The Man Who Ate Everything - Jeffrey Steingarten [85]
The second way that alcohol protects the heart involves the tendency of the platelets in your blood to clump together and form clots, especially around areas on your arteries’ inner walls that have already been damaged by fatty plaque deposits. As very small amounts of alcohol do not raise a drinker’s HDLs but do affect blood clotting, this seems a likely explanation for the protective effects of very light drinking. Both alcohol and aspirin diminish the tendency of these clots to form, which is why doctors regularly recommend that their older patients take an aspirin every other day. The formation of a blood clot involves a complicated series of steps, and nobody has figured out exactly where aspirin or alcohol intervenes in the process, whether they work in the same way or enhance each other’s protective effect. Enough research has been done to suggest that each may reduce clotting in its own way.
Contrary to recent publicity, red wine does not appear to be significantly more or less protective than hard liquor. Few large prospective studies have found a significant difference either way, though wine seems to have a slight edge in some. The effects of wine and hard liquor on HDLs and on blood clotting appear identical; beer usually comes in last in studies that have measured its effects.
Serge Renaud of INSERM (the French equivalent of NIH, our National Institutes of Health), in Lyons, told me that any advantage wine-drinking countries have in the coronary sweepstakes probably comes from the fact that wine is usually drunk slowly with meals and not hastily, with a handful of pretzels, in some dimly lit bar; food slows the absorption of alcohol into the bloodstream, which may, according to a paper Renaud is about to publish, be ideal for decreasing the tendency of the blood to clot. Binge drinking may work just as well as slow drinking on your HDLs, but not on your platelets. Renaud might also have added that wine-drinking countries generally show the highest consumption of alcohol.
Research continues on chemical compounds found in the skins of wine grapes that may find their way into red wine but not into white, which is made without the skins. Resveratrol is produced by grapes and other plants to ward off fungal infections and has been reported in Japanese research to lower cholesterol in rats; a paper on resveratrol by two fruit scientists at Cornell will be published by the time you read this. Another treasure in the skins of vine grapes (and yellow onions) is quercetin, which has powerful antitumor and anticlotting effects in the laboratory. But it will be years before researchers figure out how much of either substance actually enters our bloodstreams after we drink red wine and what effect they may have in our bodies.
Now that you know more about why alcohol protects the heart, how will this change your life? In the course of poring over hundreds of papers and abstracts, I became increasingly convinced that doctors who refuse to recommend a drink or two a day should be liable for medical malpractice and that the surgeon general, with her completely one-sided warning label, should be censured.
Now I’m not so sure, except about the surgeon general. Most health officials feel that publicizing the positive effects of alcohol would do more harm than good because of the dangers of both heavy drinking and alcoholism. As one doctor wrote, “Our inability to recommend [alcohol] is attributable not to the properties of alcohol but to the properties of human nature.” But saving a handful of potential alcoholics may be heavily outweighed by the coronary benefits of sanctioned drinking.
Three groups should be careful about even moderate drinking: anybody who is about to drive an automobile, people who have had an alcohol problem (or even a family history of alcoholism), and some women.
Women at high risk for breast cancer should be especially careful; this includes women with a family history of early