Alcohol — is it good or bad?
Over the past few decades there have been a variety of studies suggesting alcohol, in all its variety of delivery systems, is anything from a definite cellular poison that should be avoided, to a substance taken in low doses which may even have a health benefit.
With so many of the contradictory health messages over the years for a variety of substances and treatments, you would be forgiven for being sceptical and somewhat confused.
The latest study published in the Lancet adds more to this confusion suggesting the only safe intake of alcohol is none whatsoever. The introduction to the study suggests that alcohol is responsible for 3 million deaths around the planet on a yearly basis and is the leading cause of death for people in the 15 to 50 age group, causing around 12% of deaths especially in males.
This study analysed 592 separate reports analysing 28 million people. Understandably, intake of alcohol varies between countries with a rather healthy place like Denmark having over 95% of the adult population consuming alcohol on a regular basis whereas in Muslim countries such as Bangladesh and Pakistan have an expected less than 1% of people who consume alcohol regularly.
The study took people who were non-drinkers, compared to those who consumed only one alcoholic drink per day over a 12 month period. The analysis suggested that for every daily alcoholic beverage consumed there was a 0.5% increase in the health problems related to alcohol consumption. In real terms, over the course of a year, the 23 separate health problems related to alcohol consumption were increased from 914/100,000 for the abstainers from alcohol to 918/100,000 for those that drink one alcoholic beverage daily (hardly earth shattering statistics to strike fear in the hearts & other organs of light drinkers).
The variety of health problems included cardiovascular disease and diabetes, a variety of cancers, liver & pancreatic disease, neurological disorders, a variety of infections, along with accidents and violence.
I would like to take a somewhat different view of these statistics and the entire issue of alcohol consumption. Firstly and most importantly, no one benefits from the excessive consumption of alcohol, apart from people who own hotels or liquor stores. There is no doubt that the regular consumption of four or more standard drinks per day for a male and half that for a female is associated with increasing health problems, such as those mentioned above. Therefore, we should not see the evidence that consuming low dose alcohol may have some benefit as an excuse for heavy or binge drinking.
Secondly, it is my opinion that it is not just the alcohol but “who the alcohol is hanging around with” that contributes to the health disorders. What I am inferring here is that you can’t consume an unhealthy diet and expect two glasses of alcohol will afford you some health benefit. For example, if you look at the data from areas of America where a poor diet is consumed, there is no benefit from consuming alcohol, and there is a possible detriment. But, for example, in a more affluent area such as Boston, The Male Physician’s trial demonstrated around an 80% reduction in sudden cardiac death associated with the consumption of one glass of red wine on a daily basis. The Copenhagen Heart study, obviously performed in Denmark where there is a very high proportion of drinkers demonstrated a 50% reduction in heart disease and cancer when two glasses of red wine were consumed with a healthy Danish diet. The Lyon Heart study, of 36,000 Frenchmen over 12 years showed exactly the same result.
Again, staying with the Harvard data from the Boston area from the Nurses’ Health study, again suggested that even one glass of alcohol daily can increase the risk for breast cancer. This risk, however, was negated by taking a daily multivitamin on a regular basis for 15 years and beyond.
Finally, it is also important to ask why people consume alcohol? Many people use alcohol as an antidepressant or sedative to numb the pain of a difficult life. Could it be that the alcohol in these people is purely a marker for a mental health disorder and not the actual cause of the problem, thus also increasing the risk for physical disease-a well known association?
Food and alcohol are at the centre of many of our celebrations in life. With around 70% of Australian males and around 50% of females overweight or obese, could it be more that the obesity interacts poorly with the alcohol contributing to all of the health problems mentioned above?
I was recently asked the question as to whether grape juice had the same benefits as red wine? The reality is that the polyphenols (strong plant chemicals) in grape juice are in a very complex, polymeric form and therefore are more difficult to absorb. When wine is fermented, these polyphenols are converted to a more monomeric form and are more easily absorbed. I therefore believe the combination of the reduced absorption of polyphenols and the sugar content of grape juice makes it less healthy than the low dose consumption of wine. Red wine, especially, has very concentrated polyphenols, that is, in my view, the evidence for the health benefits in low doses in people who also consume a healthy diet and take a daily multivitamin.
There will always be people with a vested interest either way who will condemn any alcohol consumption on the one hand and those who for other reasons will want to promote the health benefits of alcohol consumption, often playing down the social and health problems created by overuse. As with most issues in life, I believe the answer lies somewhere in the middle and am yet to be convinced that the low-dose, responsible intake of alcohol causes harm and in my view this low dose consumption does have a weak health benefit when combined with all the other aspects of a healthy lifestyle.
