Benefits and risks of moderate alcohol consumption on cardiovascular disease

An open access article published in the Journal Nutrients critically reviews the current knowledge on the relationship between alcohol intake and cardiovascular disease. More than 140 papers were included in the review. In their conclusion the researchers suggest that the relationship between alcohol consumption and CVD appears in general terms biphasic, being protective at low and moderate amounts and detrimental at high intakes, even when occasionally consumed. They also find that current evidence supports that low amounts of alcohol are safe and beneficial for the CV system. However they highlight that the main body of evidence relies on epidemiological studies of associative nature which carry several limitations such as the quantification of alcohol consumption. The authors suggest that in the future, these studies should include reliable measurements of biological biomarkers of alcohol exposure such as urinary ethyl glucuronide which may better reflect short-term and habitual alcohol consumption than self-reported intake and should also include repeated measures over time. The authors emphasise that the benefits of cardio protective effects derived from low/moderate alcohol consumption should be weighed against the potential harms from an individual perspective and addressing serious issues such as the propensity to alcohol dependence and collateral social harms, genetic vulnerability, pregnancy or even the family history of cancer. They state that as no large randomized trials have been able to be performed, from a public health perspective, these question still remain unanswered : (1) Which daily amount of alcohol consumption can be considered as safe and truly cardio protective? (2) Which type of alcoholic beverage is really more beneficial? (3) Do the effects of alcohol vary according to the region and socioeconomic status of the countries and because of genetic and ethnical traits? (4) Are the effects of alcohol consumption specific at different ages? (5) Do sex-specific differences in the pathophysiological effects of alcohol consumption disappear at a certain age?
The authors conclude that the question on whether to drink or not to drink? remains unanswered. They argue that this is especially important considering the fact that the majority of disease endpoints attributable to alcohol consumption are also associated with aging and also considering that the main body of evidence relies in countries with the highest life expectancy. Meanwhile, as alcohol consumption is part of the lifestyle of several cultures, they advise that it would be wise to suggest low–moderate alcohol consumption among current drinkers and not recommending commencing drinking among non-drinkers in order to improve health outcomes.
Source: Benefits and Risks of Moderate Alcohol Consumption on Cardiovascular Disease: Current Findings and Controversies. Gemma Chiva-Blanch and Lina Badimon. Nutrients 2020, 12(1), 108.