Tag Archives: Alcohol

Alcohol Types Other Than Wine Increase Risk of Cancer in Men

Merlot, or Welch's Grape Juice?

Merlot, or Welch's Grape Juice?

Researchers recently reported that Canadian men who are regular alcohol drinkers – on a daily or weekly basis – have a higher risk of cancer of the esophagus, stomach, colon, liver, lung, and prostate.  The more men drink, the greater the risk.

The investigators suspect that alcohol may be responsible for up to 5% of all invasive cancer deaths.  Their article abstract does not address the possibility that regular drinkers may live longer than non-drinkers despite increased risk of cancer. 

Readers of this blog will note that I am a bit of an advocate of alcohol consumption – for carefully selected people – for prolongation of life and reduction of cardiovascular disease.  I’m also on record as favoring wine over other alcoholic beverages for these potential benefits.

I happy to report that the Canadians did not find an association between wine consumption and cancer

Steve Parker, M.D.  

Reference:  Benedetti, Andrea, et al.  Lifetime consumption of alcoholic beverages and risk of 13 types of cancer in men:  results of a case-control study in MontrealCancer Detection and Prevention, 32 (2009): 352-362.

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Wine Safely Lowers Fasting Blood Sugar in Type 2 Diabetes

"Is the room spinning, or is it just me?"

"Is the room spinning, or is it just me?"

Wine consumption lowered fasting blood sugar levels by 15% in type 2 diabetics who had previously not been habitual drinkers, according to a 2007 study in Israel.

Background

Judicious alcohol consumption is linked to lower rates of cardiovascular disease (heart attack and stroke), longer lifespan, and lower risk of developing type 2 diabetes.  The beneficial health effects of alcohol seem to be more pronounced in people who already have type 2 diabetes. 

Israeli investigators wondered how initiation of an alcohol habit would effect fasting and after-meal blood glucose levels in type 2 diabetics.

Methodology

Researchers studied 109 type 2 diabetics (41-74 years old)  in Israel who previously had abstained from alcohol.  They were randomly assigned to drink either 150 ml (5 oz) of wine or nonalcoholic diet malt beer (as a control) during dinner daily for three months.  Wine choices were a dry red (Merlot) or white (Sauvignon Blanc).  Three out of four chose the Merlot.

Use of anti-diabetic medications was not reported.  People using more than two insulin injections daily or an insulin pump were excluded from participation.

Results

In the wine group, average fasting plasma glucose decreased by 21 mg/dl, from 139 to 118 mg/dl, a 15% drop.  [The authors calculated this as a 9.2% drop, but I stand by my calculation of 15%.]   Fasting glucose did not change in the control group. 

There was no difference between the groups in glucose levels measured two hours after dinner.

In the wine group, 5% reported low blood sugar, headaches, or weakness, and 8% reported increased sexual desire.  But these numbers were not statistically significant compared to the control group.

Patients with higher baseline hemoglobin A1c levels had greater reductions in fasting glucose.

The wine group reported an improved ability to fall asleep.

Three months after the end of the study, 61% of the wine group said they thought the alcohol was beneficial to them, and half of the group continued to drink in moderation.

Conclusions of the Investigators

Among patients with type 2 diabetes who had previously abstained from alcohol, initiation of moderate daily alcohol consumption reduced FPG [fasting plasma glucose] but not postprandial glucose.  Patients with higher A1C may benefit more from the favorable glycemic effect of alcohol.  Further intervention studies are needed to confirm the long-term effect of moderate alcohol intake.

My Comments

The investigators imply that the various types of alcohol – beer, wine, spirits (whiskey, vodka, gin, etc) – will have the same effect on fasting glucose levels.  The study at hand provides no evidence except for wine.   

Some type 2 diabetics have fasting glucose levels routinely as low as 80 mg/dl.  If they start drinking wine like this, dropping their fasting glucose to around 6o or less, they could end up with symptomatic hypoglycemia in the mornings, or even hypoglcymia while asleep.  Use caution.  I’ve read other studies indicating that hypoglycemia usually is not a problem with light to moderate alcohol consumption. 

The potential adverse health effects of alcohol are well-documented elsewhere, as are other reasons not to drink.

Diabetics who are diet-controlled, or on diabetic medications that don’t cause hypoglycmia by themselves, are unlikely to develop hypoglycmia with wine or other alcohol. 

Wine has significant potential to prolong life and reduce rates of cardiovascular disease in type 2 diabetes.  It will be years, if ever, before we have confirmatory studies.  Who’s going to pay for the research?  The California Winegrowers Association?

Steve Parker, M.D.    
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Reference:  Shai, Iris, et al.  Glycemic effects of moderate alcohol intake among patients with type 2 diabetes: A multicenter, randomized, clinical intervention trialDiabetes Care, 30 (2007): 3,011-3,016. 

Disclaimer:  All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status.  Always consult your personal physician before making any dietary or exercise changes.

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Potential Adverse Effects of Alcohol

In a recent blog post, I discussed the potential benefits of alcohol consumption on longevity, coronary artery disease, and dementia.

Not so fast there, buddy!

Not so fast there, buddy!

I have no intention of overselling the benefits of alcohol.  If you are considering habitual alcohol as a food, be aware that the health benefits are still somewhat debatable.  Consumption of three or more alcoholic drinks per day is clearly associated with a higher risk of breast cancer in women.  Even one or two drinks daily may slightly increase the risk.  Folic acid supplementation might mitigate the risk.  If you are a woman and breast cancer runs in your family, strongly consider abstinence.  Be cautious if there are alcoholics in your family; you may have inherited the pre-disposition.  If you take any medications or have chronic medical conditions, check with your personal physician first.

For those drinking above light to moderate levels, alcohol is clearly perilous.  Higher dosages can cause hypertension, liver disease, heart failure, certain cancers, and other medical problems.  And psychosocial problems.  And legal problems.  And death.  Heavy drinkers have higher rates of violent and accidental death.  Alcoholism is often fatal. 

You should not drink alcohol if you . . .

■  have a history of alcohol abuse or alcoholism
■  have liver or pancreas disease
■  are pregnant or trying to become pregnant
■  may have the need to operate dangerous equipment or machinery, such as an automobile, while under the influence of alcohol
■  have a demonstrated inability to limit yourself to acceptable intake levels
■  have personal prohibitions due to religious, ethical, or other reasons.

Steve Parker, M.D.

Author of The Advanced Mediterranean Diet

References: Lieber, Charles S.  Alcohol and health: A drink a day won’t keep the doctor away.  Cleveland Clinic Journal of Medicine, 70 (2003): 945-953.

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Potential Beneficial Effects of Alcohol

FOD023For centuries, the healthier populations in the Mediterranean region have enjoyed wine in light to moderate amounts, usually with meals.  Observational studies there and in other parts of the world have associated reasonable alcohol consumption with prolonged lifespan, reduced coronary artery disease, diminished Alzheimer’s and other dementias, and possibly fewer strokes. 

Alcohol tends to increase HDL cholesterol, have an antiplatelet effect, and may reduce C-reactive protein, a marker of arterial inflammation. These effects would tend to reduce cardiovascular disease.  Wine taken with meals provides antioxidant phytochemicals (polyphenols, procyanidins) which may protect against atherosclerosis and some cancers.

What’s a “reasonable” amount of alcohol?  An old medical school joke is that a “heavy drinker” is anyone who drinks more than the doctor does.  Light to moderate alcohol consumption is generally considered to be one or fewer drinks per day for a woman, two or fewer drinks per day for a man.  One drink is 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of 80 proof distilled spirits (e.g., vodka, whiskey, gin). 

The optimal health-promoting type of alcohol is unclear.  I tend to favor wine, a time-honored component of the Mediterranean diet.  Red wine in particular is a rich source of resveratrol, which is thought to be a major contributor to the cardioprotective benefits associated with light to moderate alcohol consumption.  Grape juice and grape extracts may be just as good—it’s too soon to tell.

Don’t miss my next blogging topic – “Potential Adverse Effects of Alcohol.”

Steve Parker, M.D.

Author of The Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer  

References:

Standridge, John B., et al.  Alcohol consumption: An overview of benefits and risks.  Southern Medical Journal, 97 (2004): 664-672.

Luchsinger, Jose A., et al.  Alcohol intake and risk of dementia.  Journal of the American Geriatrics Society, 52 (2004): 540-546.

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Which Components of the Mediterranean Diet Prolong Life?

We're pro-life

We're pro-life

Researchers at Harvard and the University of Athens (Greece) report that the following specific components of the Mediterranean diet are associated with lower rates of death:

  • moderate ethanol (alcohol) consumption
  • low meat and meat product intake
  • high vegetable consumption
  • high fruit and nut consumption
  • high ratio of monounsaturated fat to saturated fat
  • high legume intake

Minimal, if any, contribution to mortality was noted with high cereal, low dairy, or high fish and seafood consumption. 

The researchers examined diet and mortality data from over 23,000 adult participants in the Greek portion of the European Prospective Investigation into Cancer and nutrition.  You’ll be hearing more about the EPIC study for many years.  Over an average follow-up of 8.5 years, 1,075 of participants died.  652 of these deaths were of participants in the lower half of Mediterranean diet adherence; 423 were in the upper half.

Alcohol intake in Greece is usually in the form of wine at mealtimes. 

The beneficial “high ratio of monounsaturated fat to saturated fat” stems from high consumption of olive oil and low intake of meat. 

It’s not clear if these findings apply to other nationalities or ethnic groups.  Other research papers have documented the health benefits of the Mediterranean diet in at least eight other countries over three continents. 

The researchers don’t reveal in this report the specific causes of death.  I expect those data, along with numbers on diabetes, stroke, and dementia, to be published in future articles, if not published already.  Prior Mediterranean diet studies indicate lower death rates from cardiovascular disease and cancer.   

Steve Parker, M.D.

Reference:  Trichopoulou, Antonia, et al.  Anatomy of health effects of the Mediterranean diet: Greek EPIC prospective cohort studyBritish Medical Journal, 338 (2009): b2337.  DOI: 10.1136/bmj.b2337.

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