We always hear that praise: “He is a good man. He does not smoke cigarettes and does not drink alcohol.” While smoking cigarettes has no known benefits to health at all, drinking of moderate amount of alcohol may be actually good for your health!

The February 10, 2003 issue of the Journal of American Medical Association found that while heavy alcohol consumption increases the relative risk of stroke, but light or moderate alcohol consumption may be protective against total and ischemic stroke. Light to moderate alcohol intake is defined as 0.5 to 1 drink daily (approximately 0.5 to 1 glass of wine or can of beer). Interestingly, moderate alcohol intake is also associate with lower total mortality rate, which is found consistently across the world in the US, Great Britain, Italy, Trinidad, Japan and China. The one performed in China is particularly interesting. About nineteen thousand men from Shanghai were followed for three years. Compared with lifelong non-drinkers, those who consumed 1-14 drinks a week had a 20% reduction in overall mortality. This protective effect was not restricted to any specific type of alcoholic drink. It is also associated with a 36% reduction in death from ischaemic heart disease. As expected, heavy drinking (29 or more drinks per week) was significantly associated with increased risks of death from cancer of the esophagus, stomach and liver, hepatic cirrhosis, and stroke.

Another study showed that the risk of diabetes mellitus is inversely related to alcohol consumption. In prospective studies of 42,000 men and 85,000 women, the relative risk of diabetes among moderate drinkers (2 to 3 drinks daily for men, 1 or more drinks daily for women) decrease by 40% when comparing to abstainers.

One may ask, how does alcohol protects against heart disease and stroke, which is the number one and number three killer now in the US? One possible mechanism is the increase of high-density cholesterol (the so-called good cholesterol). This change is thought to account for most of the observed cardiovascular benefit. In addition, wine may contain antioxidants that inhibit the formation of the oxidized form of LDL, a major component of plaques in arteries. Moreover, alcohol may prevent clotting of arteries which occur during strokes or heart attacks.

However, there are potential deleterious effects of moderate alcohol consumption. Pregnant women should not consume any alcohol at all because of possible growth retardation, central nervous system dysfunction and may increase the risk of spontaneous abortion. Alcohol, especially consumed in excess, may increase risk of breast cancer, GI cancer, liver cirrhosis, and pancreatitis. The net risk-benefit balance associated with moderate alcohol consumption is likely to differ in various age groups and populations. As an example, an increase in breast cancer might be important in patients at low risk for coronary disease, such as 30 to 40 year-old women. On the another hand, people who are at high risk of heart disease (such as those older than 45, with diabetes, high blood pressure, low HDL level, or smoking) may benefit most from moderate alcohol consumption.

In my practice, I do not routinely recommend start drinking alcohol to most of my patients. I also strongly discourage my patients from excessive alcohol use. But for men over the age of 40 and women over the age of 50, especially who have one risk factor for heart disease, such as diabetes, low HDL, strong family history of heart disease or stroke, I will discuss with them initiating light to moderate amount of alcohol daily as a mean to protect against heart disease and stroke. After all, our ancestor may have known it better: “Alcohol invigorates the blood and is good for health”.