Health - Alcohol Debate

When it comes to alcohol, does the good outweigh the bad?


The Alcohol Debate: Should You or Shouldn't You?

By Kathleen Zelman

Reviewed By Louise Chang, MD

Has a daily drink replaced the apple a day as a way to keep
the doctor away?

Scientists have long touted the heart
benefits of drinking small amounts of alcohol. Newer studies have
credited moderate drinking with everything from helping to keep our
minds sharp as we age to lowering our risk of developing diabetes.

In fact, the new U.S. dietary guidelines give many of us
official permission to enjoy one to two drinks daily.

This is great news for folks who follow the French lifestyle
of sipping a glass of wine with dinner, or who enjoy an evening
cocktail. But what about teetotalers -- should they start drinking? Are
there some people who shouldn't drink, under any circumstances? And how
do you balance the health effects of alcohol with its high calorie
count?

Since some 55% of U.S. adults drink alcohol according to the
CDC, it's important to understand how it affects our health. To get
some answers, WebMD talked to experts about alcohol's risks and
benefits and its place in a healthy diet.

Does It Help or Hurt?

Drinking alcohol can be good for your health, but it can also
be harmful. It all depends on how much you drink, your age, and other
factors.

There's no denying that too much alcohol can lead to serious
problems. Excess alcohol can increase your risk of:

• Liver disease


• High blood pressure


• High blood fats (triglycerides)


• Heart failure


• Stroke


• Fetal alcohol syndrome (if you're pregnant)


• Certain cancers


• Injury, violence, and death

And, of course, drinking too much alcohol piles on the
calories, which can lead to obesity and a higher risk for diabetes.

For some segments of the population, alcohol can lead to many
health problems. Those who should not drink include:

• Pregnant and breastfeeding women


• People at risk for certain cancers


• People with family histories of alcohol abuse


• Children and adolescents


• People taking medications that can interact with alcohol


• Those with health conditions such as liver problems or
  ulcers


• Anyone requiring skill or coordination to perform a task


• People who have a history of pancreatitis (inflammation of
  the pancreas)

According to the U.S. Dietary Guidelines, in middle-aged and
older adults, moderate consumption is associated with the lowest
all-cause mortality (that is, the rate of death from all causes). But
in younger adults, alcohol consumption provides little, if any, health
benefits, according to the guidelines. Instead, it's associated with a
higher risk of serious injury or death.

The CDC has reported that excessive drinking causes more than
75,000 deaths from various causes in the U.S. each year. And what
exactly is "excessive"? For men, it's an average of more than two
drinks daily, or more than four drinks at one time, according to the
CDC. For women, it's an average of more than one drink per day or more
than three drinks at one time.

Alcohol's Advantages

Alcohol's effects on the heart -- for both men and women --
are well documented. Studies have shown that moderate drinking can
raise levels of "good cholesterol," which helps prevent harmful blood
clots and helps keep blood flowing smoothly through our bodies,
reducing risks of heart attack and stroke.

In fact, moderate drinking can increase "good cholesterol"
levels by as much as 20%, if it's accompanied by a healthy diet and
regular physical activity, says Harvard researcher Eric Rimm, DrS.

That's similar to the improvement you might see by taking
cholesterol medication or running a half-marathon, Rimm says. (He's
quick to point out that exercise has many other health benefits and
that alcohol should never replace exercise.)

Research has also suggested that moderate drinking can
increase insulin sensitivity, which can reduce the risk of diabetes,
among other things. But the empty calories in alcohol can be a problem,
as there is a link between type 2 diabetes and excess weight.

Rimm, who has reviewed several large studies, has found a
delicate balance between the risks and benefits of alcohol and its
impact on diabetes. However, he says, "there appears to be a reduction
in risk of type 2 diabetes in adults who consume moderate amounts of
alcohol."

Recent research also suggests that women who enjoy a little
alcohol may be more likely to keep their minds sharp as they age.

A study published in The New England Journal of
Medicine in 2005 evaluated the mental abilities of 12,480
women aged 70-81. The researchers found that moderate drinkers had a
23% reduced risk of mental decline compared with nondrinkers.

(Continued in Part II)