On alcohol

I wrote in the margin of my clinical pathology notes, next to discussion on fat metabolism disorders: resveratrol, 1 glass of red wine per day for women, 2 glasses per day for men. I remember it clearly, my professor remarking that it’s a shame the concentration of resveratrol is not as high in her preferred form of alcohol (tequila) and that it’s patently unfair that men are allowed more glasses of wine per day. There was a healthy dose of laughter in the auditorium after her comments, as she shifted the discussion to further dietary recommendations and lifestyle modifications for high cholesterol and high triglycerides.

 

So, when my father, an immunologist, told me about new research that alcohol confers no benefit to health, I was very surprised. (This article is published by The Lancet, that also published the studies recommending spinal manipulative therapy as a viable and preferred treatment option for low back pain.) Time published an article summarizing the study’s findings, and other experts’ commentary on those results. TL;DR? Worry not, because I will break this debate down for you.

 

Pro-moderate drinking

  1. Moderate drinking offers some cardiovascular benefit, especially for women.
  2. Copious data still exist that concludes that moderate drinking correlates with decreased total mortality and decreased risk of cardiovascular disease.
  3. While tuberculosis may be the leading alcohol-related disease worldwide, it is very rare in the United States. Because The Lancet article researched worldwide morbidity and mortality resulting from alcohol consumption, its results may not be completely applicable to the United States.

 

Anti-moderate drinking

  1. While a drink a day decreases risk for cardiovascular disease, it increases a women’s risk for breast cancer.
  2. Consumption of one alcoholic drink per day afforded a 0.5% increase in risk of developing one of twenty-three alcohol-related health conditions in a year (not a huge increase).
  3. Consumption of two alcoholic drinks per day afforded a 7% increase in risk of developing one of twenty-three alcohol-related health conditions in a year (uh oh).
  4. Consumption of three alcoholic drinks per day afforded a 37% increase in risk of developing one of twenty-three alcohol-related health conditions in a year. (Note the exponential increase in risk, from adding just one drink.)
  5. Alcohol was the seventh leading risk factor for premature death in 2016.

 

I have never recommended to a patient to start drinking in interest of cardiovascular health, and I never will. Indeed, as many experts quoted in the Time article state, the positive research on moderate drinking merely suggest that people who drink moderately may not incur adverse health effects. However, this last statement is called into question by The Lancet article. Is moderate drinking truly harmless? Or, should we steer the conversation towards other dietary recommendations and lifestyle modifications, as my professor did in clinical pathology class?

 

I’d love to hear your thoughts on this topic. Comment below, or we can discuss at your next appointment.

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