Can a Little Alcohol Cut Stroke Risk? A Doctor Weighs In

Translated by: Ana Badica

source: https://shueisha.online/articles/-/252103

As New-Year’s celebrations grow near, the opportunities to drown ourselves in alcohol do as well. Controversy abounds as some vociferously proclaim the detriments of drinking, while, on the other hand there are those who advocate for the long-term benefits of responsible consumption, remembering the age-old adage: “A good wine makes good blood” (in Japanese: “Alcohol is chief of all medicine”). So it’s only natural that we would ask ourselves: is alcohol good or bad for us?

Dr. Yusuke Tsugawa, Associate Professor, Physician at UCLA, and author of “10 rules to protect you from illness: a guide to understanding medical knowledge” explains to us the real effects of alcohol – and it’s all based on rigorous evidence.

Is alcohol good or bad for us?

Many people view alcohol as a tool to enjoy life. There are those who drink alcohol in order to alleviate anxiety or stress, and those who simply enjoy going drinking with their buddies – what we would call social drinking.

Then there are those, depending on the work culture at their respective workplaces – who end up going for a drink with their colleagues or mates every night. It’s usually those of this former category that are the most worried about the effects of alcohol on our health.

We’ve all heard stories about alcohol consumption led to disastrous health outcomes, or have family members who claim that drinking moderately actually led to a more balanced lifestyle, so it’s no wonder that we might feel lost amongst this throng of contradictory information.

But there is actually a reason for this contradiction, and it’s not just a matter of opinion. The results of multiple studies have led to these two diverging opinions which is why we have ended up with so many unanswered questions.

When it comes to illness where arteriosclerosis causes our blood vessels to get blocked, studies have shown that drinking irresponsibly leads to an increased risk of strokes, while drinking moderately can actually reduce the risk, but in the case of cancer, any amount of alcohol extensively increases the risk of the cancer to develop further.

This differentiation on how alcohol interacts with certain diseases and illnesses is the main cause of the confusion surrounding alcohol consumption. 

Therefore, let’s examine a bit more deeply what we actually know about alcohol.

Moderate consumption can reduce the risk of stroke?

This belief (namely that moderate consumption reduces the risk of stroke and aids with maintaining a balanced diet) actually comes from France. It has been known for several decades that smoking and having a diet rich in fats greatly increases the risk of arteriosclerosis, which in turn can lead to cerebral and myocardial infarction.

However, studies have reported that amongst all European countries, France has fewer deaths from myocardial infarctions despite their consumption of buttery foods and smoking habits, phenomenon dubbed “the French paradox”, and this is what has sparked the hypothesis that moderate consumption of alcohol is actually healthy.

After that, several studies reported that the consumption of alcohol helps preventing arteriosclerosis, and from this the belief that alcohol is good for us was born.

For example, in 2018, world-renowned and critically-acclaimed medical journal “Lancet” published an article that summarised the results of 83 previously conducted studies with the conclusion that even if we consumed an equivalent of 100g of alcohol per week, our risk of arteriosclerosis and cardiovascular disease would not increase.

However it’s important to note that a causal relationship between the consumption of alcohol and risk factors of infarction has not been clearly established nor has it been shown that people who already were not at risk of myocardial infarction became more likely to suffer more cardiovascular disease.

Due to many genetic factors, some people are able to consume alcohol without feeling any effect while others might find their face becomes red and inflamed, and it’s not unreasonable to say that people who understand they are lightweights tend to avoid over-consuming alcohol. Therefore, it is believed that people who have a genetic predisposition that prevents them from consuming alcohol in vast amounts may also have the genetic markup to protect them from developing cardiovascular diseases.

That being said, if small amounts of alcohol do not increase the risk of infarction, what effects does alcohol have on other types of diseases and illnesses?

Alcohol and Cancer: Destined to be enemies?

As a matter of fact, cancer (especially breast cancer) seem to be a deadly combination. In other words, the effect that alcohol has on your body actually depends on your genetic predisposition to succumb to different types of illnesses.

In 2018, The Lancet published another paper that assessed the overall impact of alcohol and cancer.

This large-scale paper combined research from 592 studies conducted in 195 countries all around the world and provided a comprehensive assessment of the effects of alcohol on 23 health markers, including myocardial infarction and breast cancer.

The relationship between alcohol intake and risk of alcohol-related diseases

According to the paper, one serving of alcohol a day represents little to no risk. One serving, that is 10g of pure alcohol, is identical to a glass of wine or a pint of beer.

The paper found that the most reliable amount of alcohol consumed in order to minimise risk, with a probability of 95%, is between 0 and 0.8 servings. In response to the paper, many found themselves thinking that of course, 0 is the best way to make sure we minimise our risk, but the study shows that even one serving does little to put our health on the line.

Looking at alcohol consumption through the lens of cardiovascular disease, it can be observed that women who drank 0.92 servings per day and men who drank 0.83 had a significantly lower risk than those who drank more than 1 serving per day.

On the other hand, in the case of women who consumed any amount of alcohol (even less than one serving), the risk for tuberculosis and breast cancer increased significantly (while for men, the risk of mouth cancer increased exponentially), so the lower risk of infarction is offset by the higher risk of cancer or alcohol-related traffic accidents.

DNA Match-making

By taking all of this into consideration, how should we change our lifestyle? It’s only natural that everyone must make their decision based on their own genetic predispositions.

If you’ve had no close family members who have had cancer (or family members with low risks of cancer), then having a serving or two a day of alcohol probably will not hurt you in the long run. For many, this choice might improve their quality of life and have the added benefit of reducing their risk of cardiovascular disease.

On the other hand, to those who have higher risk of cancer, staying away from alcohol might be a more appropriate decision.

Of course, there are those who love alcohol and believe that limiting yourself this much makes life boring – to them, abstinence may be advisable only through the recommendation of a doctor.

Only one thing is clear: alcohol is not a one-pint-fits-all.