Slow and steady the way to alcohol's health benefits: study (2024)

It has become almost an assumption lately that a little alcohol is actually good for one’s health. A new Canadian review of 30 years of research into the question paints a foggier picture, however, finding conflicting evidence on drinking and heart disease, and a complex message for doctors and the public.

The bottom line is that moderate volumes of alcohol do seem associated with fewer heart attacks and other cardiac illness — but only if that volume is spread out evenly, with one or two drinks a day, rather than clumped together in sporadic binges, says Jürgen Rehm, lead author of the study just published in the journal Addiction.

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That caveat — that it is not just low average consumption that might help, but a regular, modest pattern of drinking — is a major one, since less than 5% of North Americans are estimated to follow such consistent drinking patterns, noted Prof. Rehm in an interview.

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“If you want to reap all those benefits, you have to drink it almost as a medicine,” said the head of social and epidemiological research at Toronto’s Centre for Addiction and Mental Health (CAMH). “The problem is that, a lot of the lay messages deal with alcohol as if it has only one dimension, ie. how much you drink overall. From a scientific perspective, alcohol has at least two dimensions: first, how much do you drink overall and, secondly, how do you drink it.”

Since the evidence to date has come from less-than-rigorous “observational” studies with sometimes-questionable methodology and complicating factors, it is all but impossible to offer solid advice now about drinking’s potential as an actual booster of health, the paper concludes.

A similar review published by Alberta scientists last year, though, reached more positive conclusions about the potential benefits of moderate imbibing. Dr. William Ghali of the University of Calgary said Monday he sees less ambiguity in the data than Prof. Rehm did, noting that one of his studies, published in the British Medical Journal, even estimated that moderate drinking was linked to a reduced risk of death from all causes — not just heart disease — of as much as 18%.

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A public-health campaign advocating a beer or glass of wine a day and no binges might actually have some merit, though there would also be the danger of inadvertently encouraging excessive drinking, Dr. Ghali said in an interview.

“Imagine a 20% reduction [in mortality] across the population,” said the head of the Calgary Institute for Population and Public Health. “That would be massive, in terms of number of lives.”

Prof. Rehm and his colleagues found 44 studies conducted between 1980 and 2010 that they considered of sufficiently high quality, dealing with between about 300 and more than 240,000 subjects each, and conducted what is called a “meta-analysis” to summarize the results.

It suggested an average of one to three drinks a day was tied to a reduction in risk of heart-related disease and death of as much as 60%. Yet results across the different studies varied widely, with some showing no statistically significant association at all, meaning that the “cardio-protective” effect at that level of drinking is likely “borderline,” the researchers said.

In men, the maximum heart-disease prevention impact seems to come with an average of 2-1/2 to five drinks per day, but those levels would also inflate the risk of other deadly conditions, the paper notes. Drinking an average of 3.5 drinks a day, for instance, can double or even triple the chances of developing mouth, pharynx, larynx or esophageal cancer, and make colon or rectal cancer 50% more likely, according to the Canadian Cancer Society.

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The CAMH study suggests that one to two drinks per day for men and one drink a day for women would provide most of the desired heart-disease benefit, without upping the danger of other illness.

Consuming that average in periodic binges, though, would definitely not work, said Prof. Rehm.

The chief way that alcohol seems to help shield against cardiac illness is by, essentially, thinning the blood and preventing deposits in the arteries that can lead to heart attacks, and by increasing levels of the so-called good cholesterol, HDL.

Binge drinking, though, does not combat dangerous blood clotting, and actually appears to raise levels of LDL, the “bad cholesterol,” Prof Rehm noted.

As for the widely propagated notion that red wine protects heart health, that is not quite a myth, but at best accounts for less than 20% of the potential benefits of drinking, said Prof. Rehm. His paper did not distinguish between types of alcohol.

It all means that there is insufficient evidence to recommend anyone take up drinking as a way to stave off heart disease, the study concluded.

National Post
tblackwell@nationalpost.com

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