Alcohol: No Heart Benefit After All?

Study Questions Reduced Death Risk in Moderate Drinkers

Medically Reviewed by Louise Chang, MD on March 30, 2006
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March 30, 2006 - Drink to your health -- not for it. Moderate drinking does not protect against death from heart disease, a new study suggests.

You've seen the headlines. For 30 years, a steady stream of studies has found that moderate drinkers (one or two drinks per day) live longer than abstainers or heavy drinkers (more than two drinks per day).

But nearly all those studies have a fatal flaw. They count as "abstainers" people who have stopped drinking because of ill health, says sociologist Kaye Middleton Fillmore, PhD, emerita professor at the University of California, San Francisco, School of Nursing.

"Once you get to late middle age or become elderly, more and more people drink lightly or abstain altogether," Fillmore tells WebMD. "The decrease in alcohol consumption in these age groups is associated with illness and frailty and use of medications that might interact with alcohol. By not removing these people from the abstainer group, abstainers appeared to be less healthy because of absence of alcohol. In truth, they were ill -- and showing all signs of death, premature or not."

Wine Glass Half Empty

Fillmore led an international research team that took a new look at the old studies of alcohol use and death from heart disease.

Studies that separated out long-term abstainers from previous drinkers found no reduction in death risk for moderate drinkers. And when the researchers reanalyzed other studies -- by including only long-term nondrinkers in the abstainer category -- the benefit of moderate drinking went away.

This doesn't prove that moderate drinking isn't good for you, Fillmore says. But it strongly suggests that the benefits of moderate drinking have been exaggerated.

"It has got to the point where some doctors recommend that people have a drink every day," Fillmore says. "But you run risks with drinking, particularly if you are elderly. People who choose to drink one or two drinks a day should take these risks into consideration."

There really isn't enough evidence for doctors to recommend alcohol, says Christie Ballantyne, MD, director of the Center for Cardiovascular Prevention at Houston's Baylor College of Medicine. Ballantyne was not involved in the Fillmore study.

"I do not recommend people drinking alcohol to reduce their risk of heart disease," Ballantyne tells WebMD. "We don't know for sure that a little alcohol is good. There are lots of risks with alcohol, and the benefits are not really clear."

Even if there is a benefit to moderate drinking, Ballantyne says it would be hard for a person to know the right dose. As with other powerful drugs, just a little bit too much alcohol might be harmful instead of helpful.

"Yes, a little bit of alcohol may be beneficial, but we also know that too much is dangerous," he says. "You can get liver disease, bad blood pressure, high levels of blood fats -- and that doesn't count car accidents and other drinking problems."

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SOURCES: Fillmore, K.M. Addiction Research and Theory, May 2006; early online edition posted March 30, 2006. Kaye M. Fillmore, PhD, emeritus professor, University of California, San Francisco, School of Nursing. Christie Ballantyne, MD, professor of medicine and director, Center for Cardiovascular Prevention, Baylor College of Medicine, Houston.
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