The healthy benefits of booze?

A glass of wine with dinner or a cold beer on a hot day can bring us pleasure, but is booze actually good for our health? The answer may depend on you — and whom you ask. While heavy drinking and binge drinking isn’t healthy for anyone, there’s a lot of confusion over whether a drink or two a day can help or harm.

The most recent entry into the debate is a recent study published in the Canadian Medical Association Journal (CMAJ) which linked alcohol consumption to an increased risk of atrial fibrillation among cardiovascular patients. While people who drink heavily and binge drink had the highest incidence of atrial fibrillation, rates were higher among people who drank in moderation versus people who drank little.

Why is this finding important? Several studies have suggested that moderate drinking can have a positive effect on heart health such as helping to lower blood pressure and prevent blood from forming clots. However, atrial fibrillation — a condition characterized by an irregular heartbeat — increases the risk of stroke and heart failure. It’s possible that moderate drinking could lower some risks while increasing others.

In short, there are no easy answers. Here’s the gist of what we know so far.

Benefits of moderate drinking

First of all, what is “moderate drinking”? It’s a benchmark that health experts have set in order to reduce alcohol related deaths. “Regular” or “moderate” consumption is defined as one to two drinks per day for women to a maximum of 14 drinks per week and two to three drinks per day for men to a maximum of 21 drinks per week. (Canada’s Low-Risk Alcohol Drinking Guidelines limit weekly totals to 10 and 15 drinks respectively, suggesting people take days off to avoid forming a habit.) One drink equals 12 oz. of beer, 5 oz of wine, 1.5 oz of spirits.

How might moderate drinking help?

– Several studies have found that alcohol or the substances in alcoholic drinks may help prevent platelets from sticking together to form clots. When you decrease the risk of clot formation, you also decrease the risk for heart attack and stroke.

– A few studies suggest that moderate drinking has some protective benefit for diabetes and may help reduce the risk of dementia. Moderate drinking may even help alleviate the pain of rheumatoid arthritis.

– Experts say one of the best known effects of alcohol we’ve seen so far is a small increase in HDL (or “good” cholesterol). However, too much alcohol can raise the level of triglycerides (fats) in the blood and increase cardiovascular risk.

– Some research suggests that the antioxidants in alcoholic drinks offer protection from disease. Several studies have pointed to a connection between red wine and a reduced risk of death among certain populations, thanks in part to an antioxidant called resveratrol. However, not enough is known and the research is conflicting — and there are plenty of sources of anti-oxidants besides alcohol.

In addition, experts note that a drink or two can help people “unwind” — thereby helping to reduce stress. However, experts don’t recommend drinking as a stress management strategy.

Potential dangers of moderate drinking

Experts have long known that there’s no safe limit for some people including women who are pregnant, people taking certain medications, people living with certain conditions and people who struggle with substance abuse.

For everyone else, there could be some risks too:

– Alcohol or the substances in alcoholic drinks may prevent blood from forming clots. There’s a flip side to that benefit: it can increase the risk of bleeding in some people.

– Experts have found a link between alcohol consumption and an increased risk of cancers in the head and neck, especially among smokers and among women. It’s also been linked to a higher risk for colorectal cancer and cancer of the rectum.

– Alcohol consumption has also been linked to an increased risk for breast cancer. Some experts advise women who are at a higher risk for head, neck and breast cancer to limit their consumption to one drink a day or less.

– Everyday medications like aspirin have their own risks such as stomach problems and stomach bleeding, and moderate drinking can increase these risks.

– Weight gain is also a concern — especially since maintaining a healthy weight reduces our risk for disease. Not only do all those empty calories add up, but alcohol can also stimulate the appetite and cause us to eat more. (However, one study suggests that women who drink in moderation gain less weight than their non-drinking peers.)

(The American Heart Association has a good summary of Alcoholic Beverages and Cardiovascular Disease for more details.)

The pitfalls in the research

There are a lot of studies stretching back through the decades — and it’s important to consider things such as the participants, the methodology used, the size and type of the study and who provided the funding.

We also have to be careful about reading too much into the findings. For instance, just because there is a link or correlation between two things, it doesn’t mean there is a cause-and-effect relationship. In some studies, experts note that lifestyle habits could be a factor — but those habits weren’t part of the study.

The only way to know for sure would be a randomized comparison trial or “intervention study” where participants have the same characteristics and one is given a therapy (alcohol, in this case) while the other is designated a control group. The results would be compared to see what harm arises. It shouldn’t come as a surprise that no such study would make it past an ethical review board. Instead, a lot of studies rely on data from large, long-term studies.

Another potential problem: experts suspect some types of alcohol are better than others. For instance, people who consume beer might not see the same effects as someone who drinks red wine. Just because one type of alcohol is beneficial in one area — like heart health — doesn’t mean it’s beneficial for other conditions. Moderate drinking guidelines don’t get into these specifics.

In short, there’s still a lot that experts don’t know about the effects of certain types of alcohol.

What’s a person to do?

Confused? Ultimately, how much we drink — and whether we drink at all — is an individual decision. There’s no universal advice because the risks and benefits depend on a variety of factors such as age, weight, sex, family history, medical conditions, risk for chronic diseases and whether we smoke.

Health experts and organizations such as the American Heart Association and Heart and Stroke Foundation warn to weigh the risks and potential benefits of consuming alcohol and talk it over you’re your doctor. People over age 65 should be especially careful as changes to the body with age can increase sensitivity to alcohol.

If it’s safe for you to drink and you choose to do so, experts say to stick to the guidelines for moderate drinking. It’s fine to drink less, but drinking more can increase your risk of certain cancers, high blood pressure, cardiovascular disease and a whole host of other diseases. Experts also warn it’s not okay to “save up” your drinks and have a whole bunch at once.

If you don’t drink or only drink occasionally, don’t worry about missing out. There are plenty of other ways to get those heart-protective benefits such as eating a balanced diet, getting enough exercise and reducing stress. No one is advising that people who don’t drink should start drinking.

The bottom line: as always, talk to your doctor before changing your habits so you can weigh the potential risks and benefits. The best course of action depends on you as an individual.

ON THE WEB
For more information, check out this recent FAQ on Alcohol and Your Health from WebMD and Alcohol: Balancing Risks and Benefits from Harvard Health.

Additional sources: BBC Health, Canadian Public Health Association, CBC News Health, Health Canada, Heart and Stroke Foundation, MayoClinic.com, National Institute on Alcohol and Alcohol Abuse, U.S. Centers for Disease Control and Prevention.

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