Abstract: Published health benefits of regular light-to-moderate alcohol consumption include lower myocardial infarction rates, reduced heart failure rates, reduced risk of ischemic stroke, lower risk for dementia, decreased risk of diabetes and reduced risk of osteoporosis. Numerous complimentary biochemical changes have been identified that explain the beneficial effects of moderate alcohol consumption. Heavy alcohol consumption, however, can negatively affect neurologic, cardiac, gastrointestinal, hematologic, immune, psychiatric and musculoskeletal organ systems. Binge drinking is a significant problem even among moderate drinkers and is associated with particularly high social and economic costs. A cautious approach should be emphasized for those individuals who drink even small amounts of alcohol. Physicians can apply the research evidence describing the known risks and benefits of alcohol consumption when counseling their patients regarding alcohol consumption.
Key Words: alcohol, benefit, recommendations, risk
**********One drink is too many and a thousand is not enough. --Alcoholics Anonymous aphorism
For a person with a substance abuse disorder, alcohol consumption is likely to serve as a trigger for the compulsive behavior associated with the disease. For other individuals a decision matrix can be applied to inform choices concerning responsible consumption of alcohol. Physicians can apply the research evidence describing the known risks and benefits associated with alcohol consumption when counseling with their patients regarding alcohol-related decisions and behaviors.
Of the 113 million Americans classified as "current drinkers," (1,2) perhaps as many as 23.8% of men and 4.7% of women meet DSM-IV criteria for dependence. (1-5) Males and whites dominate these categories, (1) particularly at higher-volume consumption levels. (6) Alcohol-related social, legal, and health problems (4) result in annual economic costs to society totaling more than $166 billion. (2)
Demographers have long noted an unexpected low incidence of cardiovascular disease in the French population despite an unfavorable exposure to cardiovascular risk factors; namely, a high-fat cuisine combined with heavy tobacco use patterns. A beneficial effect of regular wine consumption has been advanced as a possible explanation of this "French Paradox." Numerous scientific articles have been published in the last few decades that describe beneficial alcohol-related outcome data and beneficial changes in biochemical and metabolic markers for cardiovascular disease. These data support the initial assumptions of the "French Paradox."
Health Benefits of Alcohol
The published health benefits of regular light-to-moderate alcohol consumption define a lower incidence of cardiovascular, metabolic, and dementing illnesses. Other data define the metabolic and biochemical influences of alcohol that, in turn, explain the mechanisms by which mild to moderate alcohol consumption improves these health outcomes.
Lower Myocardial Infarction Rates
Data collected on 87,938 men in the Physicians' Health Survey revealed benefit of alcohol consumption in reducing coronary heart disease (CHD) in both diabetic and nondiabetic populations. A 5.5-year follow-up revealed more dramatic risk reduction in the diabetic cohort. The relative CHD risk was 1.02 for nondiabetic men who drank monthly, 0.82 for those who drank weekly, and 0.61 for daily drinkers. In diabetic men the corresponding relative risks (RR) were 1.11, 0.67, and 0.42. (7) In the Nurses' Health Survey involving...