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According to data from the second National Health and Nutrition Examination Survey, average levels of HDL cholesterol were higher among drinkers than among abstainers, no matter what their age, sex or race. Also, as alcohol consumption increased, so did HDL levelsan average increase of 5.1 milligrams/deciliter for daily or weekly use. (This study suggests reducing your risk of coronary heart disease by means other than alcohol consumption, however.)
For seven years, the Multiple Risk Factor Intervention Trial followed a subgroup consisting of 11,688 middle-age men who were at high risk for heart disease. During that time, those who consumed about two drinks per day (with each drink equal to 4 ounces of wine, 12 ounces of beer or 1.5 ounces of 80-proof spirits) had higher HDL levels than nondrinkers. This alcohol intake seemed largely responsible for a 22 percent reduced chance of death from heart disease, researchers said.
Researchers at Kaiser Permanente Medical Center in Oakland, California, studied the alcohol consumption patterns of nearly 129,000 people. Those who had one to two drinks a day were 30 percent less likely to die from coronary heart disease than those who did not drink. But people who had six or more drinks a day had a 60 percent greater risk of death from noncardiovascular causes than nondrinkers.
Dr. Kwiterovich and his colleagues had 56 men with low levels of HDL either drink one beer a day or abstain from alcohol. After two months, there were no differences in HDL levels between the two groups. But the beerdrinkers experienced a 10 percent increase in apoprotein A-I, the major protein component of HDL. This protein is believed to help extract cholesterol from the cells and move it to the liver for excretion. Alcohol also makes blood platelets less sticky, which cuts the risk of clot formation and reduces the risk of heart attack, and raises blood levels of an enzyme called tissue-type plasminogen activator, or tPA, which helps keep blood clots from forming.
Researchers at Harvard Medical School and Brigham and Women's Hospital in Boston measured blood levels of tPA in 631 male doctors. These doctorsparticipants in the Physicians' Health Study, a study of 22,000 American doctorsgave blood samples and reported on their drinking habits. Researchers found that tPA levels rose with drinking frequency. The doctors who consumed two or more drinks a day had 35 percent higher levels of tPA than doctors who rarely or never drank. What's more, the doctors who drank more had significantly higher levels of HDL cholesterol than the doctors who didn't.
Booze: No Magic Bullet
If you think that simply hoisting a beer stein or sipping your favorite Bordeaux will have a beneficial effect on your cholesterol level, think again. "Two glasses of wine a day will have a modest effect upon your HDL, and even that modest effect is beneficial," says Dr. Castelli. "But if you're looking for a magic bullet, this isn't it."
Further, overimbibing to benefit your cholesterol level is risky, say experts. "Alcohol is like coffeeit has some theoretical benefits and some potential risks," says Neal Barnard, M.D., president of the Physicians Committee for Responsible Medicine in Washington, D.C. Risks include developing certain cancers and provoking cardiac arrhythmias, cirrhosis of the liver and high blood pressure, says Dr. Castelli.
"It appears that women have an increased risk of breast cancer from increased alcohol consumption, even at the moderate levels recommended as potentially beneficial for heart disease," says Marla Mendelson, M.D., assistant professor of medicine at Northwestern University Medical School in Chicago. "So women who have a significant risk of developing breast cancer have to think twice about drinking."
There are other issues to consider. "If you have high blood pressure, alcohol can raise it more," says Frederic J. Pashkow, M.D., cardiologist at the Cleveland Clinic Foundation in Cleveland and author of 50 Essential Things to Do When the Doctor Says It's Heart Disease.
What's more, alcohol can actually raise triglycerides by lowering the concentration of an enzyme used to break them down. "Even having a glass of wine with dinner every night can substantially raise triglycerides in people who are overweight or who have hereditary triglyceride problems," says Thomas Bersot, M.D., associate professor of medicine at the University of California, San Francisco.
The bottom line? If you choose to imbibe, do so in moderationand if you don't drink, don't start, says Margo Denke, M.D., associate professor of medicine in the Center for Human Nutrition at the University of Texas Southwestern Medical Center at Dallas.
Dr. Barnard agrees. "I suggest that people follow a low-fat diet. I'm not sure that adding alcohol to that would be helpful."
See also Grape Juice, Wine
Excerpted from Cholesterol Cures by Richard Trubo and the Editors of PREVENTION Magazine. Copyright © 1996 by Rodale Press, Inc.. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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