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Why Moderate Drinking Isn't The Answer

A flurry of well-publicized studies claim that alcohol may be a boon to your health. But a closer look suggests that even for moderate drinkers, the risks often outweigh the rewards. 

By Judy McGuire

04/13/11

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Since the ‘90s, a flurry of studies has been released from a respected network of academics, testifying to the health benefits  drinking. A couple of glasses of Chardonnay apparently lowers the risk of cardiovascular disease.  A nightly martini might keep diabetes at bay. And a snifter of scotch can prevent you from developing dementia. Plus, a few drinks a week will surely make you more social and relaxed, and we all know that loneliness can be a killer. While it’s certainly counter-intuitive to consider drinking for your health when alcohol almost killed you, justifications to pick up again can come in cunning and baffling forms.

Dr. R. Curtis Ellison, a physician and professor of medicine and public health at Boston University, is one of a growing number of physicians who believe that, unless contraindicated for health or religious reasons, drinking in moderation (meaning roughly two drinks a day for men and one for women) has a variety of health benefits; most of them related to the heart.

“You’ve heard of the French Paradox?” he asks. The paradox being that while the French eat three times as much saturated fat as we Americans do (who can resist a nice Camembert?), only a third as many succumb to heart attacks. One of the hypotheses researchers have come up with is that the French drink red wine with many of their meals. “On Sunday night, when you have your glass or two of wine, your platelets are less sticky, your arterial lining is improved, and your glucose is improved,” Ellison says. “But it only lasts 24-48 hours.” Which is why, while seven to 14 glasses of wine a week might be beneficial, that benefit is negated if you drink all 14 in one sitting. “It’s the regular moderate consumption that has the benefits.” Ahh, we knew there was a rub.

“Northern Ireland consumes the same average per capita of alcohol as France, yet in Northern Ireland you see much fewer health benefits,” he continues. “Because the number of French who binge drink is very low, while binge drinking is kind of the norm in Northern Ireland. And in Northern Ireland, 50 percent of the population abstains from drinking. So if Ireland has the same per capita consumption as France, that means half the Irish who drink are drinking twice as much.”

Not surprisingly, the slew of new studies talking up the benefits of moderate drinking have caused some experts—and even some recalcitrant sober alcoholics—to question the benefits of complete abstinence. But in doing so, they ignore the fact that these vaunted health benefits—if they indeed exist—are limited. They’re also often funded by groups like the International Center for Alcohol Policies, a non-profit group financed by the alcohol industry.

Despite several promising studies, most scientists aren’t completely convinced. “It seems that moderate drinkers certainly have a lower risk of heart attack,” says Dr. Arthur L. Klatsky, a California cardiologist. “Alcohol raises the H.D.L. [good cholesterol] and it probably also reduces the risk of diabetes,” though the doctor admits that this is far from proven. “It’s very biologically plausible that limited drinking has a few benefits,” he concludes. “But that doesn’t establish causality. There are really no blind, well-controlled, long-term clinical experiments.” Also, says Ellison, the health benefits of moderate drinking are almost exclusively found in middle-aged and older people.  “And the adverse affects of binge drinking and intoxication are particularly common in the young.”

“So far, in the area of moderate drinking, there hasn’t been a single gold-standard clinical trial of moderate alcohol use and any health outcome,” says Dr. Tim Naimi, an epidemiologist at Boston Medical Center. “It may be like hormone replacement therapy, where despite the hype, it turns out there aren’t any benefits and there may actually be some harm.” Naimi is annoyed that this scientific limitation is dismissed and overlooked by moderate drinking proponents. “And for people who question these findings, there’s been quite a bit of scientific bullying—much of it on the part of folks whose research has been industry supported.”

But all that may be academic.  Even if there are some heart-healthy benefits to being a middle-aged moderate drinker, there’s still no shortage of risks. After all, alcohol is a drug that was deemed to be more harmful than crack or heroin, according to a study published last year in the British medical journal The Lancet. Indeed, Dr. Sam Zakhari, director of the National Institute on Alcohol Abuse and Alcoholism’s division of metabolism and health effects, points out, “Even moderate drinking can decrease the reaction/response time and result in accidents.”  

Then there’s the slippery slope. The Centers for Disease Control defines “moderate” drinking as no more than two drinks a day for men and no more than one for women. This is because of differences in size, and body fat levels, as well as the difference in the way alcohol is metabolized by the two genders. Dr. Naimi says, “People would be surprised to learn that the lowest risks for death are with drinking only a third of a drink for women and a half a drink for men. People who drink above those levels face risks that far outweigh the benefits of moderate drinking.” And let’s face it, who stops after a third of a glass of wine anyway?

The one thing that every physician we consulted agreed to was that they would never advise anyone to start drinking for health reasons. And not smoking, staying fit, eating well, and taking care of high blood pressure and diabetes were all cited as far more beneficial for health. This goes double if the person in question has ever had an issue with alcohol or drugs. Women who have a history of breast cancer in their families also face an increased risk. Ellison says, “If I were a woman with a mother and sister who’d had breast cancer, I’d be loath to have more than an occasional drink.” Dr. Zakhari agrees, saying, “Women who have a history of breast cancer or a mutation in the gene should be careful about drinking even a small amount.”

Naimi concedes that while there may be benefits to very small amounts of alcohol, he has yet to see any conclusive results. “Meanwhile,” he says, “alcohol is producing devastating health and social consequences and is the third leading preventable cause of death in the U.S." Ultimately, Naimi concludes, "If people want to have a drink—good for them. But they don’t need to twist themselves into pretzels trying to also show that it’s healthy. As [the late evolutionary biologist/paleontologist/writer] Stephen Jay Gould once said, ‘We ought to be strongly suspicious of ideas that are enormously comforting.’”

Judy McGuire is a Brooklyn, NY-based freelance writer and a columnist at the Seattle WeeklyYou can find her at dategirl.net.

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