[PHNUTR-L] Two Drinks Called Potent Addition to Heart-Healthy Lifestyle

[Kathrynne Holden]

Colleagues, the following is FYI and does not necessarily reflect my own
opinion. I have no further knowledge of the topic. If you do not wish to
receive these posts, set your email filter to filter out any messages
coming from   @nutritionucanlivewith.com    and the program will remove
anything coming from me.
---------------------------------------------------------
  	Two Drinks Called Potent Addition to Heart-Healthy Lifestyle
		
http://www.medpagetoday.com/Cardiology/AcuteCoronarySyndrome/dh/4372	
   	
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 
researchers here.

Action Points

     * 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 
medical records.

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

Source reference:
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 >
"Ask the Parkinson Dietitian"  http://www.parkinson.org/
"Eat well, stay well with Parkinson's disease"
"Parkinson's disease: Guidelines for Medical Nutrition Therapy"
http://www.nutritionucanlivewith.com/