all. Several studies say that the J-curve may also apply to a moderate drinker’s risk of stroke.
Reviewing resveratrol
Resveratrol, found in grapes and peanuts, is a flavonoid, one of a group of plant chemicals credited with lowering cholesterol and thus reducing your risk of heart attack. It’s also linked to a lower risk of some forms of cancer, but that’s another book.
In 2001, two reports — one in the American Heart Association’s Circulation, the other in Atherosclerosis — confirmed earlier speculation that resveratrol powers up antioxidants, such as vitamin E and vitamin C. These compounds prevent molecule fragments from linking up to form rogue molecules that damage body cells.
Juice from purple grapes has more resveratrol than the juice from red grapes, which has more resveratrol than the juice from white grapes (get the red wine connection?). To be even more specific, in 1998, a team of food scientists from the USDA Agricultural Research Service and Mississippi identified a native American grape, the muscadine, as an unusually potent source of resveratrol.
About half of all muscadines grown in the United States are used to make grape juice. With that in mind, you can see that teetotalers can get their resveratrol from grapes and grape juice. Don’t you love it when science serves up something for everybody?
But suppose you also absolutely, positively hate grape juice. What to do? Easy: Just pick a pack of peanuts.
A 1998 analysis from the USDA Agricultural Research Service in Raleigh, North Carolina, shows that peanuts have 1.7 to 3.7 mcg (micrograms) of resveratrol per gram versus the 0.6 to 8.0 mcg of resveratrol per gram in red wine. This fact may explain data from the long-running Harvard University/Brigham and Women’s Hospital Nurses Health Study, which shows that women who eat an ounce of nuts a day have a lower risk of heart disease. To review: Wine, grape juice, peanuts — all tools to lengthen life.
Wait. There’s more. Resveratrol pills may be looming on the health horizon.
The whole world knows by now that cutting calories is one way to lose weight, and that cutting lots and lots of calories may lengthen life, at least in laboratory mice for which seriously low-calorie diets appear to increase lifespan to the human equivalent of 162 years. No jokes about the quality of that life, please.
In 2006, researchers at Harvard Medical School announced that feeding resveratrol to the mice does the same thing, by “turning on long life genes shared by almost all living organisms,” in the words of study coauthor and molecular biologist David Sinclair.
Unfortunately, to get the amount of resveratrol needed to produce this effect in mice, human beings would have to down gazillions of glasses of red wine a day. But one can practically hear the hoof beats of drug companies in the distance rushing into to find out how to pack the necessary resveratrol into a human size pill.
To which one can only say, “Get a move on, guy. The world is waiting.”
The other side of the glass
The term alcohol abuse usually means drinking so much so frequently that it interferes with the ability to live a normal, productive life. Alcohol abuse is also hazardous to your health because it’s a serious risk factor for liver damage, high blood pressure, and cancer of the esophagus and stomach, not to mention injury, violence, and death from accidents. In addition, for some people, even moderate amounts of alcohol may be too much. The obvious examples are young people; pregnant women; people taking medicines, such as sedatives, that interact with alcohol; and those who plan to participate in sports or an activity — such as filling out tax forms — that requires really clear thinking. As for drinking and driving, fuggedabboudit. Period.
Written by Perry Luntz in "Whiskey & Spirits for Dummies", Wiley Publishing, 2008,USA, excerpts pp. 307-316. Digitized, adapted and illustrated to be posted by Leopoldo Costa.