FROM THE EDITOR'S KEYBOARD

It is being hailed by some as a "health-giving" factor. However my reading of the scientific literature reveals it to be the opposite.

In this first issue of WellnessWise for 1996, we turn our attention to a lifestyle habit that was well represented when the clock struck 12 at the beginning of this new year--social drinking. In scientific circles the issue engenders much debate. Frankly, however, I have to admit I am perplexed by the controversy.

True, there are some reports that suggest that social drinking may have some tendency to decrease heart disease risk in people on a poor lifestyle. However, it does not seem that individuals on a healthy lifestyle help their heart by moderate alcohol consumption. As one example, it appears that the widely touted heart protective effects of red wine can be obtained by drinking unfermented grape juice--or even eating the grapes themselves.

On the other hand, alcohol is linked to a number of problems. Experts estimate that each year in the U.S. alone, some 100,000 people go to their graves prematurely because of the consequences of alcohol use. Diseases that seem to be increased by even moderate alcohol consumption include: digestive problems (including some cancers), hemorrhagic stroke (stroke with bleeding into or around the brain), and infectious diseases (due to alcohol related immune suppression). Alcohol is also a contributor to the epidemic of obesity in our nation. One recent classification of American dietary habits ranked alcohol as the third leading source of calories in the U.S. diet. Of course, social drinking also has known effects on performance and productivity. Some of these effects are paradoxical. Alcohol, for example, helps a person fall asleep but it interferes with sleep quality--leading to less restful sleep--and possibly impaired performance the following day.

The radio scripts in this issue look at still other concerns with alcohol use. These include the well-recognized link with accidental deaths such as traffic fatalities, as well as less appreciated concerns such as increased risks of breast cancer and diabetes.

To me the bottom line is that alcohol is _not_ a health-giving commodity.

If you have recently taken up social drinking "for your health," I would challenge you to rethink that decision. On the other hand, if you use alcohol because you enjoy it, you may still want to reassess this habit. Consider the body of research linking adverse health effects with even social levels of drinking. The good news is that there is solid scientific evidence that you can develop new enjoyments by changing your lifestyle and sticking with those changes.

--DJD

COMING IN THE NEXT WEJ ISSUE:

Another full issue special: "Perspectives on Weight Loss"

SECTION II

TRANSCRIPTS FROM THE WELLNESSWISE RADIO PROGRAM

(All scripts copyright 1995 and 1996 by David J. DeRose, MD, MPH)

DRINKING AND DRIVING

It's a leading killer of some of the most promising members of our society. I'm Dr. David DeRose. "Drinking and Driving" in a moment on WellnessWise.

In the United States, motor vehicle accidents are the leading cause of death for individuals between 1 and 34 years of age. A significant portion of these deaths are alcohol related. In fact, each year about 17,000 Americans die in alcohol related motor vehicle accidents. The economic impact of these drinking related fatalities is also staggering--estimates put the annual cost at $46 billion.

The good news is that alcohol related fatalities are decreasing. In the early 1980's over 25,000 people died each year in alcohol related crashes--8,000 more than the current figure.

However, there still are problems. For example, in any given year, for every 100 licensed drivers, one of them will be arrested for driving while impaired. At least two things may help to further decrease the number of intoxicated drivers on the roadways: stronger legislation for repeat drinking and driving offenders and an even stronger community ethic that drinking and driving are unacceptable.

Even small changes in the percentage of alcohol related fatalities can save thousands of lives and billions of dollars.

For WellnessWise, I'm Dr. David DeRose.

Reference: Morbidity and Mortality Weekly Report 43(47):861-863, December 2, 1994, articles: "National Drunk and Drugged Driving Prevention Month" and "Update: Alcohol-Related Traffic Fatalities--United States, 1982-1993."

ALCOHOL, BREAST CANCER AND HORMONES

Social drinking may affect your risk of breast cancer. I'm Dr. David DeRose. We'll look at the concerns in a moment on WellnessWise.

Breast cancer--it's one of the most feared cancers among women. However, one potential risk factor--social drinking--has not received much publicity. In over 30 studies that have looked at the issue, the majority suggest that women who drink alcohol socially have more breast cancer. Although in some scientific circles the link is still considered controversial, many experts believe that the collective research is quite compelling. Even small amounts of alcohol--perhaps as little as three or four drinks per week--appear to increase the risk of breast cancer between 40 to 100 percent.

However, _how_ could alcohol increase breast cancer risk? A group of prestigious researchers discovered one possible answer in 1993. The team studied the effects of alcohol in women aged 21 through 40 over the course of six menstrual cycles. During three menstrual cycles, the women drank two drinks per day. For the other three cycles they totally abstained from alcohol.

The researchers found that sex hormone levels (like estrogen) were higher during the months the women used alcohol. Since these hormones are believed to play a role in breast cancer development, this study provides evidence as to how social drinking may increase the risk of breast cancer.

The study also provided some good news as well. Some of the observed hormonal effects appear to be reversible after abstaining.

For WellnessWise, I'm Dr. David DeRose.

DECREASING YOUR RISK OF DIABETES

Will you or your loved ones develop diabetes when they get older? I'm Dr. David DeRose. "Decreasing Your Risk of Diabetes"--in a moment on WellnessWise.

Older adults are prone to develop diabetes. However, before such a person actually develops the disease, his or her body generally becomes less sensitive to insulin. Insulin, of course, is the hormone that normally keeps our blood sugar under control.

To overcome the body's lack of response to insulin, the pancreas raises its insulin production to levels significantly _above_ normal. The increased insulin does help to keep the blood sugar lower for a time. However, the pancreas seems to fatigue under this strain of increased insulin production. The body is actually moving toward the development of diabetes.

These higher insulin levels exact another price. They appear to raise blood pressure and blood fats. This, in turn, increases the risk of heart attack and stroke.

To avoid the complications of blood vessel problems and the development of diabetes, a question naturally arises: can we keep our body appropriately sensitive to insulin as we get older? The answer is "yes" according to a 1994 study from the Netherlands.

Researchers there identified three factors that help us keep appropriately sensitive to insulin as we age. These factors are: regular physical exercise, a healthy diet that is rich in fiber and low in saturated fat, and avoidance of alcohol.

Healthy lifestyle choices may well help you prevent diabetes. For WellnessWise, I'm Dr. David DeRose.

Reference: Edith J. M. Feskens, J. Gerard Loeber and Daan Kromhout, Diet and physical Activity as Determinants of Hyperinsulinemia: The Zutphen Elderly Study, American Journal of Epidemiology 140(4): 350-360.

SECTION III

SCIENCE/HEALTH ABSTRACTS

Caffeine and alcohol both seem to increase the risk of hip and forearm fracture in middle-age women. A six-year study of almost 85,000 women showed a positive relationship between caffeine use and hip fracture. Alcohol use was associated with elevated risk of both forearm and hip fracture.

Young people who mature slowly are less likely to indulge in risky health behaviors. Adolescents who begin puberty later than their peers are less likely to become involved in sexual activity, alcohol or drug abuse. (Pediatric Research 29(4 Pt 2)5A, April 1991) The slower maturation allows mental and social factors to develop along with the physical.

SECTION IV

PARTING WORDS

ABOUT OUR SPONSORS

Other charter sponsors for WEJ include Living Springs Lifestyle Center and The WellnessWise radio broadcast.

Living Springs Lifestyle Center (1-800-SAY-WELL) continues to offer a New Year's special to WEJ readers: 15% off any stop smoking program, and 10% off any other one week or longer program. Simply mention "WellnessWise" and enroll in any program with beginning dates between December 31 and February 25.

More complete details about these sponsors can be obtained by sending e-mail to WEJ. Alternatively, one can refer to back issues at our Web sites as described below.

Our newest sponsor, Total Life Creations, Inc.(TM), also continues "on board."

Total Life Creations is the producer of the new "Fatigue Busters(TM)" video which documents the alarming and often subtle affects of fatigue on quality-of-life, job performance, and productivity. Through the use of cutting edge research and "expert testimony," the viewer is confronted with the realization that career, family, and personal safety are all jeopardized by this seemingly innocuous problem of fatigue.

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