Defensive Drinking: Alcohol and Your Health

Tara Mardigan, M.S., M.P.H., R.D.
Brigham and Women's Hospital
Previously published on Intelihealth.com
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• Defining a Drink
• Rewards of Moderation
• Tips for Healthful Consumption
• The Bottom Line

Is that frosty mug of your favorite brew helping or harming you? Could your daily glass of wine at dinner
actually be protective? It depends.

If you take a look at the scientific studies about the potential health effects of alcohol, you'll likely find
your head spinning as if you just polished off an entire bottle of Merlot. The data are inconclusive at best.

Defining alcohol's role in a balanced lifestyle is not clear-cut. To date, there have been no long-term
randomized trials of alcohol consumption. What we know about alcohol stems from two sources -
short-term trials looking at physical effects and observational studies comparing moderate drinkers
with those who abstain.

What's more, both sources have their limitations. Most of the studies focus on intermediate measures
rather than disease outcomes, so drawing complete conclusions may be inappropriate. Additionally,
some of the health benefits and risks associated with alcohol consumption may be related to some
other factor, not the actual intake of alcohol itself.

Where the science is limited, a shot of common sense can come in handy in determining if alcohol is
appropriate for you.

Defining a Drink

A drink is defined as 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80- to 100-proof distilled
spirits. Experts say that when it comes to alcohol, a little goes a long way for the potential health
effects. Once again, moderation appears to be the key. Sip past moderation and the effects of alcohol
can quickly become negative.

So, what's moderation when it comes to alcohol? Most studies suggest that moderate drinking is up to one
drink per day for women and two drinks per day for men. Heavy drinking is considered anything above this
amount and may include the common pattern of abstaining during the week and "binge" drinking on the
weekends.

A culmination of research studies involving alcohol suggests that the potential beneficial properties of
moderate drinking are not limited to wine alone. Whether you choose beer, wine or spirits, you'll reap the
benefits from the form of alcohol known as ethanol.

What must be clearly distinguished is that the potential health benefits of drinking alcohol are associated
with moderate drinking. In some cases, an increase past moderate drinking may actually reverse the
benefits and lead to increased risks. Here's a look at some of the possible pros of moderate drinking
and cons of heavy drinking.

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Rewards of Moderation

Moderate drinking may:

• Reduce your risk of developing heart disease, peripheral vascular disease and intermittent
  claudication (leg pain). Alcohol raises HDL "good" cholesterol, prevents plaque from forming
  in arteries, and prevents clotting.
• Reduce your risk of dying of a heart attack.
• Reduce your risk of strokes, particularly ischemic strokes.
• Lower your risk of gallstones.
• Possibly reduce your risk of developing type 2 diabetes. Alcohol appears to improve insulin
  sensitivity.
• Reduce your risk of age-related cognitive decline. Alcohol may reduce plaque build-up common
   with Alzheimer's disease.
• Possibly protect your bones. The silicon in beer is associated with improved bone mineral density
  in both men and women.
• Lower your risk of developing ulcers. Alcohol may help destroy Helicobacter pylori infection that
  commonly causes ulcers.

More is Not Better

Heavy drinking may lead to:

• Cancer, such as gastrointestinal, oral, pharynx, esophageal and liver cancers, as well as breast
  cancer in women. Alcohol appears to increase the risk of estrogen and progesterone receptor
  positive breast tumors more than estrogen and progesterone receptor negative tumors. This
  suggests a hormonal basis for the effect of alcohol on breast cancer.
• Chronic pancreatitis, especially in people with high levels of triglycerides in their blood
• Elevated levels of triglycerides in the blood
• High blood pressure
• Miscarriage
• Injuries resulting from impaired motor skills
• Sudden death in people with cardiovascular disease
• Heart failure
• Stroke
• Alcoholic cirrhosis of the liver
• Fetal alcohol syndrome in an unborn child, including slow growth and nervous system problems
• Depression
• Suicide

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Tips for Healthful Consumption

• Drink alcohol with food to slow its release into the bloodstream.
• Drink sips of water between sips of alcohol.
• Choose either a drink or a dessert when eating out to avoid excess calories.
• Take a multivitamin fortified with folic acid every day.
• Be mindful of liquid calories. A drink usually has between 100 and 135 calories.
• Avoid drinking alcohol at all if you have had a hemorrhagic stroke or have liver disease
  or pancreatic disease.
• Know your family history. You may be at risk of alcoholism if you have a family history of it.
• Remember that alcohol can interfere with common medications such as anticoagulants,
  antidepressants, beta-blockers, chemotherapies and pain relievers. Be sure to check with
  your doctor or pharmacist about potential interactions.

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The Bottom Line

Moderate drinking appears to play a role in chronic disease prevention when the other elements of a
balanced lifestyle are also present. These elements include a healthful diet, healthy weight, adequate
physical activity, no smoking, ample stress reduction and rest. Moderate drinking is only one component
of a balanced lifestyle. The choice is yours.