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Is the Party Over? The Latest Research on the Pros and Cons of Drinking Alcohol

By Kristin Ohlson, November/December 2009

Scientists spill the truth about drinking and your health.


READER'S COMMENT:
"I look forward to relaxing in the evening with a glass of red wine. If it's Friday....more likely two! We need to always consider our family health history, and remember to drink responsibly. Kudos to Kristen Ohlson for writing such an...

Here come the caveats…

Not everyone in the scientific community is so enthusiastic about the health benefits of moderate imbibing. Critics pooh-pooh the French paradox, saying that the French might have lower risks for cardiovascular disease but that they don’t have significantly lower rates of overall mortality.

In fact, not all research suggests that moderate alcohol consumption confers health benefits. For example, multiple studies have shown an increased risk of breast cancer for women who drink even as little as one glass of alcohol per day, leading some researchers to conclude that when it comes to breast cancer, any level of consumption can be considered unsafe. Other research suggests that the B vitamin folate—found in leafy greens, oranges and legumes—and its supplemental form, folic acid, may blunt alcohol’s breast cancer impact by supporting normal cell division and repairing DNA damage. One study found that women who drank alcohol did not have a higher risk of breast cancer if they consumed at least 600 mcg/day of folic acid.

“For people who have had breast cancer, or are at risk of getting breast cancer, and who drink, I do not insist on total abstinence. But I advocate that if you do drink, you should do so moderately,” says Larry Norton, M.D., medical director of the Evelyn H. Lauder Breast Center of Memorial Sloan-Kettering Cancer Center in New York City. “That’s a reasonable choice if you’re eating lots of fruits and vegetables.” (Fruits and vegetables provide nutrients, like folate and vitamin C, that may mitigate the cancer risk associated with drinking alcohol.)

However, even eating bushels of fruits and vegetables won’t erase the ill effects of too much alcohol. Some scientists are concerned that ordinary people like moi have gotten the idea that if one serving of alcohol might be good, several more might be better.

“Either consciously or subconsciously, some people omit the word ‘moderate’ and come away with the idea that drinking is good for you,” says Tim Naimi, M.D., M.P.H., an epidemiologist at the Centers for Disease Control and Prevention (CDC). “The concept of moderate drinking tends to be adjusted elastically at the level at which one already drinks.”

There’s no quibble that excessive drinking is bad for every system and every part of our bodies. Although there may be some debate about the definition of moderate drinking—from half to two servings of alcohol per day for women, two to three for men—researchers are quick to point out that this is not a weekly average. We can’t abstain from Sunday through Friday, have seven drinks on Saturday, and call ourselves moderate drinkers—that’s binging. Both excessive daily drinking and binge drinking are harmful, leading to liver damage, inflammation of the pancreas, various cancers, high blood pressure, sleep disorders, accidents and violent behavior. There’s nothing even slightly alluring about any of that.

And wanting to improve your health isn’t a reason to start drinking alcohol, most experts emphasize. There’s the issue that some people may have a history of alcoholism or predisposition that renders any level of alcohol intake dangerous. Some take medications that can cause serious health problems when mixed with alcohol. Finally, many experts argue that there really is no ironclad proof that one or two drinks daily improve anyone’s health and longevity. “You have to take these studies with a big grain of salt,” says Larry Norton.

At the heart of their caveats is this: most of the research studies on the health impacts of alcohol are observational. In this kind of research, large groups of people are studied for a long period of time, and their eating habits, their exercise patterns, their medications, their incomes and many other factors are tracked, along with their evolving health profile. Researchers look for links between lifestyle or environmental factors and certain health outcomes. Observational studies are valuable tools for the scientific and public health community. For instance, they were the first solid indication of the connection between smoking cigarettes and lung cancer. But since certain populations tend to have complicated clusters of either negative or positive behaviors, it’s tricky to draw medical advice from their comparison. “When you look at the profiles of moderate drinkers, you see that they exercise, they eat lots of green vegetables, they have a glass of wine at dinner, and so on,” says Tim Naimi of the CDC.

So is it the wine at dinner that’s really making a difference? Or is it something else?



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