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Sunday, June 23, 2013

Vitamin Alcohol: Is it a cardio tonic ?

Alcohol or liquor.  दारू or शराब in local lingo. The word is a deterrent in social circles especially the Muslim community. The topic itself is taboo and any discussion related to that would be considered a heinous crime. 
But, doctors as we are. Our medical history isn't complete without the mandatory questions related to alcohol or tobacco intake. 
Just the other day, I was put in a terrible professional dilemma. A middle aged, educated Muslim gentleman who had visited my chambers for a consultation, didn't deny that he was a social drinker. Since it was a routine health check up, I safely sidestepped the sensitive issue of alcoholism and gave the other relevant medical advice. But, Mr.X then posed the most difficult question to me. Doctor, he said, "Can I safely still continue my social drinking if all my parameters are normal?"
Being a Muslim myself, it was tough for me to allow him that liberty. But being a medico, I tried to sound politically correct and said, "better to avoid". And it was then that he asked the inevitable. The question that I dreaded to answer since long. "On the contrary, medical science says that moderate drinking is healthy for the heart and and helpful in various other conditions", he argued. I was left speechless. 


Heavy or binge alcohol consumption unquestionably leads to increased morbidity and mortality. Nevertheless, moderate alcohol consumption, especially alcoholic beverages rich in polyphenols, such as wine and beer, seem to confer cardiovascular protective effects in patients with documented CVD and even in healthy subjects.


Alcohol is absolutely contraindicated for pregnant women, children, patients with liver disease and in combination with certain medications. 

The basis of this theory dates back a long way to the times of the French Paradox

French Paradox:

It was the paradoxical observation that the French have a low incidence of coronary heart disease (CHD) despite subsisting on a diet rich in saturated fats.      

The two possible explanations are: First, the theory linking saturated fats to CHD is totally invalid. 
Second, the link between saturated fats and CHD is correct, but some intermediate factor in the diet or lifestyle of the French mitigates this risk. This factor was then identified as Red wine

This French paradox then triggered many a study where the effects of red wine and its components - polyphenols and resveratrol were evaluated. It also opened a debate as to which alcoholic beverage was more cardio protective. 


Moderate alcohol consumption is cardio protective. But how much is moderate?
The common man defines it thus: Moderate drinking may be defined as drinking that does not generally cause problems, either for the drinker or for the society. 

But US National Institute on Alcohol Abuse and Alcoholism (NIAAA) has defined moderate levels categorically as:-

Men: Maximum of 2 drinks per day or 14 drinks per week or 
4 drinks in a single day
Women: Maximum of 1 drink per day or 7 drinks per week or
3 drinks in a single day

Examples of one drink include:

Beer: 12 fluid ounces (355 milliliters)
Wine: 5 fluid ounces (148 milliliters)
Distilled spirits (80 proof): 1.5 fluid ounces (44 milliliters).


This difference in the gender is because the female sex is unable to metabolize alcohol as efficiently as its male counterpart due to reduced levels of the enzymes alcohol and aldehyde dehydrogenase. These enzymes help in the breakdown of alcohol and since females have a relative deficiency of these enzymes, they show higher levels of intoxication for the same amount of alcohol ingestion. 

To conclude,

The latest dietary guidelines thus make it clear that no one should begin drinking or drink more frequently on the basis of potential health benefits. So don't feel pressured to drink alcohol. But if you do drink alcohol and you're healthy, there's probably no need to stop as long as you drink responsibly and in moderation.








10 comments:

  1. i disagree with ur statement dat females are unable to metabolise alcohol as efficiently as men.....can u explain why females have low levels of aldehyde dehydrogenase or alcohol enzyme or watever u term it......????????

    ReplyDelete
  2. In one of the verses revealed The Koran statesthat alcohol contains some good and some evil, but the evil is greater than the good (In Surat al-Baqarah: 219).
    The Koran also states that "intoxicants and games of chance" (gambling) are sins. Alcohol and gambling fall in the same category.
    SO WHY GAMBLE (whether in moderation or in excess )WITH LIFE WHICH IS GOD'S GIFT
    For a healthy heart a healthy diet and exercise are sufficient. There is no need of alcohol even if consumed moderately by otherwise healthy people.

    ReplyDelete
  3. Nice article. Very precise. I liked the picture of the wine glasses forming a heart :-)

    ReplyDelete
  4. From the medical point of view, you have been honest in stating the facts, although being a practising Muslim.
    Now from the Muslim point of view. Quran states very explictly, the subject in discussion is 'haram' and is red wine and beer the only substances taken in moderate quantities good for the heart ? Are there no others ?
    So in short for a practising Muslim, it is better to 'let go ' the urge, have peace of mind - that which is more good for the heart.

    ReplyDelete
  5. From the medical point of view, you have been honest in stating the facts, although being a practising Muslim.
    Now from the Muslim point of view. Quran states very explictly, the subject in discussion is 'haram' and is red wine and beer the only substances taken in moderate quantities good for the heart ? Are there no others ?
    So in short for a practising Muslim, it is better to 'let go ' the urge, have peace of mind - that which is more good for the heart.

    ReplyDelete
  6. vot does dr matcheswala say ??????

    ReplyDelete