Hello and welcome to PREKURE’s weekly snippet of science, where on a weekly basis we share emergent research related to extending the human healthspan.

 

Context

We’ve all heard the popular saying before, ‘a glass of red wine is good for your heart’. But is this true? Does alcohol consumption really lead to a healthy heart, or is this simply a myth? This is a somewhat controversial topic with proponents on either side feeling rather strongly. But where exactly did this controversy begin? In the early 1990s a phenomenon was discovered that would be coined ‘The French Paradox’. Observational studies discovered that there was a J-shaped curve associated with alcohol consumption and heart health (namely the incidence of cardiovascular disease). This J-shaped curve illustrated that with low levels of alcohol consumption (particularly red wine) there was a low incidence of cardiovascular disease; however, as the volume of alcohol consumed increased, the risk of cardiovascular disease did too, exponentially. The authors found this particularly interesting given that the French tend to consume a large amount of saturated fat (which was thought and by some today still is thought to be linked to an increased risk of cardiovascular disease). So, the question was posed, how is this possible? The authors posited that this is likely the result of the antioxidants they were consuming with their regular glass of red wine. And so, the quest for understanding the health benefits of alcohol began.

Between 1990-2010 the observational evidence supporting this J-shaped curve (and the health benefits of moderate alcohol consumption) seemingly continued to pile up with several observational studies suggesting a J or U association between alcohol consumption and cardiovascular outcomes and all-cause mortality [1, 2]. These studies were published in reputable journals and indicated that those who abstained from alcohol and those who drank heavily were more likely to suffer CVD events and/or death than those who drank low to moderate amounts. Based on their findings, these authors became eager to understand how to integrate this information into clinical practice. Yes, you read that correctly, these authors wanted to understand how we could promote alcohol consumption to support heart health. This seems not only premature (based on the glaring lack of clinical evidence) but also ethically perverse. Worldwide, 3 million deaths every year result from the harmful use of alcohol, this represents 5.3% of all deaths and the harmful use of alcohol is a causal factor in more than 200 disease and injury conditions [3]. Why would clinicians encourage people to drink alcohol (when we know of the risks) when you could support them to eat better, exercise, and manage their stress more effectively? In 2010 researchers shone a light on this and began to question the lack of robust clinical data to support the notion that moderate alcohol consumption is beneficial for heart health [4].

That brings us to today’s study which shines a light on the confounders that are likely muddying the waters in many of the previous observation studies: moderate drinkers tend to have healthier lifestyles than abstainers and it is this – not the alcohol – that protects them against heart disease.

 

Methods & Results

This large cohort study used UK Biobank data from 371,463 individuals. The UK Biobank is “a large-scale biomedical database and research resource, containing in-depth genetic and health information from half a million UK participants”. They examined confounding in the epidemiological association between alcohol consumption and cardiovascular disease. The authors examined the incidence of several cardiovascular diseases, including hypertension, coronary artery disease, myocardial infarction, stroke, heart failure, and atrial fibrillation. Among the participants, the mean age was 57-years, and there was a near 50:50 ratio between males and females who consumed an average of 9.2 standard drinks each week. Interestingly the authors of this study found that;

“Individuals in the light and moderate consumption group had healthier lifestyle behaviors than abstainers, self-reporting better overall health and exhibiting lower rates of smoking, lower BMI, higher physical activity, and higher vegetable intake”

The authors go on to point out that human genetic evidence suggests that there is a causal relationship between alcohol consumption and cardiovascular disease and that this risk increases consistently and exponentially in accordance with higher levels of intake. Finally, they focus their attention on safe levels of consumption (currently around 14 standard drinks per week or 2 standard drinks per night) given that there are unequal increases in cardiovascular disease risk when alcohol consumption goes from 0-7 to 7-14 drinks per week.

 

Meaning

Does this mean you should dash home and dump all your alcohol down the drain? We’ll leave that decision up to you, but the evidence seems to suggest that moderate drinking (at a lower level than what is currently considered moderate) probably won’t have a negative impact on your heart health – it won’t improve it either. This research illustrates that other healthy lifestyle behaviours like regular exercise, maintaining a healthy weight, eating a diet low in ultra-processed foods, and being a non-smoker are the protective factors that are most important when looking after your heart for the long term. Here at PREKURE we believe strongly in this holistic, balanced approach to wellbeing and know that quick fixes just don’t cut it when trying to achieve lasting health.

 

Alcohol-Free Challenge

Curious about ditching the drinks? Why not get involved in an alcohol-free challenge! Annie Grace, author of the popular book ‘The Naked Mind’ runs a free 30-day alcohol-free experiment. You can head over to her website to give it a try or incorporate it into your work with clients.

 

 

PREKURE is all about applying cutting-edge, evidence-based science into practice and we hope that by equipping you with new knowledge on a weekly basis you can incorporate this into your own life and share it with your clients when appropriate. Each week will bring with it new and exciting research, however, if there is something you are itching to know more about please email us and we will keep it on our radar as we curate our weekly snippets. 
 
We will only be sharing open-access, freely available journal articles and blogs with you. However, we wanted to make you aware of the academic workaround for getting your hands on the latest research. When looking for research you might find yourself browsing PUBMED or Google Scholar and happen upon a research article that you want to read, unfortunately, the publishers want you to pay to access it. Oh well, guess you should just keep looking right? Wrong. You can use another website called ResearchGate to access journal articles. Here, researchers create a profile and upload their work. If the PDF you are after isn’t available you can simply click the ‘request PDF’ button and the researcher will email you a copy! As an example, here is our very own Prof Schofield’s ResearchGate profile.