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Alcohol and your heart: Moderation or none?
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Alcohol and your heart: Moderation or none?

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Research on alcohol consumption can be confusing.

Q: I used to believe a little alcohol was good for the heart. But then I read that no alcohol is healthier. What’s the status?

A: Indeed, the existing research is quite conflicting — some studies say alcohol improves heart health, while others imply the reverse.

The most recent studies suggest that minimal or no alcohol may be the healthiest choice. But that’s not proof that drinking in moderation is worse than not drinking at all.

The problem with most alcohol-related research is that it consists almost entirely of observational studies that only show an association, not a direct cause-and-effect. It’s possible that people who drink in moderation also might exercise more and eat a healthier diet, which could be the reason for better heart health, rather than drinking alcohol.

Moderate alcohol intake is associated with some heart benefits, but how much is considered moderate? The standard recommendation is no more than one drink per day for women and no more than two per day for men. More than that can lead to heart problems, such as heart failure and atrial fibrillation.

Of course, alcohol content can vary with the type and size of drink. In the United States, a standard drink is about 14 grams of pure alcohol, which equates to 5 ounces of wine,12 ounces of regular beer, 1.5 ounces of 80-proof distilled spirits, or 1 ounce of 100-proof spirits.

But the definition of moderate drinking may mean less alcohol than has previously been promoted, according to a study in The Lancet that looked at the drinking habits of almost 600,000 people without heart disease.

People who had 10 or more drinks per week died one to two years earlier compared with those who drank five drinks or fewer per week. Having 18 drinks or more per week cut life expectancy by four to five years.

Does the source of the alcohol matter? Not really. Your body reacts to alcohol the same whether it’s from beer, wine or spirits. While some research has touted the benefits of drinking red wine to fight heart disease, the findings tend to point to the wine’s high levels of resveratrol (a plant chemical that reduces inflammation) and not its alcohol content as the main reason.

Because of the lack of consistent data, the takeaway message here is to focus on moderation and avoid excessive and binge drinking. You can’t put alcohol in same category as eating a healthy diet, exercising regularly, not smoking and taking blood pressure or cholesterol medicine in terms of protecting against heart disease.

If you don’t drink now, don’t start just to lower heart disease risk. But unless definite evidence comes forth about totally avoiding alcohol, I will continue to enjoy my occasional glass of wine.

(Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.)

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