Today, when the favourable effects of drinking small amounts of wine or any alcohol at all as a prevention against death from heart attack has clearly been demonstrated, the question remains as to what is the most beneficial amount of alcohol we should drink for the benefit of our health. By far the simplest way to classify moderate drinking has been by showing that excessive drinking can be considered as three or more drinks a day. Fewer than three drinks a day were regarded as more moderate drinking. Then the classifications of moderate drinking have expanded further.
A moderate dosage of alcohol was considered to be an amount which does not trigger off the symptoms of alcohol poisoning. Pearl, back in 1926, defined it as downing two pints, that is 1.4 litres, of beer a day. The definition of a moderate drinker in the year 1942 was one who does not go in search of drunkenness, but rather drinks beer in moderation for its sedative effects. Another definition of a moderate quantity of alcohol is the statistical normal amount. That is the average amount as consumed by the majority of inhabitants. Average drinking however can mean very different things in different countries. For instance in France the person who consumes a litre of wine a day falls into the category of a moderate drinker. In some other countries such a statistically normal amount would lead to an increase in death rates from heart attack and other complications coming from excessive drinking, while in others it would not even reach the level of healthy beneficial drinking. Also, ascertaining the statistically normal amount is seen as difficult. We arrive at our figures from questionnaires and the answers are dependent very much on how the questions are formulated. We know that data obtained from the questionnaires are in retrospect 20% lower than data from a prospective form. A very serious problem is the underestimating of amounts of alcohol consumed when answering the questions. Underestimation in any individual study moves between 29% and 83% of the real amounts consumed. Given this fact we can expect that the optimal low doses of alcohol will in truth be higher than is shown, by as much as between 29% and 83%.
Moderate drinking is such that goes on without giving rise to any problems and certainly not causing any damage to the particular individual in question. The British doctor Anstie through his clinical observations arrived at the conclusion that a healthy adult male can drink 43 grams of alcohol a day. This amount is close to the current view on a moderate dosage of alcohol. Consumption of alcohol with unproblematic drinking is seen as between 21 and 57 grams of alcohol per day for men and 10 to 40 grams of alcohol daily for women. The highest tolerable dosage is between 24 and 60 grams a day for men and between 12 and 36 grams a day for women. A further attempt to define the optimum dosage of alcohol was the assessment of the lowest point on the curve indicating the dependence between the amount of drinking and death rates from heart attack.
Our contemporary opinions have stabilised around the fact that males could drink around 20 to 40 grams of alcohol a day, preferably in the form of wine, i.e. approximately 20 to 40 centilitres. For female consumers this amount should be lowered and should not exceed 20 to 30 grams in a day. Not just wine but also those alcoholic beverages in which the alcohol content can be markedly different are now being seen as being propitious against the risk of developing atherosclerosis, in other words, arteriosclerotic vascular disease (ASVD).
We assume that to recognise one single correct dosage for the entire population is in no manner rational. The reason is that the tolerance of wine in different individuals can differ substantially. Much is down to genetic factors. A low alcohol tolerance is seen for example among Native Americans and also Japanese. We also know that alcohol tolerance through the long-term drinking of even small amounts of alcohol increases progressively. It should not, however, increase proportionately to the intake of alcohol. Body weight and height also influence alcohol tolerance, as do different body compositions and of course mental health and general well-being. We must not forget that the amount and type of alcoholic drink depends not simply on trying to prevent heart attacks, but that cultural practices and social norms in the relevant territory also play their role. These are reasons why we do not mention just one single optimum intake for men and women, but relatively large range from between 20 and 40 grams of alcohol daily.
Generally the highest figure for a small daily intake of alcohol for men is around 40 grams in Italy and Australia. Above both of these countries, however, comes France, which allows up to 60 grams of daily alcohol intake for men and 36 grams daily for women, while Austria too gives 60 grams a day for males, although only 20 grams a day for females. The lowest dosage is that recommended in the United States, and that is a mere 28 grams for men a day and 14 grams a day for women. Nevertheless, various American authors give a higher figure for the moderate consumption of alcohol, from 30 grams up to 56 – 70 grams a day. The World Health Organisation also gives a low dosage, recommending just 10 to 30 grams of alcohol a day. In Great Britan 32 grams of alcohol a day is the recommendation, but in the study by a group of British doctors the increase in the death rate from heart attack was not proven even after a consumption greater than nine drinks a day, i.e. 72 grams of alcohol.
We must not forget how important it is to drink that small amount of wine or other type of alcohol every day, or at least to drink it during most of the week.
A small amount of alcohol represents for men 20 to 40 grams and for women 20 to 30 grams of alcohol intake per day, preferably in the form of wine, and that, in this country, white. Regular daily drinking is an important factor in the prevention of heart attack.
Source: Pít či nepít (Pití vína a srdeční infarkt) / To Drink Or Not To Drink (Wine drinking and cardiovascular diseases)
© Milan Šamánek, Zuzana Urbanová
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