Weighing alcohol's effects on the body. A few months ago I received a book called "The Two Martini Diet" (Authorhouse, 2008), in which Jerry Sorlucco documents his success at losing more than 100 pounds without forgoing his daily cocktails. He doesn't break new diet-book ground: Sorlucco follows well-established practices such as controlling portion sizes, eating plenty of fruits and vegetables, and managing his calorie intake and expenditure to accommodate those drinks.
I've kept the book on my desk because I'm intrigued by the interplay between healthful eating and alcohol consumption. Is it really possible, I've wondered, to incorporate alcoholic beverages into a healthful diet and lifestyle, or are those of us who hope it is possible just fooling ourselves?
New Year's Eve seems a perfect time to explore this topic: Tonight we may enjoy a midnight toast; come morning, we might resolve to cut back or quit drinking altogether.
Drinking is often considered a vice. But unlike smoking or using recreational drugs, behaviors for which it's hard to claim any health benefits, evidence is mounting that partaking of alcohol can promote not only health but also longevity.
I'm aware that my own affection for martinis may skew my opinion about the merits of including cocktails in one's diet. So I turned to some experts -- Walter Willett, chair of the department of nutrition and a professor of epidemiology and nutrition at the Harvard School of Public Health, and Donald Hensrud, a specialist in preventive and internal medicine at the Mayo Clinic and medical editor in chief of "The Mayo Clinic Diet" book, to be released Friday -- to help me put alcohol in its proper place. I hope you'll join me in reviewing their comments and deciding for yourself whether drinking belongs in your life.
First, though, let's agree on some basics: Pregnant women shouldn't drink, and people with family histories of alcoholism and certain cancers should think very carefully before lifting a glass and probably should abstain. If we choose to drink, we should avoid bingeing, which erases any potential health benefits. And never, ever should we get behind the wheel of a car after imbibing.
Beyond that, drinking has its pros and cons, depending on your own health and the health conditions you're most concerned about. Here's a breakdown of what we know about alcohol's effects on various aspects of our bodies and minds:
Heart disease
Willett says: "There's clear evidence that alcohol reduces heart-disease risk if consumed in moderation. It's substantial, a 30 to 40 percent reduction." And, he adds, "Contrary to what the French say, it is the alcohol" that confers the benefit, regardless of whether one drinks wine, beer or spirits.
Hensrud attributes half of the cardiovascular benefit associated with drinking to the fact that alcohol raises levels of HDL, or "good" cholesterol, in the bloodstream. Beyond that, he says, it thins blood and decreases platelet aggregation, which helps reduce clotting. Alcohol may help decrease inflammation, a key player in many diseases (including cancer and heart disease) and reduces risk of ischemic stroke, which occurs when a blood vessel that supplies blood to the brain is blocked by a clot.
Although alcohol is a depressant, some of its benefits may derive from its salubrious effect on our mood. In moderate amounts, Hensrud says, alcohol can help reduce stress, which is increasingly recognized as contributing to ill health.
Before you hook up your IV to a bottle of gin, Hensrud says that alcohol increases blood pressure and triglycerides in the blood, both of which can contribute to heart disease. Drinking can also cause cardiomyopathy (in which the heart doesn't beat properly), though Hensrud says that risk is outweighed by the heart-health benefits noted above.
In the end, "If someone's at very low risk of heart disease anyway," Willett says, "there's very little to be garnered by adding alcohol" to the diet.
"Even at a modest level, alcohol consumption increases breast cancer risk, and that risk increases in step-wise fashion the more alcohol is consumed," Willett says. The increased risk to women who drink two drinks per day is enough to offset the reduced mortality associated with mammography "and then some," he says. There's some evidence -- "not conclusive" -- that adequate folic acid intake may somewhat offset that risk.
Alcohol consumption slightly reduces the risk of Type 2 diabetes, Willett says. Hensrud notes that moderate drinking is also linked to reduced risk of Alzheimer's disease.
Excessive alcohol consumption raises uric acid levels, which may predispose a person to gout. It's linked to cancers of the oral cavity, liver, stomach, breast (though, as I reported in November, the increase for moderate drinkers is modest), and colon and (among smokers who also drink) head and neck cancers. Drinking is tied to increased incidence of pancreatitis, gastritis and cirrhosis of the liver. Among very heavy drinkers, alcohol can interfere with the body's ability to absorb certain nutrients.
Weight control
Alcohol is pure calories and offers no nutrition. Still, "studies show that women who consume alcohol weigh less. We're not sure exactly why," Willett says. Women and others who drink moderately may tend to be more educated and health-conscious than abstainers, he suggests. Or people who drink may consume less sugar, their taste for alcohol replacing their "drive for sweetness." Research also has shown that people who drink heavily tend to exercise more vigorously than non-drinkers.
Hensrud observes, "On average, people who consume moderate amounts of alcohol weigh the same or less than those who don't drink." It may be, he says, that the body burns alcohol's calories more easily than those from other carbohydrates. But alcohol use "does seem to increase fat deposition in the abdomen," giving you a beer belly.
Alcohol dependence
"I'm not trying to sound like a prude," Hensrud says, "but when people rely on alcohol for relaxation, it can become a crutch. There's a line some people cross and don't even know it."
"Nobody intends on becoming an alcoholic," he continues. While some people have a genetic predisposition to alcoholism, it's not a good idea for anybody to drink every day," he says. "It can become a habit and sneak up to bite you."
Longevity
"People who consume moderate amounts of alcohol have a lower risk of dying than people who don't drink at all," Hensrud says. That reduced risk probably is tied to lower incidence of heart disease among drinkers, he says.
But when people move beyond moderate consumption, alcohol's benefits start to be countered by increased risk of cancer, homicide, suicide and motor vehicle accidents, Hensrud says. In fact, he notes, research published in 2004 in the Journal of the American Medical Association attributed 85,000 U.S. deaths a year to alcohol consumption.
"At a moderate level, the overall benefits of alcohol consumption appear to outweigh the risks," Hensrud says. "But if the risks do happen, it's high stakes."
I'll drink to that. ( washingtonpost.com )
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