How true is the claim that alcohol in moderation is good for the heart?

Causing heart attacks & strokes is one of the most common ways in which alcohol kills people; and yet the belief which gives reassurance to many alcohol drinkers is that ‘alcohol in moderation is good for the heart’. This shows how successful the alcohol industry has been in shaping public opinion. 

Faulty methodology of studies which make this claim:

If one wants to study the impact of light alcohol consumption, one must compare those who drink in small quantity with those who have never taken alcohol (abstainers). However, in most studies which claim beneficial effect of light alcohol use, past alcohol users (who would have usually quit alcohol because of it having royally screwed up their health) were included in control group rather than taking only life-time abstainers. Many systemic reviews have shown that when you remove such bad quality studies and analyse only the good quality studies, this claim doesn’t hold true. Eg. In a recent meta-analysis of 87 previous studies on this issue, which analysed the data of  39,98,626 people, after controlling for various quality-related study characteristics -  no significant reduction in mortality risk was observed for low-volume drinkers (RR = 0.97, 95% CI [0.88, 1.07]).¹

Any guesses - how come so many studies chose a faulty methodology? How come none of the investigators realised that people with bodies severely damaged due to alcohol were on the control side? Either they had low IQ or they had decided before the study what conclusion they wanted to reach. I leave the judgement to you.

Influence of alcohol Industry in shaping public opinion:

It might interest you to know that ‘International Centre on Alcohol Policy’ is funded by the major alcohol producers of the world. A lot of ‘gyan’ on alcohol which you or your doctor get to read could have been funded by them. Two major ideas ICAP tries to propagate are:

a) Drinking alcohol is not problematic, only certain drinking patterns are problematic

b) Alcohol industry (which pursues aggressive marketing to get youngsters hooked on to it) is not at fault, but the people who drink irresponsibly are at fault.²

Even if we assume the claim of benefit to heart to be true, its important to keep following things in mind:

What is exactly meant by moderate consumption:

The industry uses word moderation as its very vague and most users assume that what they drink falls within moderate range. So its good to know that what is being referred to as moderate consumption is upto two drinks (2 small pegs) a day for men and upto one drink a day for women.

The claim is not applicable to atleast Indians:

In a multi-centric Indian study having a large sample size (11898 men), it was seen that the risk for Coronary Heart Disease (CHD) increased with even occasional alcohol intake, in Indian population atleast.³

People don’t get addicted by choice

Continuing to drink in control is not entirely a matter of choice: A significant proportion of drinkers end up drinking excessively, though they intended to drink in control. This brings in a lot of negative consequences for the person and his family. Hence, American Heart Association writes on its website, ““Drinking more alcohol increases such dangers as alcoholism, high blood pressure, obesity, stroke, breast cancer, suicide and accidents. Also, it's not possible to predict in which people alcoholism will become a problem. Given these and other risks, the American Heart Association cautions people NOT to start drinking ... if they do not already drink alcohol”⁴

Many who start with wish to drink in moderation end up becoming addicts:

3 of my patients of alcohol addiction had not taken their 1^st drink because some friend had forced them, but because some great doctor had advised them to start drinking alcohol in control to improve their health.

 

There are many better ways to improve your health than to drink an addictive poison:

If you really are bothered about your health - regular exercise, healthy diet, etc. is the way ahead. 

Even light alcohol consumption leads to many cancers:

There is now evidence that certain cancers are caused by even light alcohol consumption:   In a meta-analysis of 222 studies it was estimated that in 2004 worldwide, 34,000 cancer deaths were attributable to light drinking.⁵

So next time when your friend reassures you that its safe to drink in moderation, or when you are thinking of teaching your teenager son ‘responsible drinking’, or when you are thinking of giving your dear ones a treat of an alcohol party – do keep in mind this evidence and the fact that this beloved party drink kills around 30 lakh people every year, 1 person every 10 seconds.  

Dr. Dharav Shah

(Consultant Psychiatrist, Mumbai. dharavshah@gmail.com)

I have given more than 400 awareness talk on this issue. 

Our presentation can be seen on YouTube – Poisons We Love. Also do check out our facebook page www.fb.com/truthofalcoholandtobacco for cool posters which you can share with your dear ones on whatsapp & facebook.

References:

1.      Tim Stockwell, Jinhui Zhao, Sapna Panwar, Audra Roemer, Timothy Naimi and Tanya Chikritzhs. Do “Moderate” Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality.  J Stud Alcohol Drugs. 2016; Mar; 77(2): 185–198. doi:  10.15288/jsad.2016.77.185

2.      David H. Jernigan. Global Alcohol Producers, Science, and Policy: The Case of the International Center for Alcohol Policies. Am J Public Health. 2012 January; 102(1): 80–89. doi:  10.2105/AJPH.2011.300269

3.      Roy A, Prabhakaran D, Jeemon P, Thankappan KR, Mohan V, Ramakrishnan L, et al. Impact of alcohol on coronary heart disease in Indian men. Atherosclerosis 2010; 210:531-5.

4.      Alcohol & Heart Health. American Heart Association [Website on internet], Dallas. [cited on 2016 December] Available from http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/Alcohol-and-Heart-Health_UCM_305173_Article.jsp#  

5.      Bagnardi V, Rota M, Botteri E, Tramacere I, Islami F, Fedirko V, et al. Light alcohol drinking and cancer: a meta-analysis. Ann Oncol. 2013; 24:301-308.