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Do you think when you drink?

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 have 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 percent. 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 fewer 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.

 

By Eric Bakker ND

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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.