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ere's to your health."it's a traditional drinking toast in many languages, but few people ever assumed it could be a reflection of what was in their glasses--that is, until now. With a tarnished reputation when it comes to health, alcohol is making a wary move into the limelight as a meaningful component of a beneficial lifestyle. Its redemption is due in no small part to a burgeoning body of research from the Harvard School of Public Health, whose large population studies are shedding light on the impact of drinking on disease. "While it's a very specific area of study in the field of nutritional epidemiology, I think it's something our cohorts have contributed probably the most to in the world," says Associate Professor Eric Rimm, SD'91, director of the School's Health Professionals Follow-Up Study, which has monitored the behaviors of more than 51,000 male medical workers over two decades.

A nutritional epidemiologist specializing in cardiovascular disease, Rimm has, both by fate and necessity, become something of an expert on potent potables. Most recently, he and his colleagues found that men who consumed moderate amounts of alcohol three or more times a week had up to a 35 percent lower risk of heart attacks than non-drinkers. These results have added one more piece to a compelling collection of evidence that drinking in moderation--defined as one or two alcoholic beverages a day, regardless of the type--is good for your heart. Previous research from the School and elsewhere has shown that modest alcohol consumption can substantially reduce the risk of cardiovascular disease, stroke, and hypertension in both men and women. "It's a dramatic effect," says Rimm, "comparable in risk reduction to a person who was overweight by 30 pounds losing that excess weight."

The key seems to be a paradoxical combination of frequency and restraint. The most pronounced health payoffs occur when alcohol is consumed on a daily or near-daily basis. But for every one of drinking's benefits there is an equal and opposite risk if one or two glasses turn into three or four. "You begin to see trouble at three to five drinks a day," notes Rimm. Heavy drinking can cause increased rates of high blood pressure, heart failure, and mortality. He suggests the best approach is to treat alcohol like any other drug, taking a small daily dose to reap maximum rewards without adverse consequences. After all, we wouldn't dream of saving up all our weekly multivitamins or Lipitor for a Saturday night.

But alcohol is certainly a different beast than your average medicinal drug, and offering blanket individual advice based on the observational studies of large numbers of people can be tricky. For many, alcohol is completely inappropriate, such as those with a family history of alcoholism or liver disease, or teens for whom the risk for heart disease is negligible--which is why experts generally recommend that the decision to drink be a personal one made in concert with a doctor. It is also why Rimm believes that alcohol's benefits warrant further investigation--there's so much left to learn. Still, from the genetic mechanisms through which alcohol operates to its impact on other metabolic disorders like obesity and diabetes, the learning curve for an epidemiologist can start to get steep. "Every time someone asks how I'm keeping up, I have to say I'm falling behind," Rimm laughs. But he's too intrigued by how all the pieces fit together to let that dampen any of his enthusiasm for seeking scientific veritas in vino--or well, any alcoholic beverage for that matter.

Alexandra Molloy

For more information, see http://www.hsph.harvard.edu/hpfs


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