Whether alcohol can ever be healthy is a matter of controversy. For a long time, people have believed that alcohol can be beneficial as long as it’s consumed in moderation. However, is this true? In addition, should physicians ever advise patients to drink alcohol? If we do encourage our patients to drink alcohol, will it harm or help them? The answer is very complex.
First, we will examine the possible benefits of alcohol. The ways that alcohol can benefit health are actually still poorly understood. One way it might be healthy, according to some researchers, is that alcohol increases the blood’s high-density lipoprotein (that is to say, the ‘good’ cholesterol that reduces risk of heart disease).
Another way alcohol might be healthy is with antioxidants found in some wines. They can help fight disease and the effects of aging. They can also help arteries to function properly in carrying blood from the heart to the rest of the body. When an artery is unhealthy, the first sign is that it becomes clingy and adhesive, which causes fat to stick to it and blockages. Alcohol might help prevent blockages by thinning the blood and stopping blood clots.
All those theories have been backed up with what’s called “observational research.” This kind of study looks at patients who already have heart problems and tries to determine whether alcohol was the cause.
However, all scientists agree the best type of research is a double blind study with a placebo-control group. They’re called double blind studies because neither the participants nor the researchers themselves know which groups the participants are in. Even though this type of study is the most reliable, it’s never been done with alcohol, because it would be difficult.
There is an observational study suggesting that if a person drinks one to two drinks a day, it may reduce the chance of heart attack. However, if a person drinks more than two drinks a day, not only is any health benefit is lost, but also the alcohol starts to harm the body instead of doing good.
A drink is defined as any beverage that contains half an ounce of pure alcohol. That is the same amount of alcohol in a 12-ounce bottle of beer, a 4-ounce glass of wine, or a 1-and-a-half-ounce shot of liquor. Each of those is considered to be one drink.
The term drink is useful because different types of alcohol – wine, beer and spirits – contain different percentages of alcohol. For example, liquor is often 40 percent alcohol, whereas beer is typically only 5 percent. By counting in drinks, we can easily count the amount of alcohol across many different types of alcoholic drinks.
To provide a balanced view, let’s look at how alcohol can be harmful. First, it can kill cells. Some people have what’s called ‘hypertrophic obstructive cardiomyopathy,’ which means there’s an overgrowth of heart muscle inside the heart which obstructs blood flow to the rest of the body. We can treat this with a procedure called ‘alcohol septal ablation,‘ in which a physician inserts alcohol into the blood vessel that feeds the overgrown muscle. The alcohol safely kills off the cells of the excessive heart muscle.
That demonstrates that alcohol can kill cells it comes into contact with. But when we drink alcohol, it comes into contact with our stomach and gut cells and can cause ulcers.
In addition, if we consume alcohol in excess, it can cause liver and heart damage, which can lead to heart failure. On top of that, alcohol is addictive, especially for people with a predisposition to dependency. Drinking also increases the danger of breast cancer, suicide, hypertension, obesity, stroke and accidents. Most studies have found alcohol to be beneficial for middle-aged to older individuals, but not young people in their 20s and 30s.
It’s clear then that there won’t be any 100-percent certain instruction any time soon about alcohol consumption. Nevertheless, we certainly advise the following individuals to avoid drinking alcohol:
- people with a personal or family history of alcoholism;
- people with hypertriglyceridemia (in which a certain type of fat builds up in the bloodstream);
- sufferers of pancreatitis, liver disease, certain blood disorders, heart failure, and uncontrolled hypertension;
- pregnant women;
- people on certain medications that interact with alcohol.
Moreover, there is no clear evidence that young people can get healthier by drinking alcohol, so they shouldn’t trick themselves into believing that by taking alcohol they’re actually helping the health of their heart.
Dr. Ramin Manshadi is among the top American cardiologists and the author of The Wisdom of Heart Health. He serves as Associate Clinical Professor at UC Davis Medical Center and as Clinical Professor at University of the Pacific. He can be reached at [email protected].