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Alchohol a potent medicine?


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http://content.iospress.com/articles/journal-of-alzheimers-disease/jad161153

 

Alchohol in moderation again shown tp protect our brains and general well being. This association I have to wonder if it has something to do with sickly people not being able to tolerate alchohol, rather than a benefit per se. It seems 3 drinks a day being associated with health benefits is unlikely.

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Reduced mortality and moderate alcohol consumption: The phospholipase D-mTOR connection

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2957519/

 

The mechanism by which moderate alcohol consumption influences coronary heart disease

https://nutritionj.biomedcentral.com/articles/10.1186/s12937-015-0011-6

 

 

Effects of Wine, Alcohol and Polyphenols on Cardiovascular Disease Risk Factors: Evidences from
Human Studies

https://academic.oup.com/alcalc/article/48/3/270/244770/Effects-of-Wine-Alcohol-and-Polyphenols-on

 

Is a cardioprotective action of alcohol a myth?

https://www.researchgate.net/publication/230632657_Is_a_cardioprotective_action_of_alcohol_a_myth

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  • 7 months later...

As a lay person, I've felt pretty confused trying to navigate all of the studies claiming health risks and benefits of moderate drinking.

 

This is the study that convinced me that even moderate alcohol consumption increases your risk of cancer for pretty much every part of your body that the alcohol touches.

 

As a matter of public health policy, the author of this study says we should be focusing our efforts on convincing moderate drinkers to abstain completely rather than focusing on convincing heavy drinkers to drink more moderately. I think she is right about that. Although the risk of heavy drinking is much greater, it is also much more difficult to change behavior of people who have a drinking problem. It is much easier to convince moderate drinkers to think differently and reduce their risk of cancer, and if all moderate drinkers stopped drinking, the reduction in cancer would be significant. Better to spend our resources there.

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Good illustration from Dr. Greger, although since he's not known for being perfectly unbiased I do wonder.

 

2 drinks a day sound too much anyway and if the linear dose-response relationship really holds, I wonder if there is still an hormetic region enclosing the low quantities, like one tenth or one twentieth of a drink a day, for example.

 

This would also allow us to enjoy the best expensive wines, since the bottle would last weeks (providing we can resiste the temptation to indulge).

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Good illustration from Dr. Greger, although since he's not known for being perfectly unbiased I do wonder.

 

2 drinks a day sound too much anyway and if the linear dose-response relationship really holds, I wonder if there is still an hormetic region enclosing the low quantities, like one tenth or one twentieth of a drink a day, for example.

 

This would also allow us to enjoy the best expensive wines, since the bottle would last weeks (providing we can resiste the temptation to indulge).

 

Well, I do drink wine, and occasionally beer. Wine 4-5 times a week usually between 1 and 2 drinks for a total of between 4-10 drinks a week of wine (usually red). I also take regular breaks from drinking, like Dry January, around medical events like colonoscopy (right now, I won't drink for the next 3 weeks) etc. I started because of the supposed medical benefits. I do enjoy it, but I can drop it at any moment if the evidence becomes clear that it's not beneficial. Drinking tiny amounts (1/10, 1/20 of a drink a day) won't really do anything for your taste buds or possibly health as once you open the wine it oxidises fairly rapidly and changes taste and possibly molecular structure of its various non-alcoholic compounds, possibly obliterating any health benefits beyond whatever alcohol benefits there may be. You can of course try to gas flush the bottle and keep it around, but that's not really any monetary savings.

 

For now, I'll continue drinking as I have done for the past 15 years or so, it's a pleasant ritual with dinner. But I'm keeping my eyes peeled for more authoritative medical science findings - and will drop it without hesitation, should that be indicated. Btw., the cost does add up over time, so it's not meaningless in purely $ terms either.

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TomB, prompted by your remarks I did a quick search and yes, the sommeliers agree that after 3-4 days of the opening of the bottle the wine will be degraded and it may last 6-8 days max if in the fridge with those contraptions sucking air out. 

 

I must say my taste buds do not appreciate the oxydation of the compounds responsible for some taste nuances. I appreciate wine cold, and I appreciated it often after 1 month from opening. Now I have a 3-liters jug which I opened 3 months ago, and maybe it starts loosing some taste. Going to throw it away, too bad but that's it.

 

As far as the beneficial compounds are concerned, like various polyphenols, tannins, resveratrol, anthocianyns, an environment rich of such compounds usually is favourable to conservations, since they tend to counteract the damaging effects of oxydation.

Also, alcohol content is a factor. The wines I drink are usually 14% alcohol or more, rich in polyphenols, so maybe degradation is slowed up.

 

Bottom line, as far as the health POV is concerned (not a sommelier's POV), probably the beneficial effects last more than 4-8 days, although at this point I'm having some doubts about the possible degradation over times longer than a couple of weeks.

 

Pigments and tannins do remain in wine pretty undegraded. And they are good for health.

 

Consuming a 0.75 lt bottle  in one week would mean about 100 cl per day, 3/4 of a drink approximately.

 

Once in a while it's OK, that's a sound strategy, I don't mind though being enslaved to the idea of drinking regularly for a week. Exceptional wines like some of the brands we have may make the slavery feel good though. 

 

Another avenue to keep advantage of the phytonutrients is cooking. Yesterday I had my mushrooms with one glass of wine. Alcohol will evaporate, leaving the heat-resistant phytonutrients.

 

My next strategy: buying occasionally (/meaning, once a month or every other month) only the most polyphenols rich wines fermented in oak barrels, containing acumissimn-A beyond the large natural content of polypheols. Drinking them within 10 days. Making a scheduled stock of resveratrol and other compounds.

 

I'm going to open another thread about wines polyphenols content, or reopening the one I maybe opened time ago, I've lost track of the threads I opened.

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I just browsed something on the chemistry of phenolic compounds in wine. Complex! Some compounds have an oxydation propensity, some less. Polymeric tannins are not astringent, oligomeric are. Tannins are sometimes added to the wines. Many unknown aspects of the industrial production of wines.

 

The material is not in English so I won't link it for now.

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  Journal of the American College of Cardiology
Volume 70, Issue 8, August 2017 DOI: 10.1016/j.jacc.2017.06.054
 
Relationship of Alcohol Consumption to All-Cause, Cardiovascular, and Cancer-Related Mortality in U.S. Adults
 
Bo Xi, Sreenivas P. Veeranki, Min Zhao, Chuanwei Ma, Yinkun Yan and Jie Mi

http://www.onlinejacc.org/content/70/8/913?_ga=2.79371485.857119933.1522911

https://www.medscape.org/viewarticle/886475

 

F1.medium.gif

 

Abstract

Background Previous studies have revealed inconsistent findings regarding the association of light to moderate alcohol consumption with cardiovascular disease (CVD) and cancer mortality.

 

Objectives The aim of this study was to examine the association between alcohol consumption and risk of mortality from all causes, cancer, and CVD in U.S. adults.

 

Methods Data were obtained by linking 13 waves of the National Health Interview Surveys (1997 to 2009) to the National Death Index records through December 31, 2011. A total of 333,247 participants ≥18 years of age were included. Self-reported alcohol consumption patterns were categorized into 6 groups: lifetime abstainers; lifetime infrequent drinkers; former drinkers; and current light, moderate, or heavy drinkers. Secondary exposure included participants’ binge-drinking status. The main outcome was all-cause, cancer, or CVD mortality.

 

Results After a median follow-up of 8.2 years (2.7 million person-years), 34,754 participants died of all causes (including 8,947 CVD deaths and 8,427 cancer deaths). Compared with lifetime abstainers, those who were light or moderate alcohol consumers were at a reduced risk of mortality for all causes (light hazard ratio (HR) 0.79; 95% confidence interval [CI]: 0.76 to 0.82; moderate - HR: 0.78; 95% CI: 0.74 to 0.82) and CVD (light—HR: 0.74; 95% CI: 0.69 to 0.80; moderate - HR: 0.71; 95% CI: 0.64 to 0.78), respectively. In contrast, there was a significantly increased risk of mortality for all causes (HR: 1.11; 95% CI: 1.04 to 1.19) and cancer (HR: 1.27; 95% CI: 1.13 to 1.42) in adults with heavy alcohol consumption. Binge drinking ≥1 d/week was also associated with an increased risk of mortality for all causes (HR: 1.13; 95% CI: 1.04 to 1.23) and cancer (HR: 1.22; 95% CI: 1.05 to 1.41).

 

Conclusions Light and moderate alcohol intake might have a protective effect on all-cause and CVD-specific mortality in U.S. adults. Heavy or binge drinking was associated with increased risk of all-cause and cancer-specific mortality.

 

 

https://www.telegraph.co.uk/news/2017/08/14/glass-wine-beer-day-reduces-risk-early-death-says-new-study/

 

[...]For the new study, researchers examined the association between alcohol consumption and risk of mortality from all causes, cancer and cardiovascular disease in the United States.

 

They studied data from 333,247 participants obtained through the National Health Interview Surveys from 1997 to 2009. The study participants were surveyed regarding their drinking and patterns of use.

 

They were divided into six groups, based on their drinking patterns: lifetime abstainers, lifetime infrequent drinkers, former drinkers and current light (less than three drinks per week), moderate (more than three drinks per week to less than 14 drinks per week for men or less than seven drinks per week for women) or heavy drinkers - more than 14 drinks per week for men or seven per week for women.

 

Study lead author Doctor Bo Xi, associate professor at Shandong University School of Public Health in China, said: "Our research shows that light-to-moderate drinking might have some protective effects against cardiovascular disease, while heavy drinking can lead to death. "A delicate balance exists between the beneficial and detrimental effects of alcohol consumption, which should be stressed to consumers and patients."

 

[...] Researchers found that male heavy drinkers had a 25 per cent increased risk of mortality due to all-causes and a 67 per cent increase in mortality from cancer.The increases were not significantly noticed in women. There was no association found between heavy drinking and cardiovascular disease mortality.

 

Moderate drinking was associated with a 13 per cent and 25 per cent decreased risk of all-cause mortality, and 21 per cent and 34 per cent decreased risk of cardiovascular disease mortality, respectively, in both men and women.Similar findings were observed for light drinking in both genders.

 

Study co-author Doctor Sreenivas Veeranki, assistant professor in preventive medicine and community health at University of Texas Medical Branch, said: "We have taken rigorous statistical approaches to address issues reported in earlier studies such as abstainer bias, sick quitter phenomenon and limited confounding adjustment in our study. "

 

"A J-shaped relationship exists between alcohol consumption and mortality, and drinkers should drink with consciousness."

 

Doctor Giovanni de Gaetano, director of the Department of Epidemiology and Prevention at IRCCS Istituto Neurologico Mediterraneo Neuromed said the findings show younger adults should not expect considerable benefit from moderate drinking. But he added: "For most older persons, the overall benefits of light drinking, especially the reduced cardiovascular disease risk, clearly outweigh possible cancer risk."   [see: http://www.onlinejacc.org/content/70/8/923?_ga=2.141766779.857119933.1522911961-1635755854.1522911961&sso=1&sso_redirect_count=5&access_token=]

 

http://fortune.com/2017/08/15/moderate-drinking-health/

 

A 2016 meta-analysis of 87 long-term studies on alcohol and death rates found that many of these health benefits likely stemmed from baked-in design flaws in how the research was conducted. For example, many of the studies compared moderate drinkers to current abstainers, a group that included former heavy drinkers and those who avoided alcohol entirely because of health conditions, potentially skewing the comparison.

 

After correcting for these perceived biases, the study’s authors found no evidence that moderate drinking had protective health benefits.

 

But the debate is far from over.

 

On Monday a study was published in the Journal of American College of Cardiology that found light-to-moderate drinking did, in fact, lower the risk of dying from cardiovascular disease. (Moderate drinking was defined as less than 14 drinks per week for men, and seven for women.)

 

The study used data from more than 333,000 people, who were tracked between 1997 and 2009. Of these participants, around 34,000 died sometime during the course of this eight-year period. Light-to-moderate drinkers were about 25% less likely to die from cardiovascular disease than those who didn’t drink at all.

 

The researchers were careful to address issues present in previous studies on alcohol and health. For example, in the study, the non-drinker group only included lifetime nondrinkers, a strategy meant to exclude former heavy drinkers and those who gave up alcohol because they got sick.

 

“Our conclusions definitively show there is a J relationship” between drinking and heart health, says Dr. Sreenivas Veeranki, one of the study’s authors (i.e. as alcohol consumption goes up, at first the risk of dying from cardiovascular disease decreases slightly—the bottom of the J—before swooshing upwards once intake exceeds a certain level.) The curve illustrates “moderate drinking has a protective effect, while heavy drinking or binge drinking is harmful.”

 

Tim Stockwell, the director of the Centre for Addictions Research of BC who also happens to be the lead author of the 2016 meta-analysis, isn’t convinced. While he concedes this latest study solves for many of the design flaws present in previous research, problems still remain.  Most glaringly, in his view: lifetime nondrinkers, particularly in the U.S., are relatively rare. While the Journal of American College of Cardiology controls for a range of important factors—including smoking, BMI, physical activity, and smoking status—it’s close to impossible to control for everything. Abstainers could share other, unforeseen traits that impact their health, whereas “people who are moderate drinkers might be moderate in a lot of other ways,” leading to an overall healthier lifestyle.

 

The new study isn’t poorly designed, says Stockwell. But, as with most research that try to parse alcohol’s impact on health, it’s an observational study and can’t illustrate causation.

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I did a quick review of the other threads on alcohol, and methinks we may reach some conclusions here.

 

The material would tend to suggest that the overall balance of a moderate alcohol consumption is beneficial. Since the RRs of total mortality are lower within a certain dose range, we may infer that, although there is a little risk to cause cancer, this is offset by the greater benefit to the CV system.

 

By moderate according to the other thread and with reference to the Costanzo et al. 2006 metanalysis, posted by michael Rae, we may include a range from one third to one drinks of alcohol, with the optimum being around 7 g/d

 

One American drink = 14 grams of alcohol = 18 mL of alcohol, = about 130 mL of a 14% alcohol wine, less than a glass. So, since 7/14=0.5, the optimum for a strong 14% wine would constitute 65 mL/d.

 

Up to about 14 grams (one drink) hazard doesn't change much, so the 130 ml of  of a 14% alcohol wine reference would stand.

 

ira60012f2.png

 

 

I think that probably we'll have to start using beakers to check that we are into the optimal range:

 

mile-zero-beakers-933x1024.jpg

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Now, there is the critical issue: should I choose to drink wine according to the optimum outlined by the Costanzo et al., 2006 study, then one 750 mL standard bottle would last me 11.5 day, which is longer than the chemical stability of wine, even in a fridge and an aspirating pump to eliminate some of the oxygen.

 

Max stable duration of wines, according to what I read seems to be (fridge+pump) 8 days, so that would mean 94 mL /day, which is still about 85% RR of overall mortality, so it sounds good, although it requires some strategic thinking and a little more drinking than I'm accustomed to.

 

The above is the alcohol related issue.

 

The polyphenols issue is probably undebated, in that its content is beneficial without any detrimental drawbacks.

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This is one starter i foundn about TPs content in wines. It's a baisc, yet useful reference.

 

http://winefolly.com/tutorial/what-types-of-red-wines-are-good-for-you/

 

Sagrantino has also been pointed out to me as the Italian wine highest in TPs by a local oenologist. It scores an hefty 4000 mg/L in the displayed graph.

 

I tasted it a few times, it has a very robust taste, deep ruby, not everyone's first choice I believe. That's a good qualitative way to estimate the TPs content of a wine.

 

The wines locally produces here (Montepulciano d'Abruzzo) tend to reach about 2000 mg/L  TPs, not too shabby a value.

 

I now go mainly by the qualitative taste assessment. I may recalibrate my taste by buying a good Sagrantino bottle.

 

Other Italian wines rich in TPs are Aglianico, Montepulciano, Nebbiolo.

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One additional consideration: as MR was hinting at previously, the studies deal with alcohol, irrespective of its origin. Even if none probably drinks pure alcohol, there is a substantial difference whether that alcohol comes from vodka ro comes from a red wine hi in total polyphenols. This is another potential confounding factor which apparently has not been examined. For example, acutissimin-A, a phenolic compound found in red wine aged in oak barrels, is considered a potent anti-cancerogenic molecule, which theoretically migh counteract the putative carcinogenity of alcohol.

 

Bottom line, probably we can optimize our drinking strategy in such a way to minimize the risks of cancer and maximize the beneficial effects to CV system. In a way similar to the science of operations research.

 

I don't know whether to open another thread on optimization strategies, which may vary considerably.

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Good illustration from Dr. Greger, although since he's not known for being perfectly unbiased I do wonder.

 

2 drinks a day sound too much anyway and if the linear dose-response relationship really holds, I wonder if there is still an hormetic region enclosing the low quantities, like one tenth or one twentieth of a drink a day, for example.

 

This would also allow us to enjoy the best expensive wines, since the bottle would last weeks (providing we can resiste the temptation to indulge).

 

Well, I do drink wine, and occasionally beer. Wine 4-5 times a week usually between 1 and 2 drinks for a total of between 4-10 drinks a week of wine (usually red). I also take regular breaks from drinking, like Dry January, around medical events like colonoscopy (right now, I won't drink for the next 3 weeks) etc. I started because of the supposed medical benefits. I do enjoy it, but I can drop it at any moment if the evidence becomes clear that it's not beneficial. Drinking tiny amounts (1/10, 1/20 of a drink a day) won't really do anything for your taste buds or possibly health as once you open the wine it oxidises fairly rapidly and changes taste and possibly molecular structure of its various non-alcoholic compounds, possibly obliterating any health benefits beyond whatever alcohol benefits there may be. You can of course try to gas flush the bottle and keep it around, but that's not really any monetary savings.

 

For now, I'll continue drinking as I have done for the past 15 years or so, it's a pleasant ritual with dinner. But I'm keeping my eyes peeled for more authoritative medical science findings - and will drop it without hesitation, should that be indicated. Btw., the cost does add up over time, so it's not meaningless in purely $ terms either.

 

 

As a result of Tom's remarks, I started throwing wine away. Even if I used it to cook, after 2 weeks half a bottle of red local wine was left. I threw it away.

 

Now I opened a bottle of red wine aged in oak. Good taste. I'm going to keep it a few days then I'll throw what's left away. Maybe I should start drinking rum or whiskey, which keeps longer...

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I like the coravin contraption, ideal for a guy like me who loves good wines but drinks them in hormetic amounts. I'm going to enquire locally about the cost.

 

A good local wine here starts from 15 € (the Rosarubra organic which is a bargain) to 100 € (the Valentini range which is very renowned but I don't know about). I'm also attracted by the Montefalco Sagrantino which is reputed to be the most high in TPs. This variety costs 35 €:

 

plani-arche-montefalco-sagrantino-brown-

 

That way I may just get a kick out of the best brands (aged in oak barrels,now that I know about acutissimin A it has almost become a mandatory requirement ), buying one each month or trimester and not worry about half or more of the bottle being wasted, which would definitely discourage me from buying a US$ 50 bucks brand. More than that, is probably not worth it if consumed for the polyphenols content.

 

Heck, it might just become a new hobby. Who says that search for longevity must be dull?

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Thank you Al Pater for posting this

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5879951/pdf/fnagi-10-00081.pdf

 

It did not look at all positive for any alchohol or at least very little if you want to protect your brain health. Other research has indicated one drink for woman and as much as 2 drinks for men was protective against brain declines. This article refutes such and indicates almost any alchohol is a negative! Ahh round and round we go!

 

Of course it may be red wine is the exception. Im hoping that little 3.5 oz glass is a plus for the brain as generally that which is good for the heart tends to be good for the brain also.

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http://www.nejm.org/doi/full/10.1056/NEJMoa041152

 

The above is an older study but thats irrelevant. The study CONTROLLED FOR FORMER DRINKERS and it showed significantly LOWER rates of cognitive decline for up to 15 grams of alchohol a day for nurses. So thats woman who are not as effecient at metabolizing alchohol and who are generally smaller than men. It is also important that all the participants were nurses because that tends to eliminate the socio-economic bias seen in studies on alchohol especially wine. Nurses who drank 15-30 grams a day had no difference from non drinkers wrt cognitive declines.

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Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies

 

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30134-X/fulltext

 

For cardiovascular disease subtypes other than myocardial infarction, there were no clear risk thresholds below which lower alcohol consumption stopped being associated with lower disease risk. 

 

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Who benefits most from the cardioprotective properties of alcohol consumption--health freaks or couch potatoes?
Britton A, et al. J Epidemiol Community Health. 2008.
 
Authors
Author information 1 Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E6BT, UK. a.britton@ucl.ac.uk
Citation

J Epidemiol Community Health. 2008 Oct;62(10):905-8. doi: 10.1136/jech.2007.072173.

 

 

RESULTSA significant benefit of moderate drinking compared with abstinence or heavy drinking was found among those with poor health behaviours (little exercise, poor diet and smokers). No additional benefit from alcohol was found among those with the healthiest behaviour profile (> or =3 hours of vigorous exercise per week, daily fruit or vegetable consumption and non-smokers).

CONCLUSIONThe cardioprotective benefit from moderate drinking does not apply equally to all drinkers, and this variability should be emphasised in public health messages.

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The recent posts on the 5 habits that extend life expectancy show a benefit for alchohol up to 1 drink a day for woman and 2 drinks for men. 15-30 grams. This is consistent with the vast majority of data, And red wine shows an even more robust outcome in data provided by Michael Rae.

What is most reassuring about this particular data (below) is the socio-economic parity and the long term follow-up.

In this study drinking at the 15-30 gram levels is .99 HR VS 1.27 for non drinkers. Former drinkers were controlled for.

http://circ.ahajournals.org/content/circulationaha/early/2018/04/25/CIRCULATIONAHA.117.032047.full.pdf?download=true

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