Any study suggesting a glass or two a day can keep the doctor away is greeted with disproportionate(一边倒的) enthusiasm by the media and general public. But it is a complex task to determine whether or not alcohol in moderation(适量饮酒)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 diseaseacross 18 developed countries, including the US, UK and Australia. (1979年，Cochrane和两位同事一起，试图弄明白到底是什么因素导致心脏病的不同死亡率，他们的研究横跨18个发达国家，包括美国、英国和澳大利亚。)
Their analysis came up with a clear and significant link between increasing alcohol consumption – specifically of wine – and decreasing rates of is chaemic(缺血的) heart disease (heart disease caused by the build-up of fatty deposits[沉淀物] inside the blood vessels[血管] 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(芳香烃)and other compounds in alcohol – recently hypothesised to be antioxidants(抗氧化物)such as plant-based polyphenols(多酚类)– were likely responsible for the benefits,rather than the alcohol itself.(之前的研究已经发现，饮酒与更低的心脏病死亡率之间有某种关联，Cochrane和同事们引用这些研究，指出带来这些好处的可能是酒精中的芳香烃及其他化合物——最近有人提出，这些化合物是抗氧化物，类似植物中的多酚类——，而不是酒精本身。)In the spirit of evidence-based medicine,they called for an experimental approach to the question.
Plying(提供) experimental subjects with alcohol, while amusing, is unlikely to reveal the kind of chronic disease benefits that alcohol is speculated(假定) 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.
In 1986,researchers surveyed a group of more than 50,000 male doctors in the US about their drinking and eating habits, their medical history and state of health over two years. They found that the more alcohol the doctors reported drinking, the lower their chance of developing coronary arterydisease(冠心病), despite their dietary habits.
Another large study published in 2000, also in male doctors, found a ‘U’ shaped relationship between moderate alcohol consumption and – in this case – death, rather than coronary artery disease. Subjects who drank one standard drink a day were less likely to die within the 5.5-year-long study than those who drank less than one a week, or those who drank more than one a day.(在这个跨度5.5年的研究中，每天喝一定量酒精的受试者，比起那些一周都喝不到这个量或者每天都超过这个量的相比，死亡的可能性更小些。)
This suggested there was a ‘sweet spot’ for alcohol consumption; a healthy middleground between too little or too much, where the benefit for cardiovascular(心血管的)health balanced the risk of death from all causes.(这表明喝酒有个“甜区”;一个居于“太少”和“太多”之间的中间位置，这个位置给心血管健康带来的好处降低了各种死亡的风险。)
But was the alcohol itself providing the benefits, or is it just a marker for other healthy behaviours? Are people who drink in moderation also the kind of people who exercise regularly, eat a balanced diet, and generally look after themselves?
In 2005, yet another study in medical professionals – this time 32,000 women and 18,000 men– attempted to answer this question by looking at how their drinking habits affected not only their risk of heart attack, but also their physiology(生理;生理机能).
The people who drank one to two glasses of alcohol, three to four times a week, had a lower risk of heart attack, which the researchers hypothesised could be due to beneficial effects of alcohol on HDLcholesterol(胆固醇)– the so-called ‘good’ cholesterol – as well as haemoglobin(血色素)A1c(a marker of diabetes risk) and fibrinogen(血纤维蛋白原), an agent that helps the blood to clot.These three factors all play an important role in ‘metabolic syndrome’(代谢综合症); the cluster of abnormalities that often heralds(预告……的到来)cardiovascular disease and diabetes. Other studies have found hints that alcohol might alter the balance of these factors for the better, which pointed to a possible mechanism(机理;机制) by which alcohol in moderation could improve health.
Other studies have replicated(复制)this sweet-spot effect of alcohol for is chaemic stroke (strokes caused by a blood clot in the brain) and death in general. But before you dive out and prescribe yourself a couple of bottles a week – for your health, of course–you might want to read on.
Do abstainers(不饮酒的人)actually have a higher risk of death than people who have one or two alcoholic drinks a day? It isn’t as straightforward as it looks.
In 2006, a team of researchers took a closer look at how these studies were designed.Their meta-analysis(元分析，即对别人的分析进行再分析) showed a major flaw in the way drinkers –or rather abstainers – were classified: the abstainers in many of these studies included people who had cut back or stopped drinking because of ill health or old age. This could potentially make non-drinkers look like a far less healthy group than the general population.
Importantly,the studies without this misclassification didn’t find a reduction in heart disease or death among moderate drinkers.
Other researchers have now explored this ‘misclassification hypothesis’ more closely,including a huge UK-based population study published this year.
It showed that when you simply compare alcohol consumption and health outcomes, you find a clear beneficial effect of moderate alcohol consumption. But if you take former drinkers out of the abstainers group, then the benefits don’t look so rosy – in fact, they all but disappear.
Meanwhile,another team of researchers studied people whose bodies cannot process alcohol properly – and therefore who generally don’t drink alcohol at all – and found those with this genetic marker had better cardiovascular health and a lower risk of coronary heart disease than those without it.(与此同时，另一个研究队伍考察了那些身体不能处理酒精—因此根本就不能喝酒—的人，他们发现，有这种基因特征的人与没有这种特征的人相比，心血管更健康，患冠心病的风险也低一些。)
And then there’s the really bad news. Whatever the effects that alcohol does or doesn’t have on your heart disease risk, it can still hasten your death in a myriad of(各种各样的)other colourful ways.
The World Health Organization reported last year that drinking can increase your risk of depression and anxiety, liver cirrhosis(肝硬化), pancreatitis(胰腺炎), suicide, violence, and accidental injury.
Alcohol is also linked to cancer of the mouth, nose, larynx, oesophagus, colon, liver, andbreast cancer in women. Between 4% and 30% of cancer deaths worldwide could be attributed to alcohol use (for breast cancer, the most common, the figure was8%). Importantly, even moderate drinking confers(给与)some increased risk: just one glass a day increases the risk of breast cancer by 4%, while heavy drinking can increase the risk by 40-50%.
Heavy drinking weakens the immune system(免疫系统)and is therefore linked with pneumonia(肺炎) and tuberculosis(结核). It also encourages risky sexual behaviour which increases the chance of acquiring sexually transmitted infections such as HIV.And drinking during pregnancy can cause damage to the foetus, leading to Foetal Alcohol Syndrome.
In total,there are more than 200 diseases and injuries that can be linked to alcohol consumption, including 30 that are caused only by alcohol.
But the idea that moderate alcohol consumption might be beneficial has not entirely gone away, and even organisations dedicated to combating the problem of alcohol grudgingly(不情愿地)say that small amounts of alcohol may have a protective effect against heart disease and some types of stroke.(然而，适度饮酒对身体有好处的观点并未完全消失，即使是那些致力于解决酒精问题的组织也心不甘情不愿地认为，少量饮酒对心脏病和其他类型的中风具有保护作用。)
Confused?You’re not the only one. Perhaps the best summation(概括)of how alcohol affects our health comes from a critical analysis published in early 2013. Its author concluded that, while the evidence of alcohol’s harmful effects was solid, there were plenty of reasons to take evidence of alcohol’s health benefits with agrain of salt(一粒盐;打折扣)– but not,perhaps, a slice of lemon(一片柠檬;舒服惬意).
Alcohol inmoderation 适度饮酒
Blood vessel 血管
Ply sb. with… 给某人提供……
Coronary arterydisease 冠心病
A myriad of 各种各样的
Immune system 免疫系统
A grain of salt 一粒盐;打折扣
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来源 : 网络 2017-05-24 15:49:23 关键字 : 雅思阅读
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