Some medical remedies walk a fine line between lethal poison and healing potion. (1) Doctors know, for instance, that drugs like blood thinners have a narrow ?therapeutic window? where slightly altered doses can harm patients. Could alcohol fall into this category of friend and foe? Some studies suggest that moderate drinking may benefit cardiovascular health.

WHAT?S IN A DOSE?

Most agree on a definition of moderate drinking: an average of one or two drinks a day for men and one drink a day for women who are not pregnant. (One drink is 12 ounces of beer, 4 ounces of wine or 1 ounce of 100-proof liquor.) (2) But some studies suggest that it?s not the amount but the pattern of drinking that confers benefits.

Moderate drinkers tend to consume a little every day, rather than having weekend binges. Researchers are still teasing out the ingredients that underlie alcohol?s benefits. And doctors vary on whether moderate alcohol use should be recommended only for those at risk for heart disease or to a wider spectrum.

LIFESTYLES OF THE COCKTAIL SET

Not all researchers are convinced that alcohol should be part of healthy living. They point out that exercise, proper diet and cholesterol-controlling drugs have the same effect as alcohol without potential for abuse. Others say moderate drinkers may have lifestyle factors ? like a varied diet or money for regular checkups ? that make it hard to determine alcohol?s role in good health.

THE FACTS: ? A 12-year study of 38,077 men found that those who drank three or more times a week had a reduced risk of heart attack compared with men who drank less frequently. (6)

? Women who drink an average of half a drink a day have a 14 percent lower risk of developing high blood pressure than nondrinkers, but those who drink more than one and half drinks a day can raise their risk of hypertension by 20 percent. (11)

? A 2001 study found that moderate drinkers (those who had at least seven drinks a week) had a 32 percent lower risk of dying after a heart attack than those who did not drink. (3)

? Moderate drinking has been linked to a decreased risk of heart failures other than heart attacks in older people. (4)

? Light-to-moderate drinking may slow stiffening of the arteries with age, a phenomenon that can raise systolic blood pressure over time. (5)

? One to two alcoholic drinks per day can increase levels of ?good? cholesterol by 12 percent on average, an increase similar to that seen with exercise and certain medications. (7)

? The heart-healthy effects of moderate drinking may stem from regular consumption rather than infrequent binges, according to a 2003 study of moderate drinking among black men. (8)

? Seniors age 65 and older who drank more than 15 drinks a week were 41 percent less likely to have silent strokes than abstainers, but were at greater risk for brain shrinkage, a 2001 study concludes. (2)

? A British survey suggests that alcohol?s health benefits are wasted on the young: Among men younger than 35 and women younger than 55, light drinkers had a higher risk of death than abstainers. Alcohol-related injuries may explain the trend. (9)

? White or red? A study of 1,565 adults gives the edge to white wine when it comes to boosting lung capacity and function. (10)

? Moderate drinkers may be more likely than lifelong abstainers to seek preventive health care and engage in other healthy behaviors, according to a 2001 survey. (12)

? Harvard researchers found a slight reduction in Parkinson?s disease rates among moderate beer drinkers, but the effect was so slight that the researchers could not verify beer drinking as the protective factor. (13)

NO PRESCRIPTION FOR ALCOHOL?

Despite studies connecting moderate drinking to improved cardiovascular health, few physicians recommend a half-glass of wine with dinner as a prescription for better health. This silence could be a big mistake, says Curtis Ellison, M.D., of the Boston University School of Medicine.

?The current data are so strong that it is incumbent on each physician to inquire into the drinking habits of their patients, and if there are no contraindications, to make them aware of the research on the benefits of moderate drinking,? he says.

Ellison argues that there is enough evidence to include moderate drinking in the familiar litany of lifestyle recommendations: Don?t smoke, be active, maintain a healthy weight and eat a balanced diet.

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For Information Contact:
Kristina Campbell
Editor, Health Behavior News Service
Center for the Advancement of Health
2000 Florida Ave., NW, Suite 210
Washington, DC 20009
p. 202.387.2829 / f. 202.387-2857
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? Copyright 2003, Center for the Advancement of Health