Does Alcohol Have Benefits?
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File photo. Credit: NDTV Food Can a potentially harmful drink like alcohol play a role in a healthful diet? The consensus of health experts is that it can—but not for everyone. The question continues to arouse much debate, however, and even those supporting alcohol’s usefulness often have reservations. Public health statements on alcohol are typically accompanied by plenty of “ifs” and “buts.” |
Although alcohol has the potential to reduce risk for heart disease, most health organizations recommend moderate to no drinking. It is too early in the scientific investigation of alcohol’s benefits to recommend alcohol intake for all adults. Some people, such as pregnant women, should not drink any alcohol.
| Table X-1. Definitions for Patterns of Alcohol Consumption | |
|---|---|
| Binge drinking |
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| Heavy drinking |
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| Excessive drinking |
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Consistent epidemiological evidence suggests that low to moderate drinking reduces mortality among some groups. (Table X-1 gives definitions of different levels of drinking.) compared with nondrinkers or heavy drinkers, middle-aged and older adults who drink moderate amounts of alcohol have a lower risk of mortality from all causes. This include people with heart disease, diabetes, high blood pressure, or a prior heart attack.
Research also suggests that moderate intake of alcohol can protect against other diseases, such as cancer, diabetes, inflammatory liver disease, and lower extremity arterial disease, as well as have positive effects on bone density in elderly women. Consistent and growing evidence shows that alcohol reduces insulin resistance and may protect against heart disease by improving “good” cholesterol levels and reducing blood clotting.
No evidence has suggested that moderate drinking harmed the people in the studies. In fact, analysis of data from the Nurses’ Health Study, which involves more than 12,000 participants, suggests that in women, up to one drink per day does not impair mental functioning and may actually decrease the risk of mental decline with age.
Tracked against alcohol, death rates typically follow what statisticians describe as a “U-shaped” curve.
Compared with people who rarely or never drink, people who drink slightly or moderately have lower total mortality rates. The lowest rate is seen in people who consume one drink per week. Increasing the number of drinks confers no additional benefit. In fact, as the number of drinks increases, the mortality rate rises.
People who consume two drinks per day have about the same mortality rate as nondrinkers. Beyond three drinks per day, the death rate rises dramatically. Heavy alcohol consumption increases the risk of stroke, for example, whereas light or moderate drinking appears to reduce that risk.
Alcohol’s primary benefit is to raise protective HDL cholesterol levels. It may also inhibit formation of blood clots, but this connection is less clear. In addition, alcohol may have subjective benefits such as stress relief and relaxation.
French paradox is the phenomenon observed in the French, who have a lower incidence of heart disease than people whose diets contain comparable amounts of fat. Part of the difference has been attributed to the regular and moderate drinking of red wine.
In most studies, wine, beer, and spirits appear equal in offering protection against heart disease.
Findings of reduced rates of nonfatal heart attacks among moderate drinkers support the view that protective benefits are due to alcohol itself rather than other substances in alcoholic beverages. However, international comparisons that highlight unexpectedly low rates of heart disease in France, despite a high-fat diet (the French paradox), suggest that red wine may have a unique protective effect.
Some studies show that moderate consumption of red wine reduces the risk of heart disease, attributing this association to the polyphenols in the wine itself; other studies do not support the hypothesis that polyphenols account for the suggested cardiovascular benefits of red wine. The apparent benefits of red wine may result from overall healthier behavior of people who drink red wine.
Although a direct connection between red wine and health benefits remains unproven, recognizing that alcohol generally confers moderate protection and noting the possibility that wine has a particular benefit, the Bureau of Alcohol, Tobacco, and Firearms granted permission for wine labels to include one of the following statements:
- “The proud people who made this wine encourage you to consult your family doctor about the health effects of wine consumption.”
- “To learn the health effects of wine consumption, send for the Federal Government’s Dietary Guidelines for Americans. . . .”
Because of the many harmful effects of alcohol, public health agencies and organizations caution against inappropriate drinking. Although low to moderate alcohol use may offer some benefit, these groups advise people to discuss their alcohol intake with their doctors, and they urge moderation.
The U.S. Preventive Services Task Force recommends that primary care doctors routinely screen patients for unhealthy alcohol use and, when appropriate, intervene with a brief counseling session to reduce alcohol misuse.
Public health officials also point out that numerous groups should not drink any alcohol:
- People who cannot restrict their alcohol intake to moderate levels
- Anyone younger than the legal drinking age
- People taking prescription or over-the-counter medications that can interact with alcohol
- People who have an alcohol-related illness or another illness that will be worsened by alcohol, such as liver disease, hypertriglyceridemia, or pancreatitis
- People who plan to drive, operate machinery, or take part in other activities that require attention, skill, or coordination or participate in situations where impaired judgement could cause injury or death (e.g., swimming)
- Women who are pregnant or may become pregnant
- Women who are breastfeeding
- People with a personal or strong family history of alcoholism
See also:
- Xiang L, Xiao L, Wang Y, et al. Health benefits of wine: Don’t expect resveratrol too much. Food Chem. 2014; 156:258 – 263.
- Botden IP, Draijer R, Westerhof BE, et al. Red wine polyphenols do not lower peripheral or central blood pressure in high normal blood pressure and hypertension. Am J Hypertens. 2012; 25(6): 718 – 723.
- Saitz R. Unhealthy alcohol use. N Engl J Med. 2005;352:596 – 607.
- Estruch R. Sacanella E. Mota F, et al. Moderate consumption of red wine, but not gin, decreases erythrocyte superoxide dismutase activity: A randomized cross-over trial. Nutr Metah Cardovase Dis. 2011;21(1):46 – 53.
