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Thread: Moderate drinking is healthier than not drinking at all?

  1. #1 Moderate drinking is healthier than not drinking at all? 
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    I came across an article about this book called Guilt-free Drinking: http://www.chinchinjobs.com/news/Art...-this-week-960

    I haven't read the actual book, but apparently it argues that moderate drinkers live longer than non-drinkers and also have less cancer and heart disease.

    Does anyone know why this may be? Or could anyone point me in the direction of any studies in to the subject which I can read online? As a wine enthusiast I am pretty interested to find out!

    I would guess that a glass of wine a day lowers cholesterol by de-stressing you. But how does it protect against cancer?!


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  3. #2  
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    I don't think wine would lower cholesterol due to relaxing you, possibly blood pressure, though. There are supposed to be some chemicals which compose wine which specifically help with heart health and longevity, though. Here's a story with video from a while back which 60 Minutes did:

    http://www.cbsnews.com/stories/2009/...n4752082.shtml


    You might also use google scholar to search for stuff... maybe with terms like "alcohol longevity" or "health benefits of alcohol" or something along those lines.

    http://scholar.google.com/


    As you mentioned, much of the benefit is often extinguished when people drink too much. At some point, the harm and dangers of excessive drinking surpass the benefits of doing so moderately. Good luck in your search.

    Cheers.


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    Moderate alcohol consumption is thought to have some protective cardiovascular effect for middle-aged people. It has a J shaped relationship - none has a small risk, small amount reduces risk then increases as consumption increases. Can't remember the exact mechanism - something to do with endothelial nitric oxide reducing platelet aggregation i think. It also improves insulin sensitivity and reduces LDL (the bad cholesterol) by increasing HDL (the good cholesterol), but i can't remember at all how.

    However some caution needs to be taken as these are all based on cohort and case-control studies. An RCT has never been done to confirm it - so though it's likely and generally accepted, health professionals are still cautious about recommending alcohol for cardiovacualr protection

    As for cancer, even small amounts are thought to increase risk.

    The overall recommendation is if you don't drink then you are not recommended to start for health benefits. If you do drink limit it to 1 drink (10-15 grams ethanol) a day for women and 1-2 for men.

    Just remember when reading books like that, you're just going to be getting one side of the story - unless it's a particularly good and balanced book.


    http://www.dietandcancerreport.org/

    This is the latest international report for diet and cancer, where i got my info from.
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    I do wonder if former alcoholic abstainers were counted as non-drinkers in the studies.
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    Quote Originally Posted by Pong
    I do wonder if former alcoholic abstainers were counted as non-drinkers in the studies.
    This was acknowledged as a problem in a few studies, but most now differntiate between the two. There are bigger methodological flaws to contend with anyway. Biggest two are probably the fact that most studies ask participants to self-report how their alcohol intake - a notoriously ambiguous way to measure your variable of interest in any nutritional epidemiologogical study - and consumption is often averaged over a week, ignoring consumption patterns which may be just as important as the consumption itself.

    However, there have been a lot of studies and they all suggest similar trends - but until someone does a RCT (which would be extremely difficult) then the results are accepted only tentatively.
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    Not sure as the author of the book in question, whether I’m supposed to add comments!! I spent 3 years researching the book and certainly tried to represent the epidemiological research accurately (references are provided throughout) - but I concentrated on moderate drinkers, not heavy drinkers – the health outcomes are very different. I also drew the major conclusions from large meta-analyses and review articles/government reports that consolidate results from multiple individual studies as single studies can throw up odd results.

    I note the good points made already. The vagaries that remain due to the design of studies are discussed in the book, along with “sick quitters”, drinking pattern, the under-reporting issue, etc. To get a feel for the content of the book, try clicking on the “See complete table of contents” section for “Guilt-Free Drinking” on amazon.co.uk

    Just a couple of points on cancer – the cited article mentioning my book was clearly taken from a press release and doesn’t do the subject justice (read the book). Heavy alcohol consumption does cause cancer. However, the evidence for alcohol causing cancer in light/moderate drinkers is rather thin and sometimes an extrapolation along the lines: heavy drinking is bad for you therefore moderate drinking must be moderately bad for you. To quote from the book, “If I drop a cricket ball on your head it will hurt. If I drop a ping-pong ball on your head, it won’t hurt less; it won’t hurt at all. Heavy drinking will hurt you, but will a light or moderate dose hurt you less? Perhaps it won’t hurt at all.”

    Finally, to answer the original question re cancer - alcohol is unlikely prevent cancer, but many drinks (red wine in particular) contain high levels of natural anti-oxidants - polyphenols - that show some very encouraging results.
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    Wow, what a treat to actually have the author come out to defend his work. I've not yet read the book so can't comment on it specifically, but i'd like to take issue with your comment on alcohol and cancer.

    The Food, Nutrition, Physical Activity and the prevention of cancer (link in my above post) is the single most comprehensive review of the literature on this topic, with hundreds, maybe even thousands of meta-analyses. There are maybe about 10 pertaining to alcohol and various cancers. I haven't gone through them in detail but the conclusion was
    The previous report identified a threshold of modest
    consumption of alcoholic drinks, below which no effect on
    cancer risk was observed, with the exception of breast cancer.
    Current evidence does not identify a generally ‘safe’
    threshold.
    I think you need to register (for free) to download the whole document, then the alcohol section starts on page 157.

    It would be great to know some of your sources - did you use the The Food, Nutrition, Physical Activity and the Prevention of Cancer document?

    Oh, and welcome, good to have you here.
    The mark of a moderate man is freedom from his own ideas - Tao Te Ching

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    It is difficult to sum up the mass of alcohol related epidemiological research in a few lines or make a full case for moderate drinking – I took 164 pages to do that in the book and spent far more time framing the discussion than I can here. However, I think it is worth noting that there is very little meaningful research that is not published (in peer reviewed journals) so all serious writers on the subject base their findings on the same data.

    What I conclude from that, is that people summarising the subject for the public have different perspectives. For example, it is easy to demonstrate that the majority of epidemiological research shows that moderate drinkers live longer than abstainers or heavy drinkers – the U or J-shaped curve. However, there are still those that refute this – I wrote a whole chapter on this, not to condemn the refuters but to examine how complex the issue is.

    As I said in my last post, cancer is a problem for heavy drinkers, but the situation for light/moderate drinkers needs careful consideration. I set out the various issues in the book together with the sources, from meta-analyses to government literature reviews to the IARC.

    I suspect I should close my laptop now. I just wanted to let people know that I take this subject seriously – the book does not brush the issues under the carpet – BUT most of the media and those trying to shape alcohol policy only tell the negative story about drinking. Nothing in life is totally risk-free, but I believe the moderate drinking story is one that most will find quite reassuring.
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  10. #9  
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    To upbeat

    Have you looked into the research on hormesis, as a possible mechanism?
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    There is certainly evidence that heavy alcohol users are at greater risk than light users, but the collective evidence cannot say that light users have no increased risk. This is based on several meta-analyses of about 300 studies - mainly cohort and case-control studies.

    The evidence that alcoholic drinks are a cause of cancers of the mouth, pharynx, and larynx, oesophagus, colorectum (men), and breast is convincing. They are probably a cause of colorectal cancer in women, and of liver cancer. It is unlikely that alcoholic drinks have a substantial adverse effect on the risk of kidney cancer
    They conclude A dose-response relationship is apparent and current evidence does not identify a generally ‘safe’ threshold.

    There are no RCTs though. If you have stronger evidence than this please could you provide the references so i can check it out. We also have to agree on what counts on 'light' alcohol use; a growing problem in the middle classes in the UK is the perception that a 'few' glasses of wine a day is light use, where healthcare professionals would classify it as moderate to heavy - but that's a different issue.

    Hope you stay around, upbeat.
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  12. #11  
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    About thresholds.
    Every damn thing has a safe threshold. Sometimes we do not know what it is, and it is very difficult nailing that piece of information down. Even when determined, there is often argument about what constitutes a threshold.

    For example : Hiroshima studies show that victims who were exposed to between 50 and 80 millisieverts of radiation had a subsequent cancer rate no higher than the rest of Japan. Is this a threshold of 80 millisieverts for radiation? Probably. But there is no such consensus.

    Even 2,3,7,8 TCDD (the most toxic of all the dioxins, and the nastiest man made chemical ever) has a safe threshold. The USEPA determined that the minimum dose likely to cause cancer was 20 parts per billion. Though that is an average, and individuals may vary. But what if someone has 50 parts per trillion in their bodies? That is pretty certainly below the threshold.

    Alcohol most definitely has a threshold, and it is quite high. Alcohol is one of the very few toxins that the human body is specifically adapted to dealing with. As a result, we can deal with large amounts, relatively speaking. An earlier post suggested one standard drink per day for women and up to two for men. While again, individuals vary, that is probably about right.

    A toxic dose (the LD50 - or the dose that will kill 50% of the population) is equivalent to 1 litre of whiskey for women, and 1.5 litres for men.
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    The one drink for women and two drinks for men you refer to comes from the report from the The Food, Nutrition, Physical Activity and the prevention of cancer, the same place i am quoting there is no identified safe threshold for alcohol in relation to cancer risk.

    I accept your argument that there are safe thresholds for most substances, especially when we are talking about cumulative exposure over a lifetime to carcinogens. However, the argument made by the authors of the report is that this threshold is not known based on the cumulative evidence we have and can therefore make no reccomendations on safety limits pertaining to alcohol and cancer risk (and only cancer risk). Therefore to say that mild alcohol use does not increase the risk of cancer is not verified by evidence. This is why i challenged upbeat on this point. Perhaps there is a safe threshold, as you suggest, but we do not know it - but to suggest otherwise is contrary to the evidence.

    They make the recommendation of 1-2 drinks based on a consideration of the cardiovascular studies and the fact alcohol is enjoyed widely in many societies.

    This also brings about the point of personal freedom, and the healthcare profession. I believe it is right that we should discover such risks, and it is then up to the individual what to do with this knowledge - i don't think anyone will change their mild drinking habit based on this report. People also need to know of the many other risks and benefits of alcohol, but i think this is something not done well by the healthcare profession: as upbeat suggests, it often turns into quagmire.
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    It is always difficult to assess these things. I keep harping on individual differences, with good reason. There are people who suffer even after quite moderate alcohol exposure and others who seem to be able to drink almost unlimited amounts without harm.

    There was a BBC documentary on longevity which involved an interview with a man who was 100 years old. He was interviewed in a pub. He was happily getting drunk, which he apparently did 7 days a week, and had been doing all his adult life. He was unbelievably healthy, fit, lucid, and happy.

    The point is that we should not try to lay down definitive rules for everyone. If experience tells us that we cannot handle alcohol, then the smart thing is to go teetotal. Otherwise ..... Well, that is an individual choice.
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  15. #14  
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    Quote Originally Posted by skeptic
    It is always difficult to assess these things. I keep harping on individual differences, with good reason. There are people who suffer even after quite moderate alcohol exposure and others who seem to be able to drink almost unlimited amounts without harm.
    Good point. Many Chinese experience a semi-allergic "alcohol flush" with just one drink, so they turn red, feel ill, and keep their nation's alcoholism rate well below world average. Meanwhile it appears that North American Natives are resistant to alcohol, so to attain that giddy sensation they must intentionally drink in excess of the (European) cultural norm.
    A pong by any other name is still a pong. -williampinn
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  16. #15  
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    I am not saying that you shouldn't drink. But let's stop using health arguments to justify the consumption of alcohol.
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    Quote Originally Posted by radekisner34
    I am not saying that you shouldn't drink. But let's stop using health arguments to justify the consumption of alcohol.
    Why does it require justification in the first place?
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  18. #17 Re: Moderate drinking is healthier than not drinking at all? 
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    Quote Originally Posted by Doodlebug1980
    I came across an article about this book called Guilt-free Drinking: http://www.chinchinjobs.com/news/Art...-this-week-960

    I haven't read the actual book, but apparently it argues that moderate drinkers live longer than non-drinkers and also have less cancer and heart disease.

    Does anyone know why this may be? Or could anyone point me in the direction of any studies in to the subject which I can read online? As a wine enthusiast I am pretty interested to find out!

    I would guess that a glass of wine a day lowers cholesterol by de-stressing you. But how does it protect against cancer?!
    Okay. From your thread's name, I will answer to the question:

    Drinking a glass of wine every day, a bottle of beer every day/few days or a 100 grams of brandy is healthy, IF the alcoholic beverage you are consuming is a good quality one. And if you are not 12 years old kid. Wine is the healthiest of these, in particular - red wine. Then goes the beer. And the brandy... Well, that's not as good as that previous ones.
    If I would have money, I would definitely drink a glass of wine every day. Maybe a beer sometimes, and maybe a sip of brandy. Of course if you drink more, then it is unhealthy.
    If you want concrete explanations on what each beverage does to your organism, you should use Google, there should be plenty of information.
    Sorry for my poor English skills, I've learned it by myself... Trying to improve them, feel free to criticize, hehe.
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  19. #18  
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    Quote Originally Posted by skeptic
    It is always difficult to assess these things. I keep harping on individual differences, with good reason. There are people who suffer even after quite moderate alcohol exposure and others who seem to be able to drink almost unlimited amounts without harm.

    There was a BBC documentary on longevity which involved an interview with a man who was 100 years old. He was interviewed in a pub. He was happily getting drunk, which he apparently did 7 days a week, and had been doing all his adult life. He was unbelievably healthy, fit, lucid, and happy.

    The point is that we should not try to lay down definitive rules for everyone. If experience tells us that we cannot handle alcohol, then the smart thing is to go teetotal. Otherwise ..... Well, that is an individual choice.
    Fair enough. By definition epidemiological research looks into population risks and differences, so extrapolating to an individual is currently difficult (though the field of metabonomics might resolve this). The data exists primarily for health care agencies/governments to rationalise their resources and target health care promotion. Individuals using the data to make lifestyle choices are going to find it difficult - all things in moderation seems to be a good dictum for such things.
    The mark of a moderate man is freedom from his own ideas - Tao Te Ching

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