Moderate (wine) consumption: an independent benefit for cardiovascular diseases
The often-reported protective association of moderate alcohol intake with cardiovascular disease is frequently debated and whether the benefits are “real” or the result of methodological errors of the studies – has often been questioned. It is important to clarify this issue since cardiovascular diseases are the number 1 cause of death worldwide.
The main critiques of studies, which found benefits of a moderate consumption of alcoholic beverages and cardiovascular health were:
- the selection of the reference group and,
- the lack of consideration of possible confounding factors.
The purpose of this study was thus to examine whether the often-reported protective association of light to moderate consumption of alcoholic beverages with cardiovascular health would be apparent when the reference group was restricted to very light drinkers (1-4 drinks in 14 days) and whether the observed associations would be the same, even after adjusting for potential confounders.
Best reference group: very low consumption
A sample of 908 US veterans between the age of 50 and 60 and without any symptoms of cardiovascular disease, who took part in a longitudinal study about ageing, were examined and questioned. Blood lipids, cholesterol levels and blood pressure as well as their lifestyle habits (smoking, physical activity, vegetable and fruit intake and intake of alcoholic beverages) were determined.
They were divided into 6 groups according to their consumption habits over the last 2 weeks:
- abstinent individuals,
- those who quit drinking,
- very low consumption (1-4 drinks),
- light (5-14 drinks),
- moderate (15-28 drinks) and
- high (> 28 drinks) consumption.
One drink was the equivalent of 14 g of alcohol, which would be approx. 125 ml of wine.
After finding out that the health status of non-drinkers and former drinkers was considerably different from the other participants but not the group of very low consumption, the latter was selected as reference group.
3 risk scores speak for light to moderate consumption…
The data of the participants were entered in 3 different risk score calculators to determine the 10-year risk for cardiovascular diseases: for the ASCVD score (Atherosclerotic Cardiovascular Disease) and the Framingham score, age, gender, smoking, diabetes, and cholesterol values were entered, whereas for the 3rd score (metabolic syndrome), the lipid values, waist circumference and fasting blood glucose were important.
The results showed that light to moderate consumption of alcoholic beverages (5 to 28 drink in 2 weeks) compared to the reference group was associated to a lower risk in all 3 risk scores. These associations did not change when adjusted for potential confounding factors (such as socio-economic status, physical and mental health status, or an earlier life history of alcohol misuse). This means that the observed lower risk was independent of these influencing factors.
… and for wine
This study did not examine the drinking pattern, but the participants were asked about their beverage preferences. From all alcoholic beverages, the protective associations were more apparent in wine drinkers: all 3 scores showed a significantly reduced cardiovascular risk among this sample of middle-aged men.
Source: McEvoy, KL et al.: Moderate alcohol use is associated with reduced cardiovascular risk in middle-aged men independent of health, behavior, psychosocial, and earlier life factors. Nutrients 2022;14:2183
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