Monday, January 14, 2008
Trading exercise for alcohol?
by A. Chris Gajilan
Medical News Senior Producer

We all know that exercise is good for your heart. In addition, most of you probably already know that drinking moderately is better than no drinking at all when it comes to your health, and more specifically your ticker. But did you know that exercise and drinking alcohol lower your coronary heart disease risk in similar ways?

Exercise and alcohol drinking basically work through the same properties. They both raise your good/HDL cholesterol and lower your bad/LDL cholesterol. According to Dr. Arthur Klatsky, cardiologist and researcher at Kaiser Permanente Northern California, "They do operate on good cholesterol HDL (high density lipoproteins). It acts like Drano to clean out the pipes. It takes away bad LDL cholesterol where it may be deposited like in blood vessel walls. The higher the level of HDL, the less likely it is that a person has vascular disease. The lower the levels of HDL, vascular disease becomes more likely."

Based on this effect, Danish researchers wanted to find out whether you can swap one for the other when it came to the cardiovascular benefit. "If you don't want to exercise too much, can you trade it for one to two drinks per day and be fine?" asked Dr. Morten Gronbaek, epidemiologist at the National Institute of Public Health in Denmark.

Not surprisingly, his team's study published in the latest issue of the European Heart Journal didn't find that alcohol and exercise were interchangeable, but rather they had a compounded, additional effect together. In an observational study of almost 12,000 people followed for 20 years, this is what researchers found: Moderate drinking exercisers had a 50 percent reduced risk of coronary heart disease compared with abstainers who didn't exercise. Among those who were tee-totaling exercisers, there was a 30 percent decreased risk. A similar 30 percent decreased risk goes for moderately drinking couch potatoes. All in all, those who didn't drink and didn't exercise had double the risk for heart disease as those who did exercise and drink moderately.

But this changes with age. "The new thing about this study is that physical activity and light to moderate alcohol intake in middle-aged and elderly people are both preventive and independent from one another," says Dr. Gronbaek.

I'm sure many of you may be asking - what level is considered moderate? Moderate drinking was considered one to 14 drinks per week in this study. The observational study was based on surveys and did not distinguish between type of drink (wine vs. beer) or serving size (pint vs. shot). Dr. Gronbaek says the optimal level for women at risk of coronary heart disease is one drink per day and one to two drinks per day for men.

But hold on - age is a huge factor. "You wouldn't advise everyone to drink," says Dr. Gronbaek. "You shouldn't even think about doing it until age 45 or 50 because the prevention of coronary heart disease is only relevant until this age for most people. There's absolutely no proof of a preventative and protective effect before age 45."

Have you added a daily drink or two to your diet to keep your heart healthy? Would you consider it?

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I bike about an hour or so every day to stay healthy. I drink maybe once a month, maybe less frequently than that. This study hasn't made me really want to drink, because it's not something I enjoy, but it has made me aware that my parents (who are in their mid fifties) are definitely benefiting from having a drink or two a few nights of the week. Maybe when I'm older (I'm 23) I'll consider alcohol as a medicinal thing, but not for a while yet. As a researcher, I'd love to try and see what it is about alcohol on a molecular level that helps prevent heart disease. my personal guess is alcohol tends to make one blush (vasodialation) and maybe this prevents arthlerosclerotic plaques from forming.
Ugh. The issue with alcohol in the diet is you can't really add it without adding calories that have minimal nutrition, which overtime can really add up and endanger your health and heart.
This is interesting. I'm a moderate drinker who bikes regularly for exercise but I haven't heard of the age limit until now. I kept telling myself the wine was good for me with dinner, now perhaps I'll have to reconsider for another 20 years.
I exercise 4 days a week in the gym. Most of my exercises include running, cycling and some weight lifting. On gym days I get very exhausted. So when I return home for dinner, I usually get 1 drink (vodka and diet coke) that goes with my meal. I have realized doing so I feel very fresh the next day and also I get a very relaxed sleep.
Its too bad that our culture does not teach our children how and when to drink. Our society is slowly sliding into another round of prohibition.

Before prohibition, most people drank beer or wine. During prohibition, distilled spirits became the norm (they were easier to transport and had a higher profit). My father was a young man during prohibition and he said that it taught more peolple how to get drunk instead of how to drink. I was kind of amazed as I watched how people would drink themselves into a stupor on purpose when I was a young man. Maybe the Europeans have a better attitude and method for learning how to drink.
While the study cited looks at over all health, in fact alcohol consumption can decrease athletic performance even the next day - which is why most collegiate teams, for example, do not allow their athletes to drink during the competitive season (even if they're over the legal drinking age of 21).

The myth about the Europeans having healthier drinking habits may be true for some but most popular reports here about the Europeans and alcohol come from visits of Americans who neither look at the data nor visit the hospitals. In fact the French have almost double the rate of alcoholic cirrhosis that we have in the U.S. American kids drink less than most west European kids. In Europe the World Health Organization and health ministries have declared a major health crisis related to drinking by young people. Ireland, also considers alcohol consumption to be one of its leading health problems.

Two other factors should also be considered - in Italy getting drunk is culturally frowned upon and in Scandinavia their strong concerns about drunk driving have led to laws that most Americans would find Draconian. The Danes have huge problems with alcohol consumption and anyone who's visited a Munich beer hall might question the assumption that they know how to drink responsibly.

Finally, while Prohibition changed drinking habits somewhat (the biggest change was a huge decrease in consumption and a reduction in alcoholism and violence related to alcohol consumption - the battles over illegal production and import added to the violence), Prohibition came about as a result of a combination of religious fervor, women getting tired of being beaten up by their drunk husbands and especially by their men spending substantial parts of their very limited income at the local tavern while the rest of the family scrounged. The reason why we have much higher taxation rates and controls on distilled spirits and wine than on beer is because the public and officials after Repeal still considered them to be the main danger that had led to Prohibition. The volume of pure alcohol consumed not whether it's in beer, wine or liquor is what determines the impacts - so our policy is probably misdirected although I'd hate to see young people drinking the same liquid volume of whiskey that many drink of beer.
Having a drink a day may be good for my heart, but what about my risk for breast cancer? How do I decide if the benefit for my heart is worth the risk?
Hippocrates, the father of medicine, believes that disease is not a punishment from the gods but has natural causes. Therefore, natural means can cure it. Hippocrates recommends different types of wines to treat different ailments.

"One not only drinks wine, one smells it, observes it, tastes it, sips it, and one talks about it."

Edward VII (1841-1910)

(may be added: one exercises for it)

The Book named "WINE:From Neolithic Times to the 21st Century" by Stefan K. Estreicher.
Dr. Gupta,

I am Type 2 Diabetic and have been diagnosed since 1989. However, I think I have been all my life. I have been on the metformin pill all this time and think I'm doing ok. However, I made a decision to cut out all red meat, and eat mostly oatmeal with raisings and nuts, chicken, fish, and fruits. I stopped eating processed foods and anything with a list of names I cannot identify. I have lost weight, my blood pressure seems to be very good. My A1c is a little iffy, but that's because I have to raise it a little more at night to keep it from dropping too low. Perhaps, if your patients who are overweight would adopt the same kind of diet, they will have a slightly less of a struggle with their condition. I don't call it an illness, because I try to maintain control over how it affects me.
I just cannot understand how having a drink or two could ever be considered as good for you as going for a walk during the same time frame. Was this another one of these studies that is sponsered by maybe the Alcohol industry?
I worked a rotational shift on the North Slope of Alaska for 8 years. During that time I had annual blood tests that consistently reported my HDL around 62 with an overall cholesterol count varying between 190 and 220. I eat whatever I want (considered a poor diet by friends--few vegetables mostly pasta, meat, cheese, bread) but lead an active lifestyle including gym exercise when not recreating. While on slope, there is no alcohol allowed; however, when off slope I usually drink red wine or a couple beers every night. So, I was "wet" for two weeks then "dry" for two weeks maintaining an HDL level around 62 over an eight year period.

About six months after taking a new town based position, my annual test reported an HDL of 101 with total cholesterol at 218. My HDL jumped about 40 points. The doctor asked what I had changed. The only change in my habits were likely poorer diet (the shift work made salads and fruit easily accessible--not so at my home); but undoubtedly, my alcohol consumption had increased close to two glasses of wine or beer almost every night. I know there could be other reasons, but I thought this data point interesting. I am now going back to a slope rotation, so will watch for another HDL shift. My personal health strategy is to stay active and eat small portions of whatever looks yummy. I consider the drinking a vice but find adult beverages quite tasty. Scott
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