Say Cheers to Drinking (Moderately)

Victoria Shanta Retelny, R.D., L.D.N.

Alcohol may make you happy, but can it really keep you healthy? The good news is that moderate alcohol intake can fit into a healthy lifestyle and even offer some benefits -- welcome tidings for the estimated 100 million American adults who drink alcohol responsibly. Alcohol's potentially positive effects on health and quality of life have been on the public health radar screen for decades, dating back to 1979, when one of the first research papers was published on the topic.

While there are positive health effects documented with moderate alcohol intake, drinking too much clearly wipes away any potential benefits. Consider alcohol as a double-edged sword with the shiny side holding the promise of improved health and the lackluster side leading to health risks. Experts contend that garnering the health benefits (or not) of alcohol depends on the amount consumed, drinking environment, age, and other unique characteristics of the drinker. Here are a few interesting areas of research on alcohol and health.

Alcohol and the heart. One of the most publicized benefits of drinking alcohol is heart health; research has linked moderate drinking to a 25 to 40 percent reduction in risk of coronary heart disease. What is it about alcohol that makes it heart healthy? "The ethanol in any alcoholic beverage -- beer, wine and liquor -- imparts benefits to counter atherosclerosis or hardening of the arteries," explains Andrea N. Giancoli, M.P.H., R.D., a spokesperson for the American Dietetic Association. "Alcohol is one of the only dietary practices that increases the 'good' high-density lipoprotein (HDL) cholesterol and lowers the 'bad' low-density lipoprotein (LDL) cholesterol, as well as lowers the risk of blood clots," says Giancoli.

Research in the British Medical Journal showed convincing evidence that one to two alcoholic drinks per day increased HDL cholesterol by as much as 15 to 20 percent. This, in turn, reduced narrowing of the arteries caused by plaque and decreased the propensity for blood clotting, a common cause of heart attacks. It didn't take long to see positive results; this study showed that within one to two weeks of regular, moderate imbibing the HDL cholesterol was affected for the better. In addition, the cardio-protective benefit was found to compound with regular exercise. People who worked out for 30 to 60 minutes four to five times a week experienced even greater increases in HDL cholesterol when combined with moderate alcoholic intake.

Alcohol for diabetes defense. While you do not want to drink alcohol solely to manage blood sugar levels, it may be another added benefit of moderate consumption. According to Giancoli, "Drinking alcohol in moderation also has been found to improve insulin sensitivity, which controls blood sugar levels and staves off type 2 diabetes, a risk factor for heart disease and premature death." Research in the Journal of the American Medical Association published in 2002 examined whether daily consumption of none to moderate amounts of alcohol (0, 15, or 30 grams/day) influenced fasting insulin, glucose concentrations and insulin sensitivity in 51 non-diabetic postmenopausal women. After eight weeks, the greatest impact was observed in the group that drank 30 grams of alcohol (about two drinks) a day; fasting insulin levels decreased and insulin sensitivity improved as a result of regular, moderate alcohol consumption compared to those who didn't drink at all.

Toast to longevity. Another bonus to drinking alcohol responsibly is increased longevity or lower death rates. According to the 2010 Dietary Guidelines for Americans, people who have one to two drinks a day live longer due to lower rates of all-cause mortality found among moderate drinkers. The lowest incidence of deaths due to diseases like heart disease and type 2 diabetes occurs in moderate alcohol drinkers. In a literature review published in 2008 in the Journal of the American Dietetic Association, moderate drinking was found to consistently reduce mortality rates and disease risk among middle aged (45-65 years) and older adults.

Cancer: no cause for celebrating alcohol. On the other side of the coin, studies show that even one drink a day can pose an increased risk for certain cancers, such as breast cancer. Experts caution women with a family history of breast cancer to monitor alcohol intake and abstain, if possible. And in a new meta-analysis published September 2011 in the Annals of Oncology, researchers identified a 21 percent increase in colorectal cancer risk associated with moderate alcohol consumption.

The moderation motto. For many people, the key to drinking for health is clearly moderation. The American Heart Association's (AHA) Diet and Lifestyle Recommendations, published in 2006, specifically suggests moderation for people who drink, with cautionary advice against taking up drinking just for the sake of health.

What is considered "moderate" when it comes to drinking? The AHA guidelines, as well as the 2010 Dietary Guidelines for Americans, recommend no more than one drink a day for women and two drinks a day for men due to men's larger size. Ideally, experts recommend that you drink alcohol with meals because food slows down the absorption rate of alcohol in your blood stream and eating will enable you to savor your drinks with food more mindfully.

The dangers of too much. Regardless of gender, be careful how much alcohol you gulp down, as heavy drinking (for women that's more than three drinks per day or seven per week; for men that's more than four drinks per day or 14 per week) can cancel out the good effects and bring on negative health consequences. Since alcohol is highly addictive -- it's the most abused substance in the country -- people need to be aware of the risks involved in heavy drinking and choose to drink more responsibly, if they choose to drink at all.

"Long term alcohol abuse can result in cardiac muscle damage, high blood pressure, brain cell destruction, malnutrition, liver and kidney damage, type 2 diabetes and certain cancers," cautions Giancoli. Disease and death rates are highest among heavy drinkers; there are 79,000 deaths in the U.S. each year due to excessive drinking, according the 2010 Dietary Guidelines for Americans. Remember that health benefits come from incremental alcohol consumption throughout the week--one to two servings daily instead of four or five in one day. So, take a look at the amount and how often you drink, as well as your overall lifestyle and eating patterns for clues to how healthy your alcohol intake is for your overall health.

Waist watchers beware. Since weight gain and high blood pressure are two potential consequences of excess alcohol intake -- as well as risk factors for heart disease -- it makes sense to watch how much you drink even more. Alcohol contains a fair share of calories; it only takes 10 additional calories a day to gain a pound in a year. It's important to get your calories from whole foods first. In the case of alcohol, awareness is the key. Stick with moderation by alternating a glass of water for each alcoholic drink -- you'll save calories, stay hydrated, and drink responsibly for your health.

Belly Up to the Bar: What's a Drink?

Apparently, Americans aren't in touch with what's in a drink. A 2000 national survey found that the majority of adults (54 percent) couldn't identify a standard serving of alcohol for distilled spirits, wine and beer.

Here are the facts to set you straight:

One standard alcohol serving (0.6 ounces alcohol) equals:

1 12-ounce beer, 150 calories

5 ounces wine, 100 calories

1.5 ounces 80-proof distilled spirits, 100 calories.

Source: U.S.D.A.

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Health - Say Cheers to Drinking (Moderately)