Drinking a glass or two of wine, beer or any other kind of alcohol every day can significantly reduce the risk of suffering a heart attack, according to a large new study that is the first to examine whether drinking occasionally or daily is the best strategy for taking advantage of alcohol's health benefits.
The research also shows clearly for the first time that drinking any kind of alcohol -- not just red wine -- can protect the heart.
"What is important is the drinking pattern and not necessarily what the individual is drinking or even the average consumption," said Eric Rimm, associate professor of epidemiology and nutrition at the Harvard School of Public Health in Boston, who helped conduct the study. "It's much more beneficial to have about a drink or two a day."
The new study is the latest installment in a long-running debate over the apparent Jekyll-and-Hyde qualities of alcohol. Alcohol has long been vilified as part of an unhealthful lifestyle. And it clearly causes serious health problems for millions of people who drink heavily, as well as countless deaths from drunken driving and alcohol-fueled assaults.
But researchers first became aware that the purported healing powers of alcohol might have merit when they noticed the "French Paradox" -- the seemingly contradictory phenomenon of the French having a surprisingly low rate of heart disease despite their rich diets. That led to speculation that there was something about the prodigious quantities of red wine the French traditionally consumed that protected their hearts.
Studies subsequently found a connection between alcohol consumption and reduced risk of coronary heart disease, apparently by raising levels of "good" cholesterol and by reducing the chances that clots will form and cut off blood flow to the heart and brain.
That has led to a debate among public health experts over whether they should not only stop discouraging people from light or moderate drinking, but possibly even begin to encourage them to have a drink regularly.
The new findings appear unlikely to convince skeptics, who fear that any positive words about alcohol will either be misinterpreted as an endorsement of excessive drinking, or used as an excuse for those who abuse alcohol to continue imbibing.
"The thing that really concerns me is the fact that we know that people who abuse alcohol are in denial, and people tend to underestimate how much they drink," said Nicholas Pace, an assistant professor of medicine at New York University Medical Center who serves on the board of the National Council on Alcoholism and Drug Dependence. "I'm not a teetotaler, but one has to be very careful with this kind of thing."
Robert H. Eckel, a professor of medicine at the University of Colorado Health Sciences Center in Denver who is chairman of the American Heart Association's Council on Nutrition, Physical Activity and Metabolism, was also cautious. "This is a tough issue. I don't know if there's a simple solution here," he said.
Others, however, were less ambivalent about the findings.
"This finally puts some numbers to how often you should drink," said R. Curtis Ellison, a professor of medicine at Boston University School of Medicine. "The dangers of that level of drinking are almost zero, and the benefits are striking. Everybody should be told the facts and let them make up their own minds. If you drink a lot, it's bad for you. If you drink a little, it's good for you."
The new data comes from the Health Professionals Follow-Up Study, an ongoing project based at the Harvard School of Public Health that is tracking the health of 38,077 male health professionals across the country while monitoring aspects of their lifestyles.
Researchers said the findings also could apply to women, noting that previous studies have also shown that light to moderate drinking can reduce a woman's risk of heart attack. Research has also indicated, however, that alcohol consumption can boost a woman's risk of developing breast cancer.
After 12 years, the researchers found that those who consumed one or two drinks three to seven days a week had a 32 percent to 37 percent lower risk of suffering a heart attack -- the lowest rate among the men. That was independent of age, smoking and exercise habits, diet and family history of heart disease.
Men who increased their alcohol consumption by one drink a day experienced a 22 percent drop in their heart attack risk, the researchers reported in today's New England Journal of Medicine. The research found that as little as half a drink every other day is enough to produce some reduction in heart attack risk.
"This does suggest that alcohol can be a very important part of a healthy lifestyle," Rimm said.