Alcohol, health benefits and health risks

It is said moderate consumption of alcohol has health benefits.

However, the questions are how much is moderate consumption, which exact health benefits are those and if there are any health risks in excess drinking.

There is always controversy about the health benefits and possible risks of alcohol. As always, the problem is with the excess.

The health benefits of alcohol

Moderate consumption of wine has been recognized for some time as healthful. Red wine in particular is widely associated with lowering the risk of heart attack and has other beneficial effects. But there are also numerous studies that show that spirits offer many of the same benefits.

Red wine studies frequently focus on the phenols that act as antioxidants, which promote cardiovascular health. But, as is becoming clear, the alcohol alone is responsible for much of the good to be had from moderate drinking.

One large scale British study reviewed the habits of 12,000 physicians aged 48-78. It concluded that overall mortality was significantly lower among those who consumed between 16-24 grams of alcohol per day.

Not surprisingly, as with anything, 'dosage' is key. Teetotalers had higher mortality rates than those who had one to two drinks per day. Those who drank in excess had higher mortality rates than either group.

The benefits ran across multiple groups. Men and women both in a variety of ethnic backgrounds and geographic locations all experienced the same positive results. That's particularly true in studies of coronary heart disease. Overall risk of CHD was reduced from 30-50% in groups that consumed moderate amounts of alcohol.

Some of the possible reasons were brought out by those studies. Moderate alcohol consumption increases HDL -the beneficial form of cholesterol- while it decreases thrombosis -blood clotting that can lead to increased chances of heart attack or stroke. It reduces artery spasms as a result of lowering stress. Modest drinking correlates strongly with a reduction in atherosclerosis - hardening of the arteries.

Other studies showed other health benefits. According to the large-scale Nurses' Health Study gallstones were less likely to occur in moderate drinkers than non-drinkers. The incidence of Type 2 diabetes was also frequently found to be lower in the drinkers versus the teetotalers. Nearly 40% of moderate drinkers had a lower risk of CHD.

But, how much is moderate?

In most studies, a 'drink' is defined differently for different beverages - wine, spirits and more. And studies differ. In the case of spirits, it is generally 1 1/2 ounces. So two to three drinks per day is anywhere from 3 to 4.5 ounces. Since spirits have a higher alcohol concentration, many of the benefits are achieved at lower consumption, around 1-2 drinks per day for men, one for women. One drink equates to about 12-14 grams of alcohol.

The relationship between health habits in general and drinking has been studied extensively, too. Over 100 studies reviewed by the Harvard School of Public Health all pointed to similar conclusions. The studies took account of the possibility that those that do only moderate drinking may have generally better health habits. Even after accounting for differing levels of exercise, diet and many other potential 'confounders', as they're called, the beneficial effects of alcohol remained.

The health risks of excess drinking

The health benefits that result from moderate alcohol consumption have been established by dozens of studies. The data is now so extensive that the conclusion can hardly be doubted. But the key word there is 'moderate'. That equates to about one drink per day for women, one to three for men.

How much is a drink? It varies, but in the case of spirits, the amount is roughly 1 1/2 ounces, which equates to 12-14 grams of alcohol. Still, just as the health benefits of moderate consumption are now widely accepted, the health risks are even better known.

Those same studies bring out some unattractive figures. About 14 million Americans meet the standard criteria for alcohol abuse. It plays a role in 25% of case of violent crime. More than 16,000 people per year die each year in auto accidents where one of the drivers drank too much.

Getting drunk then getting in a car and having a wreck is just the most obvious form of harm that excess drinking can cause. But there are more long-term risks that those who enjoy spirits should heed.

Excess alcohol consumption may have subtle harmful effects. It often leads to disrupted sleep. Sleep deprivation reduces response times, motor acuity, mental clarity, impairs memory and has other ill effects. The irritability that follows from lack of restful sleep is well known.

Weight gain can be a problem for those who don't know when to stop. A 100 ml glass (about 3 ounces) of wine contains approximately 70 calories. But the same size whiskey drink holds 220 calories. That's about three shots and the amount of calories is 10% of an entire day's normal amount for those on a modest diet.

More serious problems arise when the amount of alcohol consumed goes up, and for a longer period of time.

Liver damage from excess drinking over a long period has been known and well studied for generations. Cirrhosis (a kind of scarring) is an inevitable result from having too much for too long. Hepatitis (a liver inflammation) is a common consequence, too. Other, less well known but equally devastating effects are also well documented.

In the past 20 years or so, the link between birth defects and women who drink while pregnant has become widely recognized. The common result is something called Fetal Alcohol Syndrome. Some of the results are low birth weight and therefore increased odds of developmental problems, organ dysfunction and a higher chance of epilepsy.

In the large scale Nurses' Health Study, which followed nearly 86,000 women for over 12 years, those that drank two or more drinks per day had a 20-25% increased chance of developing breast cancer. That doesn't mean a quarter of women who drink will get breast cancer. It means that the 12% of women who do acquire the disease anyway is increased to about 14% among those who drink too much. Taking 600 mcg of folic acid per day helps offset some of the risk.

Moderate imbibing of fine spirits is a great pleasure. It tastes good, relieves stress and has numerous health benefits. Limiting intake retains those values while avoiding some of the potential problems of heavy drinking.