Wednesday, May 19, 2010

Study Challenges Health Benefits of Alcohol: A Rebuttal

The news today is a study from France challenging the beneficial effects of alcohol, adding fuel to a debate we thought had flickered out some time ago. Dr. Boris Hansel of the Hopital de la Pitie in Paris, a specialist in cardiovascular disease prevention, acknowledged in an article in the European Journal of Clinical Nutrition that while moderate drinkers are in fact healthier, the alcohol doesn’t deserve the credit. The study was an analysis of lifestyle factors of nearly 150,000 adults, and largely confirmed the long-held theory that moderate drinkers (especially wine drinkers) are healthier. But Dr. Hansel’s conclusion was that the benefit was due to associated lifestyle factors, not the alcohol. Moderate drinkers do a lot of other healthy things too, such as exercise more and eat healthier diets, again most particularly wine drinkers. (http://www.google.com/hostednews/afp/article/ALeqM5jx9U20jDoCjwpIdEN7PbNB32H3EA)


Is it really as simple as that? Not likely. For starters, the emphasis of the study was on cardiovascular disease, now known to be only a small part of the wine and health formula. But even within the category, there are specific physiological effects to credit: alcohol increases HDL cholesterol, the beneficial kind, and wine polyphenols work in several ways to counteract the formation of cholesterol plaques.

The bigger issue is the notion that with a large enough study, we can finally get to the heart of the problem, and figure out what’s really going on. But studies of this type rely on self-reporting of quantity and type of alcohol consumed, which is notoriously unreliable, so the resulting inacurracies in data become magnified. It is far more meaningful to study a small but very-well characterized population, such as a particular town where everyone drinks the local wine and a traditional lifestyle is practiced consistently. This type of study is where the original French paradox was born. The paradox now is why the French are turning their backs on their own revelation to the world about healthy living.

Statisticians may bemoan the difficulty in trying to decipher how much of the French paradox is lifestyle and how much to credit the effects of alcohol and polyphenol biochemistry, but in my way of thinking it is ultimately a useless exercise. The distinction between wine as a pharmacologic supplement and wine as a component of a healthy lifestyle is an intillectual argument that does little to help us lead happier and healthier lives. For the record though, there are several good studies to support the separate contribution of wine to health, and this most recent report provides little evidence to contradict a recommendation to drink wine with dinner whenever possible.

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