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Monday, July 14, 2008

Alcohol : Direct and indirect impacts on body health

There are at least two ways in which an alcoholic beverage such as beer might impact bene cially on the body: rst, through a direct physiological impact on bodily tissues and functions (which will be focused upon here); second, through indirect impact, but founded equally on a physiological interaction. The mellowing in uence that moderate consumption of alcohol has, with its calming and relaxing impact, will of itself have a sparing effect on stress-related illnesses (Morrell 2000). Cleophas (1999) concludes that there is a signi cant psychological component in the bene cial relationship between moderate alcohol consumption and mortality.
In either instance it will be recognised that excessive alcohol consumption will shift the status quo in a negative direction. We will address the incontrovertible direct damage to body organs that can be caused by overconsumption, and there is no denying the antisocial impact of excessive alcohol consumption in terms of behavioural changes and drink driving. One problem emphasised by many writers is the impact of underreporting alcohol consumption.
Dr Thomas Stuttaford (who for years has written a most engaging column in The Times) presents a fascinating experiential account of the likely reasons why his patients in rural Norfolk enjoyed a lesser incidence of cardiovascular problems and tended to live longer than did their counterparts in London (Stuttaford 1997). First, they had enjoyed less sedentary lives, with less dependence on the automobile. Second, they took aspirin daily to counter the osteoarthritis brought on by working in soggy agricultural conditions. Third, they weren’t teetotallers. And their chosen drink was beer, with the occasional celebratory whisky. It is of course not possible to con rm with any certainty that there was a causal link between any of those three factors and Stuttaford’s observations on mortality. Indeed, the reader will recognise the dif culty of pursuing robust research in this entire area, for the simple reason that studies relating health to any type of food intake must inherently try to remove as many interfering factors as possible and this is not easy:
Additional methodological problems are presented by a number of ‘confounding
factors’ such as age, sex, body mass index, diet, physical activity, smoking, coffee
consumption, educational attainment, type A/B behaviour, socio-economic status,
and medical history, that may be factors in particular health problems in persons who have been the subjects of the reported studies. For example, a generally
poor nutritional condition could possibly play a signi cant role in various health
problems associated with heavy drinkers.
Butterworth (1993)

Studies based on individuals’ reporting of their dietary intake are not as controlled as those in which feeding trials are performed with laboratory rats with de ned diets. Yet, of course, what is observed with a rat does not necessarily extrapolate to the human. We must critically evaluate the breadth of evidence that is presented. Most assume that if suf cient evidence of diverse origin is offered then ‘there must be something in it’. Much of the attention that has been paid to the impact of alcohol on the body has been for its negative effect on those who abuse it. These effects are amply described in the Oxford Textbook of Medicine (Weatherall et al. 1996) and, in more prosaic form, by Stuttaford (1997). In the discussions that follow I refer to these impacts and the reader is referred to those texts for more information.