No amount of alcohol is good for the heart, new report says, but critics disagree on science
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By Sandee LaMotte and Jen Christensen, CNN
Updated 1:07 PM ET, Thu January 20, 2022
(CNN )In a bold move, the World Health Federation released a policy brief Thursday saying that no amount of alcohol is good for the heart.
"At the World Heart Federation, we decided that it was imperative that we speak up about alcohol and the damages to health, as well as the social and economic harms, because there is an impression in the population in general, and even among health care professionals, that it is good for the heart," said Beatriz Champagne, chair of the advocacy committee that produced the report.
"It is not, and the evidence has increasingly shown that there is no level of alcohol consumption that is safe for health," said Champagne, who is also executive director of the Coalition for Americas' Health, an organization dedicated to improving health in the Americas.
Critics were swift to dispute the federation's stance, saying that it was ignoring studies that do show a small benefit to some heart conditions when a moderate amount of alcohol is consumed.
One such study on the risks of alcohol, published in the Lancet in 2018, was extensively used in the WHF brief, "but seriously misrepresents, and selectively reports, their findings," said David Spiegelhalter, the Winton Professor for the Public Understanding of Risk at the University of Cambridge.
"Given that the WHF report references this paper, it is really odd that their conclusion is that 'no amount of alcohol is good for the heart,'" said Emmanuela Gakidou, a professor at the University of Washington's Institute for Health Metrics and Evaluation who analyzes alcohol risks based on the Global Burden of Disease Study, which gathers worldwide data on premature death and disability from over 300 diseases.
"There are some scientific studies that support their headline, but based on my work on the Global Burden of Disease Study, which pulls together all the available evidence to date, the claim by the WHF is not supported by the scientific evidence currently available," Gakidou said.
In response to these criticisms, Champagne sent CNN the following response:
"While we stand by our key messages, it is helpful to know that the wording of parts of the policy brief can give rise to misunderstandings. To address this we have updated the document (specifically page 8) to more clearly articulate our conclusions and specifically cite the studies by which they have been reached," Champagne said an email.
"In brief, our position is that studies showing a significant cardioprotective effect of alcohol consumption have by-and-large been observational, inconsistent, funded by the alcohol industry, and/or not subject to randomized control. Furthermore, any potential cardioprotective effect is negated by the well-documented risks and harms, rendering our judgment that no amount of consumption can be considered good for heart health."
The American Heart Association, which is a member of the federation, says "moderation is key" when it comes to alcohol, which is defined as no more than one drink a day for women and two for men.
Dr. Mariell Jessup, the chief science and medical officer for the AHA, told CNN in an email that the AHA will "carefully review" the WHF brief. She said that the AHA had recently reviewed evidence on alcohol and cardiovascular risk for its 2021 Dietary Guidance Scientific Statement, and "we concluded that if one doesn't drink alcohol, do not start; and if one does drink alcohol, limit intake."
A world view
Alcohol and your heart: Just getting a buzz can trigger an irregular rhythm
The effects of alcohol on your heart can be immediate, triggering an irregular rhythm called atrial fibrillation or AFib, according to new state-of-the-art research. Alcohol appeared to immediately affect the heart's natural recovery period in a way that could trigger an atrial fibrillation event. "The electrical changes we observed in the pulmonary veins ... would enhance both the chance that atrial fibrillation will occur immediately, and would be maintained," Marcus said. "It is a first-in-human demonstration of the immediate effects of alcohol, directly on the heart," said Dr. Marco Perez, director of the Inherited Cardiac Arrhythmia Clinic at Stanford University Medical Center, who was not involved in the research.
"This study, however, does not address the question of whether or not moderate drinking is 'good or bad' for the heart, particularly in the long-term," Marcus added. "It merely helps us understand the possible mechanisms behind the observations that people who drink have higher rates of arrhythmias."
The World Health Federation is a Geneva-based health advocacy organization that represents hundreds of heart associations worldwide. It released the new policy brief, "The Impact of Alcohol Consumption on Cardiovascular Health: Myths and Measures," to counter reports that some alcohol is OK or even good for heart health.
Drinking alcohol increases the risk of several cardiovascular problems, including coronary disease, heart failure, high blood pressure, stroke and aortic aneurysm, according to the report. Any amount of alcohol, not just heavy drinking, can lead to loss of healthy life, it says.
"Over the past several decades the prevalence of cardiovascular disease has nearly doubled, and alcohol has played a major role in the incidence of much of it," the report says.
Cardiovascular disease is a leading cause of death in the world, disproportionately affecting people of low socioeconomic status. In 2019, nearly 2.4 million deaths -- not just heart-related -- could be attributed to alcohol, the report said. Alcohol negatively affects mental health, as well.
The World Health Organization has called for a 10% relative reduction in the per capita use of alcohol between 2013 and 2030, but the report said a lack of investment in proven alcohol reduction strategies, in addition to misinformation from the industry, has stymied progress toward that goal.
"The portrayal of alcohol as necessary for a vibrant social life has diverted attention from the harms of alcohol use, as have the frequent and widely publicized claims that moderate drinking, such as a glass of red wine a day, can offer protection against cardiovascular disease," said Monika Arora, a member of the WHF Advocacy Committee and co-author of the brief, in a news release. "These claims are at best misinformed and at worst an attempt by the alcohol industry to mislead the public about the danger of their product."
20 Jan 2022
GENEVA (20 January 2022) - In a new policy brief, the World Heart Federation (WHF) is challenging the widespread notion that drinking moderate amounts of alcohol can decrease the risk of heart disease, and calling for urgent and decisive action to tackle the unprecedented rise in alcohol-related death and disability worldwide.
In 2019, more than 2.4 million people died because of alcohol, accounting for 4.3% of all deaths globally and 12.6% of deaths in men aged 15 to 49. Alcohol is a psychoactive and harmful substance that can cause significant damage to the human body. Its consumption is a major avoidable risk factor for noncommunicable diseases, including cardiovascular disease, cancer, digestive diseases, and intentional and unintentional injuries, and for several infectious diseases.
The evidence is clear: any level of alcohol consumption can lead to loss of healthy life. Studies have shown that even small amounts of alcohol can increase a person's risk of cardiovascular disease, including coronary disease, stroke, heart failure, hypertensive heart disease, cardiomyopathy, atrial fibrillation, and aneurysm. Studies that claim otherwise are largely based on purely observational research, which fails to account for other factors, such as pre-existing conditions and a history of alcoholism in those considered to be "abstinent". To date, no reliable correlation has been found between moderate alcohol consumption and a lower risk of heart disease.
"The portrayal of alcohol as necessary for a vibrant social life has diverted attention from the harms of alcohol use, as have the frequent and widely publicised claims that moderate drinking, such as a glass of red wine a day, can offer protection against cardiovascular disease." said Monika Arora, Member of the WHF Advocacy Committee and co-author of the brief. "These claims are at best misinformed and at worst an atte0mpt by the alcohol industry to mislead the public about the danger of their product."
The economic and social costs of alcohol are also significant: they include the cost to health systems, out of pocket expenditure, and productivity losses, as well as the increased risk of violence, homelessness, and criminal activity. Alcohol has a greater impact on people from low socio-economic backgrounds, who are more likely to experience its adverse effects compared to people from higher socio-economic backgrounds, even when consuming similar or lower amounts.
The WHF Policy Brief, The Impact of Alcohol Consumption on Cardiovascular Health: Myths and Measures, summarizes the available evidence regarding the negative health impacts of alcohol use, explains the alcohol "harms versus benefit" debate, and presents recommendations for both individuals and policymakers to help counter the deadly impact of alcohol globally.
Cost-effective interventions to reduce alcohol consumption include strengthening restrictions on alcohol availability, enforcing bans on alcohol advertising, and facilitating access to screening and treatment.
Also, more than 92 million DALYs (Disability-adjusted life years) were caused due to alcohol in the same year(1). Alcohol has been attributed in cancers of the oral cavity and pharynx, larynx, oesophagus, liver, stomach, breast, colon and rectum(8). Even a small amount of alcohol has been linked with an increase in risk of breast cancer(9). Women are less likely to consume alcohol than men; however, the use of alcohol may have more implications for women than men with respect to physical illnesses and more severe cognitive and motor impairment with a much lower alcohol exposure as compared to men(10).
Contrary to popular opinion, alcohol is not good for the heart. This directly contradicts the common message over the past three decades from some researchers, the alcohol industry, and the media that alcohol prolongs life, chiefly by reducing the risk of CVD. For example, the use of red wine has been promoted through various diets as a "heart-healthy" beverage for the longest time.
The presence of resveratrol in wine has been known for its cardioprotective characteristics in light to moderate drinkers. However, there are multiple reasons that the belief that alcohol is good for cardiovascular health is no longer acceptable: see paper
Alcohol increases the risk for hypertensive heart disease, cardiomyopathy, atrial fibrillation and flutter, and strokes. In moderate drinkers, the risk of stroke is 1.14 times greater (95% CI, 1.10-1.17); coronary disease (excluding myocardial infarction) is 1.06 (95% CI, 1.00 - 1.11); heart failure is 1.09 (95% CI, 1.03-1.15); fatal hypertensive disease 1.24 (95% CI, 1.15-1.33) and fatal aortic aneurysm is 1.15 times greater (95% CI, 1.03-1.28).(20) It has been argued that people with moderate consumption and no binge episodes may appear to have a slightly lower risk of ischaemic heart disease (IHD), but the protective effect of moderate alcohol consumption for CVD has been challenged.(22)
Download the WHF Policy Brief