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Rethinking That Extra Drink

The New York Times reports on a recently published study that concludes there is no real cardiac benefit of alcohol consumption, even moderate intake.

The study, published late last week in the Journal of the American Medical Association, analyzed the genetics and medical data of almost 400,000 people who participated in the UK Biobank. The study, the Times reports, may help resolve an ongoing debate over the potential protective effects of moderate alcohol consumption: some researchers have reported that individuals imbibing moderately as a group have less heart disease than those who drink heavily or abstain.

But the new study concluded that the reason for this observation is not a protective effect from alcohol, but rather that light to moderate drinkers — those who consume up to 14 drinks a week — tend to have other characteristics that decrease their risk, like smoking less, exercising more, and weighing less than heavy drinkers and teetotalers.

Furthermore, the Times reports, the researchers examined known genetic variants that predispose individuals to heavier or lighter drinking, demonstrating an exponential heart disease risk curve with those variants. The study noted that actual risk for an individual depends on the presence of other conditions like diabetes or obesity. But, extrapolating from the study results, a typical middle-aged person who did not drink had an estimated 9 percent chance coronary heart disease, while a person who had one drink a day had an estimated 10.5 percent chance — relatively small. After that the risk increases quickly.

Amit Khera, an author of the study and a cardiologist at Verve Therapeutics, told the Times that the gold standard to assess the heart effects of drinking would be a large randomized clinical trial, and that a prior attempt by the National Institutes of Health to launch such a study was scuttled because the researchers had inappropriate contact with the alcohol industry during the planning stages.

Mendelian randomization techniques, like those used in the JAMA study, "are particularly helpful when a gold standard hasn't been, or can't be, done," Khera said.

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