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Finally Settled: Alcohol Consumption Linked to Lower Rates of Death and Heart Attack

Canadian and U.S. researchers report that moderate alcohol consumption seems to reduce 1) the incidence of coronary heart disease, 2) deaths from coronary heart disease, and 3) deaths from all causes.  Reduction of death from all causes is a good counter-argument to those who say alcohol is too dangerous because of deaths from drunk driving, alcoholic cirrhosis, and alcohol-related cancers such as many in the esophagus. 

Remember, we’re talking here about low to moderate consumption: one drink a day or less for women, two drinks or less a day for men.  That’s a max of 12.5 grams of alcohol for women, 25 g for men.  No doubt, alcohol can be extremely dangerous, even lethal.  I deal with that in my patients almost every day.  Some people should never drink alcohol.

The recent meta-analysis in the British Medical Journal, which the authors say is the most comprehensive ever done, reviewed all pertinent studies done between 1950 and 2009, finally including 84 of the best studies on this issue.  Thirty-one of these looked at deaths from all causes.

Compared with non-drinkers, drinkers had a 25% lower risk of developing coronary heart disease (CHD) and death from CHD.  CHD is the leading cause of death in develop societies.

Stroke is also considered a cardiovascular disease.  Overall, alcohol is not linked to stroke incidence or death from stroke.  The researchers did see strong trends toward fewer ischemic strokes  and more hemorrhagic strokes (bleeding in the brain) in the drinkers.  So the net effect was zero. 

Compared with non-drinkers, the lowest risk of death from any cause was seen in those consuming 2.5 to 14.9 g per day (one drink or less per day), whose risk was 17% lower.  On the other hand, heavy drinkers (>60 g/day) had 30% higher risk of death. 

In case you’re wondering, the authors didn’t try to compare the effects of beer versus wine versus distilled spirits. 

On a related note, scientists at the Medical University of South Carolina found that middle-aged people who took up the alcohol habit had a lower risk of stroke and heart attack.  Wine seemed to be more effective than other alcohol types.  They found no differences in overall death rates between new drinkers persistent non-drinkers, perhaps because the study lasted only four years and they were following only 442 new drinkers.  

This doesn’t prove that judicious alcohol consumption prevents heart attacks, cardiac deaths, and overall deaths.  But it’s kinda lookin’ that way.

Steve Parker, M.D.

 References:  Ronksley, Paul, et al.  Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysisBritish Medical Journal, 2011;342:d671    doi: 10.1136/bmj.d671

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Filed under Alcohol, coronary heart disease

Which Components of the Mediterranean Diet Prolong Life?

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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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Filed under Alcohol, Health Benefits, Mediterranean Diet