Gettysburg Medical News
The Clinical View
3 January 2007
by Phillip Hoffsten

Alcohol: The Good and the Bad

            There is perhaps no more controversial topic in our society than the merits of alcohol or the lack of same.  Alcohol is damned for causing 25,000 deaths per year from moving vehicle accidents that result from driving while intoxicated.  It is said to play a part in 18,000 suicides per year and at least an equal number of homicides.  Alcohol excess is responsible for the large number of individuals with alcoholic liver disease.  Our nursing facilities and domiciliarys for the disabled have an untold large number of individuals with alcoholic brain damage.  Many of these individuals cannot button their shirt or get a fork in their mouth.  The psychosocial tragic effects of alcoholism on families are well-documented.  Thus the adverse effects of alcohol and alcoholism are well-known and not really open to debate.

             But we have just finished the single day of the year with the highest alcohol consumption-New Year's Eve.  New Year's Day is well-known for hangovers and headaches.  Somehow thru all the warnings and promises of “never doing that again”, New Year's Eve alcohol consumption doesn't really seem to go down year after year.  So there obviously is something somebody enjoys about alcoholic beverages and with the repeal of prohibition in the 1930s, I don't think alcohol is going to go away.  Can it be that there really is some medical good to be said about alcohol?

             Medical literature has recently suggested that there is a protective effect of mild to moderate alcohol consumption in preventing heart disease.  Studies in the past have suggested that moderate alcohol consumption is associated with greater longevity than is enjoyed by teetotalers.  Those studies were questioned but a new one seems to answer the question very well.  An article was published in The Archives of Internal Medicine for the month of December 2006 analyzing 34 worldwide studies regarding alcohol consumption and longevity.  The answer was very clear that consumption of one to two alcoholic beverages per day was associated with an enhanced longevity.  More than two alcoholic drinks per day for women resulted in impaired longevity.  Perhaps because men are larger physically, their longevity was not impaired until more than 3 alcoholic drinks per day.

             The reason for this health benefit of moderate drinking of alcoholic beverages is the subject of extensive debate.  In as much as moderate alcohol consumption increases good cholesterol (HDL), one could surmise this is the reason for alcohol's beneficial effect.  But alcohol also decreases platelet aggregation stopping the formation of blood clots.  It also seems to be an anti-inflammatory factor and this may be the source of its benefit.  Whatever the reason the fact of its benefit has been confirmed so many times that I no longer believe it is in question.

             Speaking for myself, I believe the perceived benefit of moderate alcohol consumption may well reside in the character of the individual who has two drinks per day.  I remember my grandfather coming home from work at about 5:30 p.m. and having a “scotch and soda on the rocks" in the living room with my grandmother every night.  He would discuss the day’s events with her and have one more drink.  Then he would have supper and spend the evening and some activity but have no further drinks at night.  In those days there wasn't the 10 o'clock TV news but I am told he went to bed very quickly after I went to bed.  He was up in the morning and back to work by 8 a.m., 5 days a week.  Saturdays and Sundays were wonderful because he was there to follow around all day and do all kinds of interesting things.  He lived to age 93.  I would question whether alcohol really had anything to do with his longevity; I was much more impressed with the balance and evenness of his lifestyle.  My impression is that the person who has two drinks per day is marked for a certain personality, balance, and lifestyle associated with longevity.   Unfortunately I don't think I have gotten home at 5:30 p.m. in 40 years and when I do get home one drink will put me to sleep.  So rather than have my wife shaking me to wake up and talk to her I drink very little.  But I do have grandpa’s genes and just maybe I can make it to 93 or more.