There has been much controversy regarding the association between alcohol intake and cardiovascular disease, the leading global cause of death.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), in 2019, 86 percent of adults in the United States reported consuming an alcoholic beverage.

Moreover, 14.5 million people in the U.S. aged 12 years or older live with alcohol use disorder (AUD). The NIAAA offers that Alcohol use disorder is marked by “an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.”

Approximately 95,000 Americans die annually from alcohol-related causes. This number makes alcohol the third largest preventable death cause.

It has long been recognized that the problems with alcohol relate not to the use of a bad thing but to the abuse of a good thing. — Abraham Lincoln

On the one hand, observational studies show a lower risk of cardiovascular disease with light to moderate alcohol intake than abstinence or heavy consumption. There appears to be a J- or U-shaped epidemiologic association.

On the other hand, these supposed heart benefits of alcohol may be secondary to confounding factors, including a favorable lifestyle (and behavioral and socioeconomic factors associated with modest alcohol drinking).

Today we try to get clarity by examining the pooled results of 107 studies involving nearly five million subjects. After analysis, study co-author Tim Stockwell offs this insight:

“We just need to be very skeptical of scientific evidence or scientific studies suggesting there are health benefits.”

Red wine — a traditional view

Moderate consumption of red wine has been associated with potential health benefits. Still, it’s important to note that these benefits are not a one-size-fits-all solution and may vary based on individual factors.

Red wine contains antioxidants, such as resveratrol, linked to cardiovascular health benefits. Resveratrol may improve cholesterol levels, lower blood pressure, and reduce the risk of blood clots.

Additionally, the polyphenols found in red wine have anti-inflammatory properties, which may help to reduce the risk of chronic diseases.

However, it’s important to remember that moderation might be a key to reaping the alleged health benefits of red wine. Excessive alcohol consumption increases the risk of several health issues, including liver disease, high blood pressure, and some types of cancer.

A new study raises questions about the traditional view that moderate alcohol consumption improves health and lengthens life.

Alcohol consumption, health, and longevity

In a new sweeping analysis, researchers discovered the following:

Despite a widespread belief that moderate alcohol consumption is good for you, the more you drink, the higher your risk of early death.

The review analyzed research on nearly five million individuals’ drinking and health habits. The study is one of the largest to undermine the belief that moderate drinking of wine (or other alcoholic beverages) is healthy.

The new study also discovered that drinking relatively low levels of alcohol — 25 grams daily for women (less than one ounce) and 45 grams (roughly 1.5 ounces) or more daily for men — increased the risk of death.

In the United States, a standard drink (5 ounces of wine, 12 ounces of beer, or 1.5 ounces of distilled spirits) typically has about 14 grams of alcohol.

Alcohol consumption study — context

The findings align with a British study from last year: Researchers examined the genetic and medical data of nearly 400,000 people. They concluded that even low alcohol intake was associated with increased disease risk.

In this cohort study of over 371,000 individuals, genetic evidence supported a non-linear, consistently risk-increasing link between all alcohol amounts, high blood pressure, and coronary artery disease.

The “J-curve might not exist when it comes to alcohol consumption level and disease risk. There were modest risk increases with light alcohol intake and exponentially greater risk increases at higher consumption levels.

In summary, alcohol intake at all levels appears to be associated with increased cardiovascular disease risk.

My take on alcohol consumption and health

This study shows that moderate alcohol consumption does not promote health. In general, less alcohol appears to be better regarding health.

You may have heard of the “French paradox,” suggesting that low cardiovascular disease rates (among men in France) appeared to be associated with daily wine consumption. Subsequent analyses revealed research flaws.

If you are keeping score, be careful: The alcohol industry funded much of the research examining the effects of alcohol on health. A recent report showed that the industry has directly or indirectly paid for 13,500 studies.

Moreover, historical research often failed to adjust for confounders such as lifestyle (for example, exercise, diet, and smoking), sex, age, and socioeconomic status. The current study attempted to remove such biases and discovered no significant reductions in the risk of death among moderate drinkers.

So why did previous research show a “J-shaped” curve — with lower heart attack rates among those consuming low or moderate alcohol amounts, with higher rates at the extremes — these studies were deeply flawed. The light-to-moderate drinkers were generally healthier than non-drinkers on physical activity, diet, weight, income, and dental hygiene measures.

In addition, abstainers from alcohol may avoid drinking because of health problems. Historical research did not control for such biases. Sometimes, being able to drink is a sign that you are still healthy, not the cause of it.

Let’s end with the words of researcher Professor Dr. Ulrich John:

“Our study is one of the very few that asked for details [about the] former life of the abstainers, details that may be known risk factors for early death. Our study is perhaps the only one so far that includes a standardized diagnosis of former alcohol or drug dependence, i.e., a severe health disorder that may explain short time to death.”

We might need to rethink the notion that daily drinking of moderate alcohol amounts promotes health. My takeaway is not that all should avoid alcohol; rather, it may not be the health potion many believe it to be.

What say you?

The post Are One or Two Drinks Daily Better Than Abstaining? appeared first on Medika Life.

I live in Seattle, a wonderful verdant environment. It is also a place where a glass of wine or a cocktail is ubiquitous. A new study reminds us to be mindful of our alcohol consumption.

Drinking too much alcohol is linked with numerous leading causes of death among young adults in the USA, including heart disease, cancer, unintentional injury, and liver disease.

Unfortunately, deaths due to causes fully attributable to alcohol (such as alcoholic liver disease) have risen over the last decade, including among young folks.

However, a United States-based assessment of alcohol-attributable deaths among this population accounting for partially alcohol-attributable causes (such as cancers) is lacking.

Today we explore a study published in JAMA Network Open examining some of the perils of alcohol use in excess. Researchers examined the average annual deaths secondary to too much alcohol use among adults aged 20 to 64.

“[I]t is the wine that leads me on,
the wild wine
that sets the wisest man to sing
at the top of his lungs,
laugh like a fool — it drives the
man to dancing… it even
tempts him to blurt out stories
better never told.”
― Homer, The Odyssey

Alcohol and mortality

I will begin with a striking observation from Dr. Marissa Esser, the US Centers for Disease Control and Prevention’s alcohol program leader. Speaking to CNN, she observes this:

“While the percentage of deaths attributed to alcohol use varies state by state, it’s a leading cause of preventable death in the USA.” She adds that “alcohol is often overlooked as a public health problem.”

While the percentage of deaths attributed to alcohol use varies state by state, it’s a leading cause of preventable death in the USA. She adds that “alcohol is often overlooked as a public health problem.

Approximately one in five deaths of young adults appeared secondary to excessive alcohol use. For those 20 to 64, drinking-related deaths accounted for one in eight.

The researchers examined national and state mortality data from 2015 to 2019 and noted deaths fully (or partially) attributable to excessive drinking.

The causes included deaths from motor vehicle accidents, alcohol poisoning, and other health impacts (for example, liver disease or pancreas failure). They obtained mortality data from the National Vital Statistics System.

Such deaths have been on the rise, increasing by up to seven percent annually in the two decades before the COVID-19 pandemic.

Alcohol and mortality — My take

The study reminds us to limit our alcohol consumption to a reasonable level. The alcohol-attributable death estimates in this study are likely underestimates. The researchers did not estimate alcohol-attributable deaths due to partially alcohol-attributable conditions — the Behavioral Risk Factor Surveillance System does not collect the prevalence of former alcohol consumption.

The numbers are disturbing, with one in five deaths among adults 20 to 49 attributable to excessive alcohol consumption. Moreover, the study data showed that deaths due to alcohol have gone up in the past decade.

I do not know the solution, but the study authors note that some have proposed increased implementation of evidence-based alcohol policies (for example, increasing alcohol taxes and regulating alcohol outlet density), alcohol screening, and brief intervention.

Be careful

The Centers for Disease Control (CDC) defines moderate drinking as two drinks or less daily for men or one drink or less for women. The organization notes that two-thirds of adults consume more than moderate amounts at least once per month.

The CDC also estimates that one in six adults binge drink — women consuming four or more drinks in one sitting and men drinking five or more — with a quarter of those doing so at least weekly.

Thank you for joining me in this brief look at how one in five deaths among young adults is due to alcohol. One more thing:

A Centers for Disease Control tool can help individuals evaluate their drinking and devise a plan to make healthier alcohol choices.

The post One in Five Deaths Among Young Adults is Due to Alcohol appeared first on Medika Life.

There is growing evidence that even moderate alcohol consumption has negative effects on the brain. However, the underlying mechanisms are unknown. “Moderate” drinking was defined between 7 to <14 units of alcohol a week for women and 7 to <21 units for men. There is a possibility that accumulation of iron in the brain may play role as excess brain iron has been described in several neurodegenerative diseases, including Alzheimer’s and Parkinson’s.

In the study, published in the journal PLOS Medicine, researchers showed evidence that alcohol directly related to cognitive decline. In this study, scientists studied the relationship between self-reported alcohol intake and iron levels in the brain — which represents a potential mechanism for alcohol-related cognitive decline. Magnetic resonance imaging was used to ascertain iron content of each brain region and liver tissues, a marker of systemic iron.

Researchers collected data from 20,965 participants from United Kingdom, whose average age was 55 and 48.6% of participants were female. A total of 2.7 percent of the participants involved did not consume alcohol, while the rest consumed an average of 18 units of alcohol per week. For the record, 18 units is almost equivalent to six glasses of wine or 7.5 cans of beer.

“Drinking more than seven units of alcohol per week was associated with the accumulation of iron in the brain.”

The researchers, Anya Topiwala believed that this study was the largest study to date. She said that drinking more than seven units of alcohol per week was associated with the accumulation of iron in the brain. Higher brain iron is associated with poorer cognitive performance — poorer executive function and fluid intelligence and slower reaction speed. Iron accumulation can be a cause of alcohol-related cognitive decline.

The basal ganglia — an area in the brain that helps us perform cognitive, emotional and movement-related functions had some of the highest iron concentrations in the brain and suffered the greatest aging. There is a significant alcohol-age interactions with susceptibility, suggesting that alcohol may magnify age effects on brain iron.

Though light alcohol intake (drink <7 units of alcohol) is better than moderate intake, abstinence is still the best option. Never drinker had the lowest amount of brain iron and the best cognitive performance. This can indicate that there may be no safe level of alcohol consumption for brain health.

There may be no safe level of alcohol consumption for your health

Previous study from the same author support these findings. Using 30 year longitudinal data on alcohol consumption, the researcher found there was no protective effect for light drinkers compared with abstinence. Compared with abstinence, moderate alcohol intake is associated with increased risk of adverse brain outcomes and steeper cognitive decline.

According to NHS, it’s recommended to drink no more than 14 units of alcohol a week, spread across 3 days or more. That’s around 6 medium (175ml) glasses of wine, or 6 pints of 4% beer. There’s no completely safe level of drinking, but sticking within these guidelines lowers your risk of harming your health. Here’s how you can cut down on alcohol:

• Don’t keep alcohol in your house. Having no alcohol at home can help limit your drinking.
• Drink slowly. Sip your drink. Drink soda, water, or juice after having an alcoholic beverage. Never drink on an empty stomach.
• Choose alcohol-free days. Decide not to drink a day or two each week. You may want to abstain for a week or a month to see how you feel physically and emotionally without alcohol in your life. Taking a break from alcohol can be a good way to start drinking less.
• Choose drinks that are lower in alcohol. Try lighter beers — under 4% ABV. As a rule of thumb, white and rosé wines are lower in strength than reds. Or try swapping some or all of your drinks for no or low-alcohol alternatives..
• Stop people pleasing. Practice ways to say no politely. You do not have to drink just because others are, and you shouldn’t feel obligated to accept every drink you’re offered.
• Ask for support. Cutting down on your drinking may not always be easy. Let friends and family members know that you need their support. Your doctor, counselor, or therapist may also be able to offer help.

The post What is the Safe Amount to Consume Alcohol? appeared first on Medika Life.

But is moderate alcohol consumption okay, or does the drinking pattern matter? Can you be a weekend consumer of alcohol, drinking four drinks on Saturday and three on Sunday, and still call yourself a light or moderate drinker?

“I began to think vodka was my drink at last. It didn’t taste like anything, but it went straight down into my stomach like a sword swallowers’ sword and made me feel powerful and godlike.”
― Sylvia Plath, The Bell Jar

Alcohol problems among moderate drinkers

In their provocative recent report, researchers observe that “a significant amount of binge drinking among adults escapes public health scrutiny” because it occurs among people who drink at a moderate average level.

A new observational study looks at a binge drinking pattern in predicting alcohol problems among moderate drinkers in the United States.

Is moderate alcohol consumption safe, regardless of the drinking pattern? Researchers examined over 1,200 current drinkers enrolled in the study of Midlife Development in the United States.

Here are the study results:

Independent of the average amount of alcohol consumption, binge drinking appeared to be associated with an almost 3-fold increase in the number of alcohol-related problems and a 40 percent increase in the number of alcohol problems nine years later.

Interestingly, moderate average drinkers accounted for most cases of binge drinking and multiple alcohol problems. Among this group, binge drinking appeared to be linked to a nearly five-times increase in concurrent multiple alcohol problems.

The National Institute on Alcohol Abuse and Alcoholism defined moderate drinking as an average of no more than one drink daily for women and two for me. High drinking is an average of more than one drink for women and more than two for men.

A separate question separated a regular versus binge drinking pattern on one occasion. Researchers asked the subjects: Considering all alcoholic beverage types, how many times during the past month did you have five or more drinks on the same occasion? The scientists defined binge drinking as five or more drinks on the same occasion.

Alcohol problems and moderate drinkers: My take

Moderate average-level drinkers accounted for the majority of cases of binge drinking and multiple alcohol problems. Note that the findings represent correlation and do not establish causality. As the study participants self-reported data, there may have been recall bias.

The surveys defined binge drinking as five or more drinks on occasion for both men and women. Today, binge drinking in women is more commonly defined as four or more drinks on a single occasion; thus, the study findings may have underreported binge drinking in women.

Moderate drinkers need to be aware that they can cross into binge drinking. Everything in moderation, as we have all heard. Thank you.

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Here are the numbers: Approximately one-quarter of Americans volunteer that they made New Year’s resolutions. The most common commitments? Exercising more, with nearly half (46 percent) of those surveyed offering that as their goal. Other targets include diet (45 percent), losing weight (44 percent), and saving money (41 percent).

I put resolutions aside in favor of focusing on my pillars of health:3 Pillars of Wellness for 2022HAPPY NEW YEAR TO YOU. I genuinely appreciate that you took time out of your day to read my musings. Today, I want to…medium.com.

Irrespective of whether you make New Year’s resolutions or not, some of you may have a goal of drinking less alcohol. Cutting back can provide both short- and long-term health benefits.

Today, I will focus on cancer, even as I recognize that alcohol can influence the probability of vehicle crashes, violence, physical and mental health, and sexual risk behaviors.

Alcohol consumption guidelines

The United States Centers for Disease Control recently developed guidelines to help folks drop their risk of alcohol-related harms. Let’s look at them:

• Adults of the legal drinking age can choose not to drink or drink in moderation by limiting intake to two drinks or less in a day for men or one drink or less for women on days when alcohol is consumed.
• Individuals who do not drink alcohol should not start drinking for any reason.
• If adults of the legal drinking age choose to drink alcoholic beverages, drinking less is better for health than drinking more.

An impetus for my writing this piece is noting how many of my patients with cancer exceed these recommendations for alcohol consumption. Two in three adult drinkers report drinking above these moderate levels at least once per month.

Alcohol and cancer

The American Cancer Society reminds us that alcohol consumption is associated with a higher risk of several cancers, including breast, colon, and liver cancers. Alcohol also likely increases your chances of cancers of the stomach and other organs.

There is a dose-response relationship — the more alcohol you consume, the higher your cancer risk. My patients are often surprised when I note that some forms of cancer (for example, breast cancer) can be associated with even small amounts of alcohol intake.

Does the alcohol type matter?

You already know that ethanol is an alcohol type in alcoholic beverages, whether wine, beer, liquors, or other forms. While alcohol-containing beverages can have varying percentages of ethanol, typically, a standard drink (five ounces of wine, 12 ounces of beer, or 1.5 ounces of 80-proof liquor) has about one-half ounce of alcohol. Stronger or larger drinks have more ethanol.

The cumulative volume of alcohol consumed over time is the most critical factor for cancer risk. This is akin to tobacco and cancer risk — we calculate pack-years smoked by multiplying the number of packs per day by the number of years used.

Alcohol — Takeaway messages

Some individuals should not consume alcohol. These include those who are pregnant (or might be), young people under the legal age for drinking, those who have certain medical conditions (or are taking certain medications) that interact with alcohol, and those recovering from an alcohol use disorder or are unable to control the amount they drink.

It is probably safest for breastfeeding women to dodge alcohol, too.

With more than two out of three consumers of alcohol exceeding guidelines, I want to remind you that reducing (or stopping) alcohol can meaningfully reduce the risk of getting cancer.

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