[PHNUTR-L] Two Drinks Called Potent Addition to Heart-Healthy
fivestar at nutritionucanlivewith.com
Fri Oct 27 09:37:35 PDT 2006
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Two Drinks Called Potent Addition to Heart-Healthy Lifestyle
By Peggy Peck, Managing Editor, MedPage Today
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of
Pennsylvania School of Medicine.
October 26, 2006
BOSTON, Oct. 26 -- A couple of drinks -- liquor, wine, or beer -- added
daily to an already heart-healthy daily lifestyle further reduces the
risk of myocardial infarction in otherwise healthy men, found
* Explain to interested patients that these findings are based on
an observational study that cannot prove causality.
* Explain to interested patients that the benefit described here
was observed in men who were also following a heart-healthy regimen that
included a healthy diet, regular exercise, and abstinence from smoking.
Previous studies have linked moderate drinking to reduced risk of
cardiovascular events, but in those studies it was unclear whether the
benefit was from alcohol or some unmeasured, confounding factor, said
Kenneth J. Mukamal, M.D., M.P.H., of Beth Israel Deaconess Medical
Center and the Harvard School of Public Health, and colleagues.
To quell those lingering doubts, this study "focused on a tightly
restricted group of participants, that is, nonsmoking male health
professionals with healthy diets, regular vigorous physical activity,
and normal body weight."
Compared with non-drinking men who followed a healthy life style, men
who consumed an average of two alcoholic beverages a day were roughly
60% less likely to have an MI over 16 years of follow-up, they reported
in the Oct. 23 issue of Archives of Internal Medicine.
In this 8,867 cohort of healthy men who participated in the Health
Professionals Follow-up Study, compared with abstention, the hazard
ratios for MI in a multivariate model adjusted for age, parental history
of myocardial infarction, regular aspirin use, and history of
hypertension or hypercholesterolemia were:
* 0.98 (95% confidence interval, 0.55-1.74) for alcohol intake of
0.1 to 4.9 g/day (less than half a drink per day)
* 0.59 (95% confidence interval, 0.33-1.07) for alcohol intake of
5.0 to 14.9 g/day (up to one drink per day)
* 0.38 (95% confidence interval, 0.16-0.89) for alcohol intake of
15.0 to 29.9 g/day (one to two drinks per day)
* 0.86 (95% confidence interval, 0.36-2.05) for alcohol intake of
30.0 g/day or more (more than two drinks per day).
The P value for the trend was 0.04.
With residual confounding thus minimized, the authors wrote that it was
"unlikely, but not impossible, that an unknown confounding factor is
sufficiently strongly associated with both alcohol use and risk of MI to
have produced these findings."
All 8,867 men reported four healthy lifestyle behaviors, including a
body mass index of less than 25, moderate to vigorous activity for at
least 30 minutes a day, and abstention from smoking. They also reported
a summary diet that indicated they followed a diet rich in fruits,
vegetables, and fish and low in transfats, and red or processed meats as
well as multivitamin use. Diet, exercise, and alcohol consumption were
obtained from baseline questionnaires.
Participants were contacted every four years from the baseline
assessment in 1986 through January 31, 2002. Participants who reported
an MI at follow-up were contacted and asked for permission to review
Over 16 years there were 106 incident MIs, and 89 occurred in men who
abstained from alcohol or who drank less than half a drink a day.
The study was limited by its inability to assess the effects of
"specific drinking patterns, changes in alcohol intake over time, the
modifying effect of drinking with meals, or differences among
individuals beverage types," the authors wrote.
And although there were enough events to provide statistical power, the
confidence intervals were wide, they noted.
They concluded that the findings make a case that "future guidelines for
moderate drinking need not consider healthy lifestyle behaviors as
mutually exclusive and should instead focus on the strengths and
limitations of the evidence about moderate alcohol intake."
Additional Acute Coronary Syndrome Coverage
Mukamal, KJ "Alcohol Consumption and Risk for Coronary Heart Disease in
Men with Healthy Lifestyles" Arch Intern Med 2006; 166:2145-2150
Kathrynne Holden, MS, RD < fivestar at nutritionucanlivewith.com >
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