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Alcohol versus exercise for coronary protection.

E R Eichner

    The American Journal of Medicine
    |August 1, 1985
    PubMed
    Summary

    Exercise, not alcohol, protects against coronary heart disease (CHD). Data suggest teetotalers have the lowest CHD mortality, while alcohol

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    Area of Science:

    • Cardiovascular Disease Research
    • Public Health

    Background:

    • Both alcohol consumption and exercise are commonly believed to offer protection against coronary heart disease (CHD).
    • Existing epidemiological data present conflicting views on the protective effects of alcohol versus exercise on CHD.
    • Recent studies indicate that individuals who abstain from alcohol (teetotalers), particularly non-smokers, exhibit the lowest CHD mortality rates.

    Purpose of the Study:

    • To critically evaluate the purported cardioprotective effects of alcohol and exercise.
    • To investigate potential biases in studies suggesting light alcohol consumption lowers CHD risk.
    • To compare the physiological mechanisms through which exercise and alcohol influence CHD risk factors.

    Main Methods:

    • Review and analysis of epidemiological data, including cross-sectional and longitudinal studies.
    • Examination of metabolic data related to alcohol and exercise's impact on lipoproteins.
    • Comparison of the effects of exercise and alcohol on key cardiovascular risk factors like blood pressure, body weight, and glucose tolerance.

    Main Results:

    • Epidemiological data suggest exercise is protective against CHD, whereas alcohol is not.
    • Potential biases identified in studies favoring light drinkers include the presence of former drinkers with pre-existing CHD and healthier lifestyle choices among light drinkers.
    • Metabolic data indicate exercise favorably impacts high-density lipoprotein 2 (HDL2), a strong CHD risk marker, while alcohol may increase high-density lipoprotein 3 (HDL3), which has a weaker correlation with CHD risk.
    • Exercise and alcohol exert opposing effects on blood pressure, body weight, and glucose tolerance, with exercise's influence being beneficial and alcohol's detrimental for CHD prevention.

    Conclusions:

    • Exercise demonstrates clear cardioprotective benefits, primarily through mechanisms like increasing HDL2 levels.
    • Evidence does not support alcohol consumption as a strategy for coronary heart disease protection.
    • The apparent benefits of light drinking may be attributed to confounding factors rather than alcohol itself.
    • Alcohol consumption appears to have detrimental effects on cardiovascular health markers relevant to CHD prevention.

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