For decades, scientists have debated whether alcohol is good for your heart. A new study from the Harvard School of Public Health proves it is.

EARLIER RESEARCH

Previous studies -- more than 60 of them -- showed that people who drank in moderation had a lower risk of heart disease than nondrinkers. But scientists wondered if that was because of the alcohol -- or because moderate drinkers have healthier lifestyles. And perhaps moderate drinkers are healthier than nondrinkers because many people who don’t drink are already ill, with chronic conditions that necessitate abstinence.

Doctors at the Harvard School of Public Health wanted to help settle the issue -- by studying the link between heart disease and alcohol in disease-free people with healthy lifestyles. If alcohol lowered the risk of heart disease in these people, they reasoned, the effect of alcohol was indisputably real.

NEW HARVARD STUDY

Researchers looked at nearly 9,000 men from among the more than 51,000 men who have participated for the past 20 years in the Health Professionals Follow-Up Study (designed to evaluate hypotheses about men’s health). These 9,000 men exemplified the crème de la crème of healthy living -- they were free of chronic disease, weren’t overweight, didn’t smoke, exercised every day for 30 minutes or more and ate a healthy diet with plenty of vegetables, fruits, whole grains and fish, limiting amounts of red meat and trans fats. All these men had a low risk of heart disease, but compared with the nondrinkers, the moderate drinkers in the group were 42% less likely to have a heart attack or die of heart disease.

Conclusion: The evidence is overwhelming. Moderate drinking, defined as one to two drinks a day for men and one drink a day for women, can help protect you from heart disease. A drink is five ounces of wine, 12 ounces of beer or 1.5 ounces of 80-proof distilled spirits, such as whiskey or vodka.

HOW ALCOHOL HELPS

Moderate alchohol consumption has been linked with...

High HDL, the “good” cholesterol that carries fat away from the arteries.

Low fibrinogen, a protein that increases risk of artery-clogging clots.

Low hemoglobin A1c. The hemoglobin A1c test measures the blood sugar attached to hemoglobin molecules, the iron-rich molecules in red blood cells that deliver oxygen to your body. Low hemoglobin A1c is a result of long-term control of blood sugar in people with diabetes. Adults with high blood sugar levels are two to four times more likely to have heart disease.

Many studies show that these positive indicators are a result of ethanol -- the alcohol in alcoholic drinks. In other words, one or two drinks a day of any alcoholic drink protects the heart -- not just red wine, which has gotten most of the press lately.

Important: The study found the greatest degree of protection among those who drank regularly. One or two drinks a day, three to seven days a week, is the healthiest pattern. That does not mean you can “save up” your drinks, downing seven to 14 drinks on Saturday night. Excessive drinking puts you at higher risk for heart disease and many other chronic health problems.

SAFE FOR HIGH BLOOD PRESSURE

For many years, people with high blood pressure were told not to drink. It was believed that alcohol might worsen the condition, which is a risk factor for heart disease and stroke. There is no doubt that excessive drinking can cause or worsen high blood pressure, but new research shows that one or two drinks a day might actually help.

The Harvard researchers looked at nearly 12,000 men with hypertension. Those who drank an average of one drink a day were 19% less likely to suffer a heart attack than nondrinkers. At two drinks per day, the risk was 28% less. “Men with hypertension who drink moderately and safely may not need to change their drinking habits,” concluded the researchers, in the January 2, 2007, issue of Annals of Internal Medicine. Preliminary data among women with hypertension suggest similar results.

OTHER BENEFITS

A drink or two a day might prevent or improve many different types of heart disease, as well as other illnesses...

Atrial fibrillation (AF). The irregular heartbeat that can trigger heart attacks is not worsened by moderate alcohol intake. In fact, among moderate drinkers with AF, the risk of dying is 27% less than among nondrinkers with AF.

Congestive heart failure. Compared with nondrinkers, the risk of developing congestive heart failure is 18% lower among those having one to six drinks per week and 34% lower among those having seven to 13 drinks.

Stroke. Researchers at Columbia University found that moderate drinkers had a 33% lower risk of stroke compared with nondrinkers.

Diabetes. Recent research shows alcohol is protective against type 2 diabetes. The American Diabetes Association used to recommend that diabetics not drink. In 2006, the association approved one drink a day for diabetic women and two drinks a day for diabetic men.

Gallstones. Harvard researchers found that women who drank moderately were less likely to have an operation for gallstones than nondrinkers. Other studies have found similar results for men.

BREAST CANCER LINK

Many studies have found a modest link between alcohol consumption and breast cancer, but this may be due to the way alcohol tends to suppress the nutrient folate in the blood. A deficiency of folate can cause damage to DNA that may lead to cancer. Among women who had a diet high in fruits and vegetables and who also were taking a multivitamin supplement regularly, there was no association between alcohol consumption and breast cancer. Therefore, if you do drink, it is even more important to eat a folate-rich diet that includes fruits and vegetables, dried beans and peas, and fortified cereals.

TO DRINK OR NOT TO DRINK

If you don’t drink, don’t feel that you need to start to protect your health. You can get similar health benefits with exercise and healthier eating.

You should not drink if you’re pregnant (mothers who drink have a higher risk of miscarriage and stillbirth)... if your father or mother suffered from alcoholism (children of alcoholics are more likely to become alcoholics themselves)... if you’re on a blood-thinning medication, such as warfarin (Coumadin) -- alcohol can boost the effect of the medication, causing bleeding problems. And don’t drink and drive. More than 24,000 people die every year in alcohol-related car accidents in the US.

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Bottom Line/Personal interviewed Eric Rimm, ScD, associate professor at Harvard School of Public Health and the Channing Laboratory at Harvard Medical School, both in Boston. He is associate director of the Health Professionals Follow-Up Study on Diet and Chronic Disease. Dr. Rimm’s work on the associations between moderate alcohol consumption and risk of chronic disease has been published in The New England Journal of Medicine, The Journal of the American Medical Association and The Lancet.