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Blame It On The Alcohol

This article was printed in the Vail Daily on December 18, 2017 by Laura Bell.

When it comes to your health, there’s good news and bad about consuming moderate amounts of alcohol
 
Every other year, alcohol is given the thumbs up by doctors and health professionals, as in a glass of wine prevents heart disease or tequila helps fight cholesterol.

The following year, at least for the killjoys in the United Kingdom, red wine is bad for the heart, and tequila? The Brits are still all about tequila, as an article earlier this year in The Telegraph touted its uses for everything from possible weight loss to hosting good prebiotics.

"Clearly defined contraindications to alcohol consumption exist," said Lisa Bentley, clinical dietitian at Vail Health.

"While recent research suggests that moderate drinkers are less likely to develop heart disease than people who don't drink any alcohol or who drink too much, the American Heart Association and the National Heart, Lung and Blood Institute state that this is not a recommendation to start using alcohol."

Risks of alcohol

Bentley referred to a study by former National Heart, Lung and Blood Institute director Claude Lenfant, M.D., which reported that there are risks associated with alcohol consumption, and he does not advise the public to start drinking alcohol in order to prevent heart disease, as there are other lifestyle modifications that are strongly associated with heart disease prevention that do not carry the same risk as alcohol. 
  
"However, those who already drink alcohol should be aware that current evidence suggests that only moderate drinking may reduce the risk of heart disease in some individuals," Bentley said.

"For those individuals who already drink alcohol, it is important to keep in mind that consumption of alcohol greater than the recommended moderate consumption is strongly related to multiple health and social problems, including death."

"Alcohol is a toxin that must be detoxified. It is not a nutrient," said Dr. Dennis Lipton, internist at Vail Health. "Any positive effect is a side effect. The most commonly claimed side effect is heart attack prevention. This is because alcohol poisons platelets, leading to decreased platelet aggregation and decreased thrombus formation.

"The mechanism of heart attack is thrombosis in the coronary arteries from a ruptured plaque. Therefore, someone who has alcohol present in the blood has impaired ability to produce an artery-blocking deadly clot, and therefore is more likely to survive a cardiac event.

In the case of a person at high risk for heart attack, which, unfortunately, is a large percentage of the population, since heart disease is our biggest killer, alcohol can decrease heart attack death, Lipton said, but the downside of alcohol is obvious.

"Alcohol is responsible for around 90,000 deaths a year in the U.S," he said. "It causes liver failure, heart failure — a direct alcohol toxic effect from heavy use — brain atrophy, early dementia, not to mention accidental death from DUI and other forms of violence."


Are all alcohols created equal?

"Not so," said Max Vogelman, of Stoneyard Distillery.

"When you distill, you are pouring off a lot of the stuff that is bad for you and that you don't want to drink," said Vogleman, co-owner of the rum-producing distillery in Dotsero. "During the process of production, at lower boiling points, you throw away the stuff that gives you headaches. When you distill, you have an opportunity to get rid of some of that stuff."

However, Vogelman noted beer and wine have a much lower percentage of the "bad stuff."

As far as alcohol being healthy, Vogelman said he would never condone that.

"At the end of the day, ethanol is still ethanol," he said. "I don't think I'd ever make the statement that it is necessarily good for you."

Bentley agrees that not all alcohols are the same and stated, "While there are many claims about the health benefits of alcohol, these benefits are likely related to the consumption of ethanol — the type of alcohol found in all alcoholic beverages — and not to a particular type of alcoholic beverage. While the mechanism is complex, ethanol has been shown to act as a type of blood-thinning agent."

Unlike other alcoholic beverages, wine contains high antioxidant levels, which are shown to protect the heart and vessels from free-radical damage, she said.

"However, like any type of alcohol, the primary cardiovascular benefit of wine, according to the vast majority of studies, is raising good cholesterol," she said.

Lipton concurred: "Red wine enjoys a reputation of health due to the polyphenols and other nutrients contained in the red grapes. I would agree; if I had to pick my poison, it would be red wine."

How much is too much?

Bentley referred to the U.S. Department of Agriculture, as well as the 2015 Dietary Guidelines for Americans, which consider moderate alcohol intake to be no more than two drinks per day for men and no more than one drink a day for women.

A drink — with each drink providing approximately 12 to 24 grams of alcohol — is defined as 12 ounces of a regular beer (5 percent alcohol), 5 ounces of wine (12 percent alcohol), a 3-ounce serving of fortified wine such as sherry, port or vermouth (16 percent to 18 percent alcohol) or 1.5 ounces of spirits or liquor (rum, vodka, tequila, etc.; 40 percent alcohol).

"Some studies claim the benefits of alcohol include reduced risk of Type 2 diabetes (due to better insulin sensitivity) gallstones and cardiovascular disease (more specifically heart attack, ischemic stroke, sudden cardiac death) due to ethanol's ability to raise good cholesterol (HDL) levels and its impact on blood-clotting factors that may prevent the formation of small blood clots that are related to most heart attacks and strokes," Bentley said.

"There are many factors that affect these claims, including frequency of intake, gender and genetic makeup. However, one of the most important factors is likely the amount of alcohol consumed. As they say, the poison is in the dose."

Studies have shown a strong association between light to moderate alcohol consumption and reduced risk of heart disease. One study published in The New England Journal of Medicine in 2003 showed an inverse association with risk of heart attack in men who drank a moderate amount of alcohol three to four days a week, Bentley said.

The Harvard School of Public Health came down hard recently on both wine and the hard stuff, writing one or two drinks per day can link to an increase in cancer.

Registered dental hygienist Denise Bolton, of Vail Dentistry in Edwards, noted that while socially and emotionally alcohol is "OK in small amounts, heavy amounts or on a daily basis alcohol consumption dramatically increases inflammation and one's risk for oral cancer."

Lipton again agreed.

"Any more than one drink a day for women or two drinks a day for men is too much," he said. "There is broad agreement about this. It's an interesting topic that I discuss with patients frequently."

 

About Dr. Dennis Lipton - Internal Medicine  | (970) 926-6340
Dennis Lipton MD is a board-certified internist trained in the essentials of primary care and disease prevention and can help ensure patients receive the proper medical screening tests and immunizations.