Essay, Research Paper: Alcohol Related Deaths

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More than 100,000 deaths per year are attributed to alcohol, in the United
States. Alcohol-related auto accidents account for approximately 24,000 of these
deaths (most often the victims are under 30 years of age), while alcohol-related
homicide account for 11,000 and suicide 8,000 deaths. Certain types of cancer,
which are partly associated with the consumption of alcohol, contribute to
another 17,000 deaths. Alcohol-related strokes are responsible for 9,000 deaths.
25,000 lost lives are due to 12 alcohol-related diseases including cirrhosis of
the liver. All these deaths combined are the equivalent of 200 jumbo jetliners
crashing and taking the lives of everyone onboard, in just one year. Such
numbers are staggering until you realize that it is Coronary Heart Disease that
is the number one killer in the United States, not alcohol. There are roughly
900,000 persons admitted to U.S. hospitals for strokes annually and 830,00
admitted for Congestive Heart Failure. Though they are not always fatal, these
diseases will leave its victims at varying levels of incapacitation. Looking at
specific age groups, cardiovascular disease is the #1 killer of those age 65+
and #2 killer of those age 25 – 64 This is a political issue for the U.S. with
so many lives lost to alcohol-related disease and accidents. Leaders will not be
perceived favorably by designating research money to study the health benefits
of a drug responsible for damaging so many lives. I believe it is this political
climate which limits research in this area, and I believe it is this climate
that limits the amount of coverage the media provides about its possible
benefits. As I began to research this subject I was intrigued by the vast number
of articles and studies on the health benefits of wine. The industry has
submitted a number of press releases attempting to counter the negative social
stigma alcohol had developed circa 1992 - 98. These articles aside, I found
reputable sources, with published reports, from such respected names as Harvard,
UC Davis, Georgetown, and the Mayo Clinic. Several of these studies have been
published in the American Medical Journal, and the New England Journal of
Medicine. I found articles referring to the “French Paradox.” This is an
occurrence where the French diet contains equal levels of fat as the U.S.
however the coronary disease related mortality rate of France is 1/3 that of the
U.S. diet. I believe we must investigate and prove or disprove the assertion
that wine is somehow involved. Either we are letting hundreds of thousands of
people die or become severely debilitated senselessly by not taking advantage of
wine’s possible benefits, or we are allowing an industry to spread half-truths
with the potential of hurting unsuspecting consumers. Mounting evidence
continues to suggest that when taken with a balanced diet, moderate amounts of
wine can reduce the level of LDL cholesterol in the bloodstream, reduce the risk
of heart disease, reduce the risk of stroke, and thus lower mortality rates.
DEFINING THE PROBLEM Are there health benefits to drinking moderate amounts of
wine, which will reduce the mortality rate in humans? HYPOTHESIS Even though fat
intake in France is similar to the American diet, the liberal consumption of
wine in France protects the French against coronary heart disease by lowering
LDL cholesterol and thereby lowering the risk of blockage, thus reducing
mortality rates. EVIDENCE First, mounting evidence continues to suggest that
when taken with a balanced diet, moderate amounts of wine can reduce the level
of LDL cholesterol in the bloodstream. The human body manufactures approximately
80% of the cholesterol used and stored in its cells. The remaining 20% is
derived from eating animal products. Cholesterol is transported through the body
via the bloodstream. To allow this, the body attaches a protein to the
cholesterol. This combination is called a lipoprotein. The body requires
high-density lipoprotein (HDL) cholesterol (“good cholesterol”) to assist in
the removal of low-density lipoprotein (LDL) or “bad” cholesterol from the
blood vessels. Failure to remove excessive amounts of LDL cholesterol will
result in a plaque buildup and blockage of the body’s main arteries. Blockages
may occur gradually or suddenly. Plaque can break off and create a blood clot,
with the consequences of a possible heart attack or stroke. Doctors at the Mayo
Clinic suggest a low-fat diet and exercise to lower and maintain the correct
balance of cholesterol. If the balance can not be achieved through diet and
exercise, drugs are now available to reduce levels of HDL cholesterol; drugs for
this treatment however are costly (up to $200 per month) and are associated with
some risk of liver damage. In a Mayo Clinic Dietician report the clinic sites a
1997 American Journal of Cardiology report that alcohol provides the greatest
benefit by raising high density lipoprotein… and by decreasing the stickiness
of blood, making it less likely to clot.” The report continued by saying red
wines contain the antioxidants: flavonoids and phenols, which hinder plaque from
forming. These antioxidants also possess an anti-clotting quality. Wine contains
approximately 200 different phenolic compounds, but only a handful are
considered antioxidants. The antioxidant flavonoids are water-soluble plant
pigments. First discovered by the Nobel Prize winning scientist Dr. Albert
Szent-Gyorgyi (who first discovered Vitamin C), Dr. Szent-Gyorgyi found that
flavonoids strengthened capillary walls even better than Vitamin C. The main
sources of flavonoids include fruit, tea, and soy. The report stated that “the
flavonoids in these foods protect against heart disease and cancer.” Dr Andrew
Waterhouse of the University of Davis, Department of Viticulture, and Enology
says wine “is one of the best sources of phenolic antioxidants available to
Americans.” Davis researchers believe wine to possess five times the phenolic
levels of fresh grapes. Researchers at the Mayo Clinic as well as those at the
University of California at Davis did stress alcohol is a highly addictive drug,
and may not be appropriate for all persons (including children, adolescents and
persons with addiction issues). If used however, they believe wine should be
used only in moderation. Because of differing opinions on its benefits, the
researchers did not suggest that any patient “start” drinking. Evidence is
mounting however that wine has the ability to lower LDL cholesterol, and reduces
the damaging affects of the “bad” cholesterol. Next, mounting evidence
continues to suggest that when taken with a balanced diet, moderate amounts of
wine can reduce the risk of heart disease, and thus lower mortality rates. A CNN
report by Hacsi Horvath said on the benefits of wine, “Several studies have
shown that drinking a glass or two with meals may indeed help to protect against
heart disease.” The report referred to what some call the “French Paradox”
a phenomenon where out of 21 affluent countries studied, France has the highest
wine consumption rate, and the second lowest cardiovascular disease mortality
rate. Others have given credit for this healthful success to the
“Mediterranean Diet,” which includes:  Low red meat  Low
lard or butter, higher olive oil  High in fish  High in cheese,
low in whole milk  High in breads, fruits, and vegetables  Light
to moderate wine drinking Horvath says other studies have shown that wine
drinkers may simply be more concerned about their health, as compared to
non-drinkers, beer drinkers, or hard liquor drinkers. Some studies have shown
wine drinkers tend to eat less fat, and more fruits, vegetables, and fish. This
would coincide with the Mediterranean Diet. So why not simply drink more grape,
or other dark fruit juices? Horvath’s report said this would be beneficial,
however other reports have suggested the concentration of phenolic compounds was
greater in red wines because the juice is actually fermented with the grape
skins, pulp, and stems. In addition, during the processing of ordinary juices
the juice is exposed to much oxygen, greatly reducing the healthful benefits.
Winemaking on the other hand is an anaerobic process; the healthful properties
of the compounds are maintained. So, juice is good but wine is better. Dr.
Jean-Paul Broustet of Haut Leveque Hospital in Pessac, southern France, writing
an editorial for the British medical journal Heart noted red wine as one of the
best components contributing to a healthy heart. He states its beneficial traits
of lowering LDL cholesterol, but also notes the presence of resveratrol a
compound that heightens the production of HDL cholesterol. Red grapes produce
resveratrol to protect themselves from fungus. “The highest concentrations of
resveratrol… are found in the red wines, particularly in Cabernet Sauvignon
grapes of Bordeaux.” Because red wines ferment with grape skins and stem
parts, the red wines have higher concentrations of resveratrol than do white
wines. It is believed that some phenolic compounds including resveratrol act as
antioxidants to prevent cell damage from oxygen-containing chemicals known as
free radicals. The CNN report concluded that there was still much evidence
however that it is primarily the alcohol, which acts to lower LDL protein by
thinning the blood. Yet, wine with a balanced low fat diet, maintained lower
levels of LDL cholesterol which contributes to a lower frequency of heart
disease and lower mortality rates. Lastly, mounting evidence continues to
suggest that when taken with a balanced diet, moderate amounts of wine reduce
the risk of stroke, and thus lower mortality rates. A CNN review of a study
recently published in the Journal of the American Medical Association it says,
“alcohol consumption appears to protect against ischemic strokes, which occur
when the blood supply to the brain is blocked by a blood clot.” Dr. Salvatore
says that 80% of all strokes are ischemic strokes. The study group included 677
people forty years of age and older, from Manhattan, who had suffered an
ischemic stroke. Test results were compared to 1,139 subjects from the same
community; those who drank up to two drinks per day had a 45% lower risk for
suffering a stroke. Another study found similar results. Dr. Michael Elkind of
Columbia University said, “Our study showed that having a drink a day or
perhaps two drinks per day can reduce the risk of stroke perhaps as much as
50%.” Yet another, and much larger 16-year study of 13,000 test subjects in
Denmark just one year earlier found similar results (32% less chance of stroke)
from drinking one glass of wine per day. The study had not gained much attention
in the United States because the sample included only one ethnic race. Dr.
Stuart Seides, a cardiologist with the American Heart Association noted “that
the study is based on one ethnic population, while Americans are a diverse lot
with many dietary habits.” In Dr. Salvatore’s more recent study however,
test results were consistent across white, African American, and Hispanic
groups. The Danish test contrasted the variables of wine, beer, and hard liquor.
The same positive results were not achieved for the beer or hard liquor
drinkers. Another researcher, Jane Freedman conducting a study at Georgetown
University Medical Center introduced grape juice to cells that cause clotting,
and said, “they have a much less tendency to form clots.” Two other studies
supporting the benefits of moderate consumption of wine include the
Harvard-based Nurses Health Study and the Physicians Health Study. These studies
found moderate drinking lowers women’s risk of death by 17% and men’s risk
by 22%. Possibly because of its antioxidant value, and/or its blood thinning
effects, but evidence from studies continues to grow showing the moderate use of
wine has a positive influence on decreasing the risk of stroke. CONCLUSION A
drink is commonly defined as 12 ounces of beer or wine cooler, 5 ounces of wine,
or 1½ ounces of 80-proof distilled spirits. Researchers all agree moderation is
an important control. Evidence exists that wine in moderation (1 – 2 drinks
per day) as part of a healthy diet does provide health benefits. However like
other drugs, abuse of wine can prove destructive. If a greater number of persons
with heart disease may benefit from moderate consumption of wine, should we
limit further research because of those who may abuse the drug? If we apply this
logic to all controlled substances, we would not have access to many of the
life-saving (or pain-killing) drugs available today. Existing research seems to
indicate that further studies are required to determine the comparative levels
of effectiveness between overall diet, the moderate consumption of wine with
meals, and though not addressed in this report: exercise. Lower LDL cholesterol
levels seem to be an important factor to reducing the risk of stroke and heart
attack. The studies I reviewed indicate each of these factors contribute to a
healthier life.

Bibliography
Rodger Doyle, Deaths Due to Alcohol, (Scientific America, 1996) www.health.org
American Heart Association, Cardiovascular Diseases Biostatistical Fact Sheets,
(American Heart Association, 1996) www.americanheart.org Mayo Clinic, Mayo
Health Oasis, (Mayo Clinic, 1997) www.mayohealth.org Jack Challem, The Color of
Health: Why Nutrients Called Flavonoids Are Good For You, (The Nutrition
Reporter, 1994) Dr. Andrew Waterhouse, Wine Antioxidants May Reduce Heart
Disease and Cancer, (Washington, DC: American Chemical Society, 1994)
www.wineinstitute.org Hacsi Horvath, Will Wine Help Your Heart?, (Web MD, Inc,
1999) www.cnn.com CNN interactive, Cabernet Sauvignon Wine Called Good for
Arteries, (Atlanta: CNN, 1999) www.cnn.com CNN interactive, Cabernet Sauvignon
Wine called Good for Arteries, (London: CNN, 1999) www.cnn.com Dr. Steve
Salvatore, Study: Moderate Alcohol Consumption May Protect Against Stroke, (New
York: CNN, 1999) www.cnn.com Dr. Steve Salvatore, Study: Moderate Alcohol
Consumption May Protect Against Stroke, (New York: CNN, 1999) www.cnn.com Louise
Schiavone, Study Links Moderate Wine Drinking, Lower Stroke Risk, (Washington:
CNN, 1998) www.cnn.com Louise Schiavone, Study Links Moderate Wine Drinking,
Lower Stroke Risk, (Washington: CNN, 1998) www.cnn.com CNN interactive, A Drink
A Day Keeps the Grime Reaper Away, (Boston: CNN, 1997) www.cnn.com
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