Eric Bakker - Do You Think When You Drink?

 Read more from Eric Bakker ND

Most guys are now familiar that mild to moderate consumption of red wine reduces the risk of heart disease. This article will explore the risks as well as the benefits of drinking wine and alcohol, a topic which I feel is important to raise with patients I see in the clinic, particularly those with ongoing health challenges.

You will have heard by now of the ironic discovery in the 70’s called the “French paradox”, which established that although many French people smoke cigarettes and eat a diet high in saturated fats such as butter; they are still half as likely to die from cardiovascular disease than people in many other countries. Years of research collectively involving more than 750,000 men and women has shown that drinking one to two glasses of red wine daily lowers the risk of heart disease, heart attack and cardiovascular related deaths by up to 30 to 40 per cent. Much research since then has revealed rather that sensible (mild to moderate) drinkers have a tendency towards having a healthy lifestyle in general, they get plenty of sleep, and they make the right dietary choices, smoke little if at all and exercise regularly. They also tend to have healthy, stress free social lives, take less risks with their health and have a “happy heart” in general, both emotional and physical. Scientists used to attribute French heart health solely to a liking for red wine, but it seems there is a lot more to the French paradox than just wine; it is more likely that their Mediterranean diet high in fresh fruits and vegetables, olive oil, herbs, garlic and fish, having a regular low key red wine intake as well as their laid back Mediterranean stress-free lifestyle appear to be the most important influences to heart health.

Male patients in particular tell me “but I thought that drinking wine was supposed to be good for your heart?”  I think for many guys in particular the French anomaly has become a valid and scientifically endorsed reason to drink on a daily basis, because “my doctor told me that red wine is good for me”. Naturally, most people want to hear that drinking a moderate amount of red wine each day appears to be beneficial for heart disease and may even extend their lifespan, but there is a lot more here than meets the eye. This to me is a bit like the strange notion that eating chocolate every day is somehow good for your body. Tell me honestly, how many people can actually have one glass of red wine and one or two squares of dark chocolate daily? I call it unnecessary self-imposed temptations based on false assumptions and clever marketing.

Alcohol is a dual edged sword and can be a poison as well as a medicine, the distinction between its Jekyll and Hyde nature lies in just one thing - the dose. Red wine may well have some health promoting effects, but in my opinion, alcohol should cautiously approached as a healthy daily addition to any person’s diet.  Alcohol the only beverage I know from personal experience that when you have just “a little too much” you end up waking up literally feeling like death warmed up, and how can that be any good for your health? Any beverage which when consumed has a fine line between feeling good one moment and will have you feeling like you are about to croak the day after, makes you wonder about any health promoting benefits. And I’ll bet that there will be plenty of readers out there who partake of wine and have had the most unpleasant experience of waking up with the headache from hell, or a tummy that makes you reach for a bowl early in the morning at just the thought of cooked eggs for breakfast. That is not to say that I don’t enjoy a nice Pinot on occasion – after all, you have to live and let your hair down at times. But to have one or more units of wine, beer or spirits on a daily basis would make me feel tired and washed out in only a matter of a few weeks. And that is not how I like to feel.

Each time a new patient comes into my clinic and starts to talk about their health problems, I am keen to find out if any dietary and lifestyle habits are potentially underpinning their problems, and alcohol is often a hotly debated topic. It is surprising how many people I have convinced to stop alcohol consumption during the week and to drink only at the weekends. Most are amazed at how quickly their digestive issues, fatigue patterns, skin irritations and many more health issues just seem to disappear in a short period of time. Their health awareness also begins to grow as they start to see their family and friends in a different light. Their self-esteem increases and more healthy choices are made in terms of the diet and lifestyle. As weight-loss occurs, their energy and wellbeing increases. I call this the “upward spiral” of health. Once you start to go up this ladder it becomes easier to resist temptation, some of the friends you used to hang around with (read drinking buddies) either go up the ladder with you and clean up or decide to bail out and drop off the ladder and feel more comfortable on the lower rungs with their other mates who they play golf with, shoot, or fish with, etc. It is fantastic to see some men in the clinic become real advocates for a healthy lifestyle in their own social and family circle, these are the guys who now start to inspire their sons, fathers, brothers, and male friends to make health changes themselves, to reduce their drinking, eat more healthily and exercise regularly. Sometimes unfortunately it may take a heart attack, a car crash or even a loss of driver’s license to become even aware that there is such as thing as this “health-ladder”. Are you aware?

It is also surprising at just how much the average guy drinks on a regular basis, and it is not until they are pulled up that they sit back and take stock of their patterns of alcohol consumption that reality sinks in – they have built a real desire for it. Are you one of those guys who looks at his watch and thinks to himself: “its 5.00 o’clock, let’s have a drink” on a regular basis? New Zealand, like any other country, as if you haven’t noticed has a real problem with alcohol. But I don’t think the alcohol is the real issue here, it is rather the person consuming it, being blissfully unaware of why they need to drink so frequently and heavily. Physical, emotional or psychological tress often underpins drinking, and many will tell you that alcohol makes them feel good or relaxes them. The truth is that alcohol stresses the body creating a vicious cycle of desire, dependency and even more stress, and it is not until you break this cycle for several months that you can really understand what I mean. I know, I used to be a heavy drinker myself in my twenties who was kidding himself like a lot of blokes out there do in their twenties, thirties and even in their sixties.

Red Wine and the Heart: The Real Facts

Although one glass of red wine a day may well be good for your heart, drinking more than this seems to promote plaque build-up in blood vessels, suggest the findings from a study of over 4000 older adults.     Dr. Mukamal, a biostatistician at the University of Washington in Seattle, used data from the Cardiovascular Health Study to further evaluate these associations. The new findings are reported in the Medical Journal Arteriosclerosis, Thrombosis and Vascular Biology. (December 2003)

All subjects were tested with ultrasound to look for atherosclerosis (a build up of plaque & calcium in the arteries) in blood vessels found in the neck. Among subjects without heart disease or related problems, those who drank one to six alcoholic beverages per week had the least amount of atherosclerosis, and the greatest amount of arterial damage was found in people who consumed 14 or more drinks per week. And those who smoke and drink heavily? You guessed it, major health problems. In people with established heart disease, consuming 7 to 13 drinks per week was linked with less atherosclerosis than not drinking at all. Once again, however, subjects who drank 14 or more beverages per week showed the most atherosclerosis. So what we are looking at is about one to maximum two small drinks of red wine per day. Interestingly, this study never has looked at those who have never or very rarely have consumed alcohol.

Is Red Wine Really That Fine?

Findings in the Journal of the American Association of Medicine as recently as 2001 should caution researchers and the public to reconsider the existing evidence and the popular notion that moderate drinking is good for general health. The latest research appears to point out that many “heart tick to red wine” studies have a methodological flaw: they generally compare drinkers with non-drinkers, but fail to distinguish between those who never drank alcohol and those who quit drinking for health reasons. For example, investigators questioned more than 22,000 men aged 40 to 69 in Japan on their drinking frequency in 1990, then tracked the men until 1997. By separating these two groups of non-drinkers, investigators found that ex-drinkers did have a higher risk of mortality than non-drinkers and that moderate drinkers did not actually have decreased mortality when compared with those who had never been drinkers. The JAMA finding shows that, if an inadequate comparison group (never drinkers combined with ex-drinkers) is used, the protective effect of moderate drinking is seriously exaggerated. Thus, moderate drinkers spuriously showed a reduced risk when compared with non-drinkers, which erroneously included both ex-drinkers and never drinkers.

Alcohol Interferes With Sleep

Many people believe that wine “helps” them to relax and sleep better, when in fact quite the opposite is true – it interferes with sleep. Alcohol does have a sedative effect, in fact as you know, a glass of wine or two will put you to sleep. But consider the following drawbacks; your peaceful sleep may last only three or four hours. Then that "relaxing drink" begins to disrupt your sleep patterns. Alcohol makes occasional or chronic insomnia worse in the long run. Because of alcohol's sedating effect, many people with insomnia drink alcohol thinking that it will promote sleep. However, alcohol consumed within an hour of bedtime appears to disrupt the second half of the sleep period. The person may sleep fine during the first half of sleep, but wake from the dream state and returning to sleep with difficulty, and end up tossing and turning. This sleep disruption often leads to daytime fatigue and sleepiness. Older people are at particular risk, because they achieve higher levels of alcohol in the blood and brain than do younger persons after consuming the same amount, and they need to take particular care if they take one or several pharmaceutical drugs and drink regularly even more so. Wine is often consumed in the late afternoon (e.g., at "happy hour" or with dinner) and many studies show that a moderate dose of alcohol consumed as much as 6 hours before bedtime can increase wakefulness during the second half of sleep.

Alcohol Can Potentially Cause Long-Term Gealth Problems Even at Moderate Levels

Here are just a few health effects associated with daily moderately heavy alcohol consumption.

• Researchers have found that drinking red wine even moderately may actually increase the risk of heart disease by increasing the concentration of the amino acid homocysteine. And this corresponds with a huge increase in cardiovascular risk compared with those who abstain. Alcohol affects the stomach’s ability to bind Vitamin B12 with the hormone called intrinsic factor. This important vitamin can then not be effectively transported to the small intestine for absorption. Many guys I talk with who drink regularly have Vitamin B12 problems, and this is revealed with a blood test. The lower the B12, the higher the risk for heart disease. You see, alcohol really is a dual edged sword and I’ve only just scraped the surface with vitamin and mineral deficiencies here.

• A study has shown that consuming just one drink per day may increase the risk of breast cancer in women. Alcohol reduces the liver’s ability to clear oestrogen, as well as increasing the body's oestrogen levels generally, which may promote breast cancer. Now tell me, how many ladies stop at one glass per day?

• Other potential risks with very regular wine consumption: pharmaceutical drug interactions (many), increased incidence of accidents, several liver diseases, high blood pressure and stroke, digestive problems, as well as impaired fertility in men and women.

• Your poor brain, remember after you turned 40, how you felt that morning after only a few reds?

• Alcohol in large and regular amounts affects your ability to handle stress, which in turn increases your desire for more alcohol. People who abuse alcohol have all kinds of health-related problems as well as a lot more accidents. An impaired stress response affects several body systems, including the ability of the immune system to fight infection and even of brain cells to learn and remember, according to the researchers. Studies show that alcohol causes the body to lose part of its ability to respond to additional stressors. Heavy drinkers may therefore become unable to activate their stress axis appropriately when they are faced with a challenge, and that can be damaging.

• Wine makes you fat, each gram contains 7 calories. (fat contains 9 calories per gram). Guys end up with the belly, and women may end up in the BBC. (the big bum club!)

Here are three real case histories which illustrate what I mean about red wine, the cases are all real but the names have been changed:

Jeff

Jeff is a 33yr old guy who works as a plumber and also moonlights part-time as a web design student. Jeff came into my clinic complaining of poor sleep and libido and chronic fatigue. When I queried his lifestyle it was obvious that wine was consumed most evenings, “I have three to four glasses of wine because it relaxes me and makes me feel good”, “I make my own wine but end up giving a lot away to my mates”. Jeff also has a less than healthy diet and goes to bed quite regularly around 12.00 pm - 1.00am. Jeff has had a few accidents the past few years, including a nasty fall from the roof of his house trying to fix spouting. He admitted to me that he started the work “after a few wines” one Saturday afternoon, and he is still visiting a chiropractor three years later.  His doctor did all the obligatory blood tests, blood pressure, etc, to establish the cause of his tiredness. And of course everything came back 100% fine. The doctor never enquired into his occupation, his diet or any aspects of his lifestyle.

What I always find interesting is that when a patient presents to a doctor of Western medicine with fatigue, their diet and lifestyle is rarely addressed, and this is exactly where the problem lies most of the time.  Jeff needed somebody to sit down with him and examine where his tiredness was coming from, and to explain the likely causes. I finally convinced Jeff to stop drinking altogether for 3 months, to get to bed by 9.30 – 10.00pm at the latest and to get up early to establish a good rhythm of high energy in the morning and low energy in the evening. I also mentioned to Jeff that he probably wouldn’t have had that fall if he tackled that spouting job sober. Jeff is now very happy, he has made major changes and realised that he had his lifestyle back to front. Jeff now functions much better as a father and husband and hardly ever drinks at all.

Graeme     

Graeme is a 57yr old lawyer who came in on recommendation of his wife. When Graeme gets home from the office during the week, he has a large glass of red wine, followed by a second glass before dinner with some crackers and cheese, and a further glass is served with the evening meal. Graeme frequently goes to wine tastings and enjoys a glass at the golf club after a game. During the weekends there often friends and family often come visiting and wine is never far away, after all, they had a cellar built when the house was made and wine is bought by the carton through the wine club. Graeme is about 20 kilograms overweight, does not exercise and has been under considerable stress after one of the senior partners from the law firm moved away some time ago. You can see where this is heading, Graeme’s cardiovascular blood tests revealed a high heart health risk due to elevated homocysteine levels. Graeme explained that his doctor was fine with his “moderate” red wine consumption because his cholesterol was fine, but I disapproved. I found out that Graeme’s doctor is a member of the same golf club and wine tasting group as Graeme. In addition, Graeme has a history of gout and high-blood pressure, and was keen to start working on a wellness plan because of his family’s history of heart-disease. He was rather surprised when I mentioned that regular and daily consumption of red wine wouldn’t be helping his health, and he promised to cut back considerably.

Peter

Pete is a pilot who still flies his small airplane at the age of 74. He has been flying for almost 50 years and wouldn’t trade it for the world. He takes exceptionally good care of his health including a regular 1 hour exercise program 7 days a week because he wants to be still flying at 90. Peter’s daughter is a physical education teacher who has taught him how to stay fit and flexible. I find it rare to see an elderly gentleman is such fine shape is truely amazing and inspiring, and Pete’s radiant smile is a testimony to his health. He enjoys one small glass of red wine each day with the evening meal for medicinal purposes of course, as he declares. His sleep is great and his libido is excellent beyond 70yrs of age. Peter’s diet is on par with the best I’ve seen and his blood pressure is 120/75, which is exceptional for his age. This is how red wine adds value to a person’s health, in small and regular amounts taken long term. Peter has been drinking red wine like this since the 1970’s.

Red Wine is the Only Alcoholic Beverage which Confers Some Limited Benefit, No Other Alcohol

Sorry chardonnay fans, but in terms of health benefits, white wines pale in comparison to reds. This is because white wines are traditionally made without grape skins, or the mashed mixture containing the skins is removed early in the fermentation process, which is where most of the protective compounds are found. When choosing a red wine, look for full-bodied wines which are rich in beneficial chemicals. A good quality Shiraz, cabernet sauvignon, merlot and even a blended Grenache all fit the bill. And remember, we are only talking about red wine here, not beer, spirits and all those “mixers” our younger people are into. Much of the benefit appears to be due to the polyphenols, an antioxidant, found in grape skins and red wine. Polyphenols are known to combat damaging free radicals in the body. It appears that polyphenols lower "bad" LDL cholesterol while raising "good" HDL cholesterol and decrease the production of a protein that plays a major role in the development of heart disease.

But before you go out and stock your pantry with red wine there are some precautions that need to be taken. While drinking about one glass of red wine each day may yield some benefit, drinking two or more glasses (of wine or any alcoholic beverage) may offset the benefit and increase your risk of many different types of health problems as previously, even cancers. So it is likely that the alcohol itself is irrelevant to the beneficial effects of wine consumption. In fact, alcohol actually is toxic and nearly all of the benefit attributed to drinking wine may be related to these polyphenolic bioflavanoid compounds.

And people with a history of alcohol abuse or any type of liver disease should not drink alcohol at all. Also, people with diabetes and hypertension should limit their intake of alcohol very much.

You also need to be aware that consuming large amounts of wine or grapes will increase insulin levels and eventually have a negative impact on your health – you may pile on the weight. If you really want the flavonoid benefits of the grape, why then not consume whole a small amount of grape skins (spit out the seeds) and pass up most of the meat of the ripe grape, which has no real major benefit but a lot of extra fructose (sugar). A small bunch of ripe grapes daily is a great addition to any diet, and so is red grape juice. Now we are talking, all the benefits of the polyphenols but without the damaging effects of alcohol. There is no doubt, alcohol does have the ability to extract a lot more goodness from the red grape skin than can be offered from grape juice, but the downside is the damaging effects of the ethanol (alcohol) to the gut, brain and health in general as already mentioned.  

One Small Glass a Day of Red is the Key

If you are going to drink, it does make sense to choose red wine over other alcoholic beverages, and use a wine saver to ensure the wine doesn’t oxidise and go rancid. You can even buy “wine saver” gadgets allowing you to pump out the air inside the bottle prior to sealing, making the remaining wine very durable. But wait for it, the liver suffers from alcohol!  Even marginal drinking has an effect of undermining the liver’s ability to clear toxins from the body. Remember Peter the pilot? In Peter’s case, there are no fatty foods consumed, no chocolate or dairy products, take aways, etc. The only food or beverage Peter consumes which could potentially affect his liver is the tiny amount of red wine he consumes each evening, so no problems here. Once a person consumes several glasses of alcohol daily and in addition takes paracetamol or other medications regularly, consumes a take-away once or twice a week, eats high fat foods like peanuts or regular chocolate bars, consumes sugary foods, etc, is when you start to load the liver’s capacity to detoxify. It’s all about the concept of “total load”.

Can We Test the Liver’s Function?

Standard LFT’s (liver function tests) studies done by your doctor are effective for detecting actual damage to your liver. These blood tests are of limited value however in detecting your liver’s actual detoxification potential, because they measure acute liver cell damage directly, rather than functional capability of your liver, i.e., the uptake, metabolism, storage, and excretion of toxic substances like alcohol, drugs, chemical sprays, solvents, etc. Why wait until damage is done? Besides the standard liver function test, there is a simple urine test available which can identify how your liver, the body’s main detoxifying organ, is handling a wide variety of chemicals, including wine.  Your naturopath can fill you in more.

All of the research I have studied appears to back up what we have always known, than light to moderate reed wine consumption is ok for your health. But that is exactly the point, light to moderate consumption. When it comes to alcohol, like anything else in your life, moderation is your key.

References

• JAMA September 2001 (286:1177-1178)

• Medical Journal Arteriosclerosis, Thrombosis and Vascular Biology. (December 2003)

• Landolt, H.-P., et al. Late-afternoon ethanol intake affects nocturnal sleep and the sleep EEG in middle-aged men. J Clin Psychopharmacol 16(6):428-436, 1996.

• Vitiello, M.V. Sleep, alcohol and alcohol abuse. Addict Biol (2):151-158, 1997.

• Aldrich, M.S. Effects of alcohol on sleep. In: Lisansky Gomberg, E.S., et al., eds. Alcohol Problems and Aging. NIAAA Research Monograph No. 33. NIH Pub. No. 98-4163. Bethesda, MD: NIAAA.

• Alcoholism: Clinical & Experimental Research 2000;24:110-122.

DISCLAIMER: GrownUps is not a Health Professional and we are not making a recommendation to you. GrownUps accepts no responsibility for decisions made as a result of using the information provided by the author.

Published 1st May 2009

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