HEALTH MATTERS: Just a drink a day

As a primary care physician, I often get asked at parties about the new scientific evidence surrounding the benefits of alcohol. As a social drinker myself, I usually have to present the facts to justify my medical licence and my next drink. I usually end the conversation by quoting the Greek philosopher, Democritus, “Throw moderation to the winds and the greatest pleasures bring the greatest pains.” With alcohol, that pain is usually liver cancer. Ample evidence exists that chronic alcohol consumption is a cause of liver cirrhosis, which predisposes to liver cancer.

The benefits of alcohol

The most significant study of the benefits of alcohol is from a paper published in the prestigious New England Journal of Medicine which links moderate alcohol consumption to a reduced risk of heart disease. The study, which examines the roles of drinking patterns and heart disease, found that after 12 years of follow-up, men who consumed alcohol between three and seven days a week had fewer heart attacks than men who drank once a week.

Alcohol causes a rise in HDL Cholesterol levels (HDL is the good cholesterol that keeps your brain and heart arteries from clogging up). The evidence shows that alcohol is as important as any other lifestyle factor in raising the HDL cholesterol levels.

Moderate drinking of alcohol also improves the sensitivity of the body to insulin which in turn lowers the risk of diabetes. Another study shows that moderate drinking of alcohol also reduces risks of dementia. There is no evidence yet to show what mechanisms are responsible for this. Some suggest that social drinking means drinkers get out more often and socialise and this process could contribute to preventing dementia.

For us doctors, a drink is usually a glass of wine, a 1.5oz shot of spirits or half a glass or a can of beer. All of these have roughly the same unit of pure alcohol in them. We usually define moderate drinking as one drink per day.

Those who should not be drinking

But pregnant women and adults under 21 have significantly greater risks from consuming any alcohol and should eliminate alcohol from their diets. Another significant risk of moderate drinking is in people living with Hepatitis C, as it may increase their risk of permanent liver damage. Anyone with hepatitis C should not be drinking at all and people with risk factors should get screened if they are having any drinks.

If you must drink and drive, drink water. Or a soda.

Most significantly, a lot of people think that moderate drinking does not impair consciousness and cloud the judgment. A study of simulated drivers, however, reveals that a low level of alcohol impairs the judgment significantly.

Nothing beats plain old caution and common sense

For these reasons, I still suggest that any moderate drinking should be done at home and should be with a meal to prevent high blood alcohol levels. It is important to note that the potential risks and benefits of alcohol vary according to a person’s health history, their age, sex and family history. There is not yet enough evidence to suggest that you go out and get a drink to prevent a heart attack. I suggest you have a lengthy discussion with your primary care doctor on this one.

Dr. Adedayo Osholowu is an International Olympic Committee (IOC) certified Sports Physician based in Lagos. He is also the Clinical Director of the Special Olympics International Healthy Athletes Program in Nigeria. He is a writer and a reviewer for the British Medical Journal.