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Wednesday, April 21, 2010

Alcohol and Health

*** A GLASS A DAY ***
Why a glass a day WILL keep the doctor away?? An advice to teetotallers...........

Health benefits : Women put on less weight if they stick to red wine rather than soft drinks or other beverages.
The health benefits of red wine have long been a consolation to those who enjoy an occasional glass or two. But the news has got even better. A study has shown that moderate women drinkers put on less weight than those who stick to soft drinks - and those who drank red wine put on the least weight. The findings by Brigham & Women’s Hospital in Boston suggest drinkers turn the calories into heat, not fat.

Here we look at the other surprising ways in which alcohol - when taken in moderation - may benefit your body. Men should not exceed three to four units a day and women should not exceed two to three units a day.
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RED WINE
BENEFITS : Fights cancer, raises good cholesterol, boosts brain power, helps insomnia and protects against hearing and tooth decay.The health benefits of red wine are down to resveratrol, a plant chemical in the skins and pips of grapes. Salicylate, an antioxidant in red wine, can help to prevent deafness by protecting the tiny hairs in the inner ear that are vital for hearing.
It can also sharpen your wits, says Dr Clinton Wright, professor of neurology at Columbia University, New York, who found moderate red wine drinkers score higher in mental agility tests than teetotallers.
A team of U.S. researchers discovered that chemicals in the seeds and skins of grapes blocked the ability of corrosive bacteria to bind with tooth enamel, protecting teeth from decay.
Red wine can also help insomnia, according to the University of Milan. Grape skins contain melatonin, a hormone that keeps body clocks in check and induces sleep.
BEER
BENEFITS : Contains vitamins and minerals needed to protect the heart and bones, plus fibre.
A pint of ale contains more than a quarter of an adult’s recommended daily dose of vitamin B folate, which stops the build-up of homocysteine, linked to heart attacks.
Beer also contains boron, another trace mineral needed to maintain healthy bones. A pint supplies a tenth of the recommended daily allowance of niacin, which is needed to help release energy from food, as well as 10 per cent of an adult’s daily fibre needs.
A pint a day reduces the risk of kidney stones by up to 40 per cent because beer is low in calcium and high in magnesium - key factors in avoiding stone formation.
Like red wine, one beer a day cuts the risk of heart disease and strokes, thanks to its antioxidants.
But does it give you a beer belly? Martin Bobak, an epidemiologist at University College London, compared 2,000 beer drinkers with non- drinkers. There was little difference in their waist-hip ratios.

GINBENEFITS : Anti-inflammatory, diuretic.Gin is a distilled form of pure alcohol with few chemical congeners - or impurities - to give you a hangover.
It is flavoured with juniper, a berry known for its diuretic properties and used in herbal medicine to treat kidney and bladder stones, and bloating.
Juniper has anti-inflammatory properties that help relieve arthritis, rheumatism and gout.

WHITE WINE
BENEFITS : Lowers cholesterol; benefits lungs; anti-inflammatory.The grape flesh used in white wine contains the chemicals tyrosol and hydroxytyrosol, which lower artery-clogging LDL cholesterol. When drunk moderately, white wine may help keep lungs healthy over a lifetime. Its antioxidants protect against harmful molecules that can damage lung tissues.
White wine also contains caffeic acid, which can help to suppress inflammation. This may help ease pain suffered by people with inflammatory conditions such as rheumatoid arthritis.

BRANDYBENEFITS : Protects against heart attacks and blood clots.As a distillation of red wine, brandy contains high concentration of phenolics or antioxidants, which mop up free radicals that damage organs and tissues - 30ml provide the equivalent antioxidant potential as the daily recommended intake of vitamin C.
The University of Bordeaux has shown that a regular tot of Armagnac has a similar effect to aspirin because it helps stave off heart attacks and blood clots. It is believed this is due to brandy being stored in oak casks, which are high in anti- oxidant plant compounds that mop up damaging free radicals in the body.

CHAMPAGNEBENEFITS : Helps brain injuries.Researchers triggered a stroke in two groups of mice. The group which had champagne - which is packed with antioxidants - had more protection against brain cell damage.
To our health! Champagne is packed with antioxidants and helps protect against brain cell damage.

BAILEYSBENEFITS : Protects against cancer.This Irish liqueur contains whiskey, which has high levels of ellagic acid. This inhibits the growth of tumours caused by carcinogens and kills cancer cells without damaging healthy cells.
The Hollings Cancer Institute at the University of South Carolina carried out clinical trials on 500 cervical cancer patients over nine years. They found ellagic acid stopped cancer cells dividing.

SHERRYBENEFITS : Protects heart.
Sherry shares many of the antiinflammatory benefits as red wine. It contains high levels of polyphenols, believed to reduce the risk of coronary artery disease.
These protect the heart by preventing ‘bad’ cholesterol from becoming sticky and building up as a deposit on blood vessel walls. They also increase the body’s production of ‘good’ cholesterol.

CIDER
BENEFITS : Protects against high blood pressure and heart disease; good for muscle control.According to the Institute of Food Research at Norwich, cider has the same level of antioxidants as green tea, blackcurrant juice or red wine, helping to fight disease.
It is also high in potassium, needed for nerve function, muscle control and to regulate blood pressure. Low levels of potassium are linked to hypertension, diabetes, stroke and heart disease.

GUINESS
BENEFITS : Protects against blood clots and heart attacks.Researchers at the University of Wisconsin found a daily Guinness with a meal reduced clots and the risk of heart attacks.
This is because it contains antioxidants - similar to those found in fruit.
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(Courtesy of a forwarded mail from CK Cheong)----------------------------------------
A fair, prudent and critical, albeit a little lengthy, professional comment, or more aptly a great piece of lecture notes, by medical research scientist cum nutritionist Dr Lim Ju Boo (pic right), BSc, Postgrad Dip Nutr (Lond), MSc (R’dg), MD, PhD (Med), FRSH (Lond), FRSMed (Lond), DSc (Int Medicine) Malaysia, is reproduced as follows:

Is Wine and Alcoholic beverages good for health?
Thank you for referring this question to me.

To some extent it is true that red wine drunk in moderation s good for the heart and prevents free radical damage. The active ingredient in red wine is resveratrol which act as an antioxidant to quench free radical damage. There are several studies on this. This is correct.

Salicylates in food:

But I am unsure if red wine contains salicylate which is the natural form of aspirin (acetylsalicylic acid) as claimed in the article? But we do know that a lot of fruits and vegetables, especially curry leaves and curry spices contain a very high content of salicylates, and this has been shown to prevent heart disease and colorectal cancers. I am also unsure if wine is good for gout as claimed in your article. This seems to contradict what nutritionists believe. This is because of the high content of salicylates in wine as mentioned in the article.

Uric acid-salicylate relation:

Do salicylates promotes or inhibit the excretion of uric acid? I cannot be too sure of the answer based on my current knowledge on nutrition and pharmacology. So I did an extensive literature search on this subject, and the findings are very contradictory and controversial. The researchers there themselves are not too sure based on current knowledge on the pharmacokinetics of urate-salicylate renal reabsorption and their co-relation with blood-urine acidity.

Of course some clinicians who are not too well versed in pharmacology will tell you that taking aspirin will aggravate gout because it prevents the excretion of uric acid. It is not as simple as that because other researchers found it the other way. It is a very complicated pharmcodynamics –pharmacokinetics- biochemical mechanism which also involves renal physiology. So we cannot be too sure. So you must be very careful what unqualified people advise you through e-mails. They simply take the claims from the Internet and circulate them round to everyone. I have people doing this to me.

But we think that in obese individuals drinking large amounts of alcohol can interferes with excretion of uric acid, because alcoholic beverages contain purines which may aggregate the disorder further. This also is very controversial. Some think not, others think otherwise. We need to do extensive literature review to answer this. Nutrition is a very tough and complicated subject, often so confusing even to us as researchers.

A different initial metabolic pathway alcohol takes:
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Wine and all alcoholic do contain energy – calories, and although the metabolism of alcohol initially follow a different metabolic pathway using alcohol dehydrogenase. The first step in the metabolism of alcohol is the oxidation of ethanol to acetaldehyde catalyzed by alcohol dehydrogenase containing the coenzyme NAD+. The acetaldehyde is further oxidized to acetic acid and finally CO2 and water through the citric acid cycle. A number of metabolic effects from alcohol are directly linked to the production of an excess of both NADH and acetaldehyde.
Alcohol can be toxic:

Alcohol causes inflammation of the stomach, pancreas, and intestines which impairs the digestion of food and absorption into blood. Moreover, the acetaldehyde (the oxidation product) can interfere with the activation of vitamins, and damage the organs, especially the liver, brain and the eyes. In the liver, the enzyme alcohol dehydrogenase oxidizes ethanol into acetaldehyde, which is then further converted into the harmless acetic acid (vinegar) by acetaldehyde dehydrogenase.

Acetaldehyde is more toxic than alcohol and is responsible for many hangover symptoms. N-acetylcysteine (NAC) is known to assist in processing acetaldehyde in the body and therefore can help to relieve hangover symptoms.
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Individuals with deficient acetaldehyde dehydrogenase activity are far less likely to become alcoholics, but seem to be at a greater risk of liver damage, alcohol-induced asthma, and contracting cancers of the oro-pharynx and esophagus due to acetaldehyde overexposure. Furthermore if any alcoholic beverages if taken in excess, it can damage the liver and kidney.

Okay in moderation:

With moderate drinking, the liver can process alcohol fairly safely. However, heavy drinking overtaxes the liver resulting in serious consequences. A liver clogged with fat causes liver cells to become less efficient at performing their necessary tasks, resulting in impairment of nutritional health. Fatty liver is the first stage of liver deterioration in heavy drinkers, and interferes with the distribution of oxygen and nutrients to the liver cells. If the condition persists long enough, the liver cells will die, forming fibrous scar tissue (the second stage of liver deterioration, or fibrosis).

Only organ that can regenerate in humans:
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Some liver cells can regenerate with good nutrition and abstinence, however in the last stage of deterioration, or cirrhosis, the damage to the liver cells is the least reversible. Cirrhosis of the liver is a precursor to cancer of the liver (hepatoma). So just be very careful no matter how beneficial red wine or other alcoholic beverages are. In moderation or an occasional social drink is okay.

Energy supply:

The initial metabolic pathway of alcohol is quite different from those of carbohydrates, starches and sugars, fats and proteins where they all have to enter the Kreb’s Cycle directly after digestion. This metabolic cycle, also known as citric acid cycle or tricarboxylic acid cycle (TCA cycle), or more rarely, called the Szent-Györgyi-Krebs cycle is where all nutrients enter for metabolism, and the release of energy later through oxidative phosphorylation.

This is a separate metabolic pathway that uses energy released by the oxidation of nutrients to produce adenosine triphosphate (ATP), but we shall not go into the depth of this biochemistry.

The alcohol by taking a different metabolic pathway to provide energy directly, do spare carbohydrates and sugars from being metabolized initially. By providing an alternative source of energy, this causes an accumulation of un-burnt energy supposed to come from carbohydrates and sugars. This cause all the other nutrients to dam back and stored as fat. That is why alcoholics normally do have a pot-belly due to the accumulation of unused fat.

Not orthodox:

So the info you sent me – I quote here “but does it give you a beer belly? Martin Bobak, an epidemiologist at University College London, compared 2,000 beer drinkers with non- drinkers. There was little difference in their waist-hip ratios” is not true as far as scientists and nutritionists know this far. Maybe it is a new finding?

Surprising finding:

As a nutritionist and researcher, I really need to study (not just read) the original published paper. I need to know how Martin Bobak came to this unusual conclusion different from what we conventionally know. This is because there are so many other factors that can influence the development of pot-belly and obesity, and not just alcohol. So I really need to know how he did the study because of so many other influencing factors towards abdominal obesity.

Proper study design is extremely important:

Normally a biomedical statistician will need to come in to help with the design of the study, before the researcher begins experimenting to gather the data. The design of the study is extremely, extremely important. If the initial design is faulty, then no matter how large the population size the study, or how fantastic and dynamics the study was, the data collected will all have to be thrown into dust bin. The study is deemed to be statistically faulty.

This is a very serious error, and we as research scientists have to listen to the statistician. He has the technical power to criticize the validity of the study. Normally the scientific community listens to the statistician and takes his advice before designing any serious study.

If there are too many factors influencing the study, then the appropriate meta-analysis need to be applied after controlling as many confronting factors as possible before we can be sure we are interpreting the results correctly?
Medical statistics needed:

In short, all biomedical scientists, including research clinicians (highly qualified specialist doctors with an additional research PhD degree) must have a very powerful knowledge of statistics, else, what ever they say nobody in the academia would listen. They will throw them into the dustbins, and the editors of scientific journals will also do the same. It is not as easy as that by just claiming. This is science, not fairy tales.
So it is only fair for me to say that many things in the article there I do not have the answers. I need to study the original findings first, and not something friends and strangers pick it up from some websites in the Internet and have them circulated round to everybody, shouting out claims like empty gongs. Some unqualified people in the past have done this to me. Of course I ignore them because they do not have the scientific training and credentials. They were just parrots hearing, imitating and copying fairy tales to others.

Original paper needed:

Normally we as research scientists refer to the original peer-reviewed paper published in respected international refereed journals. We then cross-check with other findings published elsewhere. We do not accept all sorts of claims circulated via e-mails and things mentioned in the Internet. We are very professional and highly ethical as far this is concerned. Of course if
they are jokes (as I very often do) they are okay. Sometimes we do also need to release tension from our profession - by writing jokes.

Researchers worthy of their salt do not normally depend on the Internet info because anyone without qualifications and credentials can write anything inside a website. There is no cited references, no statistical and mathematical analysis shown there, but just claims and claims that’s all.

So as a medical research scientist, I really do not know the answers to all the other things you sent. I need to read the original papers before answering you. But there was no citation inside. It would be very unprofessional if I agree everything there.

I hope this answers your question.

JB Lim
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(Note: The sentences or phrases highlighted in orange are selected by the blogger who feels that they are tantamount to "words of wisdom" worthy of attention to all internet addicts. )