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Alcohol consumption: the benefit is in the dose

June 29, 2012 By 3 Comments

We know that excessive alcohol consumption is dangerous. It is well-documented that drinking leads to motor vehicle accidents, serious diseases, and a weakened immune system.

But there’s a saying first coined by Parcelsus in the 1500s : “The  difference between a drug and a poison is the dose.”  And it certainly applies to alcohol consumption. Two important new meta-analyses underscore this point.

In the first article, the authors included 84 studies that look at the connections between cardiovascular risk and alcohol consumption. They came to the conclusion that the evidence is now so clear that moderate drinking reduces cardiac risk that no further meta-analyses are necessary. Instead “debate should centre now on how to integrate this evidence into clinical practice and public health messages. In the realm of clinical practice, the evidence could form a foundation for proposing counseling for selected patients to incorporate moderate amounts of alcohol into their diets to improve their coronary heart disease risk.”

But they didn’t stop there. They also conducted a second meta-analysis of “feeding studies” (where alcohol is experimentally administered). These studies eliminate the concerns about confounding in the observational studies, and can thus point to mechanisms by which alcohol protects against heart disease.

The finding? “Moderate alcohol consumption had favourable effects on levels of high density lipoprotein cholesterol, apolipoprotein A1, adiponectin, and fibrinogen. These results strengthen the case for a causal link between alcohol intake and reduced risk of coronary heart disease.”

“We don’t need any more studies examining this association,”  said Dr. Cary Reid, a geriatrician at Weill Cornell Medical College. “This meta analysis is well conducted and is one of many conducted over the past decade that has shown a consistent protective effect of moderate alcohol consumption on cardiovascular outcomes.”

The challenge, Reid says, is communicating the evidence to patients. “It remains unclear whether this finding will be translated into clinical practice given clinicians’ concerns about increased alcohol use – particularly among older people – and the associated effects of falls, fractures, and decreased psychological functioning.”

The key message is “moderate.” And there are some specific guidelines about what that means issued by the National Institute on Alcohol Abuse and Alcoholism. (The rule of thumb is one drink a day for women and two drinks a day for men.)

So raise a glass – but just one of two, and not if you’re driving – to your health.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: , , ,

The media gets it right: The health effects of coffee

June 26, 2012 By 2 Comments

Here at EBL, we love it when a major media outlet takes a fair and balanced look at the evidence.  As we’ve written about before, mainstream publications don’t always present all of the evidence.  But this week, the New York Times published an excellent update on the health effects of coffee.

Health writer Jane Brody first wrote up a thorough review of the health effects of coffee in 2008.

Among the findings she reported:

  • Drinks with fewer than 550 milligrams of caffeine, which includes a Grande brew from Starbucks, are equally as hydrating as drinking pure water. (Many previous reports have touted coffee’s diuretic effects.)
  • There is very little evidence that coffee increases your risk of heart attack or abnormal heart rhythms.
  • Coffee causes a small, temporary rise in blood pressure, but there’s no evidence that it leads to chronic hypertension.
  • And on a positive note, coffee is found to increase alertness, happiness and endurance in aerobic activities. It also helps blunt the feeling of pain. (No wonder so many Americans love it so!)

Brody’s update, published this week, was based on a study published in May in the New England Journal of Medicine. Here’s how she summed it up:

“When smoking and many other factors known to influence health and longevity were taken into account, coffee drinkers in the study were found to be living somewhat longer than abstainers. Further, the more coffee consumed each day — up to a point, at least — the greater the benefit to longevity.”

That’s good news on two fronts: Coffee drinkers the world over can enjoy brews without worry, and the New York Times gets accolades for balanced, comprehensive reporting.

Filed Under: Evidence-Based Living, Health and Wellness, In The Media Tagged With: , , ,

Studies on same-sex parenting: The details matter

June 20, 2012 By 1 Comment

Here on EBL, we’ve talked frequently about what makes for quality research. There’s new research out this month on gay parents that illustrates the importance of seeking out high quality research.

A new study by a University of Texas sociologist  surveyed nearly 3,000 Americans ages 18 to 39 to ask about their family structure growing up. Of the participants, 248 grew up in households where one parent  had a same-sex relationship at some point.  The study found that children of these parents were more likely than kids in other family structures to be on public assistance, unemployed or in therapy as adults, among other negative outcomes.

To collect information about same-sex parenting, the study asked: “Did either of your parents ever have a romantic relationship with someone of the same sex?” and then asked whether participants had lived with their parents at the time.

But the question does not collect enough information about these families. Are they parents involved in heterosexual marriages who had an affair, or divorced and then entered into a same-sex relationship?  We just know. The study didn’t ask any questions about whether participants were raised in stable homes with committed parents who were of the same sex.

The study has sparked a flurry of media attention, including the New York Times and Time magazine, among other

s, with plenty of criticism. And the criticism is merited, said Ritch Savin-Williams, Director of the Sex and Gender Lab at the Cornell’s College of Human Ecology.

“The research design of this study is sufficiently flawed (inappropriate comparison group) as to merit disbelief in the findings,” he said. “It is unclear if this major shortcoming was lack of scientific rigor or in some part influenced by the funding sources that have both religious and political agendas.”

There is a systematic review on same-sex parenting that provides more answers. The review looked at 33 studies that lesbian, gay and heterosexual parents. Their analysis found no difference in parenting ability or the children’s psychological and social success between same-sex and heterosexual parent partners.

Clearly, the issue of same-sex parenting is politically-charged for a lot of reasons. The point we’d like to make here on EBL is that it’s important to understand the details of research study, and draw your conclusions with all of the evidence.

Filed Under: Evidence-Based Living, In The Media, Youth Development Tagged With: , , , ,

Bodyfat facts: Real evidence on the consequences of obesity

June 14, 2012 By 2 Comments

We often hear in the media – this blog included – that obesity is an epidemic in the United States, and move straight to discussing solutions to the problem. But lately I’ve found myself wondering, what exactly are the health consequences of being overweight or obese?

So, of course, I went on a hunt to find some evidence.  It turns out there are many. The Harvard School of Public Health provides a great summary of the health risks of obesity with references – many of them systematic reviews.

Their summary finds obesity associated most strongly with the diabetes and cardiovascular disease. Meta-analyses have found significantly greater risks of developing coronary artery disease, stroke and cardiovascular death.

While the link between obesity and cancer is less clear, there is certainly still ample evidence that shows obesity is a risk factor for developing cancers. A major review of the data by the World Cancer Research Fund and the American Institute for Cancer Research found evidence of an association between obesity and cancers of the esophagus, pancreas, colon and rectum, breast, endometrium, and kidney, and a probable association between obesity and gallbladder cancer. Since the report was released in 2007, the group is providing continuous updates about the evidence on diet, physical activity, body fatness and cancer.

There are other serious risks that come along with obesity: depression, dementia, infertility, asthma and arthritis.

I have to say that, personally, I was astounded by the sheer volume of evidence out there on the consequences of obesity.  I know my fair share of people who are overweight. Reviewing the evidence bring their struggles into a whole new light for me. It doesn’t seem like you can live with obesity without some health consequence.

I did find one silver lining though.  There is some pretty clear evidence in this report from the National Heart Blood and Lung Institute that losing some weight – even without reaching an ideal weight – offers some health benefits for adults who are obese. The clear take-home message here is to do what you can – eat more fruits and veggies, go for a walk, cut out junk food – to move toward a healthier weight.

Filed Under: Evidence-Based Living, Health and Wellness Tagged With: , ,

Disney takes its cues from the evidence

June 11, 2012 By Leave a Comment

In major news this week, the Walt Disney Co. banned the advertising of junk foods from its television, radio and Internet programming. Under the new guidelines, advertisers who want to promote food and beverages on Disney programming for children must meet guidelines on serving size, calories, and fat and sugar content.

While it’s inspiring that such a large company is interested in promoting health among kids, I was even more inspired that Disney created a policy based on real evidence. Because, in fact, there is a growing body of evidence that links media consumption – and specifically advertisements – with negative health outcomes for children.

This systematic review, for example, looked at 173 studies examining the relationship between media consumption and health outcomes among children. In 80 percent of the studies, more media exposure was associated with a negative health outcome, and childhood obesity had the strongest correlation. This analysis considered the quantity of media that children watched, but not the content.

Another meta-analysis found a significant association between the proportion of children overweight and the number commercials per hour on children’s television, especially ads that promoting junk foods. The study used data from surveys of advertising on children’s television and estimates of the prevalence of overweight among children, in the U.S., Australia and eight European countries. It concluded the quantity and content of advertising on children’s television programs has a specific effect on children.

It’s great to see a major company taking cues from the evidence in an effort to improve the health of children!

Filed Under: Evidence-Based Living, Health and Wellness, policy Tagged With: , , , , ,

Can running be deadly?

June 5, 2012 By 1 Comment


Every now and again, a high-profile runner or participant in a major marathon dies of cardiac arrest – inevitably raising the question: Is long-distance running bad for your heart.

Being a long-distance runner myself, my personal inclination is to dismiss the question. Afterall, I reason, hundreds of thousands of people complete marathons each year and only a small handful of them suffer heart problems. It just happens that the problems are what we hear about in the news.

Still, it was a relief to find that the evidence supports my own personal conclusion.  In fact, I found two separate studies that found marathon running is not associated with any increase in cardiac risk or death.

The first, published in the New England Journal of Medicine earlier this year, looked at the incidence of cardiac arrest during marathons and half-marathons in the United States over the course of a decade. Overall, the study considered nearly 11 million race performances. Of those 11 million racers, the researchers found 59 cases of heart attacking during the race, with 42 resulting in death – a fairly slim risk.

The second study, published in the American Journal of Sports Medicine just last week, scoured news sources to documents participants who died during or up to 24 hours after marathon races in the U.S. from 2000 to 2009.  In examining 3.7 million marathon, the researchers identified 28 people who died during the marathon race and up to 24 hours after finishing – a similar conclusion to the previous study.

The take-home message: Long distance runners who suffer from heart problems often make the news, but that doesn’t mean running increasing your chance of having a hear attack. In reality, the benefits of running well outweigh the risk.

Filed Under: Evidence-Based Living, Health and Wellness
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