Beer : Health and Nutrition

The Impact of Alcohol on Health 123
in. This enzyme produces more acetaldehyde but no assimilable energy. The enhanced
acetaldehyde blocks respiration in the mitochondria, thus exaggerating the accumulation
of fat in the liver. Ketoacidosis is promoted and lipid peroxidation and collagen synthesis
promoted, which contributes to alcoholic hepatitis and cirrhosis. There is also free
radical generation, which can promote liver damage.
Direct and indirect impacts
There are at least two ways in which an alcoholic beverage such as beer might impact
bene cially on the body: rst, through a direct physiological impact on bodily tissues
and functions (which will be focused upon here); second, through indirect impact, but
founded equally on a physiological interaction. The mellowing in uence that moderate
consumption of alcohol has, with its calming and relaxing impact, will of itself have a
sparing effect on stress-related illnesses (Morrell 2000). Cleophas (1999) concludes that
there is a signi cant psychological component in the bene cial relationship between
moderate alcohol consumption and mortality.
In either instance it will be recognised that excessive alcohol consumption will shift
the status quo in a negative direction. We will address the incontrovertible direct damage
to body organs that can be caused by overconsumption, and there is no denying the
antisocial impact of excessive alcohol consumption in terms of behavioural changes
and drink driving. One problem emphasised by many writers is the impact of underreporting
alcohol consumption.
Dr Thomas Stuttaford (who for years has written a most engaging column in The Times)
presents a fascinating experiential account of the likely reasons why his patients in rural
Norfolk enjoyed a lesser incidence of cardiovascular problems and tended to live longer than
did their counterparts in London (Stuttaford 1997). First, they had enjoyed less sedentary
lives, with less dependence on the automobile. Second, they took aspirin daily to counter the
osteoarthritis brought on by working in soggy agricultural conditions. Third, they weren’t
teetotallers. And their chosen drink was beer, with the occasional celebratory whisky.
It is of course not possible to con rm with any certainty that there was a causal link
between any of those three factors and Stuttaford’s observations on mortality. Indeed,
the reader will recognise the dif culty of pursuing robust research in this entire area, for
the simple reason that studies relating health to any type of food intake must inherently
try to remove as many interfering factors as possible and this is not easy:
Additional methodological problems are presented by a number of ‘confounding
factors’ such as age, sex, body mass index, diet, physical activity, smoking, coffee
consumption, educational attainment, type A/B behaviour, socio-economic status,
and medical history, that may be factors in particular health problems in persons