January 20, 2015

expert reaction to alcohol intake and risk of heart failure

A paper published in the European Heart Journal has examined the effects of alcohol consumption on levels of heart failure, reporting that having up to seven drinks a week was associated with lower levels of heart failure in both men and women.

Ms Catherine Collins, Principal Dietitian at St George’s Hospital NHS Trust, said:

“Heart failure is already known to be associated with a high alcohol intake, and the heart can be damaged from the direct toxic effects of alcohol, from associated nutritional deficiencies (particularly B1, B6, folic acid and B12), and sometimes from toxic substances added to alcoholic drinks.

“This study of middle-aged overweight subjects (average BMI 26-28) noted self-reported alcohol intake – always a concern for researchers on diet and nutrition, as most drinkers under-report alcohol consumption. The study found that, compared to non-drinkers or heavy drinkers, a modest alcohol intake of up to seven alcoholic drinks a week seemed to be associated with a lower risk of developing heart failure by 20% in men, and 16% in women. However, whilst small amounts of alcohol may appear protective, as alcohol intake increased so did the proportion of people who smoked (from 25-30% of the modest drinkers group, up to 50-60% of the heavy drinkers group) or had high blood pressure. Both smoking and high blood pressure are linked to heart failure, so the effect noted may not have been solely an effect of alcohol. This is a common difficulty in nutrition research – separating out the effect of one food from the diet and lifestyle of a group.

“An ‘alcoholic drink’ was defined as one providing 14g alcohol, but in the UK we talk about alcohol in 10ml ‘units’ – or 8g of pure alcohol. Translating this study into UK units, a ‘modest alcohol’ intake of seven drinks a week would equal 12 units of alcohol weekly. Twelve units is around 1 – 1.5 bottles of wine a week – or if you prefer – around 3 pints of beer or cider weekly.

“The study confirmed that higher intakes of alcohol not only increased heart failure risk, but also risk of death. The risk of death increased significantly for women drinking 20 units a week, and for men taking 30+ units a week.

“Bottom line for bottoms up? The Mediterranean diet, which is best for heart health overall, includes alcohol in moderation. This study adds to the data that modest drinking doesn’t increase your risk of heart failure, but enjoying it too much paves the way for heart problems.”

Prof. Tony Lai, cardiac expert, Cardiff University School of Medicine, Wales Heart Research Institute, said:

“This is an interesting topic, but it is difficult to make any strong assertion from the study’s observations, as the authors themselves state that their work ‘does not necessarily mean that moderate alcohol consumption causes the lowered risk’. In particular, it should not be used as evidence to encourage an increase in alcohol consumption as a way to reduce the occurrence of heart failure.”

Prof. David Leon, Professor of Epidemiology, London School of Hygiene & Tropical Medicine, said:

“This study makes a small additional contribution to the evidence that light drinkers may suffer less from heart failure later in life than people who have never drunk alcohol. However, the authors point out that as the amount people drink goes up so does their overall risk of death. So while this study may be of interest to scientists studying how alcohol affects the heart, overall it is consistent with the emerging consensus that any level of drinking carries risks, and that the more you drink the higher the probability of dying prematurely from something. The findings of this study would be misunderstood if for health reasons they encouraged non-drinkers to take up drinking, or for occasional drinkers to drink more regularly.

‘Alcohol consumption and risk of heart failure: the Atherosclerosis Risk in Communities Study’ by Alexandra Goncalvesname et al. published in the European Heart Journal on Tuesday 20 January 2015. 

Declared interests

None declared