Can moderate consumption lengthen life, or does drinking alcohol mean you won’t live as long?
We all know that drinking too much alcohol can be bad for our health. But what is “too much,” and is it only liver disease we have to watch out for? A major study done for the National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides some answers.
The study suggests that light to moderate drinking may have benefits, although heavy drinking definitely leads to poor outcomes. Data was examined from 333,247 U.S. adults who self-reported how much they drank over the 12-year period starting in 1997 and ending in 2009.
They were grouped into one of six categories:
- Lifetime abstainers
- Lifetime infrequent drinkers
- Former drinkers
- Current light drinkers (fewer than three drinks per week)
- Moderate drinkers (between three and 14 drinks per week for men, and seven or fewer drinks per week for women)
- Heavy drinkers (more than 14 drinks per week for men, and more than seven drinks per week for women)
Over the study period, 34,754 participants died. Of these, 8,427 were the result of cancer., 6,944 were due to heart disease, and another 2,003 were attributed to cerebral events. Men who were heavy drinkers had a 25% increased risk of death overall. However, women who qualified as heavy drinkers didn’t exhibit a higher mortality risk, although the reason for this disparity was unknown.
The study reinforced what other research had found: Drinking too much alcohol at once or over a long period of time can result in heart problems, liver disease and even cancer. Alcohol-related deaths total about 88,000 annually in the U.S., making alcohol the third leading preventable cause of death.
Binge Drinking Up in Older Adults
A 2019 study found that approximately one older American in 10 binge drinks. Those 65 and older are putting down five or more drinks at a time for men and four for women at home, in bars, in restaurants and in senior living centers.
"When we think about binge drinking, the image we usually think about is younger adults or college students, but this is in fact a growing trend in older Americans," said Dr. Tara Narula on "CBS This Morning" on July 31, 2019. "It's been under-reported in both the scientific literature and in the media, but the problem is that the alcohol has a very strong effect on people who are older. They're more vulnerable to the health problems than even a younger population.
"Currently, around 10.6% of older Americans are binge drinkers. In the previous decade, it was anywhere from 7% to 9%. So, that number is growing. Also growing: just a general increase in alcohol use and any sort of harmful alcohol use.”
Dr. Narula notes that binge drinking can be more dangerous for older adults than their younger counterparts. Older adults are more sensitive to alcohol and can get impaired more easily. They may also have chronic conditions such as diabetes, hypertension or cardiovascular disease that could be aggravated by drinking heavily at one time. It can also spur new problems, such as gastritis or certain cancers.
"Really no American who is older should be drinking more than three drinks a day,” says Dr. Narula. “If you have some sort of chronic disease or are on prescription meds, you should speak to your doctor, and they may recommend something even lower. Low-risk drinking is less than two drinks a day for a man, or one drink a day for a woman.
"It's really important that doctors screen for this and also educate about it. A lot of these people may be at home drinking alone. Nobody really knows what's going on. The problems may be attributed to, 'Oh, they're getting older, that's why they're confused and falling.' It can be a little silent unless we actually look for it.”
On the flip side, moderate drinkers (both men and women) were found to have a decreased risk of mortality. They were 13% to 25% less likely to die from all causes, and 21% to 34% less likely to die from cardiovascular disease. Men and women who were light drinkers also exhibited a decreased risk of dying.
“Our research shows that light to moderate drinking might have some protective effects against cardiovascular disease, while heavy drinking can lead to death,” says lead author Dr. Bo Xi from the Shandong University School of Public Health in China. “A delicate balance exists between the beneficial and detrimental effects of alcohol consumption."
Researchers found a J-shaped relationship between alcohol consumption and mortality. That is, complete abstainers were more likely to die from certain causes than light or moderate drinkers, but much less likely to die than heavy alcohol users. This is even after statistical approaches addressed common faults found in previous studies, such as lumping those who no longer drink due to poor health with those who simply choose to abstain.
“We have taken rigorous statistical approaches to address issues reported in earlier studies,” says co-author Dr. Sreenivas Veeranki from the University of Texas Medical Branch in Galveston.
Heart Problems Reduced
A 2015 study found that drinking up to seven alcoholic drinks (4.4 ounces of wine, about 11 oz. of beer or just under a shot of liquor) a week could protect against heart failure. Researchers from Brigham and Women’s Hospital in Boston, Massachusetts, analyzed 15,000 participants. Men who had up to seven drinks weekly reduced their risk of heart failure by 20%, while women who drank up to the same amount had a 16% lower risk of heart failure.
In fact, the Harvard School of Public Health confirms that over 100 prospective studies link moderate alcohol use with protection against stroke, heart attack, heart disease, sudden cardiovascular death and other cardiovascular conditions. How is this possible?
Wine, and possibly other alcoholic beverages, may increase levels of high-density lipoprotein (HDL), the “good” cholesterol.
"The grape skin provides flavonoids and other antioxidant substances that protect the heart and vessels from the damaging effects of free oxygen radicals produced by our body,” explains Prakash Deedwania, chief of the cardiology division at the University of California-San Francisco School of Medicine. "The strongest evidence is in favor of wine, but some evidence recently showed beer and other types of alcohol may provide the same benefits related to increasing good cholesterol.”
The Harvard School of Public Health posits that the formation of small blood clots that can block arteries in the heart, neck and brain may be prevented by moderate alcohol consumption.
Diabetes Risk Lowered
While heavy drinking is linked to an increased risk of diabetes, it’s possible moderate alcohol intake could lower the chances of getting the condition. A 2005 study found moderate drinkers were 30% less likely to be diagnosed with Type 2 diabetes compared to both nondrinkers and heavy drinkers. A 2010 study from the Netherlands confirmed the finding.
It’s possible that moderate drinking increases insulin sensitivity, since it encourages levels of adiponectin, a protein that helps regulate glucose levels.
A June 2014 study published in The Journal of Nutrition found a link between moderate alcohol consumption and improved memory and thinking skills. Women who were 70 and above made the most gains. Another study that year found older people who were moderate drinkers displayed a higher episodic memory (the ability to recall events) than their peers, and had a larger hippocampus, a region of the brain involved with memory.
"For most older persons, the overall benefits of light drinking, especially the reduced cardiovascular disease risk, clearly outweigh possible cancer risk,” according to Giovanni de Gaetano, director of the Department of Epidemiology and Prevention at IRCCS Istituto Neurologico Mediterraneo Neuromed in Italy.
But before you pop the cork on that bottle of Cabernet, make sure you’re not at risk for alcohol addiction or an alcohol use disorder, such as binge drinking. You’ll lose any benefits that light to moderate consumption might bestow.
Another research team found that health benefits related to alcohol consumption may even be “overestimated.” Among 18,000 participants, mortality benefits were limited to men aged 50 to 64 and women 65 and over who were moderate or light drinkers.
Researchers hypothesized that other studies made inappropriate selections in their participants. “The effect of such biases should therefore be borne in mind when evaluating findings from alcohol health studies, particularly when seeking to extrapolate results to the population level,” they warned.
Click below for the other articles in the October 2019 Senior Spirit
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