So What Does it Mean that Studies Reveal that Moderate Drinkers Are Healthier than Teetotalers ?

Personal Health

We know too much drinking can be hazardous to our health. But new research suggests that drinking too little might be hazardous, too.

I don't want to go to rehab, but a raft of recent studies show that moderate alcohol consumption lowers our risks for many dire conditions including heart disease, stroke, gallstones, diabetes and dementia. Some studies even suggest that the answer to pesky menopause symptoms comes in six-packs and goes great with pretzels.

The keyword here is "moderate." Some studies define this as one drink per week; others as up to four drinks per day. This haziness notwithstanding, these studies show that heavy drinkers are far more likely than moderate drinkers to die from certain diseases.

But so are people who don't drink at all.

It's a bell curve. But while one half of the bell is well, duh, the other half -- the half involving abstinence -- is pretty shocking. In study after study, abstainers get sick and die sooner and in larger numbers than moderate drinkers.

In these studies, "you get this protective effect no matter what you drink: wine, beer or liquor," says nutrition therapist Karen Scheuner.

Absinthe, beaujolais, King Cobra: It's all good -- or good for you.

"The benefits don't increase with amount," Scheuner says, "and they disappear altogether if you consume four or more drinks per day."

A study published this summer found that women who consume one drink daily and men who consume two drinks daily are 23 percent less likely than nondrinkers to develop Alzheimer's disease. Heavy drinkers, defined here as consumers of at least three to five drinks daily, face higher Alzheimer's risks than both moderate drinkers and abstainers. (Well, duh.)

And a study published in Annals of Internal Medicine found that, compared to abstinence, drinking one to three alcoholic beverages daily is associated with a 33 to 56 percent lower incidence of diabetes -- and imbibing over three drinks daily is associated with a 43 percent higher incidence of diabetes. (Duh again.)

A study presented two months ago at the European Respiratory Society Annual Congress found that both abstainers and heavy drinkers are nearly one and a half times as likely to develop asthma as are moderate drinkers, defined here as consumers of one to six alcoholic beverages per week. Abstainers face the highest asthma risk of all, topping even that of heavy drinkers.

A 2007 study found that drinking at least one alcoholic beverage daily is associated with a 30-percent lower risk than abstinence of developing one type of kidney cancer. But its authors warn that alcohol consumption -- light, heavy and moderate -- is linked with increased rates of breast cancer, liver cancer, oral cancer, esophageal cancer and other cancers. I don't like those odds.

A study published in the New England Journal of Medicine that tracked over 22,000 men for more than 12 years found that those who regularly consumed as little as one drink a week had a lower stroke risk than did abstainers. A study published in the Journal of Urology that tracked over 120,000 men found that those who regularly consumed at least 1.3 ounces of alcohol daily -- about half as much as is found in your average Manhattan -- had a 35-percent lower risk than abstainers did of developing prostatic hyperplasia, whose symptoms include incontinence and a wide array of other urinary woes.

Other recent studies found moderate drinkers facing significantly less risk than abstainers for macular degeneration, arthritis, osteoporosis -- and even death itself.

A 2010 study found that abstainers' all-cause mortality rate is twice as high as that of moderate drinkers. Examining death rates among middle-aged people, this study also found a 70 percent higher mortality rate for heavy drinkers than for moderate drinkers. So does abstaining mean you'll die that much sooner than both your social-drinker, daiquiri-a-day ex and alcoholic Uncle Joe, who blacks out in alleyways?

Is life unfair?

The trouble with scientifically studying alcohol consumption is that drinking habits are intertwined with countless variables that have less to do with physiology than with lifestyle, demographics and class -- and even intelligence.

What else is happening in the lives of those who drink nothing, a little or a lot?

"People who are at lower risk for the diseases related to moderate alchol consumption are also following these general guidelines as it relates to healthy behaviors: moderation, balance and variety," Scheuner says. "They likely also exercise in moderation, sleep the 'right' amount, eat a balanced and varied healthy diet that includes moderate alcohol, and keep their stress levels in a healthy range."

A Danish study investigating drinking patterns -- as opposed to quantities -- found that women who drink alcohol on at least one day per week have a lower risk of heart disease than women who drink less frequently. But the study's authors found that "unhealthy traits (smoking and a low intake of fruit and vegetables) were common at both extremes of drinking frequency" -- that is, common among both abstainers and heavy drinkers.

Sometimes the health benefits clearly come down to chemistry. Alcohol consumption increases heart-healthy high-density lipoprotein cholesterol, aka "good cholesterol." Alcohol consumption also protects against heart disease by lowering levels of fibrinogen, a plasma involved in blood clotting. Studies show that resveratrol, an antioxidant found in red wine, protects the heart and slows the aging process. Still more studies associate a hops-derived phytoestrogen with lower incidence of hot flashes, leading some to consider beer a natural menopause treatment.

Throughout history, alcoholic beverages have been used as medicine. Hippocrates recommended wine as a diuretic, sedative and fever reducer. Medieval Europeans quaffed huge quantities of gin and other spirits, believing this might stave off the Black Plague. Liquor-based "patent medicines" were an American frontier mainstay; one popular brand, Hostetter's Bitters, contained 43 percent alcohol. The 18th-century French monks who distilled 100 herbs, flowers and secret ingredients into Chartreuse called it an elixir végétal. In 1903, Britain's royal physician commissioned a London distillery to create a beverage that could "warm and revivify" King Edward VII, who was susceptible to colds. The result was a lustrously silky-spicy liqueur, the King's Ginger, still used by the royal family.

Our snake-oil-swigging ancestors weren't altogether idiots.

Alcoholism kills in a thousand ways. But somewhere in that borderland between avoidance and indulgence is a sweet spot. And at this point in history, science doesn't really know why.

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