The idea that alcohol might be good for our hearts and blood vessels is a popular one, right up there with the notion that chocolate is a health food.
But before you pour your next cocktail, beer or glass of wine, you should know this: the science suggesting a benefit has never been conclusive. And some experts believe the evidence is getting thinner all the time.
“In health as elsewhere, if something looks too good to be true, it should be treated with great caution,” says an editorial published this week in the medical journal BMJ. Mike Daube, professor of health policy at Curtin University in Australia, writes that the once-touted benefits of moderate drinking “are now evaporating.”
His editorial accompanies a British study that finds death rates among moderate drinkers and non-drinkers are not different enough to suggest any real health benefits for drinkers. The only possible exception: women over age 65.
Also, a recent Swedish study found that middle-aged people having more than two drinks a day – just above the moderate level for men — had a markedly increased stroke risk.
Studies will continue, and not everyone has given up the idea that moderate drinking — up to two drinks a day for men and one day for women — might have some cardiovascular benefits.
Here’s what U.S. experts say you need to know for now:
• Any benefits are unclear. “I cannot prove and I don’t think anyone can prove that alcohol consumption can prevent anyone from dying or prevent heart attacks,” says Kenneth Mukamal, an associate professor of medicine at Harvard Medical School, Boston. But he says some studies show moderate drinking can boost levels of “good” HDL cholesterol and a hormone key to blood sugar control. Some studies following moderate drinkers and non-drinkers for decades find lower death rates and fewer heart attacks and strokes in the drinkers, he says. But those studies do not prove alcohol is the reason for the differences. One theory, backed by the new British study: the results are skewed by the fact that some non-drinkers are former drinkers with health problems.
• The risks are real. For some people, even moderate drinking is clearly risky. Those include people taking blood-thinning medicines and those with uncontrolled high blood pressure, says Curtis Rimmerman, a cardiologist at Cleveland Clinic. Alcohol raises blood pressure and thins blood, he say. It’s also a source of “non-essential liquid calories,” a big concern in an overweight nation, he says. And heavy drinking is not good for anyone: It has long been linked with stroke, heart failure and many non-cardiovascular hazards, including car crashes.
• Gender matters. Women are advised to drink less than men, partly because they tend to be smaller. But that’s not the only reason, says Lori Mosca, a professor of medicine at Columbia University Medical Center and a spokesperson for the American Heart Association. “Our blood vessels have a different hormonal milieu,” she says and women are more vulnerable to the anti-clotting effects of alcohol – something that could raise the risk of bleeding strokes. Another consideration: even light drinking is associated with an increased risk of breast cancer, according the National Cancer Institute.
• Age matters too. There’s no evidence drinking in your 20s or 30s has any health benefits. “At those ages, any benefit we get from moderate drinking is only to the extent that someone who is moderately drinking is not heavily drinking,” Mukamal says.
• There’s probably nothing special about wine. “About a decade ago, there was this myth that red wine was better than white wine and wine was better than beer and spirits,” Mosca says. Studies have failed to prove any difference.
“I don’t want to be a killjoy,” Mosca says. “But I would never recommend alcohol as a preventative intervention.”
“There may be some evidence that perhaps one glass with a meal is OK,” says Demetrius Lopes, a neurological surgeon at Rush University Medical Center, Chicago, and another spokesperson the heart association. “But it’s a slippery slope to saying ‘OK, maybe two is better.’ I do think people don’t know the dangers.”
No health agency or major medical group recommends drinking for health. But, if you do drink, groups including the American Heart Association and U.S. Centers for Disease Control and Prevention recommend:
• No more than two drinks a day for men.
• No more than one drink a day for women (and none for pregnant women).
A drink is:
• 12 ounces of beer
• 5 ounces of wine
• 1.5 ounces of 80-proof spirits or 1 ounce of 100-proof spirits.
This reader-friendly piece successfully conveyed the main point of a new study: science linking alcohol consumption to heart health is inconclusive. Featuring plenty of independent sources and bolded bullet points addressing key caveats about alcohol-related research, the piece smartly counters the narrative that alcohol is unquestionably heart healthy. While the overall story is solid, a bit more detail about the new study’s design, findings, and limitations would have been helpful.
Many people are familiar with the notion that drinking moderate amounts of alcohol, particularly red wine, could be good for the heart. And so, many people clink glasses and drink to “one’s health.” But as an an editorial that accompanied the study reported on states, “Globally, more than three million deaths each year are attributable to alcohol.” The potential — but uncertain — benefits of alcohol consumption should be balanced against its known harms.
Cost was not an issue here. People generally know what a bottle of wine or other alcohol costs.
The article stated: “the science suggesting a benefit has never been conclusive,” which could explain why the story hesitated to put numbers down in this case.
But the story pointed out that women over the age 65 could be an exception, as this age group experienced some health benefits with moderate drinking. What were these health effects? And how much more benefit did this group see?
Also, with a Swedish study mentioned in the story, it’s said that middle-aged people who had more than two drinks a day “had a markedly increased stroke risk.” What does that mean? And by how much?
Some numbers could have clarified sweeping statements such as these.
The story notes a variety of potential harms associated with moderate drinking: excess calorie intake, increased blood pressure (among those with hypertension), and increased breast cancer risk in women.
The article also pointed out that heavy drinking is not good for anyone: “It has long been linked with stroke, heart failure and many non-cardiovascular hazards, including car crashes.”
This rating was a close call. On the one hand, there was no discussion of how the studies that are the focus of the article were conducted, and there wasn’t any mention of their specific limitations. For example, the investigators acknowledged that the study’s self-reported data may be inaccurate because it depends on participants’ memories, which are proven to be hazy. According to data from the US National Alcohol Survey, 52.9 percent of participants who claimed they never drank in 1992 had reported drinking in a previous survey.
But on the other hand, the story did include expert comments that speak to the main limitation of most research on the health benefits of alcohol consumption — namely, that they are observational studies that can’t prove cause and effect. As the quoted expert puts it, “I cannot prove and I don’t think anyone can prove that alcohol consumption can prevent anyone from dying or prevent heart attacks.” He adds: “Some studies following moderate drinkers and non-drinkers for decades find lower death rates and fewer heart attacks and strokes in the drinkers. But those studies do not prove alcohol is the reason for the differences.” The story further notes that results of previous studies could be skewed by the fact that some non-drinkers are former drinkers with health problems.
The article did not engage in disease mongering.
The article interviewed four solid sources at reputable academic centers – an associate professor at Harvard Medical School, a cardiologist at Cleveland Clinic, a professor of medicine at Columbia University Medical Center, and a neurological surgeon at Rush University Medical Center.
The reporter interviewed two physicians who were knowledgeable about heart health – the cardiologist and the spokesperson for the American Heart Association (AHA). It was a missed opportunity to briefly explain some adjustments one can make to diet and lifestyle to fight heart disease as an alternative to a glass of red wine a day. For example, the AHA recommends 30 minutes of moderate exercise every day and a diet rich in fruits and vegetables to help control weight, blood pressure and cholesterol. An additional sentence along those lines would’ve satisfied this criterion and, we think, improved the message for readers.
The availability of alcohol is not in question.
The report briefly went into how a couple of recent studies may be challenging the claim that alcohol is good for your heart. But it didn’t give much background on why these studies differ from dozens of previous studies that have reported potential benefits of moderate alcohol consumption. Researchers argue that participants were poorly selected or grouped in the past. A bit more discussion on this issue in the story would have been welcome.
The USA Today report was not based on this press release about the study.