Alcohol Rx for Men Who Survive Heart Attacks: Has the Time Come?

Topics: Obesity and Weight Loss, Wellness and Health, Wine and Tea

The purpose in preventing a man’s second heart attack is to prevent death.  And disability.

In other words, it’s quality of life, not just quantity. For decades, American physicians have proscribed alcohol to men, warning of its dangers (which are real, if done in excess) and putting aside the data which show regular, moderate drinking improves mortality and morbidity.

And it does, if you’ve had a heart attack and if you’re trying to prevent one. The latest research study, on >50k U.S. men over 20 years confirms the former yet again. For women, there is an increased breast cancer risk at some alcohol intake, though the cardiovascular benefits remain.

There is a lot else to say: physiologic mechanisms (HDL-cholesterol, (HbA1C), fibrinogen); the antioxidant and anti-inflammatory agents quercetin in grapes and resveratrol in wine; the continuing French Paradox; the U shaped curve of benefit (none for tee-totalers, and hazards for those who average over 3 glasses/day); the definition of regular (daily) and moderate (up to two five ounce glasses of wine, 12 oz beer, 1 oz spirits).

The Rx, however, should be written, for most men.

The real concern, however, is not liver damage or drunkenness. It’s calories: alcohol is metabolized and stored before other calories, especially fat calories, which are those most people try to burn–especially the ones that are stored around the middle.

Alcohol has little or no satiety effect, and tends to increase food intake: it turns on other appetites. The research is equivocal about whether it causes weight gain in men (except for heavy drinkers, where it does). It’s quite solid about whether it can prevent second heart attacks, in a delicious way.

  • Denise

    Hi,
    It sounds like I should make sure my husband gets some wine in his diet a little more often. Unfortunately, I enjoy the taste of wine, but the sulfites bother me and the alcohol seems to disturb my sleep. And I am only talking about one glass of wine with dinner! So it might take him a few days to finish off a bottle. He has not had a heart attack, but his cholesterol and trigycerides are high.
    Maybe we’ll have to get him a bunch of those little “airplane” size bottles!!

    Are there other juices, etc we could use that might have the same effect and not too much sugar???

  • Denise, I don’t know of a juice that has the same effect, though grape juice has lots of polyphenols and some resveratrol: it is most likely the alcohol that provides most of the (physiologic) benefit. Some benefits of alcohol on heart attack/death prevention probably can’t be measured: time spent with family and friends, often time sitting at meals instead of standing, the aesthetic appreciation of good wine.

    Instead of airplane bottles, get a Vacu-Vin: I have used one for 15 years, and find they preserve freshness well beyond replacing the cork: here’s a popular one: http://drjlp.com/WineSavr

  • Denise

    Hey Dr. L,
    Thanks for replying to me so quickly! I am impressed! Thanks for the great idea about the Vacu-vin – that will be sooo helpful. I heard you on People’s Pharmacy and saw you on a Dr. Oz show. Both times you gave sensible and easy to use advice. I am in the process of adding 30 minutes of walking to each morning. Otherwise, we do pretty well with what we choose to eat – no trans fats, about 7 servings of fruits and veggies each day, less red meat, more legumes and fish. Thanks for all the guidelines in your ChefMD book. We love the Fage 2% yogurt and often have it for breakfast with frozen berries and some almonds – Yummy!

    Thanks again for your educational efforts and your caring ways!