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Is drinking alcohol good for my health?

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Health risks: alcohol use has been linked to several types of cancer of the head, neck and digestive tract, while liver cancer has been strongly linked to alcohol use (File photograph by Marvin Joseph/Washington Post)

Is alcohol good for my health? This is a question without a simple answer. Drinking too much alcohol contributes to accidents and injuries and can lead to liver disease, cardiovascular problems, various cancers, birth defects, and psychiatric issues, among other health concerns.

However, mild to moderate alcohol use may provide certain benefits, particularly with regard to coronary heart disease.

Understanding the possible risks and benefits of alcohol is essential to make an informed decision about alcohol use.

In the United States, one serving of alcohol is defined as approximately ten to 15 grams of ethanol (pure alcohol), which can be found in:

• One 12-ounce bottle or can of beer

• One 5oz serving of wine

• One shot (1.5oz) of 80-proof distilled spirits

Moderate drinking is generally defined as three to nine servings of alcohol per week, depending on age, gender and other conditions.

The US National Institute on Alcohol Abuse and Alcoholism defines “low-risk drinking” as no more than three or four drinks on any given day, and no more than a total of seven drinks per week for a woman, and no more than 14 drinks per week for a man.

Alcohol and health conditions

• High blood pressure: people who consume more than two drinks per day have a twofold increase in the incidence of high blood pressure compared with non-drinkers.

• Heart attack: drinking a moderate amount of alcohol is associated with a lower risk of having coronary disease and heart attack.

Peripheral vascular disease (PVD) can cause pain in the calves with walking, known as claudication. Moderate alcohol use reduces the risk of PVD in otherwise healthy men.

• Stroke: alcohol consumption has been shown to affect the risk of stroke in contradictory ways, depending upon the amount of alcohol consumed and the type of stroke. Strokes may be due to a blockage (ischemic stroke) or rupture (haemorrhagic stroke) of one of the brain vessels.

Heavy alcohol use increases the risk of both types of stroke. Moderate use is associated with fewer ischemic events, however, haemorrhagic stroke risk appears to rise even with minimal alcohol consumption.

• Cancers: there is consistent evidence that breast cancer risk is higher for women consuming any daily amount of alcohol. Taking folic acid may reduce this risk.

In addition, alcohol use has been linked to several types of cancer of the head, neck, and the digestive tract, even at low levels of consumption. People who drink and smoke have a greater risk than would be expected from either factor alone.

Liver cancer (hepatocellular carcinoma) has been strongly linked to alcohol use. This may be secondary to liver scarring (cirrhosis) that occurs in people who consume excessive amounts of alcohol, since cirrhosis is a major cause of hepatocellular carcinoma.

While drinking at low levels has not been shown to cause liver cancer, this same amount may increase cancer risk in people with inflammation of the liver (hepatitis) due to infection with certain viruses, like hepatitis C. People with chronic hepatitis should fully avoid alcohol.

• Pancreatitis: heavy drinking increases the risk of both sudden (acute) and long-term (chronic) inflammation of the pancreas.

• Osteoporosis: heavy drinking increases the risk of hip fractures because it increases the risk of osteoporosis and falls.

• Pregnancy: there is a significant risk of birth anomalies related to use of alcohol during pregnancy.

Heavy drinking can cause fetal alcohol syndrome, which prevents normal growth and may cause mental retardation, malformations of the skull and face, and other defects.

There is no known “safe” quantity of alcohol use during pregnancy.

Thus, experts advise to completely avoiding alcohol during pregnancy.

• Accidents and trauma: alcohol use increases both the risk and severity of injury from motor vehicle accidents. Exposure to alcohol is generally measured in blood alcohol concentration (BAC) rather than drinks per day or week.

In the US, the legal BAC limit for driving is 0.08 per cent. However, the risk of having an accident while driving doubles at a BAC of just 0.05 per cent, and driving ability is impaired with BAC as low as 0.02 per cent.

• Violence: alcohol is involved in more than a quarter of all rapes and at least a half of serious assaults and homicides.

A word about wine

Some, but not all, research suggests that wine provides the strongest protection against cardiovascular disease, possibly due to naturally occurring compounds known as flavonoids.

In France, for example, death from coronary events is lower than would be expected from the high rate of smoking and saturated fats in the diet; this “French paradox” has been attributed to regular red wine consumption.

So, is alcohol good for my health? The diseases that may be prevented by moderate drinking (for example, coronary heart disease and ischemic stroke) are most prevalent in older adults.

For these groups, moderate alcohol use may reduce that risk. However, for young to middle-aged adults, particularly women, moderate alcohol use increases the risk of the most common causes of death, such as breast cancer and trauma.

Also, men younger than 45 may experience more harm than benefit from drinking. In these two younger age groups, moderate alcohol use is unlikely to reduce the risk of dying.

Joe Yammine is a cardiologist at Bermuda Hospitals Board. He trained at the State University of New York, Brown University and Brigham and Women’s Hospital. He holds five American Board certifications. He was in academic practice between 2007 and 2014, when he joined BHB. During his career in the US, he was awarded multiple teaching and patients’ care recognition awards. The information herein is not intended as medical advice nor as a substitute for professional medical opinion. Always seek the advice of your physician. You should never delay seeking medical advice, disregard medical advice or discontinue treatment because of any information in this article

Expert advice: Joe Yammine is a cardiologist at Bermuda Hospitals Board (File photograph by Akil Simmons)