Sunday, October 08, 2006

Health - Alcohol Debate (Part II)

What Type, How Much, and When?

According to the experts, it doesn't make too much difference whether you
prefer wine, beer, or spirits.

"The research evidence points to ethanol -- or the alcohol component -- of
beer, wine, or spirits as the substance that can help lower cholesterol levels, increase HDL (good cholesterol), and improve insulin sensitivity in overweight individuals," Rimm says.

It's how much you drink that really matters. The U.S. Dietary Guidelines and the American Heart Association define moderate drinking as onedrink for women and two for men per day -- not averaged over the week. (One drink is defined as 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of 80-proof distilled spirits such as vodka.)

When you drink is also important, says Alice Lichtenstein, DrS, a professor at Tufts University. If you do consume alcohol, it's best to have it with meals, she says.

Some studies have suggested that drinking alcohol without eating raises the chance of developing high blood pressure.

Also, "alcohol can stimulate the appetite, so it is better to drink it with food," says Arthur Agatston, MD, a cardiologist and author of the popular book The South Beach Diet. "When alcohol is mixed with food, it can slow the stomach emptying time and potentially decrease the amount of food consumed at the meal."

And what about people who don't drink at all? The experts agree that, though alcohol has some health benefits, it's not a good idea to start drinking if you don't already.

The new U.S. dietary guidelines point out that there are many ways to reduce the risk of chronic diseases besides moderate drinking, including:

  • Eating a healthy diet
  • Exercising
  • Quitting smoking
  • Maintaining a healthy weight

Those Extra Calories

Alcohol is fairly high in calories, but provides few essential nutrients.

The benefits of moderate drinking do not outweigh the risks of being overweight, says Theresa Nicklas, DrPh, a member of the dietary guidelines advisory committee. So if you have a drink, you should budget it into what the U.S. dietary guidelines call your "discretionary calories" -- the ones you have left over after you eat all the nutritious foods you need.

The problem, says Nicklas, is that most Americans are sedentary, so their calorie needs are relatively low. For example, someone on an 1,800-calorie eating plan only has 195 discretionary calories per day -- the equivalent of one 9-ounce glass of wine (and that leaves no room for sweets or other treats).

And, of course, when you drink too much alcohol, it's hard to get all the nutrients you need without taking in too many calories. Heavy drinkers who substitute alcohol calories for nutritious foods run the risk of malnutrition.

Another problem, according to National Institutes of Health researcher Rosalind Breslow, PhD, is that "liquid calories from alcohol do not satisfy hunger." She notes that drinks made with high-calorie mixers, like pina coladas and white Russians, can have as many as 400 calories apiece.

The best bet for people who want to enjoy a drink most days is to get more physical activity, Nicklas says. She points out that the benefits of regular physical activity are much greater than those of moderate drinking, and she advises everyone to strive for at least 30 minutes daily.

The Bottom Line

More research remains to be done on the relative risks and benefits of drinking alcohol.

But the bottom line is that to get any health benefits from alcohol, we must drink responsibly. That means having no more than 1-2 drinks per day, having them at mealtime and as part of an overall healthy diet, and making sure you aren't exceeding your calorie needs.

Medically updated July 31, 2006

SOURCES: The New England Journal of Medicine, Jan. 20,
2005. Report of the Dietary Guidelines Advisory Committee on the Dietary
Guidelines for Americans,
2005. American Heart Association Science
Advisory: Wine and Your Heart,
2001. Archives of Internal Medicine,
2003; 263. Theresa Nicklas, DrPh, professor of pediatrics, Baylor College of
Medicine; member, dietary guidelines advisory committee; Alice Lichtenstein,
DSc, Gershoff Professor, Friedman School of Nutrition Science and Policy, Tufts
University. Eric Rimm, DrS, professor of epidemiology and nutrition, Harvard
School of Public Health; Arthur Agatston, MD, FACC, associate professor of
medicine, University of Miami School of Medicine; author, The South Beach
Rosalind Breslow, PhD, researcher, National Institute on Alcohol Abuse
and Alcoholism. Monica Gourovitch, PhD, senior vice president for scientific
affairs, Distilled Spirits Council. WebMD Feature: Beer, Wine Liquor - The
New Health Drinks?,
by Jennifer Warner, published June 14, 2002. WebMD
Medical News: Drinking Too Much Claims 75,000 Lives a Year, by Jennifer
Warner, published Sept. 23, 2004. WebMD Medical News: Moderate Alcohol May
Improve Diabetes,
by Salynn Boyles, published June 1, 2004. WebMD Medical
News: Alcohol Without Food Boosts Blood Pressure, by Miranda Hitti,
published Dec. 21, 2004.