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Protect Yourself: Alcohol Risk Factors

Among dietary items, alcohol is a risk factor of unparalleled proportions. The complication: Some health experts say light or even moderate alcohol use may be good for you. Other statistics argue against this theory, though:

  • A light drinker (who quaffs one pint of beer a day) faces a one in 50,000 chance of getting usually fatal cirrhosis of the liver in any single year. Over a drinking lifetime of 50 years, the odds narrow to one in 1,000.
  • Heavy drinkers obviously face starker odds. Their odds of dying from the habit are one in 100.

And both of these projections only calculate disease. They don't count the even greater risk of accidents -- in a car or on foot.

Despite the statistics, other researchers still claim moderate drinking can lower death rates from other diseases -- particularly coronary artery disease. The National Institute for Alcoholism and Alcohol Abuse (NIAAA) took a long look at this theory.

The NIAAA studied the alcohol and the heart "trade-offs" in a paper that asked the obvious question: "Will the cardioprotective effects of drinking outweigh the risks associated with alcohol use?"

The study described the mechanisms by which alcohol is thought to protect against cardiac illness, explored the potential risks and benefits of alcohol use and recommended a method by which people could determine the benefits and risks of alcohol use.

The study found that several plausible mechanisms support the possibility that drinking some alcohol protects against coronary artery disease. Of these, the best documented is protection by raising the high-density lipoprotein (HDL) or so-called "good" cholesterol, and decreasing the low-density lipoprotein (LDL) or "bad" cholesterol that we mentioned earlier.

LDL may be involved in at least two later steps of heart disease:

1) the gathering of cellular debris in fibrous plaque; and

2) defects in the integrity of the layer of cells lining the inside of blood vessels of the heart.

The human body produces antioxidants to protect itself from the effects of toxic molecules such as LDL. But it may need some help from compounds such as flavonoids, a group of compounds found in plants, that are able to prevent LDL from developing or "oxidating."

The potent antioxidant activity of phenolic substances in red wine has been offered as an explanation of the French Paradox (the apparent incompatibility of a high-fat diet with a low incidence of coronary heart disease among French people).

The rest of alcohol's healthy impacts have to do with its anticlotting effects: Alcohol increases the body's release of plasminogen activator, an enzyme involved in clot degradation. An anti-clotting effect would explain the apparent protective effect provided by relatively small amounts of alcoholic beverages.

For some people, moderate alcohol consumption appears to decrease risk of ischemic stroke, caused by blockage of blood flow in blood vessels. However, due to the anti-clotting effects of alcohol and the effect of alcohol on blood pressure, moderate drinking also increases the risk of hemorrhagic stroke -- caused by the loss of blood through the walls of a blood vessel.

Age is an important factor in weighing the risk versus benefit of moderate alcohol consumption. Coronary heart disease impacts primarily on men age 45 and older and women age 55 and older. Thus, the older you are the more you drink each day, the more likely you are to move from the healthy effects to the dangerous ones.

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