Is Alcohol Good for You or Not?

Paracelsus was one of the great physicians of all time. He was also a philosopher, botanist, and scientist. He worked his magic in the early 1500s, the supposed Dark Ages. He was the first physician to notice that some diseases have psychological causes.

He’s most famous for being the first physician to wonder about the effects of toxins on the body. In that regard, he’s credited as the founder of toxicology. And undoubtedly his greatest accomplishment in toxicology was the incredible insight that there’s no such thing as a toxic substance – just toxic doses.

But is this true of alcohol?

In other words, Paracelsus discovered for the first time that any substance in a low enough dose has beneficial effects on the body. And any substance in a high enough dose was toxic to the body. We’re talking about any substance – vitamins, heavy metals, pesticides, cyanide, viruses, bacteria, water, whatever.

But today, 500 years later, this fantastic observation still eludes many doctors, scientists, and lay people who still view certain substances as inherently toxic while other substances as inherently safe. Paracelsus showed us that it’s not the substance of a thing that makes it toxic, it’s the dose. Today’s example of this law is alcohol.

A review article entitled, “Alcohol and endothelial function: a brief review,” points out how important dose is to the effects of alcohol on the body. The authors state that, “Regular light to moderate alcohol intake appears to confer protection against both coronary artery disease and ischemic stroke. In contrast, heavy alcohol consumption increases the risk of coronary artery disease and the risk of both hemorrhagic and ischemic stroke.” So, what is it about alcohol that makes it so healthy for us? And more importantly, what’s the right dose?

It looks like the main reason drinking alcohol is healthy is because, in the right dose, it stimulates nitric oxide formation. As I've told you before, our bodies make nitric oxide from the amino acid arginine in the presence of oxygen and an enzyme called nitric oxide synthase (NOS). Nitric oxide is the primary determinant of how well our circulation works. It increases circulation by opening up (vasodilating) our arteries and small blood vessels. Without enough nitric oxide, the vessels tighten up, and blood flow decreases. And alcohol increases nitric oxide production.

Alcohol does it by increasing the activity of NOS, the enzyme that forms nitric oxide. And it can do this very effectively. Here’s how we know. In the body, nitric oxide is converted to nitrite and nitrate. These substances are good indicators of how much nitric oxide your body is producing. The higher the levels of either nitrite or nitrate, the higher the levels of nitric oxide. One study looked at the effect of three ounces of alcohol spirits in a group of men and women and found that the alcohol doubled their nitrite and nitrate levels over the next 12 hours. But here’s the thing.

Dose is important. The authors discovered that higher doses have the opposite effect. According to the authors, “It is clear that acute low doses of alcohol increase both the release of nitric oxide and NOS expression, and augment endothelium-mediated vasodilatation [opening blood vessels], whereas higher doses impair endothelial functions [close blood vessels].”

But that’s not the only problem with high doses. The article goes on to show that not only do high doses not improve nitric oxide production, they actually decrease production. This Paracelsus effect is also pointed out in various other clinical studies on the biological effects of alcohol. One of them is entitled, “Risk of dementia and alcohol and wine consumption: a review of recent results.”

That study looked at a large population of men and women in Bordeaux, France. As you might suspect, all that good wine in Bordeaux does not go unnoticed. The researchers found that people drinking from three to four standard glasses of wine per day were an amazing 81% less likely to get dementia of any type than non-drinkers. And they were 72% less likely to get Alzheimer’s. These incredible reductions took into account age, sex, education, occupation, baseline cognitive performances, and other possible factors that could have affected the results. It was clear from this study that drinking alcohol had a markedly positive effect when it came to dementia across the board. And this isn’t the only study to find this relationship.

The results were the same in another report called the Rotterdam study. In that study, much lower amounts of alcohol had the same protective effect. Drinking one to three drinks per day led to a 42% reduction in all forms of dementia, and a 71% decrease in vascular dementia. Vascular dementia is caused by decreased circulation to the brain, and is associated with decreased levels of nitric oxide. The authors of the Rotterdam study also noticed that the positive effects of moderate alcohol intake was not affected by different forms of alcohol. Wine, spirits, beer all had the same effects. Okay, so in the right dose alcohol prevents dementia of all kinds. What about strokes?

Strokes are one of the most common causes of serious functional impairment in the United States and other developed countries. The most common kind of stroke is an ischemic stroke. Ischemic strokes happen when the blood supply to the brain is suddenly cut off. 80% of all strokes are ischemic strokes. Several studies of the risk of ischemic strokes and alcohol have shown that heavy drinking increases the risk. However, according to the authors of this study, “Regular light to moderate drinking seemed to be associated with a decreased risk for ischemic stroke.” Protects against strokes. Protects against dementia. How about coronary artery disease?

The authors of a meta study published in 2000 set out to see if there was a connection between alcohol consumption and the risk of coronary heart disease. After all, given the nitric-oxide-stimulating effect of alcohol, it makes sense that the right dose could prevent the disease. A meta study is a study that looks at the overall results of a great many studies. In this case the authors looked at all of the population studies that were published from 1966 to 1998 regarding alcohol consumption and coronary artery disease. Although they found a total of 196 studies, they settled on the 28 studies that met their criteria of a high quality study. Here’s what they found.

In men and women drinking up to 20 grams a day of alcohol there was a 20% decrease in risk for coronary artery disease. 20 grams is about ¾ of an ounce of spirits, ¾ a glass of wine, and ¾ a can of beer. When the researchers looked at the effect of larger amounts of alcohol up to 72 grams per day, the protection from alcohol decreased to only 4% (72 grams is about 2½ ounces of sprits, 2½ glasses of wine, or 2½ cans of beer).

I think the research is pretty clear. Drinking alcohol has a healthy effect on the body. But overdoing it undoes the positive effects. In general, it seems like the best effects happen when drinking one to two glasses of wine or cans of beer or ounces of liquor per day. That seems to be the optimal dosage range needed to get enough of an increase in nitric oxide production to have strong clinical effects.