Health for life

Many observational epidemiologic studies have found an inverse association between alcohol consumption and hematological cancers (such as lymphoma and leukemia). This study, based on the Million Womens Study in the UK, is large enough to permit an evaluation of associations with various types of such cancers. Further, it takes into account newer coding systems for morphology so that diseases associated with the lymphatic system can be separated from those of the myeloid system.

The key findings are that alcohol consumption appears to lower the risk of several types of lymphoma and plasma cell neoplasms, but has little effect on the risk of myeloid tumours such as acute myeloid leukaemia. Smoking is associated with an increase in risk for most such cancers. Approximately 1.3 million middle-aged women were recruited in the United Kingdom during 1996 and followed for death, emigration and cancer registration until 2009 (mean 10.3 years per woman); potential risk factors were assessed by questionnaire. Adjusted relative risks were estimated by Cox regression.

During follow-up, 9,162 incident cases of haematological malignancy were recorded, including 7,047 lymphoid and 2,072 myeloid cancers. Among predominantly moderate alcohol drinkers, higher intake was associated with lower risk of lymphoid malignancies, in particular diffuse large B-cell lymphoma [relative risk 0.85 per 10 g alcohol per day (95% confidence interval 0.75.96)], follicular lymphoma [0.86 (0.76.98)] and plasma cell neoplasms [0.86 (0.77.96)]. Among never- and current smokers, higher cigarette consumption was associated with increased risk of Hodgkin lymphoma [1.45 per 10 cigarettes per day (1.22.72)], mature T-cell malignancies [1.38 (1.10.73)] and myeloproliferative/myelodysplastic disease [1.42 (1.31.55)].

Forum reviewers considered this to be a very well-done analysis, and the ability of the authors to separate the effects on lymphoid and myeloid cancers is important. Forum members emphasize the strong differences in effect of smoking (an increase) and alcohol consumption (a decrease) on the risk of these cancers. They support future research to discover the mechanisms by which moderate drinking may lower such risk.

Its the time of year when many of us celebrate the holidays with festive foods and drinks, including alcohol. No better time then to ask if it is true, as is widely held, that moderate consumption of alcohol is beneficial to health.

A research team led by an immunologist at the University of California, Riverside now has data that could put the question to rest. The researchers found that moderate alcohol consumption could bolster our immune system, and potentially our ability to fight infections.

The finding, published Dec. 17 in the journal Vaccine, can help lead to a better understanding of how our immune system works. It can also pave the way for potentially new interventions to improve our ability to respond to vaccines and infections, benefiting vulnerable populations, such as the elderly for whom the flu vaccine, for example, has been found to be largely ineffective.

"It has been known for a long time that moderate alcohol consumption is associated with lower mortality," said Ilhem Messaoudi, an associate professor of biomedical sciences in the School of Medicine and the lead author of the research paper. "Our study, conducted on non-human primates, shows for the first time that voluntary moderate alcohol consumption boosts immune responses to vaccination."

Messaoudi did the bulk of the research while she was an assistant professor at the Oregon Health and Science University, where she collaborated with Kathleen Grant, a professor of behavioral neuroscience and a coauthor on the research paper. She joined UC Riverside earlier this year.

To study the impact of alcohol consumption on the immune system, the researchers trained 12 rhesus macaques to self-administer/consume alcohol on their own accord. The team first vaccinated the animals (against small pox) and then allowed them to access either 4 percent ethanol (the experimental group) or calorically matched sugar water (the control group). All the animals also had open access to water as an alternative fluid, as well as food. The researchers then proceeded to monitor the animals daily ethanol consumption for 14 months. The animals were vaccinated one more time, seven months after the experiment began.

The research team found that over nine months of the animals ethanol self-administration, mean daily ethanol intake varied markedly among them.

"Like humans, rhesus macaques showed highly variable drinking behavior," Messaoudi said. "Some animals drank large volumes of ethanol, while others drank in moderation."

The animals voluntary ethanol consumption segregated them into two groups: animals in the first group were those that consumed more alcohol, averaged a blood ethanol concentration (BEC) greater than the legal limit of 0.08 percent and were theore designated heavy drinkers; animals in the second group consumed less alcohol, averaged a BEC of 0.02-0.04 percent and were designated moderate drinkers.

"Prior to consuming alcohol, all the animals showed comparable responses to vaccination," Messaoudi said. "Following exposure to ethanol, however, the animals showed markedly different responses after receiving the booster vaccine."

The researchers found that, as expected based on human epidemiological data, those animals that drank the largest amounts of alcohol showed greatly diminished vaccine responses compared to the control group. In contrast, animals that drank moderate amounts of ethanol displayed enhanced vaccine responses.

"These surprising findings indicate that some of the beneficial effects of moderate amounts of alcohol consumption may be manifested through boosting the bodys immune system," Messaoudi said. "This supports what has been widely believed for some time: moderate ethanol consumption results in a reduction in all causes of mortality, especially cardiovascular disease. As for excessive alcohol consumption, our study shows that it has a significant negative impact on health."

Alcohol abuse kills 25,000 Americans annually and is one of the leading causes of preventable death in the country. Two thirds of U.S. adults consume approximately four drinks a week, considered to be a moderate amount by most consumers.

"If you have a family history of alcohol abuse, or are at risk, or have been an abuser in the past, we are not recommending you go out and drink to improve your immune system!" Messaoudi said. "But for the average person that has, say, a glass of wine with dinner, it does seem, in general, to improve heath, and cardiovascular function in particular, and now we can add the immune system to that list."

The study was carried out under strict accordance with the recommendations outlined in the Guide for the Care and Use of Laboratory Animals of the National Institutes of Health, the Office of Animal Welfare and the U.S. Department of Agriculture. The study was also approved by the Oregon National Primate Research Center Institutional Animal Care and Use Committee.

"Next, we plan to harness our observations made in this study to address bigger questions on the immune system, such as how can we boost our immune responses to vaccination, a particular challenge for our elderly," Messaoudi said.

Alcohol is thought to be responsible for 34,000 deaths in the UK each year because of the damage it does to the body, plus many more deaths due to the indirect effect of alcohol on others.

Alcohol is a sedative hypnotic drug that depresses the central nervous system, making you feel more relaxed.
Most adults in the UK drink alcohol moderately and on a social basis and derive a lot of pleasure from doing so.
However, about one in five men and one in seven women regularly drink more than the Department of Health suggests is strictly safe for good health. This is up to two to three units of alcohol a day for women and up to three to four units of alcohol a day for men, to a maximum of 14 units a week for women and 21 units a week for men. A unit of alcohol is equivalent to half a pint of ordinary strength beer, a small glass of wine or a single pub measure of spirits.

Short-term effects of alcohol

The short-term effects of alcohol are dependent on the amount consumed and can vary enormously from person to person and from one situation to another.
The main effect is on the brain, which can result in:

• Slurred speech
• Loss of coordination
• Unsteadiness when standing or walking
• Impaired attention and judgement
• Loss of inhibition
• Sleep

Relatively low doses of alcohol relax the user, make them more talkative and animated. Larger doses lead to uncoordinated movement, impaired decision-making and sedation.
The depressive effects of alcohol on normal brain function - especially those causing impaired judgement - are the main reasons its always best to avoid alcohol when driving and never to exceed the limit.

Long-term effects of alcohol

The cumulative effects of excessive alcohol consumption, especially when associated with a poor diet, affect every part of the body. The two main sites of damage are the liver and the nervous system.
The liver may become progressively damaged through a condition known as cirrhosis, which may lead to liver failure, liver cancer and death.
The nervous system may be damaged at many levels. Damage to the brain can interfere with intellectual function, and increase the risk of anxiety and depression, confusion and dementia.
Damage to the peripheral nervous system can lead to loss of balance, impotence, numbness of the feet and hands, tremor and blindness.
Alcoholism is also implicated in diabetes, inflammation of the pancreas, internal bleeding, weakening of the heart, high blood pressure and stroke. Alcohol intake during pregnancy is harmful to an unborn baby.

Symptoms of alcohol addiction

When someone becomes dependent or addicted to alcohol, they:

• Develop a strong sense of compulsion to drink
• May drink shortly after waking to reduce feelings of alcohol withdrawal
• Develop a reduced capacity to control how often and how much they use
• Organise their lifestyle around drinking

Books about alcohol and addiction

Alcoholics Anonymous - Big Book (AA Services, 2002) - a seminal book, originally published in the 1930s, for people who suffer from alcohol addiction and who want to stop drinking.
Lets Drink to Your Health! (Nick Heather and Ian Robertson, 1996) - useful advice to enable people to change their drinking patterns; a drinking diary and tips for drinking less are included.
Alcoholism: The Facts (Donald W Goodwin, 2000) - a classic text on alcoholism. Written in a clear and lively style, the book is aimed at those who have alcohol problems and the people who share their lives.
Dying for a Drink: What You and Your Family Should Know About Alcoholism (Anderson Spickard and Barbara R. Thompson, 2005) - a self-help book for people who have alcohol problems and their families.
The Easyway to Control Alcohol (Allen Carr, 2009) - a self-help guide by best-selling author on addictions and how to overcome them.
Drinking: A Love Story (Caroline Knapp, 1997) - Knapp offers insights not only about alcoholism, but about life itself and how we learn to cope with it.

Written by the fabulous Leigh, Veggie Might is a weekly Thursday column about all things Vegetarian.

Gentle Readers, it’s St. Patrick’s day. In honor of the drinkingest holiday of the year, lets talk about booze. Sort of.

Here at CHG, we have a healthy appreciation for hootch, being responsible citizens and lovers of life. A glass of wine, a bottle of cold beer, or the occasional Jager shot a well-crafted cocktail make an evening with friends or a holiday party that much more enjoyable/tolerable.

The flavors of our favorite beverages are unmistakable, and we drink them for their good taste more than their soothing aftefects. Or so we tell Aunt Helen. Ingredients like wine and sherry and Grand Marnier are included in recipes for the same reason. Their flavors are unmatched and give our recipes that je ne se quois we seek.

Red and white wine, vermouth, sherry, beer, bourbon, brandy, and a flavored liqueurs like coffee (Kahula, Tia Maria), orange (Cointreau, Grand Marnier, Triple Sec), and anise/licorice (Ouzo, Pernoud) are commonly used in cooking and baking recipes. These are the staples to have on hand if you’re keeping a well-stocked culinary bar.

But while the we of CHG appreciates a nip with dinner and splash in the cream sauce, the me of CHG is a reluctant teetotaler. I’ve got this brain thing that doesn’t like it when I drink, and while a little bourbon in my pecan pie is probably okay, I just don’t keep the stuff around; it’s not worth the expense for the occasional recipe—or the risk of a trip to the emergency room.

“But Leigh,” you exclaim, “it’s not about the alcohol, it’s about the flavor! And all the alcohol evaporates during cooking!”

Yes: true and mostly true. Most people make tequila chicken for the enhanced flavor the liquor imparts, not to get one up on their friends at margarita night. And most, but not all alcohol is cooked away when booze is applied to recipes, though claims vary as to how much evaporates during cooking. According to Kevin Weeks at NPR.com, “depending on cooking method and time, you can reduce the alcohol by 60 percent by simmering for 15 minutes, or by as much as 90 percent after two hours of simmering.” But when cooking for children or people with health or addiction issues, even a little bit can be too much.

So what then? Weeks suggests choosing another recipe, and I agree if the liquor is the distinguishing feature of the dish, like Julia Child’s famous Boeuf Bourguignon—it’s meat soaked in red wine. Something tells me it would be an altogether different experience if you decided to let your boeuf braise in grape juice overnight.

But if I passed up every fondue or stew that called for a splash of kirsch or a glug of beer, my repertoire would be quite limited—and I could toss away half of the recipes from France. So I improvise with what I have.

For example, broth or stock is an easy substitution for wine or beer in many savory dishes, like soups, sautés, and risottos. Fruit juices, like apple and grape, can replace wine in desserts. If you want a note of acid, add little vinegar. It won’t be the same, as I’m sure some would argue, but it will still be delicious.

In some cases you can just leave out the booze. Fondue will be just as good without kirsch, but keep an eye on it; the alcohol in the liqueur is there to lower the boiling point of the cheese.

In the last year I’ve made two outstanding dishes that were no worse for lack of wine. Both were from the fabulous Viva Vegan, which is still getting heavy play in my kitchen. Red Posole and Beans called for Mexican beer which I replaced in equal measure with vegetable stock, and the resulting stew was to die for.

For Quinoa-Millet Mushroom Risotto, I swapped the 1/2 cup of white wine, traditionally used in risottos, for 1/2 cup of apple juice + 1 tablespoon of apple cider vinegar. It remains one of the best things I’ve ever put in my mouth.

When baking, replace liqueurs with similarly flavored extracts and juices. Vanilla is the most commonly recommended stand in for bourbon; almond extract works great in place of amaretto; and brandy has its very own cooking extract. Orange, apple and grape, and pineapple juices fill the void left by orange liqueur, dry and sweet vermouth, and rum.

Now, it must be said that extracts contain alcohol, which works as a solvent to break down the fruit or herb so that the maximum amount of flavor is obtained. Vanilla extract is 35% alcohol by volume, or 70 proof, not far off from vodka. But the minute amount used in baked goods, partnered with dilution and evaporation, will unlikely cause anyone to feel its effects.

According to Cook’s Thesaurus, 1 tablespoon of brandy extract replaces 5 tablespoons of the real deal, yet measure for measure, they have a similar alcohol content. Extract is a safe alternative unless you’re abstaining for religious reasons or are hypersensitive. Flavored oils, powders, and straight-up ingredients like vanilla beans, may be your best solution if you want to avoid alcohol altogether.

We all love charts, right? Well, here are some handy charts, fresh from the Internet machine, to guide your alcohol-free baking and cooking adventures:

• All Recipes: Common Ingredient Substitutions
  
• Uncle Phaedrus: Wine Substitute
  
• What’s Cooking America: Alcohol Substitutions
  
• Gourmet Sleuth: Alcohol Substitutes
  
• Recipe Tips: Alcohol Substitutions
  

If you have any nonalcoholic baking or cooking tips you’d like to share, the comments are open. I’d love to hear your thoughts. Slàinte!

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If these bubbles tickled your nose, you’ll lose your head over:

• Baking and Cooking for the Sensitive and Cleansing  
• Converting Those Pesky Weights and Measures  
• 10 Modern Food Myths, Busted

College education and alcohol consumption may be linked to risk for chronic obstructive pulmonary disease (COPD). Researchers from Kaiser Permanente Medical Group in Oakland, California, followed 126,019 people who supplied baseline data from 1978 – 1985 through 2008 with analyses of hospitalizations attributed to COPD (emphysema, chronic bronchitis, or chronic airway obstruction).

Although cigarette smoking, increasing age, and history of respiratory disease/symptoms were powerful predictors of COPD, results also showed that Asian Americans (vs whites) and college graduates (vs no college) were at a moderately lower risk for COPD, as were persons reporting 1 to 2 drinks per day (vs lifelong abstainers).

A new study has found that drinking-related hypertension has a higher risk in flushers than in non-flushers, and the risk of hypertension was significantly increased when flushers consumed more than four drinks per week.

Excessive drinking is a known risk factor for hypertension. Drinking that results in facial flushing indicates high sensitivity or even intolerance to alcohol. A study of the relationship between drinking and these two conditions has found that drinking-related hypertension has a lower threshold value and higher risk in flushers than in non-flushers.

Results will be published in the April 2014 online-only issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"Facial flushing after drinking is always considered as a symptom of high alcohol sensitivity or even intolerance to alcohol, unless a patient is taking special medicine," said Jong Sung Kim, head of the department of family medicine at Chungnam National University School of Medicine. "The facial flushing response to drinking usually occurs in a person who cannot genetically break down acetaldehyde, the first metabolite of alcohol."

"Facial flushing after alcohol drinking differs across gender, age, and ethnic groups," added Kyung Hwan Cho, president of the Korean Academy of Family Medicine. "In general, it is more common in women, the elderly, and East Asians versus Westerners."

Cho noted that it is well known that excessive alcohol consumption is associated with elevated blood pressure and the likely development of hypertension. "This association persists regardless of beverage type and shows a dose-response relationship, which means excess drinking for weeks or months can increase blood pressure," he said. "However, the relationship may vary by gender, race/ethnicity, or presence of other risk factors for cardiovascular disease. Conversely, many studies have reported that meaningful blood pressure reductions occur after reductions in alcohol drinking."

"To my knowledge," noted Kim, "there has been no detailed research that has analyzed the relationship between drinking and hypertension while considering individual responses to alcohol."

Kim and his colleagues collected data from the medical records of 1,763 men (288 non-drinkers, 527 flushing drinkers, 948 non-flushing drinkers) who had received a health check-up. The risk of hypertension related to the weekly drinking amount by non-flushers and flushers was analyzed and compared with the risk of hypertension among non-drinkers.

"Our results indicate that hypertension associated with drinking has a lower threshold value and higher risk in flushers than in non-flushers," said Kim. "After adjusting for age, body mass index, exercise status, and smoking status, the risk of hypertension was significantly increased when flushers consumed more than four drinks per week. In contrast, in non-flushers, the risk increased with consuming more than eight drinks per week".

Kim added that these results indicate that facial flushing after drinking may potentially serve as a marker of risk for hypertension associated with drinking. "Our research findings suggest that clinicians and researchers should, respectively, consider evaluating their patients flushing response to alcohol as well as drinking amount in a daily routine care, and researching hazard by drinking."

"Thus, if you or your patient have facial flushing, the risk of hypertension can increase even if you drink less than those who do not have facial flushing," said Cho. "[Under these circumstances, I would] recommend limiting your or their drinking amount even more to prevent the development of hypertension."