FRIDAY, Sept. 5 (HealthDay News) -- Suppose you're a healthy,
physically fit, nonsmoking male. Your risk of heart attack is
already low. Would having a drink or two of alcohol a day provide
any additional protective benefit?
A study by Harvard University researchers suggests that the
answer is yes. Even among men who are models of health, moderate
drinking was associated with a lower risk of heart attack. Those
who had one-half to two drinks a day had the lowest heart attack
risk -- 40 percent to 60 percent lower than healthy men who didn't
drink. And that was true no matter whether they were drinking beer,
wine or liquor.
"These results tend to refute the oft-quoted hypothesis that lower coronary heart disease seen among moderate drinkers is due to their associated healthy lifestyle habits, and not to their alcohol consumption," wrote Dr. R. Curtis Ellison, director of the Institute on Lifestyle and Health at Boston University School of Medicine, and co-author of a critique of the study.
In 2008, an estimated 770,000 people will suffer a heart attack,
according to the American Heart Association (AHA).
Dozens of studies have linked moderate drinking and lower risk
of heart disease. In a nod to that evidence, the AHA advises people
who drink to do so in moderation -- no more than two drinks a day
for men and one drink a day for women.
What's been less clear is whether people who exercise, abstain
from smoking, maintain an optimal weight and adhere to an
appropriate diet would see any benefit from drinking.
Using data from more than 50,000 health professionals, study
author Dr. Kenneth J. Mukamal, assistant professor of medicine at
Harvard Medical School, and his colleagues identified more than
8,800 men who were nonsmokers, ate a healthy diet, exercised at
least 30 minutes a day and weren't overweight. Over a 16-year
period, 106 of the men had heart attacks, but those who had two
drinks a day had the lowest risk for heart attack, while
non-drinkers had the highest risk.
Several other recent studies have added to the evidence
suggesting that moderate alcohol intake complements a healthy
lifestyle.
A recent British study identified moderate alcohol consumption
among four healthy behaviors (including not smoking, exercising and
eating five servings of fruits and vegetables a day) that added 14
years to life, compared with men and women who did not adopt these
behaviors. And Danish researchers reported that both physical
activity and moderate drinking have a protective effect on the
heart and an additive benefit when combined as part of a healthy
lifestyle.
There's one glaring problem, though. None of the studies were
"randomized controlled trials" -- the gold standard of scientific
research, whereby people are randomly assigned to an intervention,
such as exercising or consuming alcohol.
There are lots of observational data to support moderate
drinking, said Dr. Robert A. Vogel, professor of medicine and
director of clinical vascular biology at the University of Maryland
School of Medicine. "However, we do not consider alcohol a validly
tested drug because to do that you would have to randomize people
for years with alcohol or not -- and that's not a study that can be
done," he said.
Vogel said he enjoys a daily glass of wine as part of a healthy
lifestyle and tells patients who do the same that it's "a
reasonable thing to do." Many doctors, though, tend to shy away
from recommending alcohol to their patients. Instead, they have
emphasized other lifestyle modifications, including diet and
exercise.
"Clinicians are very resistant to taking alcohol out of the 'alcoholism' box and asking what its effects might be at more typical levels of intake," Mukamal said. "Even if clinicians don't believe there are benefits to alcohol, and I think that's a reasonable concern since we don't have randomized trails, they should at least be discussing it, but I don't think that's happening."
Ellison agrees. For middle-aged and older men and postmenopausal
women who don't have ethical, religious or health reasons for
avoiding alcohol (such as pregnancy or diseases), "physicians
should at least inform them that the scientific data currently
available strongly suggest that a small amount of alcohol on a
regular basis may lower their risk of heart disease, stroke,
diabetes, dementia, and even total mortality," he said.
More information
For more on alcohol and the heart, visit the
American Heart Association.
