Healthy drinking, healthy heart - is it so simple?

Regular moderate drinking appears to lower the risk of serious heart disease by almost a third in men. Spanish men, anyway. But is alcohol the real cause?

Spain’s alcohol consumption per head places it sixth in the world. Yet it also has one of the lowest death rates from heart disease in the world.

The research team assessed the alcohol intake of more than 15,500 men and almost 26,000 women aged between 29 and 69. All the participants were members of the Spanish cohort of the European Prospective Investigation into Cancer (EPIC), which involves half a million adults in 10 Western European countries.

It should be noted that the research involved asking the men and women about their food and drink consumption through questionnaires. Respondents had to quantify how much of a certain foodstuff or beverage they ate/drank over the preceding year. Total alcohol intake was calculated by multiplying the average ethanol content of a standard glass of whatever type of alcohol they drank daily/ weekly.

Information on lifestyle, including exercise and tobacco use, and other potential risk factors for heart disease, such as obesity and high cholesterol, was also gathered.

Respondents’ health was tracked for an average of 10 years, during which time 609 ‘coronary events’ occurred (481 in men, 128 in women).

Male drinkers all had a lower risk of coronary heart disease.

• For former drinkers, the risk was 10% lower;
• for those drinking little (0–5 g of alcohol/day), the risk was 35% lower,
• for moderate drinkers (5–30 g/day), the risk was 54% lower
• for high (30–90 g/day) and very high drinkers (more than 90 g/day) it was 50% lower.
• In the UK, one unit of alcohol contains 8 grams of alcohol. (The average pint of lager contains two units)

MHF president Dr Ian Banks says: ‘While this research suggests that moderate drinking will not do you too much harm, it should not be concluded that heavy drinking will not either – despite the findings. If heart diesease is lower it’s only ebcuase liver disease has got there first.’

Alcohol may not be the main factor

The problem with all this stuff is the social context. It may be that non drinkers have other lifestyle factors that increase their risk of heart attacks.

A recent report in the Journal of Neurology, Neurosurgery and Psychiatry illustrates the difficulty with separating variables inherent in all lifestyle research.

Dr. Claudia Cooper, at University College London, and colleagues note that moderate drinkers - two drinks a day for men - tend to be less forgetful and have better mental skills as they age.

However, moderate drinkers also tend to have social, economic, and educational advantages that improve thinking skills over time. Cooper's study suggests that it's these advantages - and not moderate drinking itself - that are responsible for the benefits.

Cooper's team tested 1,735 men and women aged 60 to 74. On the face of it moderate drinking appeared to protect which is what previous studies have suggested. But when thinking skills when younger were taken into account, it was less significant. Tests involved how well participants could read words pronounced differently from how they are spelled which, Cooper told Reuters Health, is a good indicator of previously obtained thinking skills.

Result: in people who were not problem drinkers, higher alcohol intake was not associated with improved current cognition after controlling for premorbid intelligence and physical health.