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by Derrick Schokman

The debate about the health benefits of moderate drinking has been going on for quite some time. More than 60 studies have established links between moderate drinking and reduced heart disease.

The "French paradox" of 10 years ago that the low incidence of heart disease in France, despite a grande bouffe of foie gras and other fatty. Gallic foods, could be attributed to high wine consumption, added to the momentum of the debate.

It was thought that there was something in wine, in addition to alcohol, responsible for reducing the death rate.

Be that as it may, an epidemiological report in the "British Medical Journal" stated that "most of the coronary benefits come from alcohol and not other compounds of various drinks"

And there has been growing evidence (American Medical Association Journal "Circulation" April 18, 2001) to suggest that alcohol wards off heart disease by boosting levels of high density lipoprotein cholesterol (the good cholesterol) thinning the blood and reducing insulin resistance.

This may be good news for those people who like to end the day with a nip or two.

That the "wine that maketh glad the heart of man" need not be denied to even those having heart disease was the outcome of a recent conference in Palo Alto Calif on the effects of alcohol on health, sponsored by the New York Academy of Science.

Arthur L. Klatsky, a leading investigator on the epidemiology of alcohol and a colleague Roger Ecker, physician; presented an "algorithm" for helping physicians advise patients.

This flow chart recommends moderate drinking (one to three drinks a week) for men between the ages of 21 and 39 and women between 21 and 49 having heart disease or two or more risk factors for it.

It also suggests that men older than 40 and women older than 50 having heart disease or one or more risk factors for it could do the same.

Provided, of course, that this advice does not obviate other preventive measures.

The American Heart Association however argues that more evidence is needed to prove the health benefits of moderate drinking.

Epidemiologists have long acknowledged that short of difficult-to-conduct randomised trials, confirmation of the salutary effects of alcohol may never be confirmed.

The Association urges physicians to emphasize to their patients, preventive means other than drinking that have a firmer grounding of scientific/research such as cholesterol and blood pressure. Other life style factors like a high consumption of fruits and vegetables is also highlighted.

A recent finding is that people metabolise alcohol differently, depending on a genetic factor.

Researchers from the Brigham and Women's Hospital, Boston and the Harvard School of Medical Health declared on February 22 in the "New England Journal of Medicine" that one form of the gene of the enzyme hydrogenase which breaks down alcohol does its work more slowly than other forms of the gene.

People who have that gene and drink moderately retain high levels of high density lipoproteins and face about half the risk of heart attacks of drinkers without the gene.

My toast to those fortunate folk is Your Health - a votre sante!

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