Alcohol and health

MLipton

Mark Lipton
As your self-appointed health reporter, I wanted to see whether the recent revision of medical thinking on the impact of alcohol consumption on health (and the related redefinition of moderate drinking) has affected your wine consumption in any way. I am mindful of the old saw that there are more old wine drinkers than old doctors, but at the same time it is now clear that alcohol raises your risk for cancer, hypertension and fatty liver diseases. So, has this shift in thinking altered your consumption pattern in any way?

Mark Lipton
 
Not for me. Doesn't really come as a surprise. I was under no illusions that this stuff was anything but bad for us. Although it is tasty...
 
while I quibble not with the notion that too much alcohol is not a boon to overall human longevity, i look to the point where my increased consumption begins to degrade my enjoyment of life in general. passing that point will decrease the quality of my life, which i wish to avoid. but nobody gets out of here alive.

i care not what doctors/lawyers say. I am well aware that i will at some point i will be exited off of mother earth, and whenever that is, i will have lived a lifetime. how many trips around the sun that takes is just a number. it will still have been a lifetime.

the wine I consume will be a significant factor in how good my lifetime was. in as much as my consumption doesn't give me any bad years, i will figure that I did not consume too much.
 
I have reduced my normal wine consumption to two glasses a day (and drink no other alcohol) but this is due to age factors and not health reports.

I consider wine enjoyment to add to my peace of mind which has to be beneficial, at least to me and JoAnne.

. . . . . . Pete
 
Thanks for the feedback. For myself, my recent checkup (my first since the pandemic) on the occasion of my turning 65 showed that, although my numbers still stay within the "normal" ranges, my blood pressure and cholesterol are creeping upward toward regions of concern. For the moment, I am attempting to use diet and exercise to bring down those numbers, but I have not as yet modified my wine intake. As several of you have noted, there is a quality of life consideration, too.

Mark Lipton
 
I seem to have inherited good genetics. I had my last checkup in May when I turned 70. BP was 128/80, overall cholesterol was 170 with all the subcategories within normal range. Blood sugar is normal. Liver function is normal(!). All test results were fine.

I’m the oldest guy in my two offline groups. Ages range from late 30s to me.

With all that, I haven’t changed my wine, beer, and booze consumption. I sure as hell don’t plan to.
 
Dear Mark,

normal is normal. and it is reasonable to abide by a moderate consumption (for males) of 2 glasses of wine daily.

if the cholesterol is truly normal with a good HDL level, it would not count as a risk factor for developing cardiovascular disease. if you have other significant cardiovascular risk factors or other medical issues, you would take that into account. the same goes for blood pressure.
thus there is actually no reason to modify your dietary habits and exercise routine (other than regular exercise is good for you health wise and generally makes people feel better) let alone modifying alcohol consumption if you adhere to the "moderate" level as noted above and do not have other significant cardiovascular risk factors, medical issues or other issues like a strong family history of colon cancer etc etc.
and don't forget that there are medications that can bring a blood pressure into the normal range and screening tests like colonoscopy can lessen the chance of colon cancer mortality.

i second Mr. Ames approach and second Mr. Welles motion.

to reemphasize, normal is normal. hard to improve on that....
 
originally posted by Mark Anisman:
Dear Mark,

normal is normal. and it is reasonable to abide by a moderate consumption (for males) of 2 glasses of wine daily.

Normal lab values certainly do not mean the absence of a brewing or longterm health problem when it comes to alcohol.
And it seems pretty clear by now that 2 glasses of wine daily does have measurable negative health consequences. Though they certainly pale in comparison to being a smoker or not walking/exercising at all.

Whether those effects are outweighed by the pleasure one gets from drinking wine is a very personal decision. I certainly will not stop drinking wine or other alcohol, but I usually have a couple of days a week without.
 
I picked the wrong parents to be an exemplar of living in a blue zone. Were my cholesterol level to be compared to say, the orbital arc of a rocket ship, I would have been somewhere north (are there directions in space?) of Saturn before being prescribed meds to counteract this. And blood pressure? Jesus H, I might as well be using my heart to pump oil across the Bering Strait for the amount if crude I've got screaming through my arteries. Both sides of my family have traditionally plotzed from heart attacks, strokes, diabetes, and poor driving skills more often than from other things (like "old age" or assassin's bullets) that might otherwise add to the legend.

But pills. Yes pills. I take pills and capsules, enough to sedate a small horse, plus I do yoga 4-5 times a week, walk daily, and think good thoughts about my fellow man. The numbers now hover around "normal" figures, but it takes forever to fill out the incessant paperwork required when I see a new doctor. 'Tis a small price to pay for immortality. I've cut most processed food from my diet, and have stopped buying Meiomi, The Prisoner, and Cap'n Crunch in an effort to put the kibosh on any pre-diabetic tendencies. In general, I'm opening maybe a bottle or two per week, which despite feeling as if it's less than I'm buying per week, still feels manageable. I'm not really a beer drinker, and maybe there's a cocktail passing my lips every couple of weeks, but it's not like I'm stopping at the Elk's Lodge on my way home for a budget-price martini or old-fashioned.

I'm with Robert on the quality of life aspects of this question. I've already outlived everyone in the previous generations of my family by 10-20 years, and I'm only in my second decade of midlife crisis, so I view whatever is left to me as all gravy (but not thickened with flour)(I'd roux the day)

-Eden (would it be thought tacky to shuffle off this moral coil before shuffling off the mortal one? Sounds like it'd be more fun that way)
 
George,

"Normal lab values certainly do not mean the absence of a brewing or longterm health problem when it comes to alcohol."

A correct statement but one that does not apply to my discussion.

My discussion is of alcohol's impact on cardiovascular disease, as that would be its adverse impact on blood pressure control and possibly cholesterol values. Alcohol can increase your blood pressure and change your cholesterol numbers. I am not discussing "normal lab values" like sodium / potassium / hemogram etc etc, where normal results might not show serious underlying illness afoot.

My discussion is whether it should be of concern regarding one's cardiovascular health, in the context of your alcohol use, if your blood pressure or cholesterol is in the widely accepted normal range (assuming you do not have any cardiovascular risk factors), regardless if there have been slight changes or perturbations in the force from the alcohol use.

yes, one can die from a heart attack at age 50 and have no risk factors. certainly people who have no risk factors and are 95 years old will likely have cardiovascular disease. but to worry yourself about changing your habits or taking medications in response to blood pressure and cholesterol values that are in the normal range when you otherwise have no cardiovascular risk factors is a fool's errand. even if you do change the values in a good way it will be quite likely to have a minuscule impact on your morbidity and mortality, unless of course your goal is one more day of life.

thus i see no reason to change your alcohol habits (given alcohol's relationship with cardiovascular disease) if you have never had risk factors for cardiovascular disease, as it is of insignificant risk to your cardiovascular well being if the blood pressure and cholesterol values have changed slightly but still are normal. that's what i meant when i wrote normal is normal and it is very hard to do better than that.
 
originally posted by MLipton:
Alcohol and healthAs your self-appointed health reporter, I wanted to see whether the recent revision of medical thinking on the impact of alcohol consumption on health (and the related redefinition of moderate drinking) has affected your wine consumption in any way. I am mindful of the old saw that there are more old wine drinkers than old doctors, but at the same time it is now clear that alcohol raises your risk for cancer, hypertension and fatty liver diseases. So, has this shift in thinking altered your consumption pattern in any way?

Mark Lipton

A timely question, Mark, not only in terms of the medical zeitgeist, but also in terms of my family.

Until last year, for almost 15 years my wife Marcia (who is an MD) and I used to share a bottle every night with dinner, usually 60/40 in my favor, sometimes 50/50 (if she liked the wine a lot). Early this year she decided to cut down her share to half a bottle or less, “forcing” me to cut my consumption so that the bottle would now last two nights (otherwise my cellar management becomes a nightmare). We are both super healthy, exercise every day, and eat very conscientiously, so there's no immediate threat (I'm 69 and she's 55).

The background is that last year we began to drive a 100% electric and adopted a mostly plant-based diet (not dogmatically; we include dairy and eggs, plus some fish, and will eat “normally” in other people’s homes). In her case, the change in diet was driven by a need to avoid saturated fats for cholesterol-related reasons (a subject she researches almost daily, as well as keeping up with the oncology and cardiology literature) and a focus on building a healthy microbiota for all of us in the household. I, on the other hand, have the cholesterol levels of a teenager, so, in my case, it was the result of seeing the documentary Eating our way to extinction (see link below), which makes a compelling case, among others, that the biggest driver of deforestation is big aggro’s massive increase in the production of cereals, aided by pesticides and herbicides, to feed the growth of livestock breeding to meet the proportional growth of demand for red meat from countries like China and India, where a general increase in wealth is making it possible for the first time to afford it. Of course, our sacrifice (I love red meat) makes almost no difference, but to continue as before while blaming others for climate change seemed intolerably hypocritical on my part. I don't and won't go around preaching, in part because only this late did we decide to do our very tiny part.

More specifically, Marcia reduced her alcohol consumption not so much because it is toxic, which it is, but because the liver enzymes can only absorb so much in the aftermath of ingestion, after which the alcohol circulates in the body for hours, biding its time to be absorbed (affecting the brain, from sleepy tipsiness all the way to hangovers); as I understand it, it is when this excess circulates that it is more likely to be a risk factor for certain types of cancer (usually related to the digestive tract, all the way from the throat to the colon) and more lastingly harmful to the brain. If we only drink with meals, absorption occurs more slowly, so there is less chance of excess alcohol circulating, which is why drinking in moderation is less likely to cause cancer. But there is no “safe amount,” at least not for everyone. Alas, no more jeebs, unless spitting and discarding almost everything. Of course, almost all the research on this subject is based on observational studies, with the usual caveats, and it is impossible to do double-blind, etc., given all the surrounding variables.

 
originally posted by Tristan Welles:
I am waiting for the medical consensus to shift again before contemplating my response.

I encourage all of you to read this book:

Good News

It is heavily researched by a professional Medical journalist and cites over 300 medical studies.

Personally I have cut back mostly because I needed to lose some weight which I have done. I enjoy wine even more on the 3 or so days a week I drink.
 
The release of the 2018 Lancet article and now the WHO's "No Safe Level" paper have led me to wonder who is behind these efforts. No scientific publication of the magnitude of these two papers comes about without a big pile of money. Someone has a vested interest in us not drinking.

I have wondered about the health insurance industry, which would actually be the governments in much of the rest of the world, and the private sector in the US. Definitely a good time for all in the beverage alcohol trade to follow the money.

The thing I find remarkable is that simultaneously, we are learning about Göbekli Tepe and so many other aspects of human culture and civilization which are indicating that intoxicants - and alcohol in particular - are bound to our culture, and may have in fact catalyzed permanent encampments and even religion. Alcohol has had an impact on so much of history - peace treaties, the establishment of relationships between romantic partners, business deals, weddings and other religious sacraments, governmental negotiations, artistic creativity of all sorts, job offerings; alcohol is woven into humanity. There may be "no (physical) health benefits," but the number of mental health, interpersonal and social benefits throughout history is staggering. Humanity appears to be wed at the hip to intoxicants, primarily alcohol, and behind the scenes, someone is lobbying hard for amputation.

As is the case with so many issues in global culture/commerce/geopolitics today, our ability to factor ALL of the elements at play into our cost/benefit analysis is dramatically lacking.
 
originally posted by Ken Schramm:

As is the case with so many issues in global culture/commerce/geopolitics today, our ability to factor ALL of the elements at play into our cost/benefit analysis is dramatically lacking.

Even if we ignore the greater context, the relative size of the negative effect is usually murky. The finding that there is no alcohol consumption with zero negative effect to health seems very likely true. But how much will be gained by going from one or two glasses a few times a week to zero? I feel reasonably certain that the impact pales compared to not smoking, walking a few thousands step a day, not being extremely overweight, and foregoing highly processed foods.
 
originally posted by Ken Schramm:
The release of the 2018 Lancet article and now the WHO's "No Safe Level" paper have led me to wonder who is behind these efforts. No scientific publication of the magnitude of these two papers comes about without a big pile of money. Someone has a vested interest in us not drinking.

I have wondered about the health insurance industry, which would actually be the governments in much of the rest of the world, and the private sector in the US. Definitely a good time for all in the beverage alcohol trade to follow the money.

If it were to be true, let's say, that there's no level that is safe for everyone (the WHO has to deal with aggregates, not at the individual level), doesn't it stand to reason that governments and health insurance companies would quite justifiably have a vested interest in us not drinking and would spend a big pile of money to publicize this?

Maybe I am missing something about the logic, but you seem to be working back from scientific publications of magnitude to pile of money to vested interest, as if this causal chain was somehow suspicious. If the danger were to be legit, isn't this exactly what one would expect?

The worldwide alcohol business, like the tobacco, armaments and oil businesses, provide gigantic benefits to the economies of many countries, so it takes an equal belief in their deleterious effects to make governments go against them and their lobbies. Not something they would do lightly. What we should be suspicious of is, on the contrary, attempts to minimize the deleterious effects of these four industries. That said, it seems to me that each one of us should enjoy as much wine as their bloodwork permits within some reasonable safety margin, and not treat the issue as an all-or-nothing.
 
originally posted by Ken Schramm:
The release of the 2018 Lancet article and now the WHO's "No Safe Level" paper have led me to wonder who is behind these efforts. No scientific publication of the magnitude of these two papers comes about without a big pile of money. Someone has a vested interest in us not drinking.

I have wondered about the health insurance industry, which would actually be the governments in much of the rest of the world, and the private sector in the US. Definitely a good time for all in the beverage alcohol trade to follow the money.

The thing I find remarkable is that simultaneously, we are learning about Göbekli Tepe and so many other aspects of human culture and civilization which are indicating that intoxicants - and alcohol in particular - are bound to our culture, and may have in fact catalyzed permanent encampments and even religion. Alcohol has had an impact on so much of history - peace treaties, the establishment of relationships between romantic partners, business deals, weddings and other religious sacraments, governmental negotiations, artistic creativity of all sorts, job offerings; alcohol is woven into humanity. There may be "no (physical) health benefits," but the number of mental health, interpersonal and social benefits throughout history is staggering. Humanity appears to be wed at the hip to intoxicants, primarily alcohol, and behind the scenes, someone is lobbying hard for amputation.

As is the case with so many issues in global culture/commerce/geopolitics today, our ability to factor ALL of the elements at play into our cost/benefit analysis is dramatically lacking.

Ken it is such a good question. If you read the book I linked about there are so many studies that show the positive effects of moderate wine consumption that it would be very easy to contradict some of the negative ones but the negative side seems to be winning.
 
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