Yesterday’s Archives of Internal Medicine reported that men with healthy lifestyles who drink moderate amounts of alcohol may have a lower risk of heart attack, compared with those who drink heavily or not at all. Previous studies have confirmed this finding.

Researchers suspect these individuals have increased levels of HDL (“good” cholesterol”) in their blood. But because there are many risks associated with heavy drinking, physicians do not typically recommend that patients begin consuming alcohol to reduce their heart disease risk. Instead, they focus on other proven lifestyle interventions, including diet and exercise. These habits, however, are not mutually exclusive, according to Dr. Kenneth J. Mukamal and his colleagues at Beth Israel Deaconess Medical Center in Boston.

“For individuals who exercise, abstain from smoking, maintain optimal weight and adhere to an appropriate diet, there may be few other standard lifestyle interventions to lower risk,” they write. “Whether alcohol intake is related to a lower risk for myocardial infarction [heart attack] in such individuals is unknown.”

The 8,867 men in Dr. Mukamal’s study had healthy lifestyles, defined as not smoking, having a body mass index (BMI) of less than 25, getting at least 30 minutes of exercise per day and eating a healthful diet, including large amounts of fruits, vegetables, fish and polyunsaturated fats, with low amounts of trans-fats and red meat.

Between 1986 and 2002, 106 of the men studied had heart attacks. This included eight of the 1,282 who drank 15 to 29.9 grams of alcohol per day (about two drinks). This group had the lowest risk for heart attack; those who did not drink at all had the highest.

“There is a complicated mix of risks and benefits attributed to moderate drinking in observational studies, and the individual and societal complications of heavy drinking are well known,” the authors conclude. “It is easy to understand why clinical guidelines encourage physicians and patients to concentrate on seemingly more innocuous interventions, despite the relative paucity of effective, straightforward and generalizable methods for encouraging regular physical activity, weight reduction and abstinence from smoking in clinical practice. Our results suggest that moderate drinking could be viewed as a complement, rather than an alternative, to these other lifestyle interventions, a viewpoint espoused by some authors.”
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