Drinking Pattern

It seems quite obvious that a small, frequent intake (steady) of alcohol has different health implications than a high, irregular (binge) one, and that many of the results from studies measuring only average weekly intake, for example, are imprecise. A few studies have been able to distinguish between frequency and amount of intake, and these studies have supported the previous statement both with regard to all-cause mortality and with regard to the apparent beneficial effect of alcohol on coronary heart disease.

A very large study on all-cause mortality confirmed the J-shaped relation but also clearly showed that those who had an infrequent high alcohol intake had a higher risk of death than those with a similar average intake who had a frequent pattern (Figure 3).

One of the mechanisms by which alcohol is assumed to exert its beneficial effect on coronary heart disease is by lowering high-density lipoprotein. Studies in rats have shown that a steady small intake of alcohol implies an increase in high-density lipo-protein level, whereas a peak intake of the same average amount of alcohol does not. Australian and US studies have shown that drinking pattern— steady versus binge drinking—plays a role in the apparent cardioprotective effect of alcohol.

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