A Toast to American Heart Month?
February is American Heart Month,
So I’ve been thinking about some of the confusing recommendations about keeping your ticker ticking. Do you drink? Do you drink because it’s healthy? Are all alcoholic drinks healthy? How much is a drink anyway? This month, I’ve tried to abstain from alcohol as much as possible, book club nights and date nights being the exceptions. The American Heart Association does a great job explaining why the relationship between alcohol and heart health is so complex.
For some people, drinking is not a healthy choice. A few examples: if you have a personal or family history of addiction, already have high triglycerides, liver disease, or are taking medications that do not mix well with alcohol, please don’t drink. If you are generally healthy with normal weight, blood pressure, cholesterol, and triglycerides, the American Heart Association suggests that up to one drink per day for women and up to two drinks per day for men might be protective of your heart. Does this mean that you should have 14 glasses of wine a week? Does this mean you can drink a case of beer all by yourself on the weekend?
As a proud alumna of a Big Ten university, I can tell you from personal experience that saving all your drinks for one night, either at a particularly juicy book club or at a too-long happy hour, is a twisted interpretation of the American Heart Association’s recommendations. You know the saying, “Too much of a good thing is good for nothing”?
I was all ready to post this lesson on how much alcohol is considered a serving. I had pictures of wine in different glasses and a mini lesson on how glass size and shape affect one’s perception of quantity when I woke up on Monday to this:
This week, the nutrition and health world is abuzz about the news that the Mediterranean diet, with its liberal inclusion of alcohol, especially wine, is being hailed as effectively preventing heart disease in people at risk. I took the “How Mediterranean is Your Diet?” quiz, thinking I would score pretty highly. My diet is only moderately Mediterranean because I don’t drink enough wine! Who do you believe: the American Heart Association or a 7500-person prospective study published in the well-regarded New England Journal of Medicine? First, read the article for yourself. It’s well written and not too jargon-y.
If you don’t want to read the article, keep these points in mind: The researchers gave Spanish people, who are already following a Mediterranean-ish diet, even more olive oil and nuts than they usually consume. They did not give them more wine. The researchers think it is these healthy fats and fiber which might be responsible for the differences in risk of heart attack or stroke in people who were already at high risk for such major cardiovascular events. The researchers also point out that they lost more people to follow-up in the control group, which was supposed to follow a low-fat diet. The people in the control group were given less support, education, and intervention than the people in the Mediterranean diet groups. Maybe the difference in quantity and quality of education affected not only their adherence to the low-fat diet but also their desire to stay in the study. People from the control group who dropped out also tended to have the worst health at baseline, so they might have benefited more from intensive nutrition education and intervention, even if it was for a low-fat diet. The Mediterranean diet group was also asked to limited their intake of commercially prepared sweets, processed meats, and dairy products. The health benefits might have come from eating fewer cakes, cookies, hot dogs, ice cream, and cheese, not necessarily from the fruits, vegetables, sea food, legumes, and wine.
Also, researchers don’t know what exactly about the Mediterranean diet makes it so healthy because it comprises so many healthy components. It’s plant-based and therefore high in not only fiber but other phytochemicals that can be anti-inflammatory or cardioprotective in and of themselves. The diet is rich in omega-3 fatty acids from both fish and nuts, which are also beneficial, and low in red meat, which is high in the not-so-good kinds of fats. It could be that all of these components are synergistic in the body in protecting older people with multiple risk factors for heart disease from having a stroke or heart attack.
Back to the question of whether alcohol is good for you, I guess my professional answer remains that it depends. It depends on what the rest of your diet is like, what risk factors you have, your family history, level of activity, medications, and how you incorporate alcohol into your diet. Binge drinking is never good, and drinking your calories instead of eating them — even if you’re a healthy weight — will leave you malnourished. After reading the study, I’m not convinced that I need to add more wine to my life, but I will try to include more seafood and nuts.