I really believe moderate alcohol consumption, especially red wine, is one of the 5 essentials for good health (along with healthy diet, exercise, fish oil and aspirin), but it's the one I have the hardest time adhering to. I struggle to have at least one drink a day (and it's often beer rather than red wine) and only rarely have two, which seems to be the right amount.
The purpose of this blog is as much to keep me informed and motivated as it is to share this information, and it is for that purpose that I have prepared a comprehensive review of the latest research on the Health Benefits of Alcohol Consumption:
Alcohol consumption lowers the risk of several types of cancer
Many observational epidemiologic studies have found an inverse association between alcohol consumption and hematological cancers (such as lymphoma and leukemia). This study, based on the Million Women's Study in the UK, is large enough to permit an evaluation of associations with various types of such cancers. Further, it takes into account newer coding systems for morphology so that diseases associated with the lymphatic system can be separated from those of the myeloid system.
The key findings are that alcohol consumption appears to lower the risk of several types of lymphoma and plasma cell neoplasms, but has little effect on the risk of myeloid tumours such as acute myeloid leukaemia.
During follow-up, 9,162 incident cases of haematological malignancy were recorded, including 7,047 lymphoid and 2,072 myeloid cancers. Among predominantly moderate alcohol drinkers, higher intake was associated with lower risk of lymphoid malignancies, in particular diffuse large B-cell lymphoma [relative risk 0.85 per 10 g alcohol per day (95% confidence interval 0.75.96)], follicular lymphoma [0.86 (0.76.98)] and plasma cell neoplasms [0.86 (0.77.96)].
Alcohol consumption may decrease risk of ALS
A population-based case-control study of the rare but devastating neurological disease amyotrophic lateral sclerosis (ALS) has shown that the risk of such disease is increased among smokers, as has been shown previously. However, surprisingly, the risk of ALS was found to be markedly lower among consumers of alcohol than among abstainers.
Forum reviewers thought that this was a well-done and important paper, as it is a population-based analysis, with almost 500 cases of ALS, a very large number of cases for this rare disease. They were especially struck by the magnitude of the difference in risk of ALS between alcohol consumers and never drinkers: the risk among drinkers was about one half that of non-drinkers. Said one reviewer: "The results in this study are astonishing in this mysterious disease. One should expect that alcohol, as a toxic agent, rather should contribute to the development of ALS than to prevent it. The lower risk among drinkers compared with non-drinkers is remarkable."
Beneficial effect of moderate alcohol consumption on osteoporosis in women
Women after menopause tend to develop weaker bones from what is known as osteoporosis, which may lead to fractures (especially hip fractures) from falling. The weakness of the bones results from an imbalance between the normal resorption (a type of dissolving of old bone) and the laying down of new bone, an ongoing process for both men and women referred to as "bone turnover." For poorly understood reasons, after menopause the resorption of old bone in women continues but new bone is laid down less well, leading to a decrease in bone density. A variety of substances (calcium, vitamin D and various medications) have been used in an attempt to prevent the development of osteoporosis; in epidemiologic studies, moderate drinking of alcohol has also been shown to lower this risk.
An intervention published in Menopause, involved 40 healthy postmenopausal women of an average age of 56. The authors measured factors that relate to osteoporosis in post-menopausal women while subjects were consuming alcohol (19g a day), after they had stopped drinking, and after they had resumed their alcohol consumption. The authors state that excessive bone turnover, combined with an imbalance whereby bone resorption exceeds bone formation, is the principal cause of post-menopausal bone loss and conclude that alcohol decreases the turnover of bone in post-menopausal women, which leads to less resorption of bone, hence less osteoporosis. The study also showed that abstinence from alcohol resulted in increased markers of bone turnover (hence, higher risk of developing osteoporosis), whereas resumption of alcohol consumption reduced bone turnover markers.
Moderate alcohol intake is associated with a lower risk of kidney cancer
A majority of previous epidemiologic studies have shown that moderate drinking is associated with a lower risk of kidney cancer, which may affect about 1% of the general population. In published prospective cohort studies, the risk for such cancer among moderate drinkers is usually about 25% less than the risk seen among non-drinkers.
This well-done meta-analysis supports these findings: for the more-reliable prospective cohort studies (rather than case-control studies) the current study finds a 29% lower risk for subjects in the highest category of alcohol consumption in comparison with subjects in the lowest alcohol category. The findings suggest similar effects among men and women, and for all types of alcohol beverages. The effects are seen at a level of about one drink/day, with little further reduction in risk for greater alcohol consumption.
Study suggests moderate drinking lowers risk of developing rheumatoid arthritis in women
A follow-up study of more than 34,000 women in Sweden has shown that moderate drinkers, in comparison with abstainers, were at significantly lower risk of developing rheumatoid arthritis (RA), an often serious and disabling type of arthritis. RA is known to relate to inflammation, and it is thought that this inflammation is blocked to some degree by the consumption of alcohol. In this study, women who consumed at least 4 drinks per week (with a drink being defined as containing 15 grams of alcohol) had 37% lower risk of developing RA than subjects reporting never drinking or consuming less than 1 drink/week.
This large study is important as few prospective studies are of adequate size to have sufficient cases of RA to evaluate factors related to its development. The study supports previous research showing a lower risk of developing RA, or milder severity of the disease, among moderate drinkers than among abstainers.
Higher quality of life seen among regular moderate drinkers than among abstainers
Data from a nationally representative sample of 5,404 community-dwelling Canadians ages 50 and older at baseline (1994/1995) was used to estimate the effects of alcohol drinking patterns on quality of life when subjects were aged =50 years and after a follow-up period. Health-related quality of life was assessed with the Health Utilities Index Mark 3 (HUI3). The authors report that most participants showed stable alcohol-consumption patterns over 6 years.
Detailed information was available on the participants alcohol consumption. Moderate drinkers were defined as those having 1 drinks per week with no more than 3 on any day for women and no more than 4 on any day for men. The repeated assessments allowed for the investigators to classify subjects according to changes over time in their drinking patterns, so that "persistent moderate drinkers" could be identified. 31.4% of the subjects decreased their intake over the follow-up period. The investigators also did secondary analyses among subjects who did not report any adverse health conditions (heart disease, cancer, stroke, or diabetes) during the first four years of follow up; these subjects were referred to as "consistently healthy."
Regular moderate drinkers had the highest indices of quality of life at baseline, but subsequent changes in quality of life indicators were similar in all groups except for those reporting decreasing alcohol consumption. The investigators conclude that regular moderate drinkers had higher initial levels of health-related quality of life than abstainers and those in other groups. However, rates of decline over time were similar for all groups except those decreasing their consumption from moderate levels, who showed a greater decline in their level of health-related quality of life than regular moderate users.
Light-to-moderate alcohol consumption, in comparison with abstinence, was associated with approximately 35-45% lower risk of cognitive decline or dementia
Alzheimer's disease (AD) and other types of dementia are most common in the very elderly, and are associated with huge health costs. With a rapidly ageing population throughout the world, factors that affect the risk of cognitive decline and dementia are of great importance. A review paper by Kim JW et al published in Psychiatry Investig 2012;9:8-16 on the association between alcohol consumption and cognition in the elderly provides an excellent summary of the potential ways in which alcohol may affect cognitive function and the risk of dementia, both adversely and favourably as alcohol may have both a neuro toxic and neuro protective effect, depending on the dose and drinking pattern. Longitudinal and brain imaging studies in the elderly show that excessive alcohol consumption may increase the risk of cognitive dysfunction and dementia, but regular low to moderate alcohol intake may protect against cognitive decline and dementia and provide cardiovascular benefits.
Studies published from 1971 to 2011 related to alcohol and cognition in the elderly were reviewed using a PubMed search. At present, there are no proven agents to prevent cognitive decline or dementia, although a number of prospective epidemiologic studies have shown a lower risk of such conditions among light to moderate drinkers in comparison with non-drinkers. Other studies have found that beneficial effects are seen only among certain sub-groups of subjects. A recent meta-analysis by Peters et al of subjects over the age of 65 in longitudinal studies concluded that light-to-moderate alcohol consumption, in comparison with abstinence, was associated with approximately 35-45% lower risk of cognitive decline or dementia.
This paper provides a summary of what is known about the mechanisms by which alcohol consumption, especially heavy drinking, can be neurotoxic, and how light-to-moderate drinking may help protect against cognitive decline and dementia. The authors state that their intent is to determine if there is an "optimal pattern of drinking" that may protect the elderly against such conditions.
At present, the mechanisms by which the moderate intake of wine and other alcoholic beverages reduces the risk of cardiovascular diseases are much better defined than they are for cognition. Forum members agree with the authors that further research is needed to evaluate a potential role that alcohol may play in reducing the risk of dementia.
Forum members also agree that, at present, the specific mechanisms of such putative protection are not well defined, and it would be premature to recommend light-to-moderate drinking for reducing the risk of dementia. On the other hand, current biomedical data supports the concept that regular, moderate intake of ethanol is not simply less dangerous for cognitive function, but is positively protective. This is the same conclusion reached by epidemiologic studies."
Modest Alcohol Consumption Lowers Risk of Liver Disease
People with nonalcoholic fatty liver disease (NALFD) who consume alcohol in modest amounts – no more than one or two servings per day – are half as likely to develop hepatitis as non-drinkers with the same condition, reports a national team of scientists led by researchers at the University of California, San Diego School of Medicine.
The findings are published in the April 19, 2012 online issue of The Journal of Hepatology.
NALFD is the most common liver disease in the United States, affecting up to one third of American adults. It’s characterized by abnormal fat accumulation in the liver. The specific cause or causes is not known, though obesity and diabetes are risk factors. Most patients with NAFLD have few or no symptoms, but in its most progressive form, known as nonalcoholic steatohepatitis or NASH, there is a significantly heightened risk of cirrhosis, liver cancer and liver-related death.
NALFD is also a known risk factor for cardiovascular disease (CVD). Patients with NAFLD are approximately two times more likely to die from coronary heart disease than from liver disease. The study’s authors wanted to know if the well-documented heart-healthy benefits of modest alcohol consumption outweighed alcohol’s negative effects.
“We know a 50-year-old patient with NAFLD has a higher risk of CVD,” said Jeffrey Schwimmer, MD, associate professor of clinical pediatrics at UC San Diego, director of the Fatty Liver Clinic at Rady Children’s Hospital-San Diego and senior author. “Data would suggest modest alcohol consumption would be beneficial (in reducing the patient’s CVD risk) if you don’t take liver disease into account. When you do take liver disease into account, however, the usual medical recommendation is no alcohol whatsoever.”
Schwimmer and colleagues discovered that the benefits of modest alcohol consumption were compelling, at least in terms of reducing the odds of patients with NAFLD from developing more severe forms of the disease. Patients with NASH are 10 times more likely to progress to cirrhosis, the final phase of chronic liver disease. Cirrhosis is the 12th leading cause of death in the U.S., killing an estimated 27,000 Americans annually.
“Our study showed that those people with modest alcohol intake – two drinks or less daily – had half the odds of developing NASH than people who drank no alcohol,” said Schwimmer. “The reasons aren’t entirely clear. It’s known that alcohol can have beneficial effects on lipid levels, that it increases ‘good’ cholesterol, which tends to be low in NAFLD patients. Alcohol may improve insulin sensitivity, which has a role in NAFLD. And depending upon the type of alcohol, it may have anti-inflammatory effects.”
The study also found that in patients with NAFLD, modest drinkers experienced less severe liver scarring than did lifelong non-drinkers.
The study did not evaluate the effects of different types of alcohol, such as beer or spirits. Schwimmer said to do so would require a much larger study. Also, the study’s findings do not apply to children. All of the participants in the study were age 21 and older.
The current paper is based on analyses of 600 liver biopsies of patient’s with NAFLD by a national panel of pathologists who had no identifying clinical information about the samples. The study excluded anyone who averaged more than two alcoholic drinks per day or who reported consuming five or more drinks in a day (binge-drinking) at least once a month. All of the patients were at least 21 years of age. Schwimmer said the findings indicate patients with liver disease should be treated individually, with nuance.
“For a patient with cirrhosis or viral hepatitis, the data says even small amounts of alcohol can be bad. But that may not be applicable to all forms of liver disease. Forty million Americans have NAFLD. Physicians need to look at their patient’s overall health, their CVD risk, their liver status, whether they’re already drinking modestly or not. They need to put all of these things into a framework to determine risk. I suspect modest alcohol consumption will be an appropriate recommendation for many patients, but clearly not all.”
Moderate alcohol consumption before/after heart attack=lower mortality
The Health Professionals Follow-up Study (HPFS) is a prospective cohort study of 51,529 US male health professionals. During the follow up of these men between 1986 to 2006, published in the European Heart Journal, 1,818 men were confirmed with incident non-fatal myocardial infarction (MI) – a non fatal heart attack. Among heart attack survivors, 468 deaths were documented during up to 20 years of follow up. Repeated reports were obtained on alcohol consumption every four years. Average alcohol consumption was calculated prior to and then following the MI.
The overall results show that, in comparison with no alcohol consumption, the pre-MI and the post-MI intakes of light (0.1-9.9 g/day of alcohol, or up to one small typical drink) and moderate (10.0-29.9 g/d, or up to about 2 _ to 3 drinks) amounts of alcohol were both associated with lower risk of all-cause mortality and cardiovascular morality among these men.
The significant reductions in all-cause mortality risk (22% lower for 0.1-9.9 g/day and 34% lower for 10.0 – 29.9 g/day, in comparison with non-drinkers) were no longer present for those who drank more than 30 g/day; for this highest consumer group, the adjusted hazard ratio was 0.87 with 95% CI of 0.61-1.25.
There are a number of other informative and interesting results described from this study. First, there was little change in reported alcohol intake prior to and following the MI: drinkers tended to remain drinkers of similar amounts. Few non-drinkers began to drink after their heart attack; among heavier drinkers, there was a tendency to reduce drinking (but very few stopped drinking completely). Further there were no significant differences in outcome according to type of beverage consumed although, interestingly, lower hazard ratios were seen for consumers of beer and liquor than of wine. While the authors state that the effects of alcohol were stronger for the association with non-anterior MI's, the relative risk (versus non-drinkers) for all-cause mortality were little different: among the moderately drinking men the relative risks were 0.58 for anterior MI and 0.51 for other types of MI.
Even though exposures (such as alcohol) for cardiovascular events (such as MI) may be different after a person has an event than it was before the event, in this study the reductions in risk were almost the same. For example, both for alcohol intake reported prior to a MI, and that after a non-fatal MI, the risk of mortality was about 30% lower for moderate drinkers than it was for abstainers. This suggests that, in terms of reducing cardiovascular disease, alcohol may have relatively short-term effects, suggesting that frequent but moderate consumption (of under 30g a day for men) may result in the best health outcomes.
Alcohol In Moderation Lowers Risk Of Second Heart Attack
The online issue of the European Heart Journal reports that a study of almost 2,000 American men has demonstrated that men who survived a first heart attack and who consume alcohol in moderation have a lower risk of dying from heart disease or any other cause than non-drinkers.
The latest results from the US Health Professionals Follow-up Study, a prospective study of 51,529 US male health professionals, demonstrates that the any-cause mortality risk for men who survived a first heart attack and who consumed about two alcoholic drinks daily over an extended period of time was 14% lower, and the risk of dying from cardiovascular disease was 42% lower than in men who did not consume alcohol.
First author, Dr. Jennifer Pai, assistant professor of medicine at Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, and a research associate at Harvard School of Public Health, declared:
"Our findings clearly demonstrate that long-term moderate alcohol consumption among men who survived a heart attack was associated with a reduced risk of total and cardiovascular mortality. We also found that among men who consumed moderate amounts of alcohol prior to a heart attack, those who continued to consume alcohol 'in moderation' afterwards also had better long term prognosis."
Scientists know that amongst the healthy population, moderate alcohol consumption is linked to a lower risk of heart disease and death; however, whether the same applies to people with established heart disease is not known. There have been no prospective studies until now that measured alcohol consumption both before and after a heart attack, with long-term follow-up.
Dr. Pai and her team assessed a subset of 1,818 men in the Health Professionals Follow-up Study who survived a first heart attack between 1986 and 2006 and followed up 20 years from the time of their heart attack. 468 men died during the study period.
Every two years, the participants completed a survey regarding their lifestyle and medical factors, including their body mass index, their smoking habits, etc. and every four years they were surveyed regarding their alcohol consumption of beer, red wine and spirits and their diet.
A standard portion was defined as a 4oz or 125 ml of wine, which contains 11g of ethanol, i.e. the alcohol in the drink, a bottle or can of beer that contains 12.8g of ethanol, or a shot of spirits, which contains 14g of ethanol.
The men were categorized into four groups based on their daily alcohol intake, for instance 0g, 0.1-9.9g, 10-29.9g, and 30g or more. Between 10 to 29.9g of alcohol per day, i.e. the equivalent of about two drinks was classed as "moderate" drinking.
After adjusting for various variables, including smoking, body mass index, age and medical history, the researchers discovered that men who consumed about two alcoholic drinks per day following their first heart attack had a lower any-cause mortality risk as compared with non-drinkers, regardless of the type of drink they consumed.
The researchers examined the participants' alcohol consumption before and after the heart attack and discovered that the majority of men had not changed their drinking habits, and those who drank alcohol before and after their heart attack were more likely to have a lower risk of death compared with those who drank no alcohol. The researchers note, however, that the results were statistically not important because of the smaller numbers in their analysis.
They also observed a "U" shape in the results that demonstrated that participants' who drank 30g or more alcohol daily had a similar any-cause mortality risk to that of non-drinkers.
Dr. Pai explains:
"The adverse health effects of heavy drinking are well known, and include high blood pressure, reduced heart function and reduced ability to break down blood clots. In addition, other studies have shown that any benefits from light drinking are entirely eliminated after episodes of binge drinking.
Our results, showing the greatest benefit among moderate drinkers and a suggestion of excess mortality among men who consumed more than two drinks a day after a heart attack, emphasize the importance of alcohol in moderation."
She continued, saying:
"The findings of our study support the European Society of Cardiology recommended guidelines for long-term management of acute coronary syndromes that moderate alcohol consumption of 10-30 grams per day in men should not be discouraged and may be beneficial for long-term prognosis after a heart attack.
If the men were already consuming moderate amounts, then it may be beneficial to continue consuming moderate amounts of alcohol after a myocardial infarction. However, because excessive alcohol intake is harmful, we recommend that patients discuss drinking alcohol in moderation with their physicians to individually assess their risks and potential benefits."
The researchers are aware of the study's limitations, for instance, the fact that surveys reporting alcohol intake may include measurement errors, as well as treatments of heart attacks having changed in the last two decades, and that the findings only relate to drinking in men, although they do not believe that these factors affect the result's validity.
Dr. Pai concluded:
"Our study was only among men, so we cannot extrapolate to women. However, in all other cases of alcohol and chronic disease, associations are similar except at lower quantities for women. Thus, an association is likely to be observed at 5-14.9g per day, or up to a drink a day for women."
Light-to-moderate alcohol consumption=lower stroke risk in women
According to new research from Brigham and Women's Hospital (BWH), light-to-moderate alcohol consumption was associated with a lower risk of stroke in women.
The study will be electronically published on March 8, 2012 in Stroke, a journal of the American Heart Association (AHA).
Monik Jimenez ScD, BWH Department of Medicine, examined data from 83,578 female participants in the Nurses' Health Study. They looked at data of women who had no evidence of cardiovascular disease or cancer at baseline and followed them for up to 26 years. Participants provided information on diet, including self-reported alcohol consumption, lifestyle factors and stroke events.
There were 2,171 incidents of stroke: 1,206 were ischemic strokes, 363 hemorrhagic strokes, and 602 were of an unknown or probable type. An ischemic stroke occurs when blood flow to the brain is blocked. A hemorrhagic stroke occurs when a blood vessel bursts in the brain.
Approximately 30 percent of women reported that they never drank alcohol, 35 percent reported very low levels of consumption, 37 percent drank moderately, and only 11 percent of women reported drinking more than the equivalent of one mixed drink per day on average.
In the study, low consumption was considered less than 4.9 grams daily (less than _ glass of wine per day). Moderate consumption was considered 5 to 14.9 grams daily (_ to 1 _ glasses of wine, one serving of a mixed drink, or one beer).
After analyzing the data, the researchers saw that women who consumed low to moderate amounts of alcohol had a lower risk of total stroke compared to women who never drank. Higher levels of alcohol intake were not associated with reduced risk of stroke.
The researchers speculate on several scenarios that may explain alcohol's ability to reduce stroke risk. Alcohol may have components to prevent blood clots and cholesterol from building up in the arteries, both of which can lead to stroke. Higher levels of alcohol intake may increase the risk of high blood pressure and atrial fibrillation which are risk factors for stroke.
The study's findings support the public health message issued by AHA regarding alcohol consumption. AHA recommends that women and men who consume alcohol should do so in moderation. This means one drink per day for women and one to two drinks per day for men. The AHA defines one drink as: one 12-ounce beer, 4 ounces of wine, 1_ ounces of 80-proof spirits, or 1 ounce of 100-proof spirits. Also, in light of the study findings, AHA cautions that people who abstain from alcohol should not start drinking due to the dangers associated with it (e.g., alcoholism).
Alcohol consumption and risk of colon cancer
A study based on more than 87,000 women and 47,000 men in the Nurses' Health Study and the Health Professionals Follow-up Study, looks at whether there is a link between colon cancer and alcohol, and if so at what level of consumption, and the importance of a family history of the disease. A total of 1,801 cases of colon cancer were diagnosed during follow-up from 1980 onwards.
The authors results found that subjects with a family history, whose average alcohol intake was 30 or more grams per day (about 2 _ typical drinks by US standards or 4 UK units) had an increase in their risk of colon cancer. Those at greatest risk also ate the most red meat, smoked the most, and had the lowest intake of folate (suggesting they ate fewer green vegetables and cereals. Hence, these people have the most unhealthy lifestyles in general of the populations studied. There was not a significant association between alcohol consumption and colon cancer among subjects without a positive family history in this study.
Forum reviewers were concerned that the pattern of drinking (regularly or binge drinking) was not assessed, and that there was not a consistent increase in risk of cancer with greater alcohol intake found. Further, adequate folate intake was found to lower risk, with the highest risk for subjects with a positive family history of colon cancer, low levels of folate, and in the highest category of alcohol consumption, indicating the importance of other lifestyle facts such as a healthy diet.
The present study provides some support for an association between higher levels of alcohol intake and the risk of colon cancer among subjects with a positive family history of such cancer. It should be noted that there have been changes in the guidelines for screening for colon cancer (by endoscopy, with removal of pre-malignant tumours) and other preventive measures for people with a positive family history of colon cancer, making it hard to draw conclusions on data for colon cancer that is 30 years old. The new recommendation for screening frequency and age at initiation of screening are so different now. At least some of these cases would probably have been prevented if managed according to current guidelines. Such measures could modify the effects of all risk factors for colon cancer in future analyses.
Alcohol and your heart: Friend or foe?
A meta-analysis done by the Centre for Addiction and Mental Health (CAMH) into the relationship between alcohol consumption and heart disease provides new insight into the long-held belief that drinking a glass of red wine a day can help protect against heart disease.
"It's complicated," says Dr. Juergen Rehm, director of social and epidemiological research at CAMH. Dr. Rehm's paper, co-authored by Michael Roerecke, was recently published in the journal Addiction. "While a cardioprotective association between alcohol use and ischaemic heart disease exists, it cannot be assumed for all drinkers, even at low levels of intake," says Dr. Rehm.
Ischaemic heart disease is a common cause of illness and death in the Western world. Symptoms are angina, heart pain, and heart failure. Based on 44 studies, the analyses used 38,627 ischaemic heart disease events (including deaths) among 957,684 people.
"We see substantial variation across studies, in particular for an average consumption of one to two drinks a day," says Dr. Rehm. The protective association may vary by gender, drinking patterns, and the specific health effects of interest. Differential risk curves were found by sex, with higher risk for morbidity and mortality in women.
Moreover, for any particular individual, the relationship between alcohol consumption and ischemic heart disease should not be isolated from other disease outcomes. Even at low levels, alcohol intake can have a detrimental effect on many other disease outcomes, including on several cancers.
"Even one drink a day increases risk of breast cancer, for example," says Dr. Rehm. "However, with as little as one drink a day, the net effect on mortality is still beneficial. After this, the net risk increases with every drink."
"If someone binge drinks even once a month, any health benefits from light to moderate drinking disappear." Binge drinking is defined more than four drinks on one occasion for women, and more than five for men.
Given the complex, potentially beneficial or detrimental effects of alcohol on ischaemic heart disease in addition to the detrimental effects on other disease categories, any advice by physicians on individual drinking has to take the individual risk constellation (such as familial predisposition for certain diseases and behavior with respect to other risk factors) into consideration.
"More evidence on the overall benefit-risk ratio of average alcohol consumption in relation to ischaemic heart disease and other diseases is needed in order to inform the general public or physicians about safe or low-risk drinking levels," the study concludes. "Findings from this study support current low-risk drinking guidelines, if these recognize lower drinking limits for women."
Alcohol & polyphenols in red wine both fight cardiovascular disease
Observational epidemiologic studies relating wine and alcohol to health all suffer from the fact that they, of necessity, compare people who prefer certain beverages, but not the beverages themselves. While there have been many intervention trials in animals, randomized trials in humans are less common. Randomized crossover trials, in which each subject receives all interventions in sequence, can be especially important as they tend to avoid baseline differences among subjects and can detect effects of different interventions with smaller numbers of subjects.
This study by Chiva-Blanch G et al, just published in the American Journal of Clinical Nutrition, included 67 male volunteers in Spain who were considered to be at "high-risk" of cardiovascular disease on the basis of increased BMI, smoking, diabetes, hypertension, or other risk factors. About one half of the individuals were taking ACE inhibitors, statins, aspirin, and/or oral hypoglycemic drugs, so the results of this study may be especially relevant for patients in the real world.
The subjects agreed to not consume any alcohol for a baseline period, then for three one-month periods consumed 30 g/day of alcohol as red wine or as gin, or an equivalent amount of phenolics from dealcoholized red wine. The polyphenol contents of the RW and the DRW interventions were the same. A very high degree of compliance of the subjects with the assigned interventions is evidenced by results of counting numbers of empty bottles of the intervention beverage returned, dietary records, urinary metabolites, etc. Further, there is good evidence that there were no important changes between periods in diet or exercise habits. The effects of each intervention on a large number of adhesion molecules and chemokines that affect inflammation and relate to the development of vascular disease were evaluated.
The key results of the study were that both ethanol and nonalcoholic compounds in red wine have potentially protective effects that may reduce the risk of vascular disease. Specifically, the authors conclude that "the phenolic content of red wine may modulate leukocyte adhesion molecules, whereas both ethanol and polyphenols of red wine may modulate soluble inflammatory mediators in patients at high risk of cardiovascular disease."
Specific comments on the study: Most reviewers considered this to be a well-done, comprehensive study. As one reviewer commented: "This is an excellent paper. The results strongly indicate an effect of wine polyphenols on inflammation (in broad and modern terms) and this is just what we expect from the biochemistry and nutritional effects of fruits and vegetables. The effect of ethanol, on the other hand, likely fits a hormetic mechanism, where low doses regularly supplied are protective while high doses in a single shot are worsening the progression of disease." Another reviewer added: "We need more information on separating the effects of beer, wine, and various types of spirits. Some spirits like brandy and whisky can have useful antioxidant effects, so distinguishing effects among different types of beverages may be informative."
Another Forum reviewer commented: "This is a very interesting paper that goes a way towards answering the question whether it is the alcohol or polyphenols in red wine that confer the health benefits. The trial was well conducted and controlled, with very detailed analyses. It would have been interesting to analyse any changes in conventional risk factors after the interventions. It would also have been interesting in the study to determine the effects on vascular function by, for example, brachial artery activity (flow mediated dilatation)."
Given that the effects of both alcohol and polyphenols on physiologic factors (e.g., platelet function, fibrinolysis) are transient, generally lasting for no more than 24 hours, it was appropriate that the subjects in this study were instructed to consume the intervention substance (RW, gin, DRW) on a daily basis. When drinking is moderate, there is no evidence that having "alcohol-free days" is beneficial to health. Indeed, most epidemiologic studies show better health effects from daily consumption rather than from drinking on a few days per week.
Concerns about the present study: One Forum reviewer stated: "This appears to be a carefully designed and well executed study, but I have four concerns: (1) The study has been undertaken in high-risk individuals, more than half of whom are hypertensive, a quarter dyslipidaemic, and a quarter diabetic. It is not described what happened to the conventional risk factors during the interventions. (For example, any improvement in inflammatory markers may have come at the cost of higher blood pressure with the alcohol interventions.) (2) Was there any weight change that could have confounded any of the outcomes? (3) Both polyphenol and alcohol biomarkers were measured – did the change in these biomarkers correlate with the changes in any of the inflammatory markers; i.e., any suggestion of a dose response relationship? (4) Even though at least 30 outcome variables were assessed, the authors do not describe any correction for multiple comparisons."
Another Forum reviewer: "This is a well conducted study, and adds to our understanding of the potential cardiovascular benefits of alcohol and the non-alcoholic compounds of alcoholic beverages. However, in this study more than one-half of the high-risk subjects consumed drugs with known anti-inflammatory effects, which could be a confounding factor. The anti-inflammatory effects of these pharmaceuticals may be responsible for the beneficial results, and may not be related to the RW, DRW and gin interventions." However, others think that this concern is unlikely to be important since this was a crossover study, and there were no changes in lifestyle or medication use between the intervention periods.
The key results of the study were that both ethanol and nonalcoholic compounds in red wine have potentially protective effects that may reduce the risk of vascular disease. Specifically, the authors conclude that "the phenolic content of red wine may modulate leukocyte adhesion molecules, whereas both ethanol and polyphenols of red wine may modulate soluble inflammatory mediators in patients at high risk of cardiovascular disease." Thus, this study provides important new mechanistic evidence that the reduced risk of cardiovascular disease among red wine drinkers observed in most epidemiologic studies may result from a combination of both the alcohol and the polyphenols in the wine.
Moderate red wine drinking may help cut women's breast cancer risk
Drinking red wine in moderation may reduce one of the risk factors for breast cancer, providing a natural weapon to combat a major cause of death among U.S. women, new research from Cedars-Sinai Medical Center shows.
The study, published online in the Journal of Women's Health, challenges the widely-held belief that all types of alcohol consumption heighten the risk of developing breast cancer. Doctors long have determined that alcohol increases the body's estrogen levels, fostering the growth of cancer cells.
But the Cedars-Sinai study found that chemicals in the skins and seeds of red grapes slightly lowered estrogen levels while elevating testosterone among premenopausal women who drank eight ounces of red wine nightly for about a month.
White wine lacked the same effect.
Researchers called their findings encouraging, saying women who occasionally drink alcohol might want to reassess their choices.
"If you were to have a glass of wine with dinner, you may want to consider a glass of red," said Chrisandra Shufelt, MD, assistant director of the Women's Heart Center at the Cedars-Sinai Heart Institute and one of the study's co-authors. "Switching may shift your risk."
Shufelt noted that breast cancer is the leading type of women's cancer in the U.S., accounting for more than 230,000 new cases last year, or 30 percent of all female cancer diagnoses. An estimated 39,000 women died from the disease in 2011, according to the American Cancer Society.
In the Cedars-Sinai study, 36 women were randomized to drink either Cabernet Sauvignon or Chardonnay daily for almost a month, then switched to the other type of wine. Blood was collected twice each month to measure hormone levels.
Researchers sought to determine whether red wine mimics the effects of aromatase inhibitors, which play a key role in managing estrogen levels. Aromatase inhibitors are currently used to treat breast cancer.
Investigators said the change in hormone patterns suggested that red wine may stem the growth of cancer cells, as has been shown in test tube studies.
Co-author Glenn D. Braunstein, MD, said the results do not mean that white wine increases the risk of breast cancer but that grapes used in those varieties may lack the same protective elements found in reds.
"There are chemicals in red grape skin and red grape seeds that are not found in white grapes that may decrease breast cancer risk," said Braunstein, vice president for Clinical Innovation and the James R. Klinenberg, MD, Chair in Medicine.
Resveratrol stops breast cancer growth
New research in the FASEB Journal shows that resveratrol blocks the growth effects of estrogen by reducing the specific breast cancer receptors
A new research report appearing in the October 2011 issue of The FASEB Journal (https://www.fasebj.org) shows that resveratrol, the "healthy" ingredient in red wine, stops breast cancer cells from growing by blocking the growth effects of estrogen. This discovery, made by a team of American and Italian scientists, suggests for the first time that resveratrol is able to counteract the malignant progression since it inhibits the proliferation of hormone resistant breast cancer cells. This has important implications for the treatment of women with breast cancer whose tumors eventually develop resistance to hormonal therapy.
"Resveratrol is a potential pharmacological tool to be exploited when breast cancer become resistant to the hormonal therapy," said Sebastiano Andò, a researcher involved in the work from the Faculty of Pharmacy at the University of Calabria in Italy.
To make this discovery, Andò and colleagues used several breast cancer cell lines expressing the estrogen receptor to test the effects of resveratrol. Researchers then treated the different cells with resveratrol and compared their growth with cells left untreated. They found an important reduction in cell growth in cells treated by resveratrol, while no changes were seen in untreated cells. Additional experiments revealed that this effect was related to a drastic reduction of estrogen receptor levels caused by resveratrol itself.
"These findings are exciting, but in no way does it mean that should people go out and start using red wine or resveratrol supplements as a treatment for breast cancer," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "What it does mean, however, is that scientists haven't finished distilling the secrets of good health that have been hidden in natural products such as red wine."
Moderate drinking and cardiovascular health: beer
Beer could stand up alongside wine regarding positive effects on cardiovascular health. This is the conclusion of a study conducted by Research Laboratories at the Fondazione di Ricerca e Cura "Giovanni Paolo II", in Campobasso, Italy. Both for wine and beer the key is moderate and regular drinking.
The research, published on line by the European Journal of Epidemiology, using the statistic approach of meta-analysis, pooled different scientific studies conducted worldwide in previous years to achieve a general result. This way it has been possible to examine data concerning over 200,000 people, for whom alcohol drinking habits were associated with cardiovascular disease.
Results confirm what was already known about wine: a moderate consumption (approximately two glasses per day for men and one for women) can lower the risk of cardiovascular disease, up to 31% less when comparing to non drinkers. What this research adds are new data on beer. For the first time, in fact, evidence about dose-dependent effect is shown for this beverage. Maximum protection is observed, for a beer containing 5% of alcohol, with a consumption of slightly more than an English pint a day.
"In our research – explains Simona Costanzo, first author of the paper - we considered wine and beer separately: you first observe a reduction in cardiovascular risk with low to moderate drinking. Then, with an increasing consumption, you can see that the advantage disappears, until the risk gets higher. The interesting part of our research is that, among the studies selected for this meta-analysis, there were 12 in which wine and beer consumption could be compared directly. Using these data we were able to observe that the risk curves for the two beverages are closely overlapping".
But beer as well as wine, drinkers, should be cautious before toasting too much at these results. "What we are talking about – says Augusto Di Castelnuovo, head of the Statistic Unit of Research Laboratories and a pioneer in alcohol epidemiological studies - is moderate and regular drinking. I think we will never stress enough this concept. Wine or beer are part of a lifestyle. One glass can pair with healthy foods, eaten at proper time, maybe together with family of friends. There is no place for binge drinking or any other form of heavy consumption.
"The data reported in our meta-analysis – Di Castelnuovo emphasizes- cannot be extrapolated to everybody. In young women still in their fertile age, as an example, alcohol can slightly raise the risk for some kind of cancer. This could counterbalance the positive effect on cardiovascular disease and reduce the overall benefit of alcoholic beverages on health".
In the similarity between wine and beer regarding positive effects on cardiovascular health there is a still unanswered question: the evidence we are observing derives from alcohol alone or from other substances contained in beverages? Wine and beer are different in composition, except for alcohol, so we could think this is the main player. But they both contain polyphenols, albeit different ones. Researchers at Fondazione "Giovanni Paolo II" underline how this is something to look at more closely in the future.
"A research like this - comments Giovanni de Gaetano, director of Research Laboratories at Fondazione "Giovanni Paolo II" – is part of a concept that our group strongly pursues: to look at people's real life. Health and disease are conditions deriving from our lifestyle. New therapies, new drugs, are extremely important. But a healthy life, with a strong attitude toward prevention, is the key element of the medicine in the years to come".
Reduction in risk of coronary heart disease from alcohol consumption
In a prospective, observational study of approximately 150,000 Norwegians, the investigators found that alcohol consumption was associated with a large decrease in the risk of death from coronary artery disease. For men, the fully adjusted hazard ratio for cardiac death was 0.52 (in other words, only about 1/2 the risk of dying) when comparing subjects reporting more than one drink/week in comparison with those reporting never or rarely drinking; for women, it was 0.62 (only about 3/5 the risk of dying). There was little change in the hazard ratio when HDL-cholesterol (HDL) was added to the model, suggesting that very little of the lower risk of heart disease was due to an increase in HDL from alcohol consumption.
Forum members considered this a well-done analysis. They were surprised at the very low amounts of alcohol intake reported by the subjects, with only 16% of males and about 8% of females reporting more than one drink/week. It is possible that the low levels of drinking, or perhaps over-adjustment in the multivariable analysis, led to the lack of effect of HDL. Most other studies have shown a much larger proportion of the effect of alcohol on heart disease risk to be associated with an increase in HDL.
Light drinking = significant decrease in cancer risk
A paper from the National Institutes of Health in the United States has evaluated the separate and combined effects of the frequency of alcohol consumption and the average quantity of alcohol drunk per occasion and how that relates to mortality risk from individual cancers as well as all cancers. The analysis is based on repeated administrations of the National Health Interview Survey in the US, assessing more than 300,000 subjects who suffered over 8,000 deaths from cancer. The research reports on total cancer deaths and deaths from lung, colorectal, prostate, and breast cancers.
The overall message of this analysis is that light to moderate alcohol intake does not appear to increase the risk of all-site cancer (and light drinking was shown in this study to be associated with a significant decrease in risk). Similarly, light to moderate consumption was not associated with site-specific cancers of the lung, colorectum, breast, or prostate.
As quantity consumed increased from 1 drink on drinking days to 3 or more drinks on drinking days (US drinks are 14g), risk of all-site cancer mortality increased by 22% among all participants. For total alcohol consumption (frequency x quantity), the data indicate a significant reduction in the risk of all-site cancers (RR=0.87, CI 0.80-0.94). Moderate drinking consistently shows no effect in the analysis, and only heavier drinking was associated with an increase in all-site cancer risk. For site-specific cancers, an increase in risk of lung cancer was seen for heavier drinkers, with a tendency for less cancer among light drinkers. There was no evidence of an effect of total alcohol consumption on colorectal, prostate, or breast cancer.
The authors excluded non-drinkers in a second analysis in which they used categories of usual daily quantity and of frequency of consumption in an attempt to investigate their separate effects. For all-site cancer and for lung cancer, these results again show an increase in risk only for drinkers reporting greater amounts of alcohol. The data also show an increase in cancer risk from more frequent drinking among women but not among men. For colorectal, prostate, and breast cancer, there is no clear pattern of an increase in risk from quantity of alcohol consumed. For frequency of drinking, again there is a suggestion of an increase in mortality risk with more frequent drinking, although the trends are not statistically significant.
Heavier drinking (three drinks or more per occasion) is known to be associated with a large number of adverse health effects, including certain cancers, as was shown in this study.
Alcohol can reduce asthma risk
Drinking alcohol in moderate quantities can reduce the risk of asthma, according to Danish researchers.
The study, which will be presented at the European Respiratory Society's Annual Congress in Amsterdam, found that drinking 1-6 units of alcohol a week could reduce the risk of developing the condition.
The research examined 19,349 twins between the ages of 12 and 41 yrs of age. All participants completed a questionnaire at the start and end of the study to compare alcohol intake with the risk of developing asthma over 8 yrs.
The results showed that the lowest risk of asthma was seen in the group which had a moderate intake of alcohol, as less than 4% of those who drank 1-6 units per week developed asthma.
The highest risk of asthma was observed in people who drunk rarely or never, as they were 1.4-times more likely to develop the condition. Heavy drinkers also had an increased risk of asthma development and were 1.2-times more likely to develop asthma.
The results also suggested that a preference for beer drinking was associated with an increased risk of asthma when compared with no preference.
Previous studies have found a link between excessive intake of alcohol and asthma attacks; however, this is the first study of its kind to show a link between alcohol intake and the onset of asthma for adults over a long period of time.
Alcohol intake and 'successful aging'
Among 13,894 women in the Nurses' Health Study, investigators prospectively examined alcohol use assessed at midlife in relation to "successful ageing," which was defined as survival to age 70 years, not having a major chronic disease (such as coronary disease, cancer, stroke, diabetes), and having no major cognitive impairment, physical impairment, or mental health problems. Only 11% of the women met these criteria.
The results indicate that moderate drinkers, especially those consuming wine and drinking regularly, were more likely to exhibit successful ageing. For average amount consumed, the largest benefit (an increase of 28%) was among women who reported 15.1 – 30 g of alcohol per day (an average of just over 1 to 2 _ drinks per day), when compared with non-drinkers. The frequency of drinking was especially important: in comparison with nondrinkers, women who drank only on 1 to 2 days per week had little increase in their risk of successful ageing, but those drinking on at least 5 days per week had almost a 50% greater chance of successful ageing.
Forum reviewers had some questions about the definition of "successful ageing" used in this study. It is believed that a much greater percentage of people who may not meet these criteria make huge contributions to society and should be considered "successful."
In summary, these results support the findings of earlier studies showing that many aspects of successful ageing, in addition to just survival, are favorably affected by regular, moderate consumption of alcohol.
Moderate drinking protects against Alzheimer's and cognitive impairment
Moderate social drinking significantly reduces the risk of dementia and cognitive impairment, according to an analysis of 143 studies by Loyola University Chicago Stritch School of Medicine researchers.
Researchers reviewed studies dating to 1977 that included more than 365,000 participants. Moderate drinkers were 23 percent less likely to develop cognitive impairment or Alzheimer's disease and other forms of dementia.
Wine was more beneficial than beer or spirits. But this finding was based on a relatively small number of studies, because most papers did not distinguish among different types of alcohol.
Results are reported in the journal Neuropsychiatric Disease and Treatment. The authors are Edward J. Neafsey, PhD. and Michael A. Collins, PhD., professors in the Department of Molecular Pharmacology and Therapeutics.
Heavy drinking (more than 3 to 5 drinks per day) was associated with a higher risk of cognitive impairment and dementia, but this finding was not statistically significant.
"We don't recommend that nondrinkers start drinking," Neafsey said. "But moderate drinking -- if it is truly moderate -- can be beneficial." Moderate drinking is defined as a maximum of two drinks per day for men and 1 drink per day for women.
Among the studies reviewed, 74 papers calculated the ratios of risk between drinkers and non-drinkers, while 69 papers simply stated whether cognition in drinkers was better, the same or worse than cognition in nondrinkers. Neafsey and Collins did a meta-analysis of the studies that calculated risk ratios and found that moderate drinkers were 23 percent less likely to develop dementia or cognitive decline.
Other findings:
The protective effect of moderate drinking held up after adjusting for age, education, sex and smoking.
There was no difference in the effects of alcohol on men and women.
The beneficial effect of moderate drinking was seen in 14 of 19 countries, including the United States. In 3 of the remaining 5 countries, researchers also found a benefit, but it was not strong enough to be statistically significant.
The findings were similar across different types of studies (longitudinal cohort studies, case-control studies and cross-sectional studies).
It is unknown why moderate drinking can have a beneficial effect. One theory suggests that the well-known cardiovascular benefits of moderate alcohol consumption, such as raising good HDL cholesterol, also can improve blood flow in the brain and thus brain metabolism.
A second possible explanation involves "sick quitters." According to this theory, nondrinkers have a higher risk of cognitive impairment and dementia because the group includes former heavy drinkers who damaged their brain cells before quitting. But the analysis by Neafsey and Collins did not support this explanation. They found that in studies that excluded former heavy drinkers, the protective effect of moderate drinking still held up.
Neafsey and Collins suggest a third possible explanation: Small amounts of alcohol might, in effect, make brain cells more fit. Alcohol in moderate amounts stresses cells and thus toughens them up to cope with major stresses down the road that could cause dementia.
For people who drink responsibly and in moderation, there's probably no reason to quit. But because of the potential for alcohol to be abused, Neafsey and Collins do not recommend that abstainers begin drinking.
The researchers note that there are other things besides moderate drinking that can reduce the risk of dementia, including exercise, education and a Mediterranean diet high in fruits, vegetables, cereals, beans, nuts and seeds. Even gardening has been shown to reduce the risk of dementia.
Light-to-moderate alcohol intake, especially of wine, may be more likely to protect against, rather than promote, weight gain
A paper from Spain provides an extensive review of the association between alcohol consumption and body weight.
The study includes descriptions of cross-sectional and prospective studies (and a few small intervention studies) among subjects who varied in age (adolescence to old age), culture (from Americans and Europeans to Asians), and principal type of beverage consumed and pattern of drinking. The authors state that many of the studies they reviewed appear to be contradictory in their results. However, based on their review, they conclude that "as positive associations between alcohol and weight gain were mainly found in studies with data on higher levels of drinking, it is possible that an effect on weight gain or abdominal adiposity may only be experienced by heavy drinkers." A second conclusion of the authors is that "the type of alcoholic beverage might play an important role in modifying the effect of alcohol consumption on weight gain," with more favourable effects generally seen among consumers of wine. A formal meta-analysis is not provided.
The overall conclusions of the authors is that it is currently unclear whether alcohol consumption is a risk factor for weight gain, but if so it appears to occur mainly among heavier drinkers. They also state that "light-to-moderate alcohol intake, especially of wine, may be more likely to protect against, rather than promote, weight gain."
International Scientific Forum on Alcohol Research reviewers agreed with most of the conclusions of the authors, especially that current data do not clearly indicate if moderate drinking increases weight; further, the biologic mechanisms relating alcohol to changes in body weight are not well understood. The Forum review comments on the strong protective effects of moderate drinking on the risk of metabolic syndrome and diabetes, both of which relate to increasing obesity. Some studies suggest that even very obese people may be at lower risk of diabetes if they are moderate drinkers. Forum members also reviewed some of the distinctive mechanisms by which alcohol is metabolized in the body (it provides calories that are rapidly absorbed and are not stored in fat) that could explain differences in the effects of calories from alcohol and from other foods.
Moderate Alcohol Consumption Reduces the Risk of Hypertension for Women, Increases It For Men
Drinking too much alcohol can raise BP to unhealthy levels, especially among men. Moderate amounts of alcohol actually protect women, but not men. The meta-analysis evaluated a total of 16 prospective studies, which included 158,142 men and 314,258 women. Among men, a linear dose–response relationship between alcohol intake and risk of development of hypertension was noted. As compared to non-drinkers, men consuming < 10g/day of alcohol had a relative risk (RR) of 1.006, those consuming 10-20 g/day had a RR of 1.091, and those consuming > 30g/day had a RR of 1.416.
Among women, the meta-analysis indicated protective effects at < 10g/day (RR -0.867) and 10-20g/day (RR – 0.904) of alcohol consumption, while the risk increased in women consuming > 30g/day (RR – 1.188). The risk of hypertension significantly increases with consumption of more than 30g/day in men and women alike.
Note: 30 grams is equal to about 2 5oz. glasses of wine, or 2 12 oz. beers:
12 ounces beer = 153 calories and 13.9 grams alcohol
12 ounces lite beer = 103 calories and 11 grams alcohol
5 ounces wine (red) = 125 calories and 15.6 grams alcohol
5 ounces wine (white) = 121 calories and 15.1 grams alcohol
3 ounces sake = 117 calories and 14.1 grams alcohol
1 1/2 ounces liquor (80 proof or 40% alcohol) = 97 calories and 14 grams alcohol
Lower risk of coronary heart disease from alcohol
An analysis assessesd the 12-month prevalence of coronary heart disease (CHD) in individuals according to their category of alcohol use. The 2001 National Epidemiologic Survey on Alcohol and Related Conditions study (the NESARC study, n = 43,093) identified 16,147 abstinent individuals, 15,884 moderate consumers, 9,578 hazardous drinkers — defined as exceeding sex-specific weekly limits established by the World Health Organization, and 1,484 alcohol-dependent subjects. Diagnoses were generated using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV version.
Both moderate and hazardous drinking were associated with decreased odds of CHD when compared with abstinence, whereas odds of CHD were not significantly different between alcohol-dependent and abstinent participants. A moderate or even a hazardous consumption of alcohol was associated with a decreased likelihood of CHD after controlling for socio-demographic, psychiatric, and addictive risk factors. The study shows that alcohol may have cardio-protective effects not only in moderate drinkers, but also in individuals with patterns of use traditionally considered as hazardous.
Effects of alcohol on risk factors for cardiovascular disease
A summary paper on the effects of alcohol consumption on biologic mechanisms associated with coronary heart disease provides an excellent review of a large number of intervention studies in humans. Appropriate analyses were done and the results are presented in a very clear fashion, although there was little discussion of the separate, independent effects of alcohol and polyphenols on risk factors.
The trials the authors reviewed have demonstrated that the moderate intake of alcoholic beverages leads to increases in HDL-cholesterol (good cholesterol), apolipoprotein A1, and adiponectin and decreases in fibrinogen, all factors associated with a lower risk of heart disease. The findings described in this paper strengthen the case for a causal link between alcohol intake and a reduced risk of coronary heart disease, suggesting that the lower risk of heart disease observed among moderate drinkers is caused by the alcoholic beverage itself, and not by other associated lifestyle factors.
The reviewers independently selected studies that examined adults without known cardiovascular disease and that compared fasting levels of specific biological markers associated with coronary heart disease after alcohol use with those after a period of no alcohol use (controls). A total of 4,690 articles were screened for eligibility, the full texts of 124 studies reviewed, and 63 relevant articles selected. Of 63 eligible studies, 44 on 13 biomarkers were meta-analysed in fixed or random effects models. Quality was assessed by sensitivity analysis of studies grouped by design. Analyses were stratified by type of beverage (wine, beer, spirits).
The authors concluded that favourable changes in several cardiovascular biomarkers (higher levels of high density lipoprotein cholesterol and adiponectin and lower levels of fibrinogen) provide indirect pathophysiological support for a protective effect of moderate alcohol use on coronary heart disease.
Alcohol consumption helps stave off dementia
Experts agree that long-term alcohol abuse is detrimental to memory function and can cause neuro-degenerative disease. However, according to a study published in Age and Ageing by Oxford University Press , there is evidence that light-to-moderate alcohol consumption may decrease the risk of cognitive decline or dementia.
Estimates from various studies have suggested the prevalence of alcohol-related dementia to be about 10% of all cases of dementia. Now researchers have found after analyzing 23 longitudinal studies of subjects aged 65 years and older that the impact of small amounts of alcohol was associated with lower incidence rates of overall dementia and Alzheimer dementia, but not of vascular dementia and cognitive decline. It is still an open question whether different alcoholic beverages, such as beer, wine, and spirits, all have a similar effect. Some studies have shown a positive effect of wine only, which may be due either to the level of ethanol, the complex mixture that comprises wine, or to the healthier life-style ascribed to wine drinkers.
A total of 3,327 patients were interviewed in their homes by trained investigators (physicians, psychologists, gerontologists) and reassessed one and a half years and three years later. Information on the cognitive status of those who had died in the interim was collected from family members, caregivers or primary care physicians.
Among the 3,327 patients interviewed at baseline, 84.8% (n=2,820) could be personally interviewed one and a half years later and 73.9% (n=2,460) three years later. For the vast majority of subjects who could not be personally interviewed, systematic assessments (follow-up 1: 482; follow-up 2: 336) focusing particularly on dementia could be obtained from GPs, relatives or caregivers. Within three years, follow-up assessments were unavailable for only 49 subjects (1.5%). Proxy information could be obtained for 98.0% (n=295) of the 301 patients who had died in the interim. Since dementia is associated with a higher mortality rate, proxy information is particularly important in order to avoid underestimation of incident dementia cases.
At baseline there were 3,202 persons without dementia. Alcohol consumption information was available for 3,180 subjects:
50.0% were abstinent
24.8% consumed less than one drink (10 grams of alcohol) per day
12.8% consumed 10-19 grams of alcohol per day
12.4% consumed 20 or more grams per day
A small subgroup of 25 participants fulfilled the criteria of harmful drinking (>60 grams of alcohol per day for men, respectively >40 grams for women)
One man (>120 grams of alcohol per day) and one woman (>80 grams of alcohol per day) reported an extremely high consumption of alcohol
Among the consumers of alcohol almost half (48.6%) drank wine only
29.0% drank beer only
22.4% drank mixed alcohol beverages (wine, beer, or spirits)
Alcohol consumption was significantly associated with male gender, younger age, higher level of education, not living alone, and not being depressed.
The calculation of incident cases of dementia is based on 3,202 subjects who had no dementia at baseline. Within the follow-up period of three years:
217 cases of dementia (6.8%) were diagnosed, whereby 111 subjects (3.5%) suffered from Alzheimer dementia. Due to the relatively small numbers, other subgroups of dementia (vascular dementia: n=42; other specific dementia, e.g. dementia in Parkinson's disease, Lewy body dementia, alcohol dementia: n=14; dementia with unknown aetiology: n=50) were not considered in the following analyses.
Univariate and multivariate analyses revealed that alcohol consumption was significantly associated with a lower incidence of overall dementia and Alzheimer dementia. In line with a large-scale study also based on GP attenders aged 75 years and older, the study found that light-to-moderate alcohol consumption was associated with relatively good physical and mental health. This three-year follow-up study included, at baseline, only those subjects 75 years of age and older, the mean age was 80.2 years, much higher than that in most other studies.
Drinking Alcohol in Moderation Protects Against Heart Disease
Individuals who drink alcohol in moderation (about one drink a day or less) are 14-25% less likely to develop heart disease compared to those who drink no alcohol at all, finds research led by Professor William Ghali from the University of Calgary, published online in the British Medical Journal.
The first paper, led by Paul Ronksley from the University of Calgary, emphasizes that a balance needs to be found between the public health message that consuming large amounts of alcohol is bad for you, and the one that drinking in moderation can have health benefits.
An accompanying paper led by Dr Susan Brien, also from the University of Calgary, finds that moderate consumption of alcohol (up to one drink or 15 g alcohol per day for women and up to two drinks or 30 g alcohol per day for men) is good for health. They say moderate amounts of alcohol significantly increase the levels of 'good' cholesterol circulating in the body and this has a protective effect against heart disease.
Brien and colleagues argue that their study strengthens the case that there is a causal link between alcohol consumption and reduced heart disease.
The authors of both papers acknowledge that a number of previous studies have concluded that moderate alcohol consumption has been associated with a decrease in heart disease. However, they say that the research was out-of-date and there was a need for new material. Professor Ghali says his team's research is the most comprehensive to date.
Ghali and colleagues reviewed 84 studies of alcohol consumption and heart disease. They compared alcohol drinkers with non-drinkers and their outcomes in relation to heart disease, death from heart disease, incidences of stroke and death from having a stroke.
In the companion study, Brien and colleagues reviewed 63 studies and investigated alcohol consumption with known physical markers for heart disease such as cholesterol, levels of inflammation, fat cells and the condition of blood vessels. They also assessed the impact of the type of alcohol consumed (wine, beer and spirits).
Interestingly, Brien's research concludes that it is the alcohol content that provides the health benefits not the type of alcoholic beverage (wine, beer or spirits) that is drunk.
Professor Ghali concludes that the debate between the impact of alcohol on heart disease should now centre "on how to integrate this evidence into clinical practice and public health messages."
Alcohol Abstinence = Increased Risk of Cognitive Impairment
Previous research regarding the association between alcohol consumption and dementia or cognitive impairment in later life suggests that mild to moderate alcohol consumption might be protective of dementia. However, most of the research has been conducted on subjects already rather elderly at the start of the follow-up.
A new study published in the December, 2010 issue of the Journal of Alzheimer's Disease addresses this problem with a follow-up of more than two decades.
The study, conducted at the University of Turku, University of Helsinki and National Institute for Health and Welfare in Finland based on subjects from the Finnish Twin Cohort, shows that midlife alcohol consumption is related to the risk of dementia assessed some 20 years later. The study indicates that both abstainers and subjects consuming large amounts of alcohol have a greater risk for cognitive impairment than light drinkers.
"Our finding is significant as the changes typical of Alzheimer's disease -- the most common dementia syndrome -- are thought to start appearing two to three decades before clinical manifestation and therefore identification of early risk factors is imperative," states Jyri Virta, researcher at University of Turku, Finland.
In addition to total alcohol consumption, the authors were able to assess the effects of different drinking patterns. The study suggests that drinking large amounts of alcohol (defined as a bottle of wine or the equivalent) at a single occasion at least monthly is an independent risk factor for cognitive impairment. Such binge drinking doubles the risk of cognitive impairment even when total alcohol consumption was statistically controlled for.
Similarly, passing out because of heavy drinking on one occasion was also found to increase the development of subsequent cognitive impairment. Thus, it is not only the amount of alcohol, but also the pattern by which alcohol is consumed that affects the risk of cognitive impairment. The published study is among the first to report these effects.
Moderate alcohol consumption lowers the risk of metabolic diseases
With the emergence of an epidemic of obesity and type 2 diabetes (DM) throughout the world, the association of lifestyle habits that may affect the risk of metabolic diseases is especially important. Most prospective studies have shown that moderate drinkers tend to have about 30% lower risk of developing late onset diabetes than do non-drinkers, and moderate drinkers also tend to be at lower risk of developing metabolic syndrome (MS). A cross-sectional analysis of 6172 subjects age 35 -75 in Switzerland related varying levels of alcohol intake to the presence of DM, MS, and an index of insulin resistance (HOMA-IR).
Study findings: In multivariate analysis, the prevalence of the metabolic syndrome, diabetes and mean HOMA-IR decreased with low-risk drinking and increased with high-risk drinking. Adjusted prevalence of the metabolic syndrome was 24% in non-drinkers, 19% in low-risk, 20% in medium-to-high-risk and 29% in very-high-risk drinkers. Adjusted prevalence of diabetes was 6.0% in non-drinkers, 3.6% in low-risk, 3.8% in medium-to-high-risk and 6.7% in very-high-risk drinkers. These relationships did not differ according to beverage types.
Moderate drinkers also had the lowest weight, tryglycerides, and blood pressure. All drinkers had higher HDL-cholesterol values (that is 'good cholesterol) than did non-drinkers.
Forum comments:
Metabolic syndrome is the name given to a so called 'lifestyle disease', where patients exhibit multiple medical problems including high blood pressure, late on set diabetes, and high cholesterol.
The strengths of this paper include being population-based and having a large number of subjects who reported that they consumed 14 or more drinks/week. Also, there was a good percentage (27%) of subjects reporting no alcohol intake during the one week of assessment used for classifying subjects. Another strength is the careful confirmation of drinking status with state-of-the-art laboratory tests. In multivariate analysis, the prevalence of the metabolic syndrome, diabetes and mean HOMA-IR decreased with low-risk drinking and increased with high-risk drinking. No differences were noted according to the type of beverage consumed.
Moderate drinking, especially wine, associated with better cognitive function
A large prospective study of 5033 men and women in the Tromsø Study in northern Norway has reported that moderate wine consumption is independently associated with better performance on cognitive tests. The subjects (average age 58 and free of stroke) were followed over 7 years during which they were tested with a range of cognitive function tests. Among women, there was a lower risk of a poor testing score for those who consumed wine at least 4 or more times over two weeks in comparison with those who drink < 1 time during this period The expected associations between other risk factors for poor cognitive functioning were seen, i.e. lower testing scores among people who were older, less educated, smokers, and those with depression, diabetes, or hypertension.
It has long been known that "moderate people do moderate things." The authors state the same thing: "A positive effect of wine . . . could also be due to confounders such as socio-economic status and more favourable dietary and other lifestyle habits.
The authors also reported that not drinking was associated with significantly lower cognitive performance in women. As noted by the authors, in any observational study there is the possibility of other lifestyle habits affecting cognitive function, and the present study was not able to adjust for certain ones (such as diet, income, or profession) but did adjust for age, education, weight, depression, and cardiovascular disease as its major risk factors.
The results of this study support findings from previous research on the topic: In the last three decades, the association between moderate alcohol intake and cognitive function has been investigated in 68 studies comprising 145,308 men and women from various populations with various drinking patterns. Most studies show an association between light to moderate alcohol consumption and better cognitive function and reduced risk of dementia, including both vascular dementia and Alzheimer's Disease.
Such effects could relate to the presence in wine of a number of polyphenols (antioxidants) and other micro elements that may help reduce the risk of cognitive decline with ageing. Mechanisms that have been suggested for alcohol itself being protective against cognitive decline include effects on atherosclerosis ( hardening of the arteries), coagulation ( thickening of the blood and clotting), and reducing inflammation ( of artery walls, improving blood flow).
Alcohol consumption lowers risk of developing several arthritic conditions
Alcohol consumption is associated with a significantly reduced risk of developing several arthritic conditions including Rheumatoid Arthritis (RA), Osteoarthritis (OA), reactive arthritis, psoriatic arthritis and spondylarthropathy, according to results of a study presented at EULAR 2010, the Annual Congress of the European League Against Rheumatism in Rome, Italy. Regardless of the type of arthritis, all patients reported drinking less alcohol than controls, leading to questions around the inflammatory pathways behind the effects seen.
In this Dutch study, alcohol consumption was associated with a significantly lower risk of developing RA (Odds Ratio (OR) 0.27 (0.22-0.34), Osteoarthritis (OR 0.31, (0.16-0.62), spondylarthropathy (OR 0.34, 0.17-0.67), psoriatic arthritis (OR 0.38, 0.23-0.62), and reactive arthritis (OR 0.27, 0.14-0.52). A particularly protective effect was shown in the RA population with the presence of Anti-Citrullinated Protein Antibodies (ACPA, potentially important surrogate markers for diagnosis and prognosis in RA), (OR 0.59, 0.30-0.99).
Interestingly, researchers also found that the degree of systemic inflammation in patients was shown to increase as the amount of alcohol consumed decreased (p=0.001) and that there was no dose response relationship (low 0.12 (0.08-0.18), moderate 0.46 (0.36-0.59), high 0.17 (0.12-0.25)) between the amount of alcohol consumed and the risk of arthritis development. Researchers hypothesise that there could be two explanations for this inflammatory effect; either that patients with more severe disease activity consume less alcohol due to associated changes in their lifestyle, or that the presence of alcohol in the system could protect against the development of systemic inflammation.
"We know from previous research that alcohol consumption may confer a protective effect against developing RA, our data have shown that this effect may apply to other arthritic conditions too," said Dr Annekoos Leonoor Huidekoper, Leiden University Medical Centre, Netherlands and lead author of the study. "What intrigues us now is that the findings related to systemic inflammation, further research into the inflammatory pathways involved is needed to determine the exact nature of the association."
Patients with arthritic conditions (n=997; RA n=651, reactive arthritis, spondylaropathy or psoriatic arthritis n=273, osteoarthritis n=73) were enrolled from the Leiden Early Arthritis Cohort and healthy controls (n=6,874) recruited from the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis study. Alcohol consumption was recorded at baseline (units per week), and the effect of alcohol consumption on risk of disease development was analysed by univariate and multivariate logistic regression (statistical tests that predict the probability of an event occurring). Odds ratios and confidence intervals (95%) were adjusted for age, sex, Body Mass Index (BMI) and smoking.
Professor Paul Emery, President of EULAR and arc Professor of Rheumatology, Leeds Institute of Molecular Medicine, University of Leeds, UK said: "These are very interesting findings but we should assert the need for caution in the interpretation of these data. Alcohol should be consumed in moderation, with consideration for local public health recommendations. A number of social and medical problems are associated with increased consumption of alcohol; therefore any positive implications of its use must be understood within the wider health context."
Alcohol in moderation is good for sick hearts too
A study by the Catholic University of Campobasso, Italy, shows that a regular and moderate alcohol consumption is beneficial for people who had a previous heart attack or other ischemic vascular events
It was still an open question in medicine. Whereas scientific research has shown beneficial effects of moderate alcohol consumption in healthy people, it was not clear whether this could be valid also for patients who already had heart attack, stroke or another ischemic vascular event. A positive answer comes now from a study performed by the Research Laboratories at the Catholic University of Campobasso, Italy: moderate consumption, defined as one or two glasses of wine a day or the equivalent amounts of beer or other alcoholic beverages, significantly reduces the risk of death from any cause in those who already suffered from ischemic vascular disease.
The research, published in the Journal of the American College of Cardiology (JACC), was performed using the statistic procedure of meta-analysis which allows to combine different studies conducted worldwide to achieve more precise results. Researchers analyzed the most important scientific studies performed during the last years. Eight in total in four Countries: United States, Sweden, Japan and Great Britain. Each study took into account patients already affected by an ischemic vascular event. During the years following the disease onset, patients were followed by researchers to know which were the lifestyle habits, including alcohol consumption, able to avoid a new clinical event. The meta-analysis allowed to pool all those studies for a total of 16,351 people examined.
"We observed – says Simona Costanzo, epidemiologist and first author of the study – that regular and moderate consumption has beneficial effects even for people already affected by heart attack, or stroke. Not only they are less likely to be affected by similar diseases again, but all-cause mortality too resulted to be lower than in those who did not consume any alcoholic beverage".
The effect is very similar to that observed in healthy people. "Risk reduction - Costanzo argues - is about 20%. This means that one event out of five can be spared. It is a huge advantage, comparable to the one already recorded for healthy individuals".
"Studied by our research group for a long time – says Augusto Di Castelnuovo, Head of the Statistic Unit at the Research Laboratories of the Catholic University in Campobasso and co-author of the study - the beneficial effects of moderate alcohol consumption in healthy people are well established. Now we have reason to believe that alcoholic beverages work by the same protective mechanisms also for people already affected by ischemic vascular diseases".
But, as all researches state, the key word is moderation. "When we talk about moderate alcohol consumption, we mean something quite far from what we use to see in TV fictions – says Licia Iacoviello, Head of the Laboratory of Environmental and Genetic Epidemiology and responsible of the Moli-sani Project – We refer to moderation as drinking regularly, at low doses, within a healthy lifestyle, such as the Mediterranean diet. A glass of wine or beer during meals has always been an integral part of the Mediterranean way of eating. Our research highlights another crucial issue: drinking has not only to be moderate, but also regular. A moderate consumption spread along the week is positive. The same amount of weekly alcohol, concentrated in a couple of days is definitely harmful".
"Despite these new positive results- argues Giovanni de Gaetano, Director of the Research Laboratories - we do believe that teetotallers, either healthy or ill, should not start drinking with the aim to earn more health. Our study, as those conducted by our group in the past, is not a kind of invitation to start drinking, but the recognition of a particular lifestyle. This time we need to be cautious since we deal with sick people. We recommend to them to discuss with their own doctor the best choice in terms of alcoholic beverage consumption".
Women who drink moderately appear to gain less weight than nondrinkers
Normal-weight women who drink a light to moderate amount of alcohol appear to gain less weight and have a lower risk of becoming overweight and obese than non-drinkers, according to a report in the March 8, 2010 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
More than half of American adults drink alcoholic beverages, according to background information in the article. Alcohol contains about 7 calories per gram (with approximately 28 grams per ounce) and alcohol drinking may possibly lead to weight gain through an imbalance of energy consumed and energy burned. However, research has not consistently provided evidence that consuming alcohol is a risk factor for obesity.
Lu Wang, M.D., Ph.D., of Brigham and Women's Hospital, Boston, and colleagues studied 19,220 U.S. women age 39 or older who had a body mass index (BMI) in the range classified as normal (18.5 to 25). On an initial questionnaire, participants reported how many alcoholic beverages they typically drank per day. A total of 7,346 (38.2 percent) reported drinking no alcohol; 6,312 (32.8 percent) drank less than 5 grams; 3,865 (20.1 percent) drank 5 to less than 15 grams; 1,129 (5.9 percent) drank 15 to less than 30 grams; and 568 (3 percent) drank 30 grams per day or more.
Over an average of 13 years of follow-up, women on average gained weight progressively. Women who did not drink alcohol at all gained the most weight, with weight gain decreasing as alcohol intake increased. A total of 7,942 (41.3 percent) women who initially had normal weight become overweight or obese (BMI of 25 or higher), including 732 (3.8 percent) who become obese (BMI of 30 or higher). Compared with women who did not drink at all, those who consumed some but less than 40 grams per day of alcohol were less likely to become overweight or obese. Women who drank 15 to less than 30 grams per day had the lowest risk, which was almost 30 percent lower than that of non-drinkers.
"An inverse association between alcohol intake and risk of becoming overweight or obese was noted for all four types of alcoholic beverages [red wine, white wine, beer and liquor], with the strongest association found for red wine and a weak yet significant association for white wine after multivariate adjustment," the authors write.
Drinking Wine Protects Skin From Radiation
Drinking wine while undergoing radiation treatment for breast carcinoma may reduce the incidence of skin toxicity in breast cancer patients, according to a study in the August,2009 issue of the International Journal of Radiation Oncology*Biology*Physics, the official journal of the American Society for Radiation Oncology (ASTRO).
Preventing radiation therapy-induced side effects is an important part of a patient’s cancer treatment management. Several medications are available to help protect healthy organs from the effects of radiation, but they are often expensive, have side effects themselves and can provide protection to tumor cells as well as healthy cells.
Researchers at the Department of Oncology and the Center for High Technology Research and Education in Biomedical Sciences at Catholic University in Campobasso, Italy, the Catholic University Department of Radiotherapy in Rome, Italy, and at the National Research Council’s BioMatLab in Rome, Italy, conducted this study to determine if the natural antioxidants in wine would provide a radioprotective effect in preventing acute skin toxicity in patients undergoing radiation therapy after conservative surgery for breast carcinoma.
The study consisted of 348 patients divided into three groups based on the dose/fractionation scheme used. Patients consuming wine had a lower incidence of Grade 2 or higher acute toxicity than those who did not consume alcohol. Patients who drank one glass of wine per day had a 13.6 percent incidence of skin toxicity versus a 38.4 percent incidence in patients who did not drink wine. “If wine can prevent radiotherapy-induced toxicity without affecting antitumor efficacy, as we observed, it also has the potential to enhance the therapeutic benefit in cancer patients without increasing their risk of serious adverse effects,” Vincenzo Valentini, M.D., a radiation oncologist at Catholic University in Rome, Italy, one of the study authors, said. “The possibility that particular dietary practices or interventions can reduce radiation-induced toxicity is very intriguing.”
Champagne Is Good for Your Heart
Research from the University of Reading suggests that two glasses of champagne a day may be good for your heart and circulation. The researchers have found that drinking champagne wine daily in moderate amounts causes improvements in the way blood vessels function.
Champagne does this by increasing the availability of nitric oxide, a vascular active molecule which controls blood pressure. It is able to induce these effects because it contains polyphenols, plant chemicals from the red grapes and white grapes used in champagne production.
When you drink champagne, these polyphenols get absorbed into the circulation where they are able to act on the vascular system. Specifically, they appear to slow down the natural removal of nitric oxide from our blood, meaning that it will have a longer time to act on blood vessels and so improve the flow of blood around the body.
High nitric oxide levels in the blood, as a result of drinking champagne, can have beneficial effects, because as well as increasing blood flow, it may help to decrease both blood pressure and the likelihood of blood clots forming. This could therefore reduce the risks of suffering from cardiovascular disease and stroke, but more research needs to be done to determine the long term effects of daily champagne consumption.
Dr Jeremy Spencer, from the Department of Food and Nutritional Sciences said: "Our research has shown that drinking around two glasses of champagne can have beneficial effects on the way blood vessels function, in a similar way to that observed with red wine. We always encourage a responsible approach to alcohol consumption, but the fact that drinking champagne has the potential to reduce the risks of suffering from cardiovascular diseases such as heart disease and stroke, is very exciting news."
Moderate alcohol intake has cognitive benefits
A glass of wine here, a nightcap there – new research out of Wake Forest University School of Medicine suggests that moderate alcohol intake offers long-term cognitive protection and reduces the risk of dementia in older adults.
The study was presented at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease (ICAD), in Vienna on July 13.
While previous studies have shown that moderate alcohol intake, particularly wine, is linked with lower risk of heart attacks and dementia, most of the studies have been done in middle-aged people, and it has remained unclear if the benefits of alcohol also apply to older adults in general or to older adults who might already have some mild memory problems. This is the largest, longest U.S. study to look at the effects of regular alcohol intake on dementia in seniors, both with and without memory problems.
"As of yet, we still have no cure for Alzheimer's disease and other dementias, so it is important to look for things that might help people prevent the disease," said Kaycee Sink, M.D., M.A.S (Masters of Advanced Studies in clinical research), a geriatrician and senior author of the paper. Moderate alcohol intake has been linked to lower risk of heart attacks, stroke, dementia, and death in middle-aged adults, but there is still controversy about alcohol intake in older adults."
For the study, researchers began by examining and interviewing 3,069 individuals, 75 years or older and most without any memory or thinking problems, about their drinking habits. Participants were asked about beer, wine, and liquor. The investigators then categorized the individuals as abstainers (non-drinkers), light drinkers (one to seven drinks per week), moderate drinkers (eight to 14 drinks per week), or heavy drinkers (more than 14 drinks per week). All types of alcohol were included.
The study subjects were then examined and interviewed every six months for six years to determine changes in their memory or thinking abilities and to monitor who developed dementia.
Researchers found that individuals who had no cognitive impairment at the start of the study and drank eight to 14 alcoholic beverages per week, or one to two per day, experienced an average 37 percent reduction in risk of developing dementia compared to individuals who did not drink at all and were classified as abstainers. The type of alcohol consumed did not matter.
For older adults who started the study with mild cognitive impairment, however, consumption of alcohol, at any amount, was associated with faster rates of cognitive decline. In addition, those who were classified in the heavy drinker category, consuming more than 14 drinks per week, were almost twice as likely to develop dementia during the study compared to non-drinkers with mild cognitive impairment.
"We were excited to see that even in older adults, moderate alcohol intake decreases the risk of dementia," Sink said. "It is important to note, however, that our study found a significantly higher risk of dementia for heavy drinkers who started the study with mild cognitive impairment."
The results are consistent with previous studies of middle-aged adults that suggest mild to moderate alcohol intake may reduce the risk of dementia, except in the case of individuals who already have mild to moderate cognitive impairment. The researchers' findings support current recommendations not to exceed one drink per day for women and two for men.
It is unclear from this study whether an abstainer who begins drinking moderately in his/her 70s will experience the same benefit or if the benefit is associated with a long pattern of moderate alcohol intake that continues on into old age.
"Our results suggest that older adults who are normal cognitively and drink moderately do not need to change their drinking behavior," Sink said. "If you have mild cognitive impairment however, it might benefit you to restrict your drinking and certainly not exceed one drink a day for women and two drinks a day for men.
"The participants in this study self-reported their alcohol intake at the start, but it is unusual for people to start drinking in their 70s, so we assume that the habits they reported at the start of the study reflect stable drinking habits," Sink added. "Without scientific data showing that it is beneficial, I wouldn't recommend that non-drinkers start drinking in their 70s.
"We are starting to make progress in understanding how to prevent and treat Alzheimer's and other dementias," she said. "It is a very exciting time to be involved in geriatrics research."
The Benefits of Red Wine – Review
Benefits of all alcohol:
Studies on the use of alcohol have shown protective effects against coronary heart disease (CHD). These studies show that one or two alcoholic drinks per day increases high-density lipoprotein (HDL) cholesterol. Also, moderate alcohol consumption decreases low-density lipoprotein (LDL) cholesterol and triglycerides. Finally, alcohol consumption decreases platelet aggregation.
Benefits of Red Wine
There has been some discussion recently, including an article in the New York Times, pointing out that there is a difference in lifestyle among people who drink wine, beer, and other alcoholic beverages, including social class and diet, that may also explain why wine seems to offer more protection than others against coronary heart disease. (1)
Regardless, wine, especially red wine, really does seem to have benefits that the other sources of alcohol do not have, including:
REDUCES INFLAMMATION
Red wine may have anti-inflammatory effects. It reduces C-reactive protein, a marker of inflammation that seems to be related to atherosclerosis. (2)
ANTIOXIDANT PROPERTIES
Red wine has higher concentrations of antioxidant molecules, called polyphenols, than other alcoholic drinks. The antioxidant properties of these polyphenols may contribute to protection against coronary heart disease by reducing oxidation of LDL cholesterol. (3) The polyphenols in red wine include anthocyanins, proanthocyanidins, and resveratrol, and flavonoids, including catechins, kaempferol, and quercetin. (4,5) However, the polyphenol content of wine is dependent upon grape variety, climate, and the methods used to make the wine. White wines, unlike red wines, have very low polyphenol concentrations.
IMMUNE SUPPORT
Red wine may also reduce mutagenic DNA damage and improve endothelial function when included in a high fat diet. (6) Wine can stimulate gastric acid secretion and gastrin release. This may explain why moderate to high wine intake seems to prevent Helicobacter pylori infection. (7) Finally, the anthocyanins in red wine may help prevent various cancers. (8)
OTHER BENEFITS
Red wine may help to prevent noise-induced hearing loss (9), reduce the risk of developing age-related macular degeneration (10), may help to prevent cataracts (11), and may help to prevent rheumatoid arthritis (12).
REFERENCES
1. Rimm EB, Stampfer MJ. Wine, beer, and spirits: are they really horses of a different color? Circulation 2002;105:2806-7.
2. Estruch R, Sacanella E, Badia E, et al. Different effects of red wine and gin consumption on inflammatory biomarkers of atherosclerosis: a prospective randomized crossover trial. Effects of wine on inflammatory markers. Atherosclerosis 2004;175:117-23.
3. Klatsky AL, Armstrong MA, Friedman GD. Red wine, white wine, liquor, beer, and risk for coronary artery disease hospitalization. Am J Cardiol 1997;80:416-20.
4. Caccetta RA, Croft KD, Beilin LJ, Puddey IB. Ingestion of red wine significantly increases plasma phenolic acid concentrations but does not acutely affect ex vivo lipoprotein oxidizability. Am J Clin Nutr 2000;71:67-74.
5. Soleas GJ, Diamandis EP, Goldberg DM. Wine as a biological fluid: history, production, and role in disease prevention. J Clin Lab Anal 1997;11:287-313.
6. Leighton F, Cuevas A, Guasch V, et al. Plasma polyphenols and antioxidants, oxidative DNA damage and endothelial function in a diet and wine intervention study in humans. Drugs Exp Clin Res 1999;25:133-41.
7. Brenner H, Rothenbacher D, Bode G, Adler G. Relation of smoking and alcohol and coffee consumption to active Helicobacter pylori infection: cross sectional study. BMJ 1997;315:1489-92.
8. Hou, D. X. Potential mechanisms of cancer chemoprevention by anthocyanins. Curr Mol Med. 3(2):149-159, 2003.
9. Seidman, M., et al. Effects of resveratrol on acoustic trauma. Otolaryngol Head Neck Surg. 129(5):463-470, 2003.
10. Obisesan, T.O., et al. Moderate wine consumption is associated with decreased odds of developing age-related macular degeneration in NHANES-1. J Am Geriatr Soc. 46:1-7, 1998.
11. Jonasson, F., et al. Abstract B198: Moderate red wine drinking reduces risk for cataract. Annual Meeting of the Association for Research in Vision and Ophthalmology. Fort Lauderdale, USA. May 4, 2005.
12. Kallberg, H., et al. Alcohol consumption is associated with decreased risk of rheumatoid arthritis; Results from two Scandinavian case-control studies. Ann Rheum Dis. 2008.
Wine may boost life expectancy by 5 years
Long-term wine consumption is related to cardiovascular mortality and life expectancy independently of moderate alcohol intake
Drinking up to half a glass of wine a day may boost life expectancy by five years—at least in men—suggests research published ahead of print in the Journal of Epidemiology and Community Health.
The Dutch authors base their findings on a total of 1,373 randomly selected men whose cardiovascular health and life expectancy at age 50 were repeatedly monitored between 1960 and 2000.
The researchers looked into how much alcohol the men drank, what type it was, and over what period, in a bid to assess whether this had any impact on the risks of their dying from cardiovascular disease, cerebrovascular disease, and from all causes.
They also tracked weight and diet, whether the men smoked, and for how long, and checked for the presence of serious illness.
During the 40 years of monitoring, 1,130 of the men died. Over half the deaths were caused by cardiovascular disease.
The proportion of men who drank alcohol almost doubled from 45% in 1960 to 86% in 2000, with the proportion of those drinking wine soaring from 2% to 44% during that period.
The researchers found that light long term alcohol consumption of all types—up to 20 g a day— extended life by around two extra years compared with no alcohol at all. Extended life expectancy was slightly less for those who drank more than 20 g.
And men who drank only wine, and less than half a glass of it a day, lived around 2.5 years longer than those who drank beer and spirits, and almost five years longer than those who drank no alcohol at all.
Drinking wine was strongly associated with a lower risk of dying from coronary heart disease, cerebrovascular disease, and death from all causes.
These results held true, irrespective of socioeconomic status, dietary and other lifestyle habits, factors long thought to influence the association between wine drinking and better health.
Drinking wine lowers risk of Barrett's esophagus, precursor to nation's fastest growing cancer
Drinking one glass of wine a day may lower the risk of Barrett's Esophagus by 56 percent, according to a new study by the Kaiser Permanente Division of Research in the March, 2009 issue of Gastroenterology. Barrett's Esophagus is a precursor to esophageal cancer, the nation's fastest growing cancer with an incidence rate that's jumped 500 percent in the last 30 years.
Barrett's Esophagus affects 5 percent of the population and occurs when heartburn or acid reflux permanently damages the esophageal lining. People with Barrett's Esophagus have a 30- to 40-fold higher risk of developing esophageal adenocarcinoma (a type of esophageal cancer) because the Barrett's Esophagus cells can grow into cancer cells.
Because there are no symptoms or warning signs of Barrett's Esophagus, people discover they have Barrett's Esophagus when an endoscopy for anemia, heartburn or a bleeding ulcer reveals esophageal cells that were damaged, then changed form during the healing process. Currently nothing can be done to treat Barrett's Esophagus; it can only be monitored.
This is the first and largest population-based study to examine the connection between alcohol consumption and risk of Barrett's Esophagus. Funded in part by the National Institutes of Health, the Kaiser Permanente study looked at 953 men and women in Northern California between 2002 and 2005 and found that people who drank one or more glasses of red or white wine a day had less than half the risk (or 56 percent reduced risk) of Barrett's Esophagus. There was no reduction of Barrett's Esophagus risk among people who drank beer or liquor.
"The rate of esophageal adenocarcinoma in this country is skyrocketing yet very little is known about its precursor, Barrett's Esophagus. We are trying to figure out how to prevent changes that may lead to esophageal cancer." said Douglas A. Corley, MD, a Kaiser Permanente gastroenterologist and the study's principal investigator.
The study findings are echoed by two other studies published in the same issue of the Gastroenterology journal: Australian researchers found that people who drank wine were at a lower risk of esophageal adenocarcinoma, and Irish researchers found that people who drank wine were at a lower risk for esophagitis, an irritation of the esophagus that follows chronic heartburn and often precedes Barrett's Esophagus and cancer.
Researchers are not certain why wine reduces the risk of Barrett's Esophagus and esophageal cancer. One theory is that the wine's antioxidants neutralize the oxidative damage caused by gastroesophageal reflux disease, a risk factor for Barrett's Esophagus. Another theory is that wine drinkers typically consume food with their wine as opposed to drinking straight liquor without food, thereby reducing the potentially damaging effect of alcohol on esophageal tissue, said Ai Kubo, MD, an epidemiologist at Kaiser Permanente and lead author on the study. "But we cannot preclude the possibility that wine drinking is a proxy for other 'health-seeking' behavior," Kubo added.
This study is part of larger, case-controlled Kaiser Permanente study led by Dr. Corley that looked at abdominal obesity and consumption of dietary antioxidants, fruits and vegetables in connection with Barrett's Esophagus. It found that people can reduce their risk of Barrett's Esophagus by eating eight servings of fruits and vegetables a day and maintaining a normal body weight.
"My advice to people trying to prevent Barrett's Esophagus is: keep a normal body weight and follow a diet high in antioxidants and high in fruits and vegetables," Corley said. "We already knew that red wine was good for the heart, so perhaps here is another added benefit of a healthy lifestyle and a single glass of wine a day."
Researchers noted, though, that the protective effect of wine in terms of preventing Barrett's Esophagus was greatest with just one or two glasses a day. The protective effect of wine did not increase with higher consumption.
"It's not actually clear that treating the acid reflux will necessarily prevent getting someone from getting Barrett's Esophagus," said Dr. Corley. "The best way to prevent reflux is to maintain a normal weight."
Moderate alcohol intake associated with bone protection
In an epidemiological study of men and post-menopausal women primarily over 60 years of age, regular moderate alcohol intake was associated with greater bone mineral density (BMD). Researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging (USDA HNRCA) at Tufts University found associations were strongest for beer and wine and, importantly, BMD was significantly lower in men drinking more than two servings of liquor per day. The results suggest that regular moderate consumption of beer or wine may have protective effects on bone, but that heavy drinking may contribute to bone loss.
"Previous research suggests that moderate alcohol consumption in older men and post-menopausal women may protect against BMD loss, a major risk factor for osteoporosis," said Katherine L. Tucker, PhD, corresponding author and director of the Dietary Assessment and Epidemiology Research Program at the USDA HNRCA. The 2005 Dietary Guidelines issued by the federal government defines moderate alcohol consumption as one drink per day for women and two drinks per day for men.
"Our study also looks at the possible effects of the three alcohol classes, beer, wine and liquor on BMD," Tucker continued. "We saw stronger associations between higher BMD and beer drinkers, who were mostly men, and wine drinkers, who were mostly women, compared to liquor drinkers." The results were published online February 25 by the American Journal of Clinical Nutrition.
Tucker, who is also a professor at the Friedman School of Nutrition Science and Policy at Tufts, and colleagues analyzed BMD measurements taken at three hip sites and the lumbar spine in 1,182 men, 1,289 post-menopausal women, and 248 pre-menopausal women whose parents or in-laws participated in the original Framingham Heart Study. There was not enough data to determine the effects of more than two servings of alcohol per day in post-menopausal women or the effects of daily alcohol consumption on BMD in pre-menopausal women. Participants self-reported their alcohol intake on dietary questionnaires. One serving of beer equaled a glass, bottle or can (356 mL), one serving of wine equaled a 4-oz. glass (118 mL), and one serving of liquor equaled one mixed drink or shot (42 mL).
After adjusting for several other factors that may have accounted for the higher BMD, such as silicon intake, calcium intake and smoking history, the authors still saw an association between higher BMD and moderate alcohol consumption. One of the strongest associations was seen in men who reported consuming one or two servings of total alcohol (a combination of beer, wine and liquor) or one or two servings of beer per day. Hip BMD in this group was significantly greater compared to non-drinkers.
In contrast, the authors observed significantly lower BMD at the hip and spine in men who consumed more than two servings of liquor per day compared to men who consumed one or two servings of liquor per day. "There is a body of research showing alcoholism is devastating to bones," Tucker said. "It's a major risk factor for osteoporosis. No one should depend solely on alcohol to maintain bone health."
The authors hypothesize that the silicon found in beer is contributing to the higher BMD scores in the men who reported consuming one or two servings of total alcohol or beer per day, citing previous studies finding silicon has greater bioavailability as a liquid. It is less clear why liquor and wine might protect BMD.
"We cannot say definitively what component of these alcoholic drinks might be beneficial to bone health because our findings are from an observational study, as opposed to a clinical trial," Tucker said. "Future studies might dig deeper into patterns of alcohol consumption, as we relied on a self-reported dietary questionnaire. Another component of data worthy of exploration is whether the antioxidants found in wine, such as revesterol or polyphenols, have a protective effect on bone in addition to other health benefits."
Light to moderate drinking and socialization are jointly good for cardiovascular health
• While heavy drinking is associated with a greater risk of stroke, light-to-moderate drinking has been linked to a lesser risk of ischemic stroke and coronary heart disease.
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• New findings show that social support may enhance the beneficial effects of light-to-moderate alcohol consumption on risk of cardiovascular disease.
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While heavy drinking is associated with a greater risk of stroke, light-to-moderate drinking has been linked to a lesser risk of ischemic stroke and coronary heart disease. Other studies have shown that more social support is linked to less risk of mortality and cardiovascular disease. A Japanese examination of the effects of social support on the relationship between drinking and cardiovascular disease has found that the health benefits of light-to-moderate drinking are more pronounced in men with greater social support.
Results were published in the June, 2009 issue of Alcoholism: Clinical & Experimental Research.
"In Japan, drinking is divided into two main patterns," said Hiroyasu Iso, a professor of public health at Osaka University and corresponding author for the study. "One pattern is drinking alone and/or with family at home during the evening. Another pattern – especially for middle-aged business men – is social drinking with co-workers, friends, and neighbors. Social drinking is common."
"Alcohol can play a key role," concurred Takeshi Tanigawa, a professor in the department of public health at Ehime University Graduate School of Medicine, "for socializing as well as some business discussions. In urban areas, alcohol consumption is often used as a business tool. In rural areas, people often have a drink with classmates and people in the same community. Alcohol consumption can be used to maintain human relationships between father and son, senior and junior, community to community. Collectively, these socializing customs may help to create a stress-free space for those persons surrounded by dozens of stresses, especially in the workplace."
"Prior to our research," said Iso, "no study had examined whether psychosocial factors modify the association between alcohol consumption and risks of stroke and coronary heart disease."
Iso and his colleagues examined 19,356 men 40 to 69 years of age who were enrolled in the Japan Public Health Center-based Prospective Study. Their alcohol consumption was classified into seven categories: never, past, occasional, 1-149, 150-299, 300-449, or ≥450 grams/week. Measures used were alcohol consumption, risk of cardiovascular disease, and social support.
"We found the reduced risks of total stroke, ischemic stroke, and total cardiovascular disease associated with light-to-moderate drinking were more pronounced in men with high social support, probably due to avoidance of unhealthy behaviors and enhancement of stress buffering," said Iso. "In our study, compared with light-to-moderate drinkers with high social support, those with low social support had more unhealthy lifestyles such as physical inactivity, no job and fewer opportunities for medical checkups. Also, a potential pathway by which poor social support may lead to cardiovascular disease is mental stress. Mental stress activates neuro-endocrine components, including the hypothalamic-pituitary-adrenal-axis and autonomic nervous system, which lead to an increased risk of cardiovascular disease."
"In short," said Tanigawa, "moderate to light alcohol consumption with high social support is good for your health. Drinking with a good friend appropriately makes you feel happy and healthy. So drink with good friends for health," he advised. Tanigawa also recommended karaoke bars as one way for business persons to cope with stress. "Singers use deep breathing, which is good for the parasympathetic nervous system. After singing, they usually receive applause. It is a good kind of social support, and helps in the face of adverse occasions or stressful events."
Iso agreed that moderate alcohol consumption and socialization is good for one's health. "But remember that this beneficial effect of social support is confined to light-to-moderate drinking," he said. "Heavy drinking is risky irrespective of social support level. We believe that this also holds for other ethnic populations."
Drink For Your Health
Men who drink alcohol every day have a lower risk of heart disease than those who drink less frequently,suggests research in the British Medical Journal. It is widely known that moderate drinkers have a lower risk of coronary heart disease than those who abstain, but most research in this field has been done on men and little is known about drinking patterns and risk of heart disease among women.
Researchers in Denmark studied over 50,000 men and women aged 50-65 years who were taking part in a national health study. Details on alcohol intake and drinking frequency over the preceding year were collected, and participants were monitored for an average of 5.7 years.
Coronary heart events were recorded and results were adjusted for known risk factors, such as age, smoking, education, physical activity and diet.
A total of 28,448 women and 25,052 men took part in the study. Women consumed an average of 5.5 alcoholic drinks a week and men consumed 11.3. During the study, 749 women and 1,283 men developed coronary heart disease.
Women who drank alcohol on at least one day a week had a lower risk of coronary heart disease than women who drank alcohol on less than one day a week.
However, risks were similar for drinking on one day a week (36% reduced risk), or seven days a week (35% reduced risk), suggesting that the amount of alcohol consumed is more important than drinking frequency among women.
In contrast, for men, risks were lowest for the most frequent drinkers. For example, men who drank on one day a week had a 7% reduced risk, while men who drank daily had a 41% reduced risk. This suggests that it doesn’t matter how much men drink, as long as they drink every day.
Moderate drinking lowers women's heart attack risk
Women who regularly enjoy an alcoholic drink or two have a significantly lower risk of having a non-fatal heart attack than women who are life-time abstainers, epidemiologists at the University at Buffalo have shown._
Moderation is the key, however. Women in the study who reported being intoxicated at least once a month were nearly three times more likely to suffer a heart attack than abstainers, results showed.
One difference in the protective pattern among drinkers involved those who drank primarily liquor. Women who preferred liquor to wine experienced a borderline increase in risk of heart attack, results showed.
The study is published in the May 2007 issue of the journal Addiction.__
"These findings have important implications, because heart disease is the leading cause of death for women," said Joan M. Dorn, Ph.D., associate professor of social and preventive medicine in the UB School of Public Health and Health Professions and first author on the study.
Women seem to have a quicker reaction to a smaller amount of alcohol, she noted: "Overdoing it is harmful, and what is too much depends on each individual. In some women, one drink can cause intoxication."__
Moderate alcohol consumption has been shown to lower the risk of heart attack, but most studies have been done with men. The current study compared alcohol drinking volume and drinking patterns of women who had been hospitalized due to a heart attack, with age-matched controls without heart problems.__
Light wine intake = longer life expectancy in men
Drinking a little alcohol every day, especially wine, may be associated with an increase in life expectancy. That’s the conclusion of Dutch researchers who reported the findings of their study at the American Heart Association’s 47th Annual Conference on Cardiovascular Disease Epidemiology and Prevention.
The researchers found that a light intake of alcohol (on average less than one glass per day) was associated with a lower rate of cardiovascular death and death from all causes. When compared to spirits and beer, consumption of small amounts of wine, about a half a glass a day, was associated with the lowest levels of all-cause and cardiovascular deaths.
"Our study showed that long-term, light alcohol intake among middle-aged men was associated not only with lower cardiovascular and all-cause death risk, but also with longer life expectancy at age 50," said Martinette T. Streppel, lead author of the study and a Ph.D. student in the Division of Human Nutrition at Wageningen University and National Institute for Public Health and the Environment (RIVM) in Bilthoven, The Netherlands. "Furthermore, long-term light wine consumption is associated with a further protective effect when compared to that of light-to-moderate alcohol intake of other types."
Previous studies have shown that light to moderate alcohol intake is associated with a lower risk of cardiovascular death. However, it remained unclear whether a specific beverage was associated with more benefit and whether the use of long-term alcohol consumption was associated with increased life expectancy. Studies such as this cannot definitively show whether the agent being studied has a causal effect on health.
The Netherlands study — called the Zutphen Study — involved a cohort of 1,373 men born between 1900 and 1920 who were surveyed in detail about alcohol consumption seven times over 40 years. The participants, all from Zutphen, an industrial town in the eastern part of the Netherlands, were followed until death or until the final survey taken among survivors in mid-2000. The surveys included drinking habits, dietary habits, body mass index, smoking habits and the prevalence of heart attack, stroke, diabetes and cancer. The statistics on alcohol consumption were adjusted to account for other risk factors.
The researchers found that long-term, light alcohol intake of less than or equal to 20 grams per day (1 glass of alcoholic beverage contains 10 grams of alcohol, 1 ounce = ~30 mL of alcoholic beverage) compared to no alcohol intake was associated with a 36 percent lower relative risk of all-cause death and a 34 lower relative risk of cardiovascular death. The average long-term daily intake of the men throughout the 40-year study was six grams based on any alcohol intake of more than zero and up to 20 grams. The long-term average intake of six grams of alcohol is equal to one four-ounce beer, one two-ounce glass of wine or one one-ounce glass of spirits, daily.
When the researchers looked independently at wine consumption, the associated risk reduction was greater. Participants who drank on average half a glass, or 1.5 ounces, of wine per day, over a long period, had a 40 percent lower rate of all-cause death and a 48 percent lower incidence of cardiovascular death, compared to the non-wine drinkers.
Researchers said life expectancy was 3.8 years higher in those men who drank wine compared to those who did not drink alcoholic beverages. Life expectancy of wine users was more than two years longer than users of other alcoholic beverages. Men with a long-term alcohol intake less than or equal to 20 grams per day had a 1.6-year-higher life expectancy, compared to those who consumed no alcohol.
Most of the previous studies assessed alcohol intake at baseline; however, in this study researchers collected detailed information seven times over 40 years. "Consumption patterns usually change during life," Streppel said. "This enabled us to study the effects of long-term alcohol intake on mortality." Researchers found that the number of alcohol users nearly doubled from 45 percent in 1960 to 85 percent in the 2000 survey. Average alcohol consumption rose and then fell at various points during the study. Users’ consumption was eight grams a day in 1960, then survivors’ consumption was 18 grams a day in 1985, dropping to 13 grams per day in 2000. The percentage of wine users increased during follow-up from 2 percent in 1960 to more than 40 percent among the survivors in 2000. "One can speculate that a protective effect of light alcohol intake could be due to an increase in high-density lipoprotein (HDL) cholesterol, or to a reduction in blood clotting, due to an inhibition of platelet aggregation," Streppel said.
Furthermore, red wine consumption may have an additional health benefit because the polyphenolic compounds contained in wine have been seen in animal to interfere with the formation, progression and rupture of atherosclerotic plaques — the build-up of fatty tissue in the arteries that can result in stroke or heart attack.
"Those people who already consume alcoholic beverages should do so lightly (1 to 2 glasses per day) and preferably drink wine," Streppel said. "The cardio-protective effects of alcohol and wine only held up for light alcohol consumption in middle-aged men. Heavy alcohol consumption may cause accidents and diseases such as cancer and cirrhosis of the liver, even though this was not observed in our study. Since alcohol consumption can be addictive, starting to drink alcohol because of its positive health benefits is not advised."
How alcohol or wine might affect cardiovascular risk merits further research, but right now the American Heart Association does not recommend beginning to drink wine or any other form of alcohol to gain these potential benefits. The association does recommend that to reduce your risk you should talk to your doctor about lowering your cholesterol and blood pressure, controlling your weight, getting enough physical activity and following a healthy diet and quit smoking, if you smoke. There is no scientific proof that drinking wine or any other alcoholic beverage can replace these conventional measures.
Alcohol Can Benefit the Hearts of New Drinkers
A Medical University of South Carolina’s (MUSC) Department of Family Medicine study concluded that people who began moderately consuming alcohol in middle-age experience a quick benefit of lower rates of cardiovascular disease morbidity with no change in mortality after four years. In addition, the study found that those who consumed alcohol for the heart health benefits rarely drank more than recommended amounts. The study has been published in the American Journal of Medicine, and was conducted by MUSC’s Dana E. King M.D., Arch G. Mainous III, Ph.D, and Mark E. Geesey.
“Most people are aware that moderate alcohol use can be part of a healthy lifestyle, yet current guidelines caution non-drinkers against starting to drink in middle age,” said King, lead author of the study. “We wanted to evaluate whether adopting moderate alcohol consumption in middle-age would lower cardiovascular risk. We were excited to find that moderate alcohol consumption, or one to six servings a week, lowered cardiovascular risk for our participants.”
In contrast to a recently published study in the British Public Library of Science journal, PLoS Medicine, MUSC’s study showed no increase in blood pressure for participants at moderate consumption levels (two drinks per day or fewer for men, one drink per day or fewer for women) during the four years of the study. New moderate drinkers had a 38% lower chance of developing cardiovascular disease than did their persistently non-drinking counterparts. This difference remained after adjustment for demographic and cardiovascular risk factors.
Regular Tipple May Curb Risk of Rheumatoid Arthritis
Alcohol cuts the risk of developing rheumatoid arthritis by up to 50%, reveals research published ahead of print in the Annals of the Rheumatic Diseases.
The Scandinavian researchers base their findings on more than 2750 people taking part in two separate studies, which assessed environmental and genetic risk factors for rheumatoid arthritis.
Over half the participants (1650) had the disease and had been matched for age, sex, and residential locality with randomly selected members of the general public.
All participants were quizzed about their lifestyle, including how much they smoked and drank. And blood samples were taken to check for genetic risk factors.
The results showed that drinking alcohol was associated with a significantly lower risk of developing rheumatoid arthritis. And the more alcohol was consumed, the lower the risk of rheumatoid arthritis.
Among those who drank regularly, the quarter with the highest consumption were up to 50% less likely to develop the disease compared with the half who drank the least.
The effect was the same for both men and women.
Among those with antibodies to a specific group of proteins involved in the development of the disease, alcohol cut the risk most in smokers with genetic risk factors for rheumatoid arthritis.
Smoking is known to be a major environmental risk factor for developing rheumatoid arthritis, and this risk is further increased in those who carry these genetic variants.
The authors conclude that their research reinforces the importance of lifestyle factors in the development of the disease, and that giving up smoking remains the single most important preventive measure.
They point to recent experimental research by other authors, which showed that alcohol protected against the development and severity of rheumatoid arthritis, although it is not clear exactly how it does this.
And they draw parallels with the links between moderate alcohol consumption and a reduced risk of other inflammatory processes, such as cardiovascular disease.
Alcohol’s impact on heart and stroke risk may differ for men, women
The volume of alcohol consumption may have a significantly different effect on heart and stroke risk in men and women, according to a study of Japanese people published in Stroke: Journal of the American Heart Association.
“An amount of alcohol that may be beneficial for men is not good for women at all,” said Hiroyasu Iso, M.D., co-author of the study and professor of public health at Osaka University in Japan.
Researchers analyzed data from a survey of 34,776 men and 48,906 women (ages 40 to 79) selected from the larger Japan Collaborative Cohort Study (JACC) to determine the association of alcohol use with the risks of stroke and heart disease. Participants who had not experienced cancer, stroke or heart disease before the study completed questionnaires about their lifestyles and medical histories and provided information about their drinking of sake (rice wine), shochu (a type of brandy), beer, whiskey and/or wine.
Researchers calculated the risks and benefits of alcohol consumption after adjusting for age and several other risk factors, including smoking, weight, body mass index, the presence of high blood pressure or diabetes, exercise habits, stress, education and diet.
During a 14.2-year follow-up, 1,628 participants died from stroke and 736 died from heart disease.
Men who reported drinking heavily (at least 46 grams of alcohol per day, equivalent to four or more standard alcoholic beverages) at the time of the survey had a 19 percent lower risk of dying from coronary heart disease than nondrinking men.
In stark contrast, women who drank that much quadrupled their risk of heart disease death over that of nondrinking women. Light drinking (less than 23 grams of alcohol per day, about two drinks a day) reported on the survey was associated with a lower risk of heart disease death in women by 17 percent; while intake between 23 and 46 grams per day was associated with an increased risk of 45 percent.
“In women, we found a slightly reduced risk with light consumption but a much greater risk with heavy alcohol use,” Iso said.
In men, heavy alcohol use was associated with an increased risk of death from all types of stroke by 48 percent. The risk of hemorrhagic stroke (caused by a blood vessel bursting in the brain) was increased 67 percent. The risk of ischemic stroke (caused by a blocked blood vessel in the brain or leading to it) was higher by 35 percent.
In women, heavy alcohol use was associated with a higher risk of stroke death by 92 percent. Hemorrhagic stroke death risk was increased by 61 percent. The risk of ischemic stroke death was increased 2.43 times.
“We expected to find an increased risk of hemorrhagic stroke,” Iso said. “But since alcohol reduces the ability of the blood to clot, we didn’t expect to find the increases in ischemic stroke and coronary heart disease.”
Only 15 percent of women in JACC drank any alcohol, far less than the 45.9 percent of U.S. women who reported using alcohol in 2005, Iso said.
Before this study, evidence suggested that light-to-moderate alcohol consumption might be associated with a lower risk of cardiovascular disease in women. But data on heavy drinking was limited and the question had not been addressed in an Asian country, where both drinking and heart disease are less common.
“One limitation of the study is that, in Japanese culture, there are social restrictions against women drinking as they get older,” Iso said. “In that culture, the women who do drink may have different types of jobs or other aspects of their lifestyle that may help explain the excess risk as well as the alcohol exposure itself.”
Iso said more research could help determine how alcohol affects cardiovascular risk.
The American Heart Association does not recommend drinking wine or other forms of alcohol, since there is clear evidence that alcohol use is associated with injury to the heart in many ways. Instead, the association recommends that people talk to their doctor about lowering their cholesterol and blood pressure, controlling weight, getting enough physical activity and following a healthy diet and quitting smoking. There is no scientific proof that drinking alcoholic beverages can replace these conventional measures.
A Little Alcohol Goes a Longer Way in Women than in Men—in Good Ways and Bad
Alcohol can be a boon or a bane for health. The difference lies in the dose—a little is good, a lot is bad. But the dividing line between a little and a lot differs from person to person. It depends on many things, including sex. Women are more vulnerable than men to alcohol’s long-term effects.
Women break down alcohol more slowly than men do. If a woman and a man drink identical glasses of wine with the same meal, she will have a higher blood level of alcohol, and for a longer time. This means her tissues are exposed to more alcohol per drink than a man’s. Results from a study in Japan suggest that too much alcohol is bad for a woman’s heart and arteries, and earlier work shows it can be hazardous to breast tissue too.
What constitutes “healthy drinking”? Current guidelines say it is one to two drinks a day for men and no more than one a day for women. Keep in mind that this recommendation is for the average person. How you respond to alcohol depends on your genes, your diet, and the medications you take.
If you drink, consider taking a daily multivitamin/multimineral supplement. Alcohol blocks the absorption of folic acid and inactivates this important vitamin in the bloodstream, so drinkers need extra folic acid.
Up to 2 drinks per day not linked with higher risk of irregular heart beat for women
Women who have up to two alcoholic drinks per day do not appear to be at increased risk of atrial fibrillation (irregular heart beat), but drinking more than that amount is associated with a higher risk, according to a study in the December 3 issue of JAMA.
Studies assessing the effects of regular alcohol consumption on the risk of atrial fibrillation have provided inconsistent results, with several studies finding significant associations between moderate to high amounts of alcohol intake and increased risks of atrial fibrillation among men, but not among women. However, these studies were not of adequate size to detect significant associations among women, according to background information in the article.
David Conen, M.D., M.P.H., of Brigham and Women's Hospital, Harvard Medical School, Boston, and University Hospital, Basel, Switzerland, and colleagues analyzed data from a completed randomized controlled trial involving 34,715 women participating in the Women's Health Study, to assess the effects of regular alcohol consumption on the risk of atrial fibrillation. The participants were older than 45 years and had no atrial fibrillation at the start of the study and underwent follow-up from 1993 to October 2006. Alcohol consumption was assessed via questionnaires at the beginning of the trial and at 48 months of follow-up and was grouped into 4 categories: 0 drinks per day, greater than 0 and less than 1, 1 or more and less than 2, and 2 or more drinks per day. Atrial fibrillation was self-reported on the yearly questionnaires and subsequently confirmed by electrocardiogram and medical record review.
During a median (midpoint) follow-up of 12.4 years, there were 653 confirmed cases of new atrial fibrillation. Among women consuming no alcohol (n = 15,370), there were 294 events (1.9 percent); for women consuming more than 0 and less than 1 drink per day (n = 15,758), there were 284 events (1.8 percent); for 1 to 2 drinks per day (n = 2,228), there were 35 events (1.6 percent); and for women consuming 2 or more drinks per day (n = 1,359), there were 40 atrial fibrillation events (2.9 percent).
"In the present study, alcohol consumption of up to 2 drinks per day was not associated with an increased risk of incident atrial fibrillation among initially healthy, middle-aged women. In contrast, the small group of women who consumed 2 or more alcoholic beverages per day had a 1.6-fold greater risk for atrial fibrillation relative to nondrinking women. While this finding needs to be interpreted with some caution because of the small number of women in some subgroups, it supports a possible threshold effect in the relationship between alcohol consumption and risk of atrial fibrillation among women," the authors write.
A little wine boosts omega-3 in the body: Researchers find a novel mechanism for a healthier heart
Results from the European study IMMIDIET show that moderate wine intake is associated with higher levels of omega-3 fatty acids considered as protective against coronary heart disease
Moderate alcohol intake is associated with higher levels of omega-3 fatty acids in plasma and red blood cells. This is the major finding of the European study IMMIDIET that will be published in the January issue of the American Journal of Clinical Nutrition, an official publication of the American Society for Nutrition and is already available on line (www.ajcn.org ). The study suggests that wine does better than other alcoholic drinks. This effect could be ascribed to compounds other than alcohol itself, representing a key to understand the mechanism lying behind the heart protection observed in moderate wine drinkers.
The IMMIDIET study examined 1,604 citizens from three geographical areas: south-west London in England, Limburg in Belgium and Abruzzo in Italy. Thanks to a close cooperation with General Practitioners of these areas, all participants underwent a comprehensive medical examination, including a one year recall food frequency questionnaire to assess their dietary intake, alcohol consumption included.
Omega-3 fatty acids, mainly derived from fish, are considered as protective against coronary heart disease and sudden cardiac death, thus their high blood concentration is definitely good for our health.
Now European researchers found that moderate alcohol drinking acts like a 'trigger', boosting the amount of omega-3 fatty acids in our body.
"Several studies have shown that moderate alcohol consumption, including wine, is associated with protection against coronary heart disease and ischemic stroke - says Romina di Giuseppe, lead author of the study, from the Research Laboratories at Catholic University of Campobasso - Although the mechanisms are not completely defined, there was some evidence that alcohol intake might influence the metabolism of essential polyunsaturated fatty acids, as omega-3. That is exactly what we found in our population study. People drinking moderate amounts of alcohol, one drink a day for women and two for men, had higher concentration of omega-3 fatty acids in plasma and red blood cells independently of their fish intake".
However important these results appear to be, the best is yet to come. Researchers from Catholic University of Campobasso, in Italy, and from University of Grenoble, in France, turned their attention on the variety of alcoholic beverages consumed in order to see whether the high levels of omega-3 fatty acids detected might be ascribed to alcohol itself or to other substances.
"From our previous studies we know that association between wine drinking and increased concentration of omega-3 fatty acids have been observed – says Michel de Lorgeril, from the University of Grenoble, partner of the IMMIDIET project and co-leader of the study - Nevertheless, it was not possible to separate the effects of wine from those of beer or spirits. Our study of 3 populations with different dietary habits and different consumption of alcoholic beverages types allowed us to explore this aspect.".
"Analysis carried out on different alcoholic beverages –argues Licia Iacoviello coordinator of the IMMIDIET study at Catholic University of Campobasso - showed that the association between alcohol and omega-3 fatty acids was present in both wine drinkers and beer or spirits drinkers. However, the association was stronger between wine drinking and omega-3 fatty acids levels. This suggests that components of wine other than alcohol is associated with omega-3 fatty acids concentration. We may guess this effect can be ascribed to polyphenols".
Polyphenols are naturally occurring compounds contained in a different variety of food and beverages, such as wine. Due to their strong antioxidant activity, they are able to reduce oxidation processes caused by free radicals.
"We consider these data to be a major finding - de Lorgeril concludes - opening a new window in the field of cardiovascular prevention. Beyond the alcohol issue, our results raise crucial questions regarding the effects of polyphenols on lipids (both in blood and cell membranes) and possibly of lipids on polyphenols".
The IMMIDIET study
Funded by the European Union under Key Action 1: Food, Nutrition and Health QLK1-CT-2000-00100, IMMIDIET aims to acquire fundamental knowledge in the field of cardiovascular disease, especially regarding the interaction between genetics and lifestyle.
At the core of the study there is an important episode of Italian migration: Belgium, a country that became the new home for thousands of Italians, mostly from the Abruzzo region, who came to work in the mines. Many of those emigrants didn't come back to Italy but remained in their new country. Some of them married a Belgian partner. Their genes remained the same, of course, but how much "Italy" is still there in their diet? And how much did they transmit it to their spouses? Moreover, how many Italian emigrants assimilate dietary habits of the country in which they were guests? In this framework, the role of genetic factors and lifestyle can be assessed to explore new ways in prevention of cardiovascular diseases.
To carry on the research, married couples have been recruited in three European areas: South-East London in England, Limburg in Belgium and Abruzzo in Italy. In the first phase of the study the couples involved were formed by people from the same area, Italians married with Italians (in the Abruzzo region), Belgians married with Belgians (in the Limburg area) and English married with English (in the South-East part of London)".
The second phase of IMMIDIET recruited mixed Italian–Belgian couples to understand if, acquiring dietary habits from Abruzzo, the Belgian partner changed his own risk regarding heart diseases.
Exploring the health and protective benefits of light to moderate alcohol consumption
While the physiological damage and social havoc created by alcohol abuse and dependency are well-known, it is also true that light-to-moderate drinking has certain health benefits. This mini-review summarizes a roundtable discussion held at the July 2007 annual meeting of the Research Society on Alcoholism in Chicago, Illinois.
Results will be published in the February 2009 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.
"Alcohol abuse, often in combination with poor nutrition, is responsible for a great deal of permanent organ damage, and that includes the brain," explained Michael A. Collins, professor of biochemistry at Loyola University Chicago and corresponding author for the research roundtable. "In fact, studies of alcoholics over the years sometimes indicate that brain damage can develop earlier than liver damage, but it simply is not recognized because there are common clinical lab tests for liver disease but not for subtle cognitive impairment."
Conversely, Collins added, human studies have indicated that mild or moderate social consumption of alcohol can have beneficial effects on the cardiovascular state and cognitive function. "Alcohol in low to moderate concentrations appears to promote cytoprotective cellular mechanisms," he said, "which might explain some of these epidemiological findings. It seemed important to bring researchers together in this roundtable, in part to inform the research community about these emerging mechanisms."
Some of the key points discussed were:
- Alcohol appears to have a complex relationship with cardiovascular and neurovascular diseases. These include dose-dependent associations with a lower risk of coronary heart disease (CHD), a higher risk of hemorrhagic stroke throughout a range of drinking, a higher risk of ischemic stroke with heavier drinking, and a possible lower risk of dementia or cognitive decline with aging.
"We need greater insight into how cells in the adult brain and heart, in response to moderate alcohol exposure, are able to achieve a relatively protected state with respect to certain insults or cytotoxins," said Collins. "Knowing more about these mechanisms might allow us to design 'non-addictive' molecules that trigger key cytoprotective biochemical steps, for example. This achievement, however small, potentially could have a significant impact, since – worldwide – heart disease is the major killer, and a new case of dementia from all causes is estimated to develop every seven seconds or so."
- Experimental studies with rodents and cultures indicate that moderate alcohol exposure can promote anti-inflammatory processes involving adenosine receptors, protein kinase C (PKC), nitric oxide synthase, and heat shock proteins that may underlie cardioprotection.
"Like many chemicals that we ingest, alcohol is sort of a classic double-edged sword," said Collins. "With respect to 'inflammation,' alcohol in high binge amounts, either directly or through its metabolism, appears to trigger increases in a number of inflammatory players in many cells that include free radicals and inflammatory protein molecules such as cytokines. These are probably responsible for much of the organ damage of alcoholism."
Yet alcohol in low to moderate amounts seems to do the opposite. "It increases other factors that are typically anti-inflammatory in their effects" said Collins. "After moderate alcohol exposure, we find higher levels of cellular 'heat shock' proteins which are well known to be neuroprotective. Of further relevance to the question of aging-dependent cognitive loss is how this alcohol neuroprotection is exerted against beta-amyloid, a neuroinflammatory protein abnormally increased in Alzheimer's disease and likely underlying the progressive dementia."
- Additional evidence suggests that alcohol may even help lower the risk for dementia via "preconditioning" mechanisms, that is, inducing neuronal survival pathways through its selective activation of PKC and focal adhesion kinase enzymes, the focal adhesion complex, and stabilization of the cytoskeleton.
"I want to emphasize that none of the researchers on this roundtable panel recommends moderate alcohol consumption as a tried-and-true way of reducing the risks of heart disease or cognitive decline," said Collins. "And there are situations or conditions when any drinking whatsoever should be discouraged, for example, during pregnancy, during adolescence, or prior to driving. On the other hand, if a responsible adult is doing well socially, psychologically and physically with a stable, non-binge pattern of moderate alcohol ingestion, there is no apparent reason to stop."
Moderate drinkers often have lower risks of Alzheimer's disease and other cognitive loss
Moderate drinkers often have lower risks of Alzheimer's disease and other cognitive loss, according to researchers who reviewed 44 studies.
In more than half of the studies, published since the 1990s, moderate drinkers of wine, beer and liquor had lower dementia risks than nondrinkers. In only a few studies were there increased risks.
"Alcohol is a two-edged sword," said Michael Collins, Ph.D., a professor and neuroscientist at Loyola University Chicago Stritch School of Medicine and lead author of the refereed report in the journal Alcoholism: Clinical and Experimental Research. "Too much is bad. But a little might actually be helpful."
Moderate alcohol consumption generally is defined as 1 drink or less per day for women and 1-2 drinks or less per day for men.
The article will be published in the February 2009 issue of the journal, and is available on line now. The article summarizes a roundtable, organized by Collins, held at the Research Society on Alcoholism meetings in Chicago in 2007.
"The pathological damage and vast social havoc from addiction to and abuse of alcohol are well known, and of necessity should continue to receive primary attention by doctors, scientific researchers and health professionals," Collins and colleagues write. "However, light-to-moderate responsible alcohol consumption "appears to carry certain health benefits."
Long-term alcohol abuse can cause memory loss and impair cognitive function. It's unknown why moderate alcohol use appears to have the opposite effect. One theory is that the well-known cardiovascular benefits of moderate alcohol consumption also can reduce the risk of mini strokes that cause dementia.
Collins and another Loyola professor, neuroscientist Edward Neafsey, Ph.D., suggest a second possible explanation. Small amounts of alcohol might, in effect, make brain cells more fit. Alcohol in moderate levels stresses cells and thus toughens them up to cope with major stresses down the road that could cause dementia.
For most people who drink responsibly and in moderation, there's probably no reason to quit. But because of the potential for alcohol to be abused, Collins and Neafsey do not recommend that abstainers begin drinking. The researchers note there are other things besides moderate drinking that can reduce the risk of dementia, including exercise, green tea, education and a Mediterranean diet high in fruits, vegetables, cereals, beans, nuts and seeds.
Light wine intake = longer life expectancy in men
Drinking a little alcohol every day, especially wine, may be associated with an increase in life expectancy. That’s the conclusion of Dutch researchers who reported the findings of their study at the American Heart Association’s 2007 47th Annual Conference on Cardiovascular Disease Epidemiology and Prevention.
The researchers found that a light intake of alcohol (on average less than one glass per day) was associated with a lower rate of cardiovascular death and death from all causes. When compared to spirits and beer, consumption of small amounts of wine, about a half a glass a day, was associated with the lowest levels of all-cause and cardiovascular deaths.
"Our study showed that long-term, light alcohol intake among middle-aged men was associated not only with lower cardiovascular and all-cause death risk, but also with longer life expectancy at age 50," said Martinette T. Streppel, lead author of the study and a Ph.D. student in the Division of Human Nutrition at Wageningen University and National Institute for Public Health and the Environment (RIVM) in Bilthoven, The Netherlands. "Furthermore, long-term light wine consumption is associated with a further protective effect when compared to that of light-to-moderate alcohol intake of other types."
Previous studies have shown that light to moderate alcohol intake is associated with a lower risk of cardiovascular death. However, it remained unclear whether a specific beverage was associated with more benefit and whether the use of long-term alcohol consumption was associated with increased life expectancy. Studies such as this cannot definitively show whether the agent being studied has a causal effect on health.
The Netherlands study — called the Zutphen Study — involved a cohort of 1,373 men born between 1900 and 1920 who were surveyed in detail about alcohol consumption seven times over 40 years. The participants, all from Zutphen, an industrial town in the eastern part of the Netherlands, were followed until death or until the final survey taken among survivors in mid-2000. The surveys included drinking habits, dietary habits, body mass index, smoking habits and the prevalence of heart attack, stroke, diabetes and cancer. The statistics on alcohol consumption were adjusted to account for other risk factors.
The researchers found that long-term, light alcohol intake of less than or equal to 20 grams per day (1 glass of alcoholic beverage contains 10 grams of alcohol, 1 ounce = ~30 mL of alcoholic beverage) compared to no alcohol intake was associated with a 36 percent lower relative risk of all-cause death and a 34 lower relative risk of cardiovascular death. The average long-term daily intake of the men throughout the 40-year study was six grams based on any alcohol intake of more than zero and up to 20 grams. The long-term average intake of six grams of alcohol is equal to one four-ounce beer, one two-ounce glass of wine or one one-ounce glass of spirits, daily.
When the researchers looked independently at wine consumption, the associated risk reduction was greater. Participants who drank on average half a glass, or 1.5 ounces, of wine per day, over a long period, had a 40 percent lower rate of all-cause death and a 48 percent lower incidence of cardiovascular death, compared to the non-wine drinkers.
Researchers said life expectancy was 3.8 years higher in those men who drank wine compared to those who did not drink alcoholic beverages. Life expectancy of wine users was more than two years longer than users of other alcoholic beverages. Men with a long-term alcohol intake less than or equal to 20 grams per day had a 1.6-year-higher life expectancy, compared to those who consumed no alcohol.
Most of the previous studies assessed alcohol intake at baseline; however, in this study researchers collected detailed information seven times over 40 years. "Consumption patterns usually change during life," Streppel said. "This enabled us to study the effects of long-term alcohol intake on mortality." Researchers found that the number of alcohol users nearly doubled from 45 percent in 1960 to 85 percent in the 2000 survey. Average alcohol consumption rose and then fell at various points during the study. Users’ consumption was eight grams a day in 1960, then survivors’ consumption was 18 grams a day in 1985, dropping to 13 grams per day in 2000. The percentage of wine users increased during follow-up from 2 percent in 1960 to more than 40 percent among the survivors in 2000. "One can speculate that a protective effect of light alcohol intake could be due to an increase in high-density lipoprotein (HDL) cholesterol, or to a reduction in blood clotting, due to an inhibition of platelet aggregation," Streppel said.
Furthermore, red wine consumption may have an additional health benefit because the polyphenolic compounds contained in wine have been seen in animal to interfere with the formation, progression and rupture of atherosclerotic plaques — the build-up of fatty tissue in the arteries that can result in stroke or heart attack.
"Those people who already consume alcoholic beverages should do so lightly (1 to 2 glasses per day) and preferably drink wine," Streppel said. "The cardio-protective effects of alcohol and wine only held up for light alcohol consumption in middle-aged men. Heavy alcohol consumption may cause accidents and diseases such as cancer and cirrhosis of the liver, even though this was not observed in our study. Since alcohol consumption can be addictive, starting to drink alcohol because of its positive health benefits is not advised."
How alcohol or wine might affect cardiovascular risk merits further research, but right now the American Heart Association does not recommend beginning to drink wine or any other form of alcohol to gain these potential benefits. The association does recommend that to reduce your risk you should talk to your doctor about lowering your cholesterol and blood pressure, controlling your weight, getting enough physical activity and following a healthy diet and quit smoking, if you smoke. There is no scientific proof that drinking wine or any other alcoholic beverage can replace these conventional measures.
Moderate Drinking May Help Older Women Live Longer
A study published in Journal of the American Geriatrics Society finds that moderate alcohol intake (1-2 drinks/day for 3-6 days/week, depending on alcoholic content) may lead to increased quality of life and survival in older women. The Australian Longitudinal Study on Women’s Health followed nearly 12,000 women in their 70’s over a 6 year period. The group was comprised of non-drinkers, occasional drinkers and moderate drinkers.
The study found that non-drinkers and women who rarely drank had a significantly higher risk of dying during the survey period than did women who drank moderately. Of those who survived, the women who drank the least reported the lowest health-related quality of life. Previous studies have shown that women who have at least one drink per day stand at a lower risk for cardiovascular disease and ischemic stroke than non-drinkers.
“The results of this study indicate that moderate alcohol intake in keeping with current guidelines may carry some health benefits for older women,” says Dr. Julie Ellen Byles, author of the study. This contrasts previous studies which have suggested that moderate alcohol intake can be detrimental to older women and may lead to accidents, cancers, even dementia.
The potential causes of increased health and survival may be ingredients found in wine or ethanol, the social and pleasurable benefits of drinking or the improved appetite and nutrition that often accompanies modest alcohol intake. The author notes that the study does not advocate non-drinkers to begin drinking. Changes in diet need to be determined through consultation with a doctor due to the potential complications of mixing alcohol and medication.
Resveratrol Could Protect Against Stroke
Resveratrol, a compound found in grapes, red wine and peanuts, can improve blood flow in the brain by 30 per cent, thereby reducing the risk of stroke, according to the results of a rat study.
Researchers at the National Taiwan Normal University and the National Chia-Yi University report that rats with induced reduction of blood flow (ischemia) in the brain experienced an improved blood flow from a single dose of resveratrol.“We found that resveratrol administration… led to cerebral blood flow elevation and protected animals from ischemia-induced neuron loss,” said lead author Kwok Tung Lu.
Strokes occur when blood clots or an artery bursts in the brain and interrupts the blood supply to a part of the brain. It is the leading cause of disability and the third leading cause of death in Europe and the US. According to the Stroke Alliance for Europe (SAFE), about 575,000 deaths are stroke related in Europe every year. In the US, every 45 seconds someone will experience a stroke, according to the American Stroke Association.
The new study, published in the Journal of Agricultural and Food Chemistry (Vol. 54, pp. 3126-3131), divided 60 adult male Wistar rats into three equal groups. The first group was the control. The second group underwent the induction of cerebral ischemia, and the third group underwent the same operation but also received an intravenous dose of resveratrol (20 milligrams per kilogram body weight).
Although no change to mean blood pressure or heart rate was observed, cerebral blood flow in the second group decreased by 65 per cent compared to the control group. The ischemia plus resveratrol group's blood flow also decreased, but by only 35 per cent.
The researchers also found that the concentration of nitric oxide (NO) in the affected part of the brain was 25 per cent higher than for both the control and ischemia-only group. NO is a molecule used by lining of blood vessels (endothelium) to signal to the surrounding muscle to relax – this dilates the blood vessel and increases the blood flow.
“We suggested that resveratrol may elicit neuroprotective effects by stimulating NO formation or release, which increases cerebral blood flow,” said Lu.
The authors said that further investigation of the effects of resveratrol was needed. Of particular interest is the dose needed to produce protection While resveratrol has been the subject of various studies, particularly in relation to heart health, recent studies have reported brain protecting effects from grape juice or wine – an effect linked to a synergy between the various polyphenols present.
A recent study using Concord grape juice by researchers from Tuft's University reported that the combination of the polyphenols could decrease the effects of aging on the brain.
“It may be that the whole is greater than the sum of its parts,” lead author Barbara Shukitt-Hale wrote in the journal Nutrition (Vol. 22, pp. 295-302).
The amount of resveratrol in a bottle of red wine can vary between types of grapes and growing seasons. But nearly all dark red wines – merlot, cabernet, zinfandel, shiraz and pinot noir – contain resveratrol.
The health implications of red wine consumption appear to be filtering through to the consumer. A report from analysts Euromonitor in 2004 predicted that still red wine will exhibit by far the fastest growth in both volume and value terms between 2002 and 2007.
Their study claims that red wine is forecast to record global value sales of $82bn (€61.5bn) in 2007, a rise of some 31 per cent from 2002.
However, experts are quick to warn that moderation is the key. A study from Harvard University last year reported that people who have three or more alcoholic drinks per day have a significantly higher risk of stroke. Lowest risk was observed for those who had one, or maybe two, drinks every other day.
Red wine again linked to slowing Alzheimer's
A Mount Sinai School of Medicine study found giving mice with amyloid plaques red wine slows their memory loss and brain cell death - adding to a body of science linking compounds in the beverage to slowing the Alzheimer's disease-related symptom.
In the study in November 2006's Federation of American Societies for Experimental Biology Journal - wine-drinking mice learned to escape from a maze significantly faster than mice drinking alcohol-spiked water or water. The results could have implications for formulators in the production of supplements for age-related conditions.
According to the Alzheimers Society, there are nearly 18 million people in the world with dementia. Around 55 percent of those who suffer from dementia have Alzheimer's.
In the Mount Sinai study, the mice's wine intake was aligned to what is the equivalent of moderate consumption in humans - a five-ounce glass per day for women and two for men.
In the past, both alcohol and a red wine compound, resveratrol, have been linked to a reduction in the onset of dementia.
For several months, the Mount Sinai mice were given cabernet sauvignon or ethanol in their drinking water, while another group of mice drank plain water. All the mice had amyloid plaques in their brains that occur in humans with Alzheimer's disease.
The research team, led by Dr. Giulio Maria Pasinetti, assessed the mice's memory by testing their ability to get out of a maze. The wine-drinking mice were able to exit the maze significantly faster than those drinking alcohol-spiked water or water only, the scientists found.
The study only advocates moderate red wine consumption as part of an overall healthy lifestyle.
Drinking in moderation reduces all-cause mortality
A study provides further evidence that alcohol, when consumed in moderation, reduces the risk of death, and not just that due to cardiovascular disease
A study performed by the Research Laboratories of the Catholic University of Campobasso (Italy) confirms the beneficial effects that moderate consumption of alcohol has on our health. But this time it is not just cardiovascular disease that gets advantage from this: drinking in moderation reduces all-cause mortality.
The research, published in the American journal Archives of Internal Medicine, assembled 34 scientific studies conducted during the last years worldwide using the statistic procedure of meta-analysis, that al-lows to match different studies to achieve general results. In this way it has been possible to examine data concerning over a million of people, for which alcohol drinking habits were associated with all-cause mortality.
The conclusions researchers from the Catholic University of Campobasso came to clearly show that drinking in moderation (a couple of wine or beer glasses a day) has beneficial effects on health. But that is not all: while the greatest part of the studies conducted on this issue have looked at cardiovascular disease, a term that includes clinical events of various severity, the study published in the Archives of Internal Medicine shows a positive effect of alcohol on an unquestionably hard parameter as overall mortality.
"Our data" says Augusto Di Castelnuovo, lead author of the study, "show that consumption of little amounts of alcohol leads to a reduction of mortality up to 18%. But after a certain number of glasses things radically change: who drinks too much not only looses this advantage, but increases his own risk of death in relation to the amount of alcohol consumed".
The study shows very important differences between men and women. Whereas men report a beneficial effect after consuming 2-4 doses maximum (a dose refers to one glass of wine or beer), women should be aware: for them, the protection guaranteed from alcohol consumption disappears just after two glasses a day.
"It might be- says Licia Iacoviello, Head of the Laboratory of Genetic and Environmental Epidemiology, where the research has been performed- "a fact linked to the metabolism. We know that women metabolize alcohol in a different way and the blood concentration reaches higher levels. Therefore, consuming more than two doses might lead to several harmful effects, such as liver diseases or increased risk of certain forms of tumour".
The meta- analysis conducted by the Catholic University found that the protection given by a moderate consumption of alcohol for American men is lower than the one observed for Europeans. For women, instead, the situation is substantially the same both in USA and Europe. An explanation might be found in the different ways in consuming alcohol. Europeans are more inclined to drink wine rather than other beverages and use to do it while having meals. Two habits different from Americans’. In relation to women, the way they consume alcohol is roughly the same in both continents, thus they respond identically. However, the debate is still open and more research is needed.
Another significant data emerging from the study is related to the so called "confounding factors". During the past years, it has been thought that the protecting effect of alcohol might be ascribed to other factors. It might be, in fact, that people enjoying alcohol drinks in moderation are more concerned about their own health: it may turn out that they are more likely to do sport or to consume healthier food.
In other words it might be that they have a better lifestyle and this could be the cause, not necessarily alcohol, that keeps them in good health.
"We’ve carefully examined this aspect," Di Castelnuovo continues. "Our data suggest that, even considering all main confounding factors (as dietary habits, physical activity or the health of people studied), a moderate consumption of alcoholic beverages keeps on showing a real positive effect".
"The core of this study is not just about alcohol"- says Giovanni de Gaetano, director of the Research Laboratories at the Catholic University- "it is also the way we drink that makes the difference: little amounts, preferably during meals, this appears to be the right way. This is another feature of the Mediterranean diet, where alcohol, wine above all, is the ideal partner of a dinner or lunch, but that’s all: the rest of the day must be absolutely alcohol- free. The message carried by scientific studies like ours is simple: alcohol can be a respectful guest on our table, but it is good just when it goes with a healthy lifestyle, where moderation leads us toward a consumption inspired by quality not by quantity".
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