Best Medical Advice Is Still To Drink Moderately

Few questions in modern medical research have stirred as much interest - or confusion - as whether alcohol in moderate amounts may be good for your heart.

Don’t expect official advice any time soon.

Although public and private organizations have issued recommendations on such matters as aspirin use and fat intake, alcohol is a much more complicated question, one of the nation’s top alcohol experts said last month.

Even after scientists have published volumes on the subject, “I think recommending that everyone drink two drinks a day would be a mistake,” said Enoch Gordis, director of the National Institute of Alcohol Abuse and Alcoholism, which is part of the National Institutes of Health.

The issue is no small matter in the United States, where the per-capita consumption of alcohol among people older than 14 is equivalent to 306 cans of beer, 60 glasses of wine and 148 drinks of spirits each year.

Yet while some drinkers may be cleaning out their arteries, others are putting themselves in danger of cirrhosis, damage to the heart muscle and high blood pressure. More than 13 million people in the United States are considered alcoholics. And that’s the difficulty in issuing guidelines.

Gordis said that many of the studies have not been as conclusive as they might appear. For example, does an AVERAGE of one drink a day - which is commonly reported in study participants - actually mean abstaining during the week but downing seven drinks on Saturday night?

The health effects of alcohol caught wide public attention two years ago after publicity about the so-called French paradox. The French consume almost as much fat as Americans, yet their death rates from heart disease are strikingly low. Many scientists attribute the difference to France’s love of wine.

There is much scientific foundation for the claim.

Many studies have shown that alcohol can raise the level of HDL, the form of cholesterol that helps protect against heart disease. It is naturally laced with chemicals that can help keep the blood from forming clots that may lodge in blood vessels. Research has also reported that alcohol, especially red wine, contains substances called flavonoids that can scavenge the body for destructive molecules known as free radicals.

But alcohol to the heart may be like jalepenos to the taste buds: A little is good, but too much is painful.

“At a certain level of moderate drinking, good things happen” that worsen with either more or less alcohol, Gordis said.

He cited a long list of ailments linked to excessive drinking, including an irregular heartbeat, damage to the heart muscle, higher blood pressure and liver damage. And the problems go beyond medical. Alcohol use can lead to violent behavior and drunken driving.

Dr. Sidney Smith, the heart association’s incoming president, agreed that alcohol’s dual personality will probably keep organizations from making public policy recommendations. He acknowledged the evidence that mild drinking may be beneficial for the body. However, he said, cardiologists are also concerned that drinking exacerbates hypertension, a condition already affecting 50 million Americans.

“That’s probably a more important message,” Smith said.

In the end, Gordis said, people should drink - in moderation - only if they enjoy it.

“If you’re drinking only because you read somewhere that it’s good for your heart,” he said, “then you shouldn’t be drinking.”