Is moderate drinking really healthy?

Is moderate drinking really healthy?

A moderate consumption of alcohol is considered in our culture as protection against cardiovascular diseases. But up to what amount a health-compatible alcohol consumption is enough, many Europeans do not agree. Scientists are trying to find answers.

Moderate alcohol consumption benefits the heart and circulation
Even if there are opposite opinions, in this country it is generally assumed that a moderate alcohol consumption can be a protection against cardiovascular diseases. This is similar in other parts of Europe as well. But when it comes to the question of how much harmless is there, the ghosts part. For example, Italian doctors set the bar for a health-friendly alcohol consumption at 40 grams per day, while the Cologne Federal Center for Health Education German women only want to concede twelve grams of alcohol per day. Thus, an Italian woman would have to drink more than three times as much as a German, without having to worry.

Grotesque European differences
German scientists are now in the „German Medical Weekly“ engaged in the topic of moderate alcohol and especially wine consumption. In the respective countries, the respective recommendations diverge to an almost grotesque extent. Thus, the health risk for a Portuguese man would start only at 40 grams of alcohol a day, in a German but already at 20 grams. In France, no difference is made between the sexes and so a daily consumption of 30 grams of alcohol is granted as safe for both women and men. In the US, on the other hand, men could consume 28 and women only 14 grams without any problems. Even more surprising are the differences that are being made in Spain. Thus, for the inhabitants of Madrid, 30 grams per day would be the maximum amount for a health-compatible consumption of alcohol, but for the Catalans 70 grams and without differentiating between the sexes.

Scientists with a conflict of interest
The three researchers Professor Nikolaus Worm (Saarbrücken), cardiologist Professor Gustav Belz (Wiesbaden) and nutritionist Claudia Stein-Hammer (Mainz) have now scoured current scientific sources to the proof of the favorable influence of alcohol and wine in particular on health to lead. All three scientists are involved in their work with the German Wine Academy DWA. Since this is a lobby organization of the German wine industry, they would have in the journal „German Medical Weekly“ the resulting conflict of interest also declared. Altogether they quoted 41 studies of the last 15 years on the subject in their work „Alcohol and heart“.

Dangerous effect of the alcohol with increased consumption
The latest and most comprehensive meta-analysis of 84 long-term observational studies from around the world came to the following conclusion in 2011: „Compared with abstinence, the risk of cardiovascular mortality from alcohol consumption was reduced by 25 percent on average. The dose that indicated the lowest risk ranged from 15 to 30 grams of alcohol (200 to 400 ml of wine) per day, with women being more likely to be in the lower range. With a consumption of up to 15 grams of alcohol per day, there was also a significantly reduced overall mortality (by 13 percent).“ From most studies, it should be noted that people who give up alcohol have a higher health risk than moderate consumers. But with significantly increased consumption, the alcohol has its dangerous effect on the brain, liver and heart as well as on the development of cancer.

Depends on the protective effect of the drink or the alcohol content?
In 2011, Italian epidemiologists asked whether the protective effect was based solely on the alcoholic strength of a beverage, or whether it was specific to the beverage in question. Worm and his colleagues report: „Out of 16 case-control and long-term observational studies, they linked wine, beer and spirits consumption data to cardiovascular health and total mortality.“ Among other things, it was stated: „The largest risk reduction was 31 percent with a mean intake of 21 grams of alcohol per day. A statistically significant risk reduction was found up to 72 grams per day. In terms of cardiovascular mortality, the maximum risk reduction of 34 percent was 24 grams per day.“ In the case of beer, a preventive effect against cardiovascular diseases was also found, but not for spirits.

Regularly small amounts better than drinking binge
Also in the 2012 results of the NHANES III national study (National Health and Nutrition Examination Survey III Mortality Study), the moderate daily alcohol consumption on mortality was identified as being particularly risk-reducing. And all this against factors such as non-smoking, physical activity and healthy nutrition. Drinking habits played a decisive role here: regular but moderate drinking was better than occasional drinking. According to concurrent studies, the explanation for the infarct-preventing effect of alcohol in the influence of blood lipids. People who consume small amounts of alcohol on a regular basis seem to have more high-density lipoproteins whose job is to move the cholesterol away from the walls of the arteries and thus counter so-called calcification. At the same time, the alcohol lowers the LDL content of cholesterol, the molecules that are considered to be a major risk of heart attack because they are deposited on the vessel wall.

Wine is more than alcohol
As Prof. Worm and his team emphasize, wine is more than just alcohol: „In addition to alcohol, wine contains other ingredients with specific biological effects - especially numerous polyphenols. Polyphenols protect the plant from harmful environmental influences, such as parasites or fungi. They also have a high pharmacological potential in humans. Many have an antioxidant effect and thus inhibit the oxidation of LDL cholesterol, reduce its deposition in the vessel wall and thus apparently slow down the process of atherogenesis.“ However, despite the positive results that have been compiled, the advisors of the German Wine Academy do not want to give unlimited advice on the consumption of alcohol or wine: „At levels greater than 20 grams of alcohol per day for women and 30 grams for men, no further risk reduction in the cardiovascular area is evident. As the alcohol-associated risks - liver and pancreatic diseases, certain tumor types and addictions - increase from this dose on, more than moderate consumption is strongly discouraged.“

Even little alcohol not healthy
Other studies, however, conclude that even low alcohol is not healthy. Just recently, a team of scientists led by Manuela Bergmann and Heiner Boeing from the German Institute for Nutrition Research in Potsdam-Rehbrücke had their analysis from the data of Europe-wide „Epic study“ announced. Although the results show that people who did not consume more than the daily recommended amount of alcohol at the age of 20 have a 9 to 14 percent lower risk of developing cardiovascular disease, this does not mean that the scientists, moderate alcohol consumption contributes to the protection of the heart. The fact that this was observed only in participants who did not have high blood pressure, diabetes, cancer, heart attack or stroke before starting the study is often not detailed enough.

Controlled prosperity drinker
The amount that Worm and colleagues allow for adults is 0.2 liters for women and 0.3 liters for men per day. The protective effect of alcohol really benefited only a few people, namely the so-called „controlled prosperity drinkers“, referring to the proverbial „Glasses in honor“ can restrict. The average German, however, consumes much more. For example, from the latest figures from the German Center for Addiction Issues (DHS), Germany has 107.2 liters of beer, 25.1 liters of wine and sparkling wine and 5.4 liters of spirits per inhabitant in the upper midfield of alcohol consumption and the traditional ones France, Italy, Switzerland or Greece by laps. In addition, about 9.5 million people in Germany consume alcohol in a health risky form and about 1.3 million people are considered to be dependent on alcohol, as can be seen from the Federal Government's Drug Report for 2013. In Germany alone, 74,000 people die each year from the direct and indirect consequences of their alcohol abuse. (Sb)