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Examining Risks And Benefits Of Alcohol Consumption

June 30, 2010

A discussion by renowned epidemiologist Kenneth Mukamal has recently been published in the Journal of the American Medical Association, JAMA. It provides a discussion in response to a theoretical question, – if you are a 42 year old male, should you drink alcohol ( in moderation) for your health?

The paper provides an excellent discussion of a theoretical question about drinking and health. It focuses on the potential risks and benefits associated with moderate drinking for a middle-aged male patient. ‘ Most members of the International Scientific Forum on Alcohol Research (ISFAR) were pleased with the discussion of the topic. It was noted how uncommon it is that such knowledgeable, detailed, and mostly objective data appear in the mainstream medical literature. It was thought to be readable, informative and thoughtful.’

The reason the patient questioned his moderate use of alcohol was based on an encounter with a “specialist” who advised him to consider stopping drinking because alcohol could “accelerate brain shrinkage.” While “brain shrinkage” is a radiological term with little known relation with clinical outcomes, most studies suggest less decline in cognitive functioning over time, and lower risk of dementia, among moderate drinkers in comparison with non-drinkers. Such findings are supported by much data from basic science experiments. This illustrates the danger of incomplete information (“a little knowledge”) by a member of the medical profession. Mr. Q seems to be very careful (perhaps even a little too careful) in following a healthy lifestyle, including consuming small amounts of alcohol in a reasonable pattern. The ISFAR critique points out a number of topics that were covered incompletely in the paper, including inadequate information on the importance of the pattern of drinking: moderate regular consumption versus binge drinking. Overall, it was believed that the paper provided important information for physicians who may be discussing alcohol consumption with their patients.

To read the full critique of this research, please log onto www.alcoholforum4profs.org

Reference: Clinical Crossroads: Conferences with patients and doctors. A 42-year-old man considering whether to drink alcohol for his health. Kenneth J. Mukamal, MD, MPH, Discussant. JAMA 2010;303:2065-2073. (doi:10.1001/jama.2010.550)

Contributions to this critique by the International Scientific Forum on Alcohol Research were from the following:

Roger Corder, PhD, MRPharmS, William Harvey Research Institute, Queen Mary University of London, UK

R. Curtis Ellison, MD, Section of Preventive Medicine & Epidemiology, Boston University School of Medicine, Boston, MA, USA

Harvey Finkel, MD, Hematology/Oncology, Boston University Medical Center, Boston, MA, USA

Dominique Lanzmann-Petithory,MD, PhD, Nutrition/Cardiology, Praticien Hospitalier Hôpital Emile Roux, Paris, France

Ross McCormick PhD, MSC, MBChB, Associate Dean, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand

Francesco Orlandi, MD, Dept. of Gastroenterology, Università degli Studi di Ancona. Italy

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