We all know the harmful effects of alcohol, but do you know its healthy effects, and the line between the two? What good does alcohol do? Should we start drinking for our health? How much? At what point do its hazards dominate? Does our age matter?
One no-brainer right up front: If you don't follow the other health guidelines - eat right, exercise, sleep eight hours each night, don't smoke - alcohol is not going to compensate. It's just a boost to a healthy lifestyle, not an excuse to drink bacon drippings or regularly subsist on 6 hours' sleep. It's very high in calories, and its calories are the most fattening kind, adding weight out of proportion to its calorie content by promoting fat storage. Even moderate drinking has harmful effects.
Moderate drinking is defined as no more than one drink per day for women and no more than two drinks per day for men, based on differences in weight and metabolism. By age 65, moderation means less than one drink a day because alcohol is metabolized more slowly, so it accumulates. "One drink" is defined as the amount of alcohol that remains in your blood for one hour, which means 12 ounces of regular beer, 5 ounces of wine, or a jigger of booze. But even that amount, on a daily basis, creeps beyond the health threshold towards the potentially harmful "drinking for drinking's sake" regime. Drinking at any age does some harm, and advancing age affects some of its effects for the better and some for the worse, as we shall see.
Statistically, longevity peaks below the moderation threshold, at roughly two to four drinks per week. It declines above and below that level even after rigorous adjustment for related lifestyle variations associated with alcohol consumption. Specifically, two to four drinks a week correlates with men's lowest heart attack rate. The rate of cardiovascular disease (CVD) in men is lower for any amount of drinking than for total abstention, but for women the stroke rate climbs after seven drinks per week and heart attack incidence rises after 28 drinks per week. This implies, but does not prove, that sub-moderate consumption of alcohol may prolong our lives, especially for individuals whose primary death risk is from CVD. Yet some respected studies support 3-5 glasses of wine with each supper -- well beyond moderate -- as the optimal consumption.
Medically - clinically -- alcohol reduces the incidence of blood clots, the primary trigger of heart and brain attacks. Taking fewer than two drinks a week does not prevent clotting, and more than four drinks a week does not increase the anticlotting benefit and does increase your chances of encountering the bad side of alcohol.
The active ingredients in wine that help to prevent heart attacks are probably its bioflavinoids, not the alcohol. They inhibit the conversion of bad cholesterol to artery-clogging plaque. If you want to live longer overall, rather than fight a known high CVD risk, you should get your bioflavinoids from tea, fruits and vegetables, not from alcohol. There's no agreement on whether wine is better for us than beer or liquor; maybe the answer to the bioflavinoid question will settle that.
Bioflavinoids are especially beneficial to diabetics. One cup of red wine reduces the oxidation and blood thickening that normally occur after diabetics eat, helping to offset their higher risk of heart attack after meals. Yes, diabetics should restrict foods that cause a high rise in blood sugar, but alcohol does not cause an immediate high rise in blood sugar.
Despite its probable positive effects on heart attack risk, not one source recommends drinking alcohol to prolong your life. Even red wine increases your chances of dying from cancer and chronic liver disease, and the famous French paradox may be a myth. Does wine protect against excessive French fat consumption, or did their fat intake increase so recently that it simply hasn't had time to swell their mortality statistics yet? The race is on.
On the other hand, some substantive new research indicates that the health benefits of alcohol apply only to middle aged and elderly people, that its only effects on younger people are negative. One large, prestigious study found that in men aged up to 35 and women aged up to 55, even light drinking leads to a higher risk of death, when compared with non drinkers. Wait and watch.
Either way, a modest increase in drinking in old age is a mixed bag. It correlates with increased longevity and may oppose specific age-related brain injuries such as silent (unnoticed real-time) stroke and age-related brain-wide deterioration, and preliminary evidence suggests that small amounts of alcohol may protect against senility and Alzheimer's disease. But there's still a cost to the brain. Alcohol at any age is closely linked to deteriorating brain structure and heightened risk of stroke as we age, and white matter lesions, caused or exacerbated by alcohol, lead to reduced intellect and impaired motor skills in all the things we do each day.
Think alcohol helps athletes? Think again. It cuts endurance significantly by reducing blood flow, increasing oxygen demand, dehydrating us, and exhausting muscle carbohydrate reserves. OK ... it does help shooters by steadying their hands.
Even small amounts of alcohol can impair brain activity, alertness, coordination and reaction time, sleep and sexual function; produce headaches and high blood pressure; contribute to heartburn; and exacerbate or block many OTC and prescription medications. At some point, ranging from three to six drinks daily, the negative effects of drinking on disease and accidents override its cardiac benefits. Women under 50, who generally have relatively low rates of heart disease and relatively high rates of breast cancer mortality, may not benefit from drinking at all unless they have one or more cardiac risk factors. People with high blood pressure, heart rhythm abnormalities, liver disease, ulcers, severe acid reflux, a family history of alcoholism, or sleep apnea should not drink alcohol at all. If you're pregnant, trying to get pregnant, or nursing, don't drink; its impact on babies can be profound. One in ten people who drink may become alcoholic.
My personal decision not to drink is easy. I hate the taste of alcohol, do few things in moderation, and do not enjoy being hot, sweaty and dizzy. My dad was an alcoholic, so it's a statistical risk factor for me. Your decision may not be as simple, and is only slightly facilitated by the overwhelming amount of research and its unresolved contradictions. In a nutshell, if you drink at all, drink mostly wine, and mostly as part of supper, not for intoxication or hydration. If you don't drink, get your bioflavenoids from fruits and vegetables. If it's a big decision for you, or if you have CVD, keep watching for new data. And remember ... if anyone says you drink too much, you probably do.