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Posts Tagged ‘INTERHEART study’

Putative mechanisms 

Forget about the mechanisms. Is it really beneficial?

Very valid question. No simple answers are available. But, some truths try to emanate from this big epidemiological study by INTERHEART that found the beneficial effect of minimal amounts of alcohol with a wide geographical variation.(Mind you INTERHEART can be Interpreted totally differently if type and amount of alcohol are counted)

How much alcohol is acceptable asper ADA recommendation?

The ADA recommends no more than one alcoholic drink per day for women • no more than two drinks per day for men. One drink is defined as 12 ounces of beer • 5 ounces of wine • 1 ½ ounces of liquor.

Does this apply to the Indian population?

No, it doesn’t apply for behavioral and possibly genetic reasons.  (A. Roy, et al Impact of alcohol on coronary heart disease in Indian men, Atherosclerosis, Volume 210, Issue 2, 2010, Pages 531-535,) 

                                            One of the daily scenes In India, at an Alcohol-human Interaction site 

Final message

It is true, disciplined alcohol intake seems to do good if the person takes care of his other lifestyles and potential risk factors. The beneficial effect of moderate alcohol on lipids, and vascular endothelium is based on a weak evidence base, but still good enough to create a recommendation. These (flimsy ?) advantages of alcohol are lost if it exceeds 2 units per day. Meanwhile. let us be aware, alcohol enhances the global burden of disease by many folds and  it should never be tried as the therapeutic drug is a logical and popular opinion (Lancet 2016)

Further research question

All of us would agree, regular alcohol intake, in any amount will end up in danger for native Indians. Now, can an NRI or resident Indian, blessed with so-called western drinking discipline accrue the true benefits of moderate alcohol intake? is a  big research/common sense question.

Reference 

1.Conner H, Marks V: Alcohol and diabetes: a position paper prepared by the Nutrition Subcommittee of the British Diabetic Association’s Medical Advisory Committee.  Diabet Med 2: 413–416, 1985

2.https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm

3.Vu KN, Ballantyne CM, Hoogeveen RC, Nambi V, Volcik KA, Boerwinkle E, et al. (2016) Causal Role of Alcohol Consumption in an Improved Lipid Profile: The Atherosclerosis Risk in Communities (ARIC) Study. PLoS ONE 11(2): e0148765. https://doi.org/10.1371/journal.pone.0148765

4.Leong DP, Smyth A, Teo ; INTERHEART Investigators. Patterns of alcohol consumption and myocardial infarction risk: observations from 52 countries in the INTERHEART case-control study. Circulation. 2014 Jul 29;130(5):390-8. 

 

* ELI -Evidenceless Imagination (Closely associated with class C evidence)

 

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“It seems  certain . . . both  zero alcohol  intake and excessive alcohol  confers cardiac risk   “

I stumbled upon  the above   conclusion    from a respectable source*

*This  is from the  famous  INTERHEART  study published in Lancet.

Can it be true ?   What is the proof ?

Consuming  moderate   quantity of  alcohol  reduces  cardiac risk

  Does it make sense  to  skew   this   statement  like this

   . . . Not taking  alcohol   would   be a cardiac  risk  in other wise healthy individual .

Can we  profess  such a reasoning ?  My colleagues call it stupidity ?

If  it is true ,  are we justified  to use  alcohol as  a primary prevention drug ?

Which type  of alcohol we are  talking about ?

I am struggling to get specific answers .

After reading the INTERHEART study , my conviction is  the  “dangerous suggestion”   may indeed  have a significant  quantum of truth !  Readers may share their thinking .

In a country like India where alcohol is considered as a  killer chemical with a huge social stigma ,  it is  blasphemous to suggest  not taking it can be  cardiac  risk factor !

Reference

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2804%2917018-9/abstract#

A. DiCastelnuovo, S. Castanzo, V. Bagnardi, M.B. Donati, L. Iacoviello, G. de Gaetano. Alcohol dosing and total mortality in men and women. Arch Intern Med 166;2006: 2437-2445

R. Femia, A. Natali, A. L’Abbate, E. Ferrannini. Coronary atherosclerosis and alcohol consumption: angiographic and mortality data. Arterioscler Thromb Vasc Biol 26;2006: 1607-1612

D.L. Lucas, R.A. Brown, M. Wassef, T.D. Giles. Alcohol and the cardiovascular system. J Am Coll Cardiol 45;2005: 1916-1924

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