Unveiling alcohol’s health paradox: heart benefits and detrimental effects

Tons of ink have been expended on the health effects, both positive and negative, of alcohol consumption. Beneficial effects on the heart were discussed in the 1990s based on the “French paradox.” A paper published in 1995 noted that there was less ischemic heart disease in France compared to the U.S., despite higher saturated fat intakes and a higher prevalence of smoking.

The relatively lower incidence of ischemic heart disease in the French population was attributed to their high alcohol consumption and their intake of antioxidant vitamins, both provided by wine. The tradition of consuming wine with meals was believed to offer protection against some of the adverse effects of food. Resveratrol, a compound found in grape skins, was considered a significant factor, leading several pharmaceutical companies to explore its use.

At the same time, the detrimental effects of alcohol are numerous: liver disease, traffic accidents, gout, and various cancers are all more prevalent in heavy drinkers. A recent study from China demonstrated a higher incidence of 61 diseases among males who regularly consumed alcohol.

What is the truth?

A study published this spring in JAMA Network Open examined 107 studies investigating the relationship between alcohol consumption and mortality. The study compared non-drinkers, light drinkers (1 to 2 drinks per day for men, 1 per day for women), moderate drinkers (3 to 4 per day), and heavy drinkers (5 or more drinks per day). It’s important to note that a “standard drink” is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor.

In comparison to lifelong non-drinkers, occasional or light drinkers exhibited similar mortality rates, while moderate drinkers experienced a slightly (5 percent) higher mortality rate, and heavy drinkers had a 22 percent higher mortality rate. Notably, very heavy drinkers displayed an astonishingly high 35 percent increased death rate.

Significantly, women who consumed any quantity of alcohol had a 20 percent higher mortality rate than female lifelong non-drinkers. (Women metabolize alcohol differently than men due to their generally lower body water content, leading to higher concentrations of alcohol in the blood after consuming equivalent amounts of alcohol.)

What can we derive from this study? Do not drink solely for potential “heart health” benefits. There’s no alcohol quantity that reduces mortality risk. If you enjoy a beer or a glass of wine with dinner, you can continue, understanding that you might be trading a lowered risk of heart attacks for a higher risk of liver disease, resulting in an overall neutral impact. For heavy drinkers, it’s advisable to cut down. The life you preserve will be your own.

Edward Hoffer is an internal medicine physician and author of Prescription for Bankruptcy: A doctor’s perspective on America’s failing health care system and how we can fix it.

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