Alan P. Agins, BS, MS, PhD, President - PRN Associates, Ltd. - Continuing Medical Education
Certain foods, beverages and lifestyle habits have long been considered, either literally or teasingly, "vices" in our society. Consumption, or should I say the over-consumption, of chocolate, coffee and alcohol are often touted as being health risks as opposed to having health benefits. However, in moderation, all of those "vices" are actually appear to have health benefits. As evidenced by the increasing number of reports and articles found in both the lay and scientific press, there may be something positive about indulging in those vices . . . .
Let’s start with coffee (doesn’t everyone?). In a recent report, researchers who followed more than 37,000 people in the Netherlands for 13 years in one of the largest and longest studies ever to examine the impact of coffee and tea drinking on heart health. The study found that people who drank more than two, but no more than four, cups of coffee a day had approximately a 20% lower risk of heart disease than people who drank more or less coffee or no coffee at all. The study also found that moderate coffee consumption was associated with a slight, but not statistically significant, reduction in death from heart disease. In another study, reported in 2008, women who drank four to five cups of coffee a day had a 34% lower risk of dying from heart disease while men who drank more than five cups had a 44% lower risk. Beyond the cardiac benefits other studies have shown that caffeine appears to modeslty improve airway function in people with asthma for up to four hours and caffeine can serve as a
relatively safe pressor to help alleviate some headaches. Older studies have shown that drinking coffee was associated with a 30% lower risk of the developing Parkinson’s Disease and that coffee consumption may cut diabetes risk, the risk of gallbladder disease and more. Some of the beneficial effects of coffee have been attributed to caffeine, while others to the various antioxidant flavonoids found in the coffee bean. Interstingly, Italian researchers have reported that the compound that gives coffee its distinctive aroma and flavor (trigonelline) has both antibacterial and anti-adhesive properties that may prevent dental caries.
Chocolate, in particular dark chocolate, has also gotten a lot of press in recent years for its potential benefits in reducing heart disease. In a recent report, researchers in Germany found that people who ate the equivalent of one square of a 100 gram (3.5 oz) chocolate bar per day had a 39% lower risk of having heart attack or stroke than people who ate much less chocolate. Sounds too good to be true, huh? Well here’s the caveat - a single 100-gram bar of chocolate contains about 500 calories, and eating too much can contribute to unhealthy weight gain. A decade-old Harvard study of nearly 8,000 of its male graduates determined that eating the equivalent of few bars of chocolate a month not only lowered blood pressure, but also lowered the risk of death by 36 percent as compared to abstainers. Researchers at Johns Hopkins have recently discovered that a compound in dark chocolate may protect the brain after a stroke by increasing cellular signals already known to shield nerve cells from
damage. In addition to retrospective (and prospective) human studies, basic science is also demonstrating that dark chocolate, especially that with a cocoa content of at least 70% or more, reduces oxidative stress and improves vascular endothelial cell and platelet function.
And to cap it off, let’s talk about alcohol. Two new and rather large studies add credence to a decade or more of growing evidence suggesting that light-to-moderate drinking may have a cardioprotective effect and prevent heart-related deaths. In the first study conducted by researchers at the Beth Israel Deaconess Medical Center in Boston, they showed that light-to-moderate drinking -- about one drink per day for women and two per day for men -- reduced the risk of heart-related death in a diverse national sample of more than 245,000 adults. A second study showed moderate drinking reduced the risk of heart-related death as well as death from any cause in people with existing heart disease, thus extending the benefits already shown in healthy people. In the second study, Italian researchers analyzed eight previously published studies on alcohol and heart disease involving more than 16,000 people with heart disease and determined that moderate drinking reduced the risk of heart-related death as
well as death from any cause in people with existing heart disease, thus extending the benefits already shown in healthy people.
The mechanism(s) by which alcohol may reduce the risk of heart disease are not fully known. Some studies suggest that alcohol can affect lipid ratios and increase the amount of beneficial high-density lipoprotein (HDL) cholesterol. Newer research suggests a beneficial effect in reducing blood levels of interleukin-6, C-reactive protein and perhaps other markers of inflammation (CV risk factors). With red wine, it is becoming well recognized that certain antioxidant chemicals, in particular Resveratrol, play an important role. However, currently there is no consensus as to whether wine is better than beer or other liquor and many studies document the same cardiovascular benefits for all three. On the downside (ah, there’s always the downside) it appears that the benefits of alcohol consumption follow what I call the "Goldilocks and the Three Bears" phenomenon in medicine. Too little alcohol does not provide any noticeable benefit. Conversely, too much alcohol (defined in the Beth Israel
Deaconess study above as drinking more than 25 grams of alcohol per day) appears to be associated with an increased risk of death from all causes . . . however, moderate alcohol consumption, appears to be just right!
In the end it appears that a moderate amount of coffee, a moderate amount of dark chocolate (with dietary balance for increased calorie consumption) and a moderate amount of alcohol (though I am not professing that one should start drinking necessarily) . . . well, these may be the prescription for a longer, healthier life. So, here’s my contribution to a new fixed-dose combination concept . . . . a grande-triple-shot- dark mocha- with a shot!
Join Dr. Agins for an ACPE accredited 1 hour presentation on "The Virtue of Vices" live, online at RxSchool.com on July 25, 2010.
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