The French Paradox. Low-carb beer. Antioxidant wine. These days there's so much fizz -- and conflicting information -- about alcoholic beverages that it's enough to make one feel a little lightheaded.
The experts are trying to sort out the facts, too. Just last week, the U.S. Dietary Guidelines advisory committee began reviewing the scientific findings on alcohol as part of its five-year update on the nation's nutritional recommendations. The new guidelines won't be finalized until January 2005.
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In the meantime, just where does imbibing alcohol fit in a healthy eating plan?
"It's fair to say that alcohol helps protect against heart disease," notes Kenneth Mukamal, an internist at Boston's Beth Israel Deaconess Hospital and author of a recent study on moderate drinking in men. Research suggests that alcohol protects by raising levels of the so-called good cholesterol known as high density lipoprotein (HDL).
But before you get out the corkscrew, the findings are "not strong enough for people to feel obligated to drink alcohol for their health," Mukamal cautions.
Even in protecting against heart disease, the benefits are greatest for men and for older women, particularly those past menopause. For younger women, experts say there's little to suggest that alcohol cuts the odds of heart disease, since they already face a very low risk.
Aside from the possibilities for addiction and abuse, drinking alcohol raises the risk of breast cancer in women. Studies suggest that just two drinks a day boost breast cancer rates by 25 to 40 percent. "There's not a level of drinking alcohol that leads to less breast cancer risk," Mukamal says.
Drinking alcohol can expand waistlines. One study found that the more people drank, the more fat they piled on around the middle -- a condition that can lead to metabolic syndrome, which raises the risk of heart disease and diabetes.
Alcoholic beverages have a lot of calories. A five-ounce glass of wine has about 100 calories; dessert wines, such as port, pack about 220 because of their higher sugar and alcohol content. Light and low-carb beer have about 100 calories per 12-ounce bottle; regular beer runs about 150 calories. Distilled spirits vary by alcohol content and run from 64 (80 proof) to 82 calories (100 proof) per ounce. Add mixers and the calories rise.
Moderation really matters. That's why for the past 23 years, the U.S. Dietary Guidelines have advised that "if you drink, do so in moderation." For women, that's one drink or less per day; for men, two. A drink equals five ounces of wine or a 12-ounce beer or 1.5 ounces of distilled spirits, such as gin, rum or vodka.
Quantity counts. So no, it's not a good idea to be a teetotaler all week and a binge drinker on the weekends. In fact, an Australian study found that drinking more than nine drinks just one day a week doubled the risk of heart attacks in men. On the other hand, small amounts of alcohol -- less than one drink a day -- appear to protect women's hearts and may reduce their risk of diabetes.
Sip more than red wine. Yep, a lot of studies point to its benefits. But as experts note, most research on red wine comes from France and Italy, where it is the beverage of choice. In the United States, where beer and distilled spirits are more popular, research has shown similar benefits for these drinks. "We think it is not the type of beverage that counts, but that people drink moderately on a regular basis," Mukamal says.
No alcohol for pregnant women. That's because "there's no safe level," notes Thomas Gentry, a health science administrator with the National Institute of Alcoholism and Alcohol Abuse. "It's important to avoid it during pregnancy." Mukamal counsels his patients to avoid alcohol while trying to get pregnant, since, as he notes, "most women don't know for several weeks that they are pregnant."
-- Sally Squires
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