Disappointing news – or not – about moderate drinking

heart

Many studies and reviews have supported the notion that moderate alcohol consumption is beneficial for heart health. Why not have a daily glass or two of wine at dinner, as it could ward off disease. And now they come and spoil the fun.

A joint group of Canadian, Australian and US scientists took a hard look at the evidence presented in previously published research and found little support for a heart protective effect of moderate alcohol consumption.

And here you are believing the previously good news, who can you really trust? But not all is lost so read on.

So what did they find?

The new assessment initially agreed with the previous findings as a fully adjusted pooled analysis of all the 45 studies reviewed found significantly reduced coronary heart disease mortality for current moderate drinkers, actually for all current drinkers.  So all good now, can I continue to have a glass or two of wine to dinner and feel healthier?

Unfortunately not, as the researchers found confounding factors in that they could see an influence of age, gender, ethnicity, and heart health at baseline. When correcting for such factors they claim that moderate consumption of alcohol was not significantly protective for people at ages 55 years or younger at baseline, or for studies controlled for heart health at the beginning of the study. They even claimed that the appearance of cardio-protection among older people may reflect systematic selection biases that accumulate over the life course.

Their hypothesis is that non-drinkers may, in fact, be former drinkers who quit or cut down for health reasons. So, of course the remaining healthy drinkers will fair better than their poor abstainers that are already sick. And the seniors who are healthy may be more likely to keep enjoying that glass of wine with dinner thus biasing the results.

However, the researchers stop short of turning the previous findings on its head. They only conclude that there remain grounds for skepticism about the hypothesis that alcohol use can be cardio-protective, and recommend that future prospective studies not only avoid biased abstainer reference groups, but also take steps to minimize other forms of selection bias across the life course, including that from competing disease risks.

So there is still hope?

red_wine_(boo_licious)Yes, there is still hope that a daily glass of wine might keep you healthy longer as the researchers can’t prove it one way or the other. Only that there are grounds for a healthy skepticism as there remain plausible alternative explanations for their observed review findings.

So let’s make it clear. For now, no one is saying that people who enjoy alcohol in moderation should stop. Should there be no direct benefits, at least the risks of low-level drinking would be small.

Let’s drink to that, but only in moderation!

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Whisky – is it really “livets vatten”?

For the drinkers out there it was a while since we covered the alcoholic beverages beer and wine in previous blogs. So you will be happy to see that the focus today is whisky. I use the Scottish spelling and since the Scottish brew might have been influenced by an influx of Scandinavian vikings I allude to the Swedish expression “livets vatten”. But similar to the chicken and egg conundrum, on the contrary it might be that the Swedes translated the gaelic “uisge beatha” which actually means water of life. Or more likely both expressions might come from the Latin “aqua vitae” with the same meaning.

So what is whisky?

Whisky might be good for you (Photo: vissago)

Whisky might be good for you (Photo: vissago)

Whisky is a strictly regulated spirit worldwide with many classes and types. The typical unifying characteristics of the different varieties are the fermentation of grains, distillation, and ageing in wooden barrels. Italy, again, was at the forefront in the art of distillation with the earliest records where alcohol was distilled from wine dating from the 13th century. As most things alcoholic, its use spread through medieval monasteries, largely for purported medicinal purposes. From here the Irish beat the Scots in being the first to produce actual whisky in 1405, with the Scots almost a century late with their first records dating from 1494.

To be honest the first outputs from the attempts to make whisky were not very enjoyable. The distillation process was still in its infancy and the whisky was not allowed to age. As a result it tasted very raw and brutal compared to today’s versions. Renaissance-era whisky was also very potent and not diluted. Over time whisky evolved into the much smoother drink that we can enjoy today. People all over the world make and drink the different varieties of whisky, and each whisky has a distinct taste. Some of the differences might come from the grain used which can be rye, barley, wheat or corn.

But is it the water of life?

Although any type of alcohol can be deadly in excess, the medical community has found some health benefits to drinking moderate amounts of alcohol, especially whisky. A large shot of whisky can help protect against heart disease, scientists have claimed. They found that both whisky and red wine helped to protect against coronary heart disease by raising the body’s level of antioxidants. And as an interesting fact for the whisky lovers more of the protective compounds were absorbed from drinking whisky. Researchers also claim that drinking the equivalent of three or four pub measures of the spirit can boost the body’s general defences against disease.

No need to go overboard though, the scientists found that the benefit was achieved by drinking just once a week. So as usual alcohol should be enjoyed in moderation to accumulate the beneficial effects. And maybe not by all. Common public health advice is that any alcohol, if you drink as little as one to two units a day, can protect against coronary heart disease. But this is relevant only if you are in a risk group, such as menopausal women or men over 40 years who are prone to heart trouble.

Some more specific facts

Ellagic acid migrate from oak casks to whisky (Photo: peridude)

Ellagic acid migrate from oak casks to whisky (Photo: peridude)

People in the risk groups who consume one or two alcoholic drinks daily, including whisky, have a 50 % lower chance of having a stroke or developing dementia in old age. This moderate amount of drinking can also decrease the chance of developing diabetes by 30 to 40 %. Alcohol contains ellagic acid, an antioxidant that also is believed to destroy cancerous cells.

Ellagic acid is a natural phenol antioxidant found in numerous fruits and vegetables. The highest levels of ellagic acid are found in blackberries, cranberries, pecans, pomegranates, raspberries, strawberries, walnuts, wolfberry and grapes. Ellagic acid is also found in oak species like the North American white oak and European red oak and migrate to whisky during the ageing process in oak barrels. According to scientists whisky contains more ellagic acid than other types of alcohol.

The downside

An important reminder though if you have to look after your waist line. Alcoholic beverages of all sorts have a high energy content. Although there are many different recipes for beer with varying calorie content, a typical can of beer can be estimated to contain 150 calories. A standard restaurant glass of wine has around 123 calories. This could be compared to a shot of 80-proof whisky (confusingly 40 % alcohol) that contains 65 calories. On a volume basis whisky contains more calories than beer and wine. However, a typical serving of beer is many times the size of a serving of whisky. By that measure “a beer” has more calories than “a whisky.” Wine is comfortably in the middle by both measures.

And if you are going out to brag about the ellagic acid content of whisky with your mates be warned. The beneficial findings of ellagic acid to health is still preliminary. So some caution might be in place until the findings have been endorsed by the appropriate authorities.

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Beer drinking benefits – yes benefits!

beer_glass_(Tim_Dobson)

Healthy beer in moderation (Photo: Tim Dobson)

We have all seen the massive beer belly that we commonly associate with drinking too much beer, as is implied in the name. And we might have first hand experience of loutish behaviour after excessive beer consumption. Both negative aspects of beer drinking. No joke, but there are actually benefits from drinking beer as well, of course only in moderation. If you thought red wine, which we covered in a previous blog, was the healthy alternative, think again. Beer is giving wine a run for its money. Beer in moderation can actually be a healthier beverage choice than soft drinks or sugary fruit cocktails.

Beer has been brewed for just about as long as humans have been cultivating crops and is actually made with some very healthy ingredients. Those ingredients are hops, brewer’s yeast, barley and malt. Several beer brands can trace their origin to monasteries. Trappist monks drank beer to sustain themselves during their Lenten fasts. They called their beer “liquid bread.” Benjamin Franklin probably said it best: “Beer is living proof that God loves us and wants us to be happy.” But you don’t have to be religious to enjoy the health benefits of beer.

Health benefits of beer consumption

Studies have suggested that, when consumed in moderation, beer has many health benefits. It has long been known that moderate alcohol consumption may lower a drinker’s risk of illnesses such as cardiovascular disease, Alzheimer’s disease or diabetes, and can even reduce weight gain. Alcohol can increase good cholesterol and lower the bad, as well as lowering blood pressure. But some research suggests that other specific components in beer may play a role in fending off disease, irrespective of the alcohol content.

Beer is a surprising source of many nutrients. It is packed with B vitamins like niacin, pantothenic acid, folate, riboflavin, and vitamins B6 and B12. The folate found in beer may help to reduce homocysteine in the blood and lower homocysteine levels mean a lower risk of cardiovascular disease.

A bottle of beer, usually between 330-375 mL depending on country and brand, can contain 92 mg of potassium, 14 mg of calcium and 48 mg of phosphorus, all minerals that are essential to a healthy diet. It is also rich in silicon, a nutrient that is said to help strengthen bones. A 2010 study by scientists at the University of California’s department of food science and technology suggests that drinking beer moderately may ward off osteoporosis due to the silicon, which is important for bone growth and development.

One of the most effective forms of soluble fibre for lowering cholesterol is betaglucan, which is the predominant form of fibre in beer. One bottle of beer contains around 1-3 gram of soluble fibre. This is equivalent to around 10% of the recommended daily fibre intake.  Beers with high malt content like craft beers may even provide up to 30% of the recommended daily fibre intake.

Hops provide healthy chemicals

Hops provide healthy antioxidants

Beer contains polyphenolic antioxidants, which help reverse cellular damage and thus help reduce cancer risks. Dark beers tend to have the most antioxidants. Studies suggest that xanthohumol, a plant compound found in hops, may be one of the more important compounds that help prevent cancer. As an antioxidant it is 200 times more potent than resveratrol found in red wine.

If you like to be exclusive, you might up your antioxidant intake even further by selecting microbrews because they are made with more hops than mass-produced beers.

Further proof of health benefits

In a meta-study published in 2011, researchers at Italy’s Fondazione di Ricerca e Cura when reviewing 16 previous studies involving more than 200,000 participants found that people who drank about 500 mL of beer a day had a 31% reduced risk of heart disease. Consuming more alcohol, either beer, wine, or liquor, reversed the benefit.

A 2011 Harvard study of 38,000 middle-aged men showed that consuming one or two glasses of beer a day reduced the risk of developing type 2 diabetes by 25 percent. There was, however, no noted benefit from drinking more than two beers a day.

A 2005 study involving 11,000 older women showed that those who had one beer a day had better mental function than those who didn’t. In fact, they decreased their risk of mental decline by as much as 20 percent.

An Emory University study published in 2001 involving over 2,200 elderly men and women discovered that those who consumed at least 1.5 drinks daily had up to a 50% lesser risk of suffering from heart failure.

The other side of beer consumption

If one beer is good for you, it doesn’t mean that three or four beers must be better. Most of the studies cited above point to one beer per day as being beneficial, not drinking all seven beers in one day per week. Drinking more than one beer or any alcoholic beverage per day can put too much alcohol in your system harming the liver. This is the organ that removes toxins from the body. In the liver, enzymes first convert alcohol into acetaldehyde. During this step, a molecule called NADH (nicotinamide adenine dinucleotide) is also produced. Acetaldehyde is further metabolised into acetic acid, and then water and carbon dioxide that we breathe out.

Unfortunately, in people who drink daily, the body might not be able to metabolise the toxic acetaldehyde fast enough. To make matters worse, heavy drinking can elevate the levels of NADH, which can lead to the accumulation of fat in the liver in a condition called fatty liver. A liver clogged with fat is not only less efficient in performing its duties, it can also reduce oxygen and nutrient access for the liver cells. Left untreated, this causes liver cells to die and form fibrous scar tissue leading to liver cirrhosis.

And that’s not all. The energy content of beer can lead to obesity in those who drink excessively. Being obese, in turn, carries a lot of health risks, including heart disease and diabetes.

So as usual the adage “everything in moderation” holds true.

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