Is alcohol actually bad for you?

Those of us who enjoy the occasional glass of beer or wine would dearly love to believe that we're doing our bodies a service.

Any study suggesting a glass or two a day can keep the doctor away is greeted with disproportionate enthusiasm by the media and general public. But it is a complex task to determine whether or not alcohol in moderation has health benefits.

One of the earlier studies drawing a link between alcohol consumption and health was performed by the late, great Archie Cochrane; the godfather of evidence-based medicine. In 1979, Cochrane and two colleagues tried to work out what exactly was responsible for the differing rates of death from heart disease across 18 developed countries, including the US, UK and Australia.

Their analysis came up with a clear and significant link between increasing alcohol consumption - specifically of wine - and decreasing rates of ischaemic heart disease (heart disease caused by the build-up of fatty deposits inside the blood vessels supplying the heart).

Citing earlier studies that had found an association between alcohol consumption and lower rates of deaths from heart attack, Cochrane and colleagues suggested that the aromatic and other compounds in alcohol - recently hypothesised to be antioxidants such as plant-based polyphenols - were likely responsible for the benefits, rather than the alcohol itself. In the spirit of evidence-based medicine, they called for an experimental approach to the question.

Plying experimental subjects with alcohol, while amusing, is unlikely to reveal the kind of chronic disease benefits that alcohol is speculated to deliver. So instead, much of the research around alcohol and its health costs and benefits has been in the form of long-term, population-based studies.

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