Rethinking Drinking

There’s been great news about the health benefits of alcohol in recent years. But drinking too much takes away the potential benefits —and adds plenty of risks.

The Upside of Alcohol

Despite the caveats, there’s no doubt that, for many people, limited amounts of alcohol can help you live longer and decrease your risk of heart disease. Those who may be at risk for heart disease or stroke and those who are diabetic appear to benefit most from moderate alcohol intake (one or two drinks per day) over the course of their lifetimes.

For example, in a University of Wisconsin study of diabetic men and women with an average age of 69, the risk of death from coronary heart disease was significantly lower among moderate drinkers compared to abstainers. The death rate for those who had a drink a day was less than half of that for those who didn’t drink at all.

Alcohol consumed in modest amounts may help raise your level of HDL cholesterol, prevent blood clots, lower your risk of heart attack, as well as heart disease, adult-onset diabetes, and ischemic stroke.

By raising your level of HDL cholesterol, alcohol inhibits the buildup of plaque in the blood vessels, since HDL carries “bad” cholesterol (LDL) out of the body. Alcohol also appears to have a slight blood-thinning effect, which offers some protection against heart attack and stroke.

In the U.S. Physicians’ Health Study, men who drank one alcoholic beverage a day had a significantly lower risk of death compared with those who rarely or never drank. This lower death rate can be attributed mostly to a reduced incidence of coronary heart disease in people age 50 to 60. Don’t overdo it, however. Death rates rise significantly with three or more drinks a day.

The Downside of Drinking

Does all this mean you should start drinking alcohol if you don’t already drink? Not at all. One reason is that no one can predict who might be at increased risk for alcoholism. And of course, if you drink too much, any potential benefits of alcohol will be offset by the dangers inherent in alcohol-related disease.

Those dangers are considerable. Even light alcohol consumption has been linked to cirrhosis and cancer of the liver, a number of other cancers (of the breast, mouth, throat, and esophagus), as well as high blood pressure, hemorrhagic stroke, osteoporosis, and depression.

The Latest Findings on Alcohol Consumption

The risk of cirrhosis can jump dramatically with two to three drinks a day and may even increase in some cases with one or two drinks a day.

Alcohol can increase the risk of breast cancer beginning at just a few drinks a week. One study showed that breast cancer was 50 per cent more likely to develop in women who consume three to nine drinks per week than in women who drink fewer than three drinks a week.

Alcohol has been linked to cancers of the mouth, pharynx, larynx, and esophagus at less than one drink a day.

Two drinks a day can increase a woman’s risk of hip fracture by shrinking her bone mass.

Alcohol has a number of other negative effects. You probably know that it can dull a person’s mental edge, judgment, coordination, reaction time, and memory. Drinking can also disturb blood sugar levels, impair sexual functioning, and even interfere with normal sleep patterns, making it more difficult to stay asleep and suppressing up to 20 per cent of rapid eye movements (REM) in the restorative stage of sleep. And heavy, prolonged drinking can actually cause the brain to shrink.

Alcohol and Aging

Many experts define moderate drinking as no more than a drink a day for most women and no more than two drinks a day for most men. But even moderate drinking may be ill-advised as you get older.

Research shows that as you age, you absorb alcohol more readily and are more sensitive to its effects. So the number of drinks you could tolerate years ago may be too much for you now. Why? First, your body’s ratio of water to fat falls as you age, so there’s less water to dilute the alcohol. Second, you have less blood flow to the liver and less efficient liver enzyme action, so your body doesn’t metabolize alcohol as readily. 

Sexual Discrimination

Women need to be especially careful, since most women can’t tolerate as much alcohol as men can. One reason is that they are generally smaller, and smaller people have less blood volume, so a little alcohol goes a longer way. Women also produce less of the enzyme that breaks down alcohol in the stomach before it is absorbed into the bloodstream. And they have a higher proportion of body fat, which does not absorb alcohol. The result? Drink for drink, women have 75 per cent more alcohol in their bloodstream than men do.

The Bottom Line

Since alcohol can be potentially good and bad for your health, how are you to know how much is helpful or harmful? For some people, one drink a day may be okay; others should set the limit at two or three drinks per week. If you’re in doubt, talk it over with your doctor. You can’t make a sound decision unless you consider your health history and current health risks.

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