By James N. Dillard, M.D.
(06/11/2009) This is the season for cocktail parties and celebration of our wonderful summer. We have heard experts tell us that drinking some wine or alcohol every day is good for us. But how much is the right amount to drink, and of what, and how much is too much? How can you tell when you may have slipped from healthy to harmful?
Plenty of us do slip. Eighteen percent of Americans meet the criteria for alcohol abuse during their lifetimes, and another 10 percent are high-functioning borderline alcoholics. Then there are the 2.6 million binge drinkers between the ages of 12 and 17. Here on the East End, we have a new graduating class, many with newly minted driver’s licenses — and new risks.
Young people often get their start drinking by working in the restaurant industry. It is a common first summer job here. A 17-year-old busboy or 21-year-old bar-back can make good money. The workers end their long shift with a drink, and often people are too wired to go home to sleep, so the night just carries on. Private catering is even less supervised.
But still, we are not going to repeal the 21st Amendment to the Constitution anytime soon. People will continue to imbibe. And maybe a little drinking is good for you?
The positive health claims include decreasing your risk of heart disease and heart attacks, maybe lowering stroke risk, decreasing gallstones, and a few other things. It’s based on a fair amount of good research.
This all started with “the French paradox.” Back in 1991, Dr. Serge Renaud went on “60 Minutes” to extol the virtues of red wines from the Toulouse region of France. He pointed out that these French people ate an enormous amount of saturated fat, particularly in the form of cassoulet (beans that are baked with duck or goose fat), yet they had very little heart disease. The miracle was ascribed to the rich red wines of the region.
Unfortunately for the winemakers, much of the statistical analysis has been debunked. These French people had more heart disease than we thought, and there were many other elements in play besides the wine. But the French did seem healthier than age-matched Americans.
People then started looking into what was in the wine and came up with a pigment from the grape skin called resveratrol. This stuff has gotten quite a buzz in the media and on “Oprah.”
It is a potent antioxidant and cell protector, but, sad to say, you would have to drink about 1,000 bottles of red wine per day to get any protective effect. Enter the supplement manufacturing companies.
Resveratrol has become a hot product in the health food stores and on the Internet, but there is still little human research to justify shelling out the bucks for this dietary supplement. Mice seem to do quite well on it, but 9 out of 10 drugs that look good in mice will fail in human trials.
We do know that red wine is loaded with healthy antioxidant polyphenols, so it might be better for you than other forms of alcohol. Some research confirms this, and yet some tells us that red wine is not any better for us than beer or distilled liquor.
The dangers of overdoing it are well known. Anything more than a couple of drinks a day can lead to serious liver damage, various cancers, high blood pressure, violent behavior, serious injuries, psychological disorders, harm to your fetus, and alcohol dependence.
If you take Tylenol when you are drinking, it can lead to acute liver failure, a horrible sickness you will never forget — if you live through it. These are not things worth fooling around with — just not worth it.
Driving or boating while intoxicated is also not worth it. Just talk to someone who has had his license revoked. He’ll be glad to tell you whether or not it was worth it. Alcohol is involved in 25 percent of all motorboat fatalities. If you are in the car or on board with an intoxicated driver, you know what to do.
Still, there is enough research evidence to justify a bit of light drinking every day, if you are a man. That would be two drinks a day if you are a guy under 65 years old and one drink if you are a guy over 65. A drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of distilled liquor.
Why don’t I include women? Well, there’s a new study out that calls into question even light to moderate drinking for women called the Million Women Study. It was published in the Journal of the National Cancer Institute in February 2009.
It showed that women who drank very lightly still had increased rates of cancer, all other things being equal. The experts don’t quite know what to make of this yet. At this point the jury may still be out.
You know I hate to leave you with one of these hazy bottom lines. I wish I had more real clarity on this one. Once again, we will know more with more and better research. I’ll have to hand it back to Aristotle, who advised us, “Moderation in all things.”
It ends up with our accepting the gray areas in the science and making a personal decision. As a dear friend in Springs likes to say, “People like to feel the fog roll in around 5 o’clock.” But I hope your wine o’clock will not obscure your good sense.
Dr. James Dillard served as a clinical professor at Columbia University Medical Center and now practices in Wainscott and New York City. Questions can be directed to jdillard@ehstar.com.