Here’s to Your Health

Is drinking alcohol in moderation really good for you?

Through the ages, much has been said about the benefits of drinking. Beer lover Ben Franklin said alcohol was God’s proof that he wanted us to be happy and well. Going further back, the ancient Greeks and Romans extolled the power of drink to invoke courage and passion. Cleopatra considered it so essential to social interaction that she imported wine by the shipload from Italy and may well have been the first to introduce a sparkling version.

These days, a glass of wine is seen as a good way to reduce stress and feel whole again. But, years from now, will the scientific endorsements of its so-called health benefits still hold water (so to speak)? It appears that way, so long as you stay within the U.S. Department of Health’s recommended limits—one drink per day for women, two for men.

Those not genetically predisposed to alcoholism or alcoholic liver disease could reduce their chances of encountering the following major health problems: Hepatitis A, essential tremors, renal cell cancer, non-Hodgkin’s lymphoma, thyroid cancer, Parkinson’s disease, pancreatic cancer, and even liver disease. On the anti-aging front, benefits include preventing or reducing your chances of suffering from dementia, rheumatoid arthritis, hearing loss, macular degeneration, bone fractures and osteoporosis.

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Trouble is, it may be difficult to stay within current recommendations, especially for those who have a tendency to eat and drink in excess.

“We might have one glass in mind, but we can forget when we’re enjoying ourselves in the evening,” says Dr. Cataldo Doria, chief transplant surgeon at Thomas Jefferson University Hospital.

A native of Italy, Doria admits that his research specialty—liver transplant surgery—may seem at odds with a childhood spent growing up amid wine connoisseurs. He takes a philosophical approach to the problem of living a life of restraint in a culture of “big box” stores and commercially grown foods that are bigger and more accessible than ever before. “The message I love to deliver is that we need to do everything in moderation,” he says. “But how can we do that when we’re used to so much? Our strawberries are huge, and we get them year-round.”

By most official definitions, one drink (beer, wine or spirits) per hour is moderation. But Doria finds that misleading. “Ninety percent of toxins in the body are cleared by the liver,” he says.

The liver can only metabolize a small amount of alcohol at a time. The rest circulates in the body, so how drunk we feel is directly related to the amount of alcohol we consume.

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Interestingly, alcohol consumption and mortality have never been clearly linked, according to the Centers for Disease Control and Prevention. Still, it’s no surprise that the CDC and the American Heart Association acknowledge the health benefits of moderate drinking but temper their recommendations with warnings about dangers of alcohol. Yet both point to the difficulty of supporting even moderation when alcohol, consumed in small amounts, has been linked to breast cancer and tied to liver disease, heart damage, strokes and certain cancers when consumed in large amounts. Nonetheless, the federal government’s Dietary Guidelines for Americans states that “alcohol may have beneficial effects when consumed in moderation.”

As for doctors, they generally make a point to modify their recommendations depending on a person’s age, race and gender. “When I meet a patient, I usually have to quantify what they tell about the number of drinks they have each week,” says Dr. Michael Wolfson, a gastroenterologist at Paoli Hospital. “You might be a male under the age of 65 and have two drinks a day, but I want to know what—wine, beer, hard liquor? It’s more about averages and the type of drink.”

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And back to those studies. Many in the medical community—even avid supporters of moderate drinking—say that there’s an inherent problem in the way they’re conducted. Research trials on the effects of moderate drinking have all been observational in nature—not part of the randomized and controlled clinical trial system conducted with most drugs in this country.

There’s also the issue of financial ties between the alcoholic beverage industry and many academic studies, not to mention the fact that no one knows how to compare moderate drinkers with abstainers. Getting a research subject to switch positions, for instance, isn’t exactly what scientists want. “Let’s be honest—who’s going to sponsor that kind of study?” poses Doria.

He recommends that people with liver disease never drink, and that those who can’t stop at one or two glasses should consider themselves problem drinkers. As for the rest, he advises caution. “The bottom line is that we need to find a balance,” he says. “We need to weigh in with the negative and positive aspects of drinking.”

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A few years ago, red wine was hailed for its surplus of flavonoids and antioxidants, ingredients also found in green tea and strawberries (to name just two other examples). And it’s the alcohol’s effect on blood clotting and lipid profiles that seems to point to positive health benefits. Even more fun to ponder—presumably over a glass of red wine—is that you may be reducing your risk of stroke and cardiovascular disease simply by your HDL (good cholesterol) levels.

Critics argue that many positive trial outcomes might well be rooted in the fact that wine drinkers tend to eat healthy and have better lifestyle habits than those who consume other types of alcohol.

For individuals predisposed to heart disease—even a fit person who’s had a heart attack—drinking alcohol in moderation may win out over losing weight or eliminating salt or fat from your diet. Simply put, those who find it difficult to stick to more drastic lifestyle changes often find it easier to drink in moderation.

All of which seems to indicate that it can’t hurt to keep alcohol in your diet—so long as you don’t start drinking simply for the sake of those perceived health benefits.

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Alcohol Fast Facts

• Age is a factor in the way even a moderate drinker is affected by alcohol.

• Women develop severe alcoholic liver disease more quickly than men.

• ALD develops in three stages: enlarged or fatty liver, alcoholic hepatitis, and cirrhosis or scarring of the liver. Only the first stage is reversible.

• Tylenol or any over-the-counter pain relievers containing acetaminophen should never be mixed with alcohol. Severe liver damage can result—even a day after heavy drinking.

• Wine and beer are not “safer” than hard liquor. A general serving size of each has about the same amount of alcohol.

Warning Signs of Alcoholic Liver Disease

A liver marked by an excess of fat cells is the first stage of ALD. Many people experience no symptoms; others experience two or more of the following:

• General malaise
• Muscle weakness
• Anorexia
• Nausea
• Bloating or abdominal discomfort
• Discoloration of the skin or eyes (jaundice)

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