The Truth about Alcohol and Heart HealthIs Drinking Actually Good for You?
-- By Becky Hand, Licensed and Registered Dietician
The idea that alcohol may be good for your heart has been around for a while. While moderate drinking may offer health benefits, drinking more can cause a host of health problems. So should you turn to alcohol to protect your heart? Here's what you need to know, from what alcohol can really do, to how much you should drink, to which types of drinks—if any—are healthier than others. Use this information in conjunction with your healthcare provider's advice.
Research on Alcohol and Heart Disease
In several studies of diverse populations, moderate alcohol consumption has been associated with a reduced risk for certain cardiovascular diseases, such as coronary heart disease. These studies were observational—not experimental—and therefore had some limitations. However, they showed the need for experimental studies regarding alcohol intake and heart disease. So in 1999, a meta-analysis was conducted on all experimental studies to date to assess the effects of moderate alcohol intake on various health measures (such as HDL "good" cholesterol levels and triglycerides), and other biological markers associated with risk of coronary heart disease. As research on this topic continued to expand, researchers conducted another systematic review of 63 studies that examined adults without known cardiovascular disease before and after alcohol use. This latest meta-analysis was published in a 2011 issue of the British Medical Journal (get a link to the full report in the Sources section below).
The analysis of these numerous studies suggests that moderate alcohol consumption (defined below) helps to protect against heart disease by:
- Raising HDL "good" cholesterol
- Increasing apolipoprotein A1, a protein that has a specific role in lipid (fat) metabolism and is a major component of HDL "good" cholesterol
- Decreasing fibrinogen, a soluble plasma glycoprotein that is a part of blood clot formation
- Lowering blood pressure
- Reducing plaque accumulation in the arteries
- Decreasing the clumping of platelets and the formation of blood clots
What's the Definition of "Moderate" Alcohol Consumption?
A moderate alcohol intake is defined as up to 1 drink per day for women and up to 2 drinks per day for men. One drink contains 0.6 fluid ounces of alcohol and is defined as:
- 12 fl. oz. of regular beer (5% alcohol)
- 4-5 fl. oz. of wine (12% alcohol)
- 1.5 fl. oz. of 80-proof distilled spirits (40% alcohol)
- 1 fl. oz. of 100-proof distilled spirits (50% alcohol)
While a few research studies suggest that wine maybe more beneficial than beer or sprits in the prevention of heart disease, most studies do not support an association between type of alcoholic beverage and the prevention of heart disease. At present time, drinking wine for its antioxidant content to prevent heart disease is an unproven strategy. It still remains unclear whether red wine offers any heart-protecting advantage over white wine or other types of alcoholic beverages.
Health Risks of Drinking Too Much
While moderate drinking may have some health benefits, heavy or binge drinking can have a toxic effect on your health and your heart.
Heavy drinking is the consumption of more than 3 drinks on any day or more than 7 drinks per week for women and more than 4 drinks on any day or more than 14 drinks per week for men. Heavy drinking in particular can damage the heart and lead to high blood pressure, alcoholic cardiomyopathy (enlarged and weakened heart), congestive heart failure, and stroke. Heavy drinking puts more fat into the circulation in your body, raising your triglyceride level. It's also associated with an increased risk of cirrhosis of the liver, cancer of the gastrointestinal tract and colon, breast cancer, violence, drowning, and injuries from falls and motor vehicle crashes.
Binge drinking is the consumption within 2 hours of 4 or more drinks for women and 5 or more drinks for men. Binge drinking is also associated with a wide range of other health and social problems, such as sexually transmitted disease, unintended pregnancy, and violent crimes.
Who Should NOT Drink
According to the 2010 Dietary Guidelines for Americans, the following people should not drink alcohol:
- Adults who cannot restrict their alcohol drinking to moderate levels, as listed above
- Anyone who is younger than the legal drinking age
- Women who are pregnant or may become pregnant
- Anyone taking a medication (prescription or over-the counter) that can interact with alcohol. Talk to your doctor or pharmacist about the medications you take and alcohol consumption
- Individuals with certain medical conditions such as liver disease, hypertriglyderidemia, and pancreatitis. Talk to your doctor regarding your health history and alcohol consumption
- Individuals who plan to drive, operate machinery or take part in other activities that require attention, skill, or coordination or in situations where impaired judgment could cause injury or death, such as swimming
Research indicates that a moderate alcohol intake has been associated with a decreased risk for certain cardiovascular diseases, particularly coronary heart disease. However, health professionals and dietary guidelines suggest that if you don't drink, don't start. There are other, healthier ways to reduce your risk of heart disease like not smoking, eating right, getting regular exercise and maintaining a healthy weight. To find out if a moderate alcohol intake is appropriate for you, talk to your doctor about your consumption of alcohol, medical history, and any medications you use.
American Heart Association. "Alcohol, Wine and Cardiovascular Disease," accessed March 2011. www.americanheart.org.
Brien SE, Ronksley PE, Turner BJ, Mukamal KJ, Ghali WA, "Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies," British Medical Journal 2011; 342:d636. doi: 10.1136/bmj.d636.
Rimm EB, Williams P, Fosher K, Criqui M, Stampfer MJ, "Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effect on lipids and haemostatic factor," British Medical Journal 1999; 319:1523-8.
United States Department of Agriculture Center for Nutrition and Policy Information. "2010 Dietary Guidelines for Americans," accessed March 2011. www.cnpp.usda.gov.