Beer : Health and Nutrition

124 Chapter Six
who have been the subjects of the reported studies. For example, a generally
poor nutritional condition could possibly play a signi cant role in various health
problems associated with heavy drinkers.
Butterworth (1993)
Studies based on individuals’ reporting of their dietary intake are not as controlled as
those in which feeding trials are performed with laboratory rats with de ned diets. Yet,
of course, what is observed with a rat does not necessarily extrapolate to the human.
We must critically evaluate the breadth of evidence that is presented. Most assume that
if suf cient evidence of diverse origin is offered then ‘there must be something in it’.
Much of the attention that has been paid to the impact of alcohol on the body has
been for its negative effect on those who abuse it. These effects are amply described in
the Oxford Textbook of Medicine (Weatherall et al. 1996) and, in more prosaic form, by
Stuttaford (1997). In the discussions that follow I refer to these impacts and the reader
is referred to those texts for more information.
The heart and the circulatory system
Lichtenstein (2003) states that 15 million deaths in the late 1990s could be attributed to
cardiovascular disease. The American Heart Association has pointed out that coronary
heart disease and the related cardiovascular disease is the number-one killer in the US,
accounting for almost one in two deaths among Americans and more deaths than are
caused by all the forms of cancer combined. The impact on disability and the attendant
economic loss are enormous.
Atherosclerosis (‘hardening of the arteries’) is the term used to describe a number of
pathological events occurring in arteries and which are responsible for coronary heart
disease, stroke and diseases of the peripheral circulatory system (Fisher 1991).
Atheroma (from the Greek ather = porridge) comprises deposits of fatty material on
the walls of arteries – a material comprising cholesterol, triglycerides, brous tissue and
red blood cells. As it builds it restricts blood ow and if this is in the coronary artery
then heart attack and death may follow, as the heart muscle does not receive suf cient
oxygen. Atheroma has also been associated with the development of cataracts, macular
degeneration in the retina and the development of cancers (Emerit et al. 1991; Tunick
et al. 1994). If the atheroma accumulation (plaque) is ruptured a blood clot may form
which not only can accelerate the blockage of the artery concerned but also may break
loose and plug another artery, increasing the risk of heart attack or, if the newly blocked
artery is in the brain, a stroke.
Plainly, the intake of saturated fats and cholesterol increases the risk, although it
must be realised that four- fths of the cholesterol is made in our bodies and does not