By Dr Harold Gunatillake - Health Writer
It is generally believed that white people drink more alcohol than the non-whites and live longer. Sri Lankans from pre-historic times have been drinking local brews, but the influence of Buddhism deterred drinking in public. When the Portuguese arrived and settled along the western coastal areas, native Sinhala people had observed that these foreigners were ‘drinking blood,’ not knowing that it was alcohol, possibly red wine. Arrack became the social drink among the middle and lower classes of Sri Lankans and the rich and the affluent indulged in foreign liquor from the time of the British.
Today, in Sri Lanka even the ladies drink wines and hard drinks among the upper social classes, and the average working class and rural women do not seem to drink alcohol.
“French paradox” created interest in finding out why the French despite eating a rich diet and drinking wine with meals, had a lower incidence of heart disease. They don’t seem to drink water at all, and the theory that one should drink six glasses or more goes for a six when it comes to the French.
Research and studies reveal that alcohol’s link with health is a bit like Dr. Jekyll and Mr. Hyde. Exactly which face it shows depends on who’s drinking and how much. Most people who drink two or less alcoholic beverages seem to benefit in overall health, including cardiovascular health especially in the middle age when heart disease begins to account for an increasing incidence of morbidity and mortality, while those who drink more are liable to run the risk of colon and breast cancer.
It is also observed that heavy drinking runs the risk of developing high blood pressure, cirrhosis, incidence of various types of cancer and ill-health. Pregnant women should avoid alcohol totally, and others should drink only one per day. For men the doctors recommend two drinks only. The definition of ‘alcoholic’ is a person who drinks more than what his doctor drinks.
Non-drinkers, however, need not feel the need to start drinking alcohol to improve their health.
For people with liver disease, taking one or more medications that interact with alcohol, the risk of drinking outweighs the benefits. People on chemotherapy should check with their oncologists.
Those who drink even two drinks a day need to take multivitamins with folic acid. Folic acid is a synthetic form of folate, a B vitamin that may help lower the risk of heart disease and cancers of the breast in women and cancer of the colon. Alcohol generally depletes our body’s stores.
When you drink moderately (two glasses) — whatever drink you like — beer or spirits, each seems to have the same health benefits as long as moderation is adhered to (no more than one drink per day for women and no more than two drinks per day for men).
Excessive alcohol drinks may affect your skin giving such diseases like urticaria, porphyria, flushing, rosacea bruising, increased pigmentation, among others.
Maximum benefit in helping to prevent heart disease comes from a regular pattern of drinking small amounts of alcohol. This benefit is noted among people aged from about 40-60 years and over. A similar benefit has not been found for younger age groups. Consuming large amounts of alcohol will have a detrimental effect on your health and increase the risk of illness and death from heart disease. There is strong evidence that low risk drinking may similarly provide some protection against ischaemic stroke, and also provide some protection against gallstones. An exhaustive review of all major heart disease studies found that “alcohol consumption is related to total mortality in a U-shaped manner, meaning moderate consumers have reduced mortality compared with total non-consumers and heavy consumers.
An extensive review of recent medical research by the National Institute on Alcohol Abuse and Alcoholism found that, with few exceptions, studies from at least 20 countries around the world demonstrate a 20 to 40 percent lower coronary heart disease (CHD) incidence among drinkers compared to non-drinkers. Moderate drinkers exhibit lower rates of CHD-related mortality than either heavy drinkers or abstainers.
In a study of nearly 88,000 men, Harvard researchers found that drinking reduced the risk of coronary heart disease risk among both diabetics and non-diabetics. Weekly consumption of alcohol reduced CHD risk by one-third (33%) while daily consumption reduced the risk by over half (58%) among diabetics. For non-diabetics, weekly consumption reduced CHD risk by 18% while daily consumption reduced the risk by 39%.
Harvard researchers concluded about coronary heart disease that “Consumption of one or two drinks of beer, wine, or liquor per day has corresponded to a reduction in risk of approximately 20-40%.”
Moderate drinking reduces the risk of both heart disease and death by heart attack; studies have found variable risk reduction rates, ranging from 25% (various studies) to 40% (Nurses’ Health Study — a longitudinal study of 85,709 nurses).
Alcohol decreases LDL (bad) cholesterol and increases (good) HDL cholesterol. Alcohol decreases thrombosis (blood clotting) by reducing platelet aggregation, reduces fibrinogen in the blood which helps clotting, and increases breakdown of fibrinogen (fibrinolysis).
Alcohol reduces coronary artery spasm in response to stress, and increases blood flow. It reduces blood pressure and reduces harmful arterial plaque.
There is some early evidence that low risk drinking may provide some protection against type 2 diabetes. (Source National Health and Medical Research Council (NHMRC) (2001). Australian Alcohol Guidelines: Health Risks And Benefits. NHMRC, Canberra).
Strokes: A study published in the Journal Of The American Medical Association found that consuming one or two drinks a day can reduce the risk of ischemic stroke by about half. Its findings support the National Stroke Association Stroke Prevention Guidelines regarding the beneficial effects of moderate alcohol consumption.
Moderate drinking and obesity
This is a study conducted at Boston’s Brigham and Women’s Hospital, and published in the Archives of Internal Medicine.
In the study co-researcher Howard S. Sesso ScD, MPH, said that women who already drink in moderation showed a reduction in weight. The study included more than 19,000 women aged 39 and older enrolled in the Women’s Health Initiative.
None of the women were overweight when they entered the study, and all were asked about their daily alcohol consumption in an initial questionnaire.
About 40% reported that they did not drink at all, while 33% reported drinking the equivalent of about two alcoholic beverages a week. Another 20% reported having about a drink a day, 6% drank one to two alcoholic beverages a day, and 3% reported drinking more than this.
Over an average of 13 years of follow-up, most of the women in the study gained some weight.
But the women who reported being teetotalers when they entered the study gained the most weight. The women who reported drinking some alcohol, but no more than two drinks a day, gained the least.
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