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Alcohol: The good, the bad and the ugly

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By Ross Walker

There’s an age-old debate between the alcohol industry, a variety of health professionals, and members of society geared towards temperance, as to whether alcohol is good or bad for your health.

There really shouldn’t be a debate on the health detriments of consuming four or more standard drinks of alcohol per day.

One standard drink is considered to be 100mls of wine, one middy of beer, or one non-grandfathers nip of scotch. It’s also important to note that 10g of any form of alcohol is the equivalent of 70 calories. Therefore, alcohol consumption should be part of estimating your normal daily calorie intake.

Other important facts to consider are that 80% of drug related deaths in our society are due to cigarettes, 17% are due to alcohol, and the remaining 3% are due to illegal drugs because they are hard to obtain.

The health risks of excessive or binge drinking are well-known, but should be detailed:

1. Liver: People who are quite excessive alcohol consumers can have cirrhosis of the liver. But it can also cause alcoholic hepatitis, and even alcohol-induced diabetes. End-stage cirrhosis of the liver may also lead to oesophageal varices, which can be associated with severe gastrointestinal bleeding, and potentially liver failure, which can cause hepatic coma.

2. Brain: Chronic alcohol ingestion can markedly increase dementia risk. It can also lead to two distinct brain syndromes known as Wernicke’s encephalopathy and Korsakoff's psychosis. It may also lead to a peripheral neuropathy and a myopathy (muscle disorder).

3. Heart: Excessive alcohol can lead to ectopic heart beats. Especially when combined with hypertension, atrial fibrillation is very common. A recent study suggested that even one drink per day can increase the risk of atrial fibrillation by 5%. With each 10g of alcohol, the risk increases by 5%. The most serious consequence of excessive alcohol ingestion is a dilated cardiomyopathy. This is a relatively common cause of heart failure

4. Cancer risk: Even low-dose alcohol has been associated with an increased risk of breast cancer in women, along with oral an upper gastrointestinal cancers and liver cancer.

5. Pancreatitis has a relatively common association with excessive alcohol, and can lead to severe chronic abdominal pain, and a malabsorptive state.

6. Osteoporosis and/or falls.

7. Excessive alcohol is also commonly associated with accidents, trauma, violence and suicide.

After all of this, you must ask, are there any benefits?

Interestingly, it’s my view that low-dose alcohol does have some benefits, but only if it’s associated with proper dietary principles.

All of the studies from the Mediterranean show a 50% reduction in cardiovascular disease and cancer when less than three standard drinks per day are combined with a Mediterranean diet.

There have been other studies, such as the 00 heart study performed by Professor Leon Symons from Saint Vincent's Hospital and the male physicians’ trial from Boston. Both showed reasonable benefit from ingesting low-dose alcohol. The conclusion from most of these trials is that one to three standard drinks most days of the week, especially in the form of red wine, may reduce cardiovascular disease by somewhere between 20-30%.

First, let me make the point that, in my opinion, it’s irresponsible for any doctor to encourage a person to drink.

But, if someone does enjoy a drink, my advice is to peel back to the correct dose of preferably wine, as evidence favours red wine.

There are, however, five caveats:

1. The Walker suggested dose is 250 mls of red wine per day, with at least one or two alcohol-free days per week.

2. You do not get double the benefit for double the dose.

3. You cannot save that all up for Friday night.

4. I am not trying to convince non-drinkers to start drinking.

5. One in 20 people carry the gene for alcoholism and they should go nowhere near alcohol.

Published: Thursday, October 13, 2016


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