Beer : Health and Nutrition

The Impact of Alcohol on Health 133
would extend to an expectation that moderate consumption of alcohol in vertex-pattern
bald men would have a more favourable effect than in hirsute or front-balding men,
though I have not come across such a study.
Excessive consumption of alcohol is detrimental to the heart muscle, leading to a
disease called cardiomyopathy (McDonald et al. 1971; Schoppet & Maisch 2001). It
tends to be associated with excessive alcohol consumption over a prolonged period:
one estimate is 120 g alcohol (roughly 7 pints of beer) every day for 20 years (Urbano-
Marquez et al. 1989). Other muscles in the body are probably affected also.
In some circumstances it may not have been the alcohol alone that has led to the disease.
For example, arsenic contamination led to major heart problems in Manchester in
1900 (Reynolds 1901), while cardiomyopathy was one consequence of the ill-reasoned
use of cobalt as a foam stabiliser in Quebec and a few other places in the mid-1960s
(Morin & Daniel 1967).
Excessive drinking has been proposed (Alvarez et al. 1999) as one of the several
causes of atrial brillation – an irregular heartbeat – with attendant breathlessness and
perhaps palpitations and angina. Koskinen (1991), by contrast, did not nd a causal
link between misuse of alcohol and the occurrence of this disease. This type of con ict
in the literature is not uncommon, because many studies involved drawing correlations
between disease (or lack of disease) and records (often self-reported by patients) of
dietary information, including the intake of beer. Frequently other correlations are at play
that may confound the observations. A good example might be that people who smoke
are often heavy drinkers. A direct correlation of a disease with the smoking that might
be genuine would also correlate with alcohol intake, but this would not necessarily be
a causal link. Of course the converse might apply equally. With a weather eye for these
dif culties, let us continue.
Studies have indicated that hypertension (increased blood pressure) is twice as
common in heavy drinkers as opposed to light drinkers, seemingly unconnected with
any weight increase (Kannel & Ellison 1996). Beer use is said to be associated with
higher blood pressure (Nevill et al. 1997). Potter and Beevers (1984) found that 4 pints
daily over a period of 3–4 days had a demonstrable effect on this measurement. Keil
et al. (1993) describe a causal link between ‘chronic’ intake (> 30–60 g alcohol per
day, perhaps less for women) and the elevation of blood pressure in men and women.
As a rule of thumb, the authors claim that at levels greater than 30 g alcohol per day,
each increase of 10 g per day alcohol increases systolic blood pressure by an average
of 1–2 mmHg and diastolic blood pressure by 1 mmHg. Only obesity is a greater risk
factor. The precise way in which alcohol exerts its effect is unknown, but there appear
to be neural, humoral and direct vascular elements.
Williams (1997) has shown that despite the bene cial effect of alcohol (and exercise)
on levels of HDL-cholesterol in the body, the intake of alcohol continued to increase