Drink to excess and you might pay heavy price
SINCE the late Stone Age, people have been drinking alcohol to help them feel better.
Many studies have found that people who regularly consume a small amount of alcohol have a lower incidence of heart disease, stroke, diabetes and some cancers when compared to those who don't drink at all or drink only occasionally.
We're talking about having no more than one or two drinks most days for men.
And half this for women, whose blood-alcohol levels tend to be higher after drinking the same amount.
Of course, moderate drinking takes discipline and self-awareness. So it's hardly surprising these are also the kind of people who have fewer health problems.
Nonetheless, researchers have repeatedly attempted to establish the direct actions of drinking on health and wellbeing.
For example, alcohol has favourable effects on HDL cholesterol. This is also known as "good cholesterol" because people with high levels of HDL cholesterol have lower risks of heart disease and stroke. But if this was how alcohol worked, why would more selective strategies to increase HDL cholesterol be universally unsuccessful in preventing heart disease?
A glass before or during an evening meal is often said to be the most beneficial. This may be partly because this social pattern of drinking is easier to regulate and habituate.
Drinking with food also slows down stomach emptying. This may have health benefits by slowing the flow of sugars and fats into the bloodstream and their subsequent burden on the body.
Many alcoholic drinks - not just red wine - also contain antioxidants. Some beers and ciders have quite high levels of antioxidants, some of which may be better absorbed or more potent than those in wine.
But again, the medicinal effects of regularly taking the amounts of antioxidants found in a single glass every day are unclear. Even when taken in high doses as supplements there is little evidence of health benefits.
In some head-to-head trials, red wine seems to outperform beer or spirits with respect to surrogate markers of health, such as vascular stiffness and oxidative stress.
However, when you look at overall health outcomes in moderate wine drinkers, they appear to be much the same as those in moderate beer drinkers or those who have a glass of scotch or gin every night.
Before you start thinking a drink or two may be good for you, it is literally sobering to remember that excessive drinking is a leading cause of preventable death, particularly in young adults and men, but also increasingly in women.
Alcohol, like food, should be one of life's shared pleasures, but both need restraint.
* Merlin Thomas is Adjunct Professor of Preventive Medicine at the Baker IDI Heart and Diabetes Institute in Melbourne