Alcohol Related Deaths
More than 100,000 deaths per year are
attributed to alcohol, in the United
States. Alcohol-related auto
accidents account for approximately 24,000 of these
deaths (most often the
victims are under 30 years of age), while alcohol-related
homicide account
for 11,000 and suicide 8,000 deaths. Certain types of cancer,
which are
partly associated with the consumption of alcohol, contribute to
another
17,000 deaths. Alcohol-related strokes are responsible for 9,000
deaths.
25,000 lost lives are due to 12 alcohol-related diseases
including cirrhosis of
the liver. All these deaths combined are the
equivalent of 200 jumbo jetliners
crashing and taking the lives of everyone
onboard, in just one year. Such
numbers are staggering until you realize that
it is Coronary Heart Disease that
is the number one killer in the United
States, not alcohol. There are roughly
900,000 persons admitted to U.S.
hospitals for strokes annually and 830,00
admitted for Congestive Heart
Failure. Though they are not always fatal, these
diseases will leave its
victims at varying levels of incapacitation. Looking at
specific age groups,
cardiovascular disease is the #1 killer of those age 65+
and #2 killer of
those age 25 – 64 This is a political issue for the U.S. with
so many lives
lost to alcohol-related disease and accidents. Leaders will not be
perceived
favorably by designating research money to study the health benefits
of a
drug responsible for damaging so many lives. I believe it is this
political
climate which limits research in this area, and I believe it is
this climate
that limits the amount of coverage the media provides about its
possible
benefits. As I began to research this subject I was intrigued by the
vast number
of articles and studies on the health benefits of wine. The
industry has
submitted a number of press releases attempting to counter the
negative social
stigma alcohol had developed circa 1992 - 98. These articles
aside, I found
reputable sources, with published reports, from such respected
names as Harvard,
UC Davis, Georgetown, and the Mayo Clinic. Several of
these studies have been
published in the American Medical Journal, and the
New England Journal of
Medicine. I found articles referring to the
"French Paradox." This is an
occurrence where the French diet contains equal
levels of fat as the U.S.
however the coronary disease related mortality rate
of France is 1/3 that of the
U.S. diet. I believe we must investigate and
prove or disprove the assertion
that wine is somehow involved. Either we are
letting hundreds of thousands of
people die or become severely debilitated
senselessly by not taking advantage of
wine’s possible benefits, or we are
allowing an industry to spread half-truths
with the potential of hurting
unsuspecting consumers. Mounting evidence
continues to suggest that when
taken with a balanced diet, moderate amounts of
wine can reduce the level of
LDL cholesterol in the bloodstream, reduce the risk
of heart disease, reduce
the risk of stroke, and thus lower mortality rates.
DEFINING THE PROBLEM
Are there health benefits to drinking moderate amounts of
wine, which will
reduce the mortality rate in humans? HYPOTHESIS Even though fat
intake in
France is similar to the American diet, the liberal consumption of
wine in
France protects the French against coronary heart disease by lowering
LDL
cholesterol and thereby lowering the risk of blockage, thus
reducing
mortality rates. EVIDENCE First, mounting evidence continues to
suggest that
when taken with a balanced diet, moderate amounts of wine can
reduce the level
of LDL cholesterol in the bloodstream. The human body
manufactures approximately
80% of the cholesterol used and stored in its
cells. The remaining 20% is
derived from eating animal products. Cholesterol
is transported through the body
via the bloodstream. To allow this, the body
attaches a protein to the
cholesterol. This combination is called a
lipoprotein. The body requires
high-density lipoprotein (HDL) cholesterol
("good cholesterol") to assist in
the removal of low-density lipoprotein
(LDL) or "bad" cholesterol from the
blood vessels. Failure to remove
excessive amounts of LDL cholesterol will
result in a plaque buildup and
blockage of the body’s main arteries. Blockages
may occur gradually or
suddenly. Plaque can break off and create a blood clot,
with the consequences
of a possible heart attack or stroke. Doctors at the Mayo
Clinic suggest
a low-fat diet and exercise to lower and maintain the correct
balance of
cholesterol. If the balance can not be achieved through diet and
exercise,
drugs are now available to reduce levels of HDL cholesterol; drugs for
this
treatment however are costly (up to $200 per month) and are associated
with
some risk of liver damage. In a Mayo Clinic Dietician report the clinic
sites a
1997 American Journal of Cardiology report that alcohol provides
the greatest
benefit by raising high density lipoprotein... and by decreasing
the stickiness
of blood, making it less likely to clot." The report continued
by saying red
wines contain the antioxidants: flavonoids and phenols, which
hinder plaque from
forming. These antioxidants also possess an anti-clotting
quality. Wine contains
approximately 200 different phenolic compounds, but
only a handful are
considered antioxidants. The antioxidant flavonoids are
water-soluble plant
pigments. First discovered by the Nobel Prize winning
scientist Dr. Albert
Szent-Gyorgyi (who first discovered Vitamin C), Dr.
Szent-Gyorgyi found that
flavonoids strengthened capillary walls even better
than Vitamin C. The main
sources of flavonoids include fruit, tea, and soy.
The report stated that "the
flavonoids in these foods protect against heart
disease and cancer." Dr Andrew
Waterhouse of the University of Davis,
Department of Viticulture, and Enology
says wine "is one of the best sources
of phenolic antioxidants available to
Americans." Davis researchers
believe wine to possess five times the phenolic
levels of fresh grapes.
Researchers at the Mayo Clinic as well as those at the
University of
California at Davis did stress alcohol is a highly addictive drug,
and may
not be appropriate for all persons (including children, adolescents
and
persons with addiction issues). If used however, they believe wine should
be
used only in moderation. Because of differing opinions on its benefits,
the
researchers did not suggest that any patient "start" drinking. Evidence
is
mounting however that wine has the ability to lower LDL cholesterol, and
reduces
the damaging affects of the "bad" cholesterol. Next, mounting
evidence
continues to suggest that when taken with a balanced diet, moderate
amounts of
wine can reduce the risk of heart disease, and thus lower
mortality rates. A CNN
report by Hacsi Horvath said on the benefits of wine,
"Several studies have
shown that drinking a glass or two with meals may
indeed help to protect against
heart disease." The report referred to what
some call the "French Paradox"
a phenomenon where out of 21 affluent
countries studied, France has the highest
wine consumption rate, and the
second lowest cardiovascular disease mortality
rate. Others have given credit
for this healthful success to the
"Mediterranean Diet," which includes: ?
Low red meat ? Low
lard or butter, higher olive oil ? High in fish ? High in
cheese,
low in whole milk ? High in breads, fruits, and vegetables ?
Light
to moderate wine drinking Horvath says other studies have shown that
wine
drinkers may simply be more concerned about their health, as compared
to
non-drinkers, beer drinkers, or hard liquor drinkers. Some studies have
shown
wine drinkers tend to eat less fat, and more fruits, vegetables, and
fish. This
would coincide with the Mediterranean Diet. So why not simply
drink more grape,
or other dark fruit juices? Horvath’s report said this
would be beneficial,
however other reports have suggested the concentration
of phenolic compounds was
greater in red wines because the juice is actually
fermented with the grape
skins, pulp, and stems. In addition, during the
processing of ordinary juices
the juice is exposed to much oxygen, greatly
reducing the healthful benefits.
Winemaking on the other hand is an
anaerobic process; the healthful properties
of the compounds are maintained.
So, juice is good but wine is better. Dr.
Jean-Paul Broustet of Haut
Leveque Hospital in Pessac, southern France, writing
an editorial for the
British medical journal Heart noted red wine as one of the
best components
contributing to a healthy heart. He states its beneficial traits
of lowering
LDL cholesterol, but also notes the presence of resveratrol a
compound that
heightens the production of HDL cholesterol. Red grapes produce
resveratrol
to protect themselves from fungus. "The highest concentrations
of
resveratrol... are found in the red wines, particularly in Cabernet
Sauvignon
grapes of Bordeaux." Because red wines ferment with grape skins and
stem
parts, the red wines have higher concentrations of resveratrol than do
white
wines. It is believed that some phenolic compounds including
resveratrol act as
antioxidants to prevent cell damage from oxygen-containing
chemicals known as
free radicals. The CNN report concluded that there was
still much evidence
however that it is primarily the alcohol, which acts to
lower LDL protein by
thinning the blood. Yet, wine with a balanced low fat
diet, maintained lower
levels of LDL cholesterol which contributes to a lower
frequency of heart
disease and lower mortality rates. Lastly, mounting
evidence continues to
suggest that when taken with a balanced diet, moderate
amounts of wine reduce
the risk of stroke, and thus lower mortality rates. A
CNN review of a study
recently published in the Journal of the American
Medical Association it says,
"alcohol consumption appears to protect
against ischemic strokes, which occur
when the blood supply to the brain is
blocked by a blood clot." Dr. Salvatore
says that 80% of all strokes are
ischemic strokes. The study group included 677
people forty years of age and
older, from Manhattan, who had suffered an
ischemic stroke. Test results were
compared to 1,139 subjects from the same
community; those who drank up to two
drinks per day had a 45% lower risk for
suffering a stroke. Another study
found similar results. Dr. Michael Elkind of
Columbia University said,
"Our study showed that having a drink a day or
perhaps two drinks per day can
reduce the risk of stroke perhaps as much as
50%." Yet another, and much
larger 16-year study of 13,000 test subjects in
Denmark just one year
earlier found similar results (32% less chance of stroke)
from drinking one
glass of wine per day. The study had not gained much attention
in the United
States because the sample included only one ethnic race. Dr.
Stuart
Seides, a cardiologist with the American Heart Association noted "that
the
study is based on one ethnic population, while Americans are a diverse
lot
with many dietary habits." In Dr. Salvatore’s more recent study
however,
test results were consistent across white, African American, and
Hispanic
groups. The Danish test contrasted the variables of wine, beer, and
hard liquor.
The same positive results were not achieved for the beer or
hard liquor
drinkers. Another researcher, Jane Freedman conducting a study at
Georgetown
University Medical Center introduced grape juice to cells that
cause clotting,
and said, "they have a much less tendency to form clots." Two
other studies
supporting the benefits of moderate consumption of wine include
the
Harvard-based Nurses Health Study and the Physicians Health Study.
These studies
found moderate drinking lowers women’s risk of death by 17% and
men’s risk
by 22%. Possibly because of its antioxidant value, and/or its
blood thinning
effects, but evidence from studies continues to grow showing
the moderate use of
wine has a positive influence on decreasing the risk of
stroke. CONCLUSION A
drink is commonly defined as 12 ounces of beer or wine
cooler, 5 ounces of wine,
or 1½ ounces of 80-proof distilled spirits.
Researchers all agree moderation is
an important control. Evidence exists
that wine in moderation (1 – 2 drinks
per day) as part of a healthy diet does
provide health benefits. However like
other drugs, abuse of wine can prove
destructive. If a greater number of persons
with heart disease may benefit
from moderate consumption of wine, should we
limit further research because
of those who may abuse the drug? If we apply this
logic to all controlled
substances, we would not have access to many of the
life-saving (or
pain-killing) drugs available today. Existing research seems to
indicate that
further studies are required to determine the comparative levels
of
effectiveness between overall diet, the moderate consumption of wine
with
meals, and though not addressed in this report: exercise. Lower LDL
cholesterol
levels seem to be an important factor to reducing the risk of
stroke and heart
attack. The studies I reviewed indicate each of these
factors contribute to a
healthier life.
Bibliography
Rodger
Doyle, Deaths Due to Alcohol, (Scientific America, 1996)
www.health.org
American Heart Association, Cardiovascular Diseases
Biostatistical Fact Sheets,
(American Heart Association, 1996)
www.americanheart.org Mayo Clinic, Mayo
Health Oasis, (Mayo Clinic, 1997)
www.mayohealth.org Jack Challem, The Color of
Health: Why Nutrients
Called Flavonoids Are Good For You, (The Nutrition
Reporter, 1994) Dr.
Andrew Waterhouse, Wine Antioxidants May Reduce Heart
Disease and Cancer,
(Washington, DC: American Chemical Society, 1994)
www.wineinstitute.org Hacsi
Horvath, Will Wine Help Your Heart?, (Web MD, Inc,
1999) www.cnn.com CNN
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CNN, 1999) www.cnn.com CNN interactive, Cabernet Sauvignon
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Salvatore,
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(New
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Alcohol
Consumption May Protect Against Stroke, (New York: CNN, 1999)
www.cnn.com Louise
Schiavone, Study Links Moderate Wine Drinking, Lower
Stroke Risk, (Washington:
CNN, 1998) www.cnn.com Louise Schiavone, Study
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www.cnn.com CNN interactive, A Drink
A Day Keeps the Grime Reaper Away,
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