Una nuova importante ricerca che confronta le ricadute sulla salute di differenti modelli d’uso di alcol porta nuovi elementi di giudizio nel conflitto tra i sostenitori del “consumo zero”, soprattutto per gli adolescenti e i giovani, e i sostenitori del “bere moderato” (per lo più vino o birra consumati regolarmente ai pasti in famiglia). Ai significativi dati ottenuti attraverso i confronti fra gli stili di consumo giovanili in Italia e in Finlandia (vedi il libro curato da Franca Beccaria e recensito per Fuoriluogo da Allaman Allamani) si aggiungono ora i risultati di uno studio comparativo sulle patologie coronariche di circa 2500 bevitori irlandesi e circa 7500 bevitori francesi.
Come era prevedibile, la frequenza del bere quotidiano è risultata assai maggiore tra i francesi (75%) che non tra gli irlandesi (12%), e una analoga ma meno marcata differenza si è riscontrata nella quantità di alcol consumata (francesi 32,8, irlandesi 22,1 g/giorno). Le parti si invertono per il bere binge, 20 volte più frequente tra gli irlandesi (circa 10%) che tra i francesi (0,5%).
Indipendentemente dalla nazionalità, i bevitori binge soffrono di eventi coronarici gravi circa due volte più spesso rispetto sia ai bevitori regolari che agli astemi; quindi, ovviamente, gli irlandesi, pur bevendo mediamente di meno, soffrono più spesso di tali eventi (i pochi dati qui citati sono quelli corretti tramite “depurazione” dagli effetti confondenti abitualmente considerati in questo tipo di indagini).
E – ciliegina sulla torta mediterranea – solo il consumo moderato di vino riduce il rischio di eventi coronarici. Sine qua non, concluderebbe l’esperto gastronomo ed enologo domenicale di Sole – 24 ore.
(a cura di Giorgio Bignami)
Research
Patterns of alcohol consumption and ischaemic heart disease in culturally divergent countries: the Prospective Epidemiological Study of Myocardial Infarction (PRIME)Abstract
Objective To investigate the effect of alcohol intake patterns on ischaemic heart disease in two countries with contrasting lifestyles, Northern Ireland and France.
Design Cohort data from the Prospective Epidemiological Study of Myocardial Infarction (PRIME) were analysed. Weekly alcohol consumption, incidence of binge drinking (alcohol >50 g on at least one day a week), incidence of regular drinking (at least one day a week, and alcohol <50 g if on only one occasion), volume of alcohol intake, frequency of consumption, and types of beverage consumed were assessed once at inclusion. All coronary events that occurred during the 10 year follow-up were prospectively registered. The relation between baseline characteristics and incidence of hard coronary events and angina events was assessed by Cox’s proportional hazards regression analysis. Setting One centre in Northern Ireland (Belfast) and three centres in France (Lille, Strasbourg, and Toulouse). Participants 9778 men aged 50-59 free of ischaemic heart disease at baseline, who were recruited between 1991 and 1994. Main outcome measures Incident myocardial infarction and coronary death (“hard” coronary events), and incident angina pectoris. Results A total of 2405 men from Belfast and 7373 men from the French centres were included in the analyses, 1456 (60.5%) and 6679 (90.6%) of whom reported drinking alcohol at least once a week, respectively. Among drinkers, 12% (173/1456) of men in Belfast drank alcohol every day compared with 75% (5008/6679) of men in France. Mean alcohol consumption was 22.1 g/day in Belfast and 32.8 g/day in France. Binge drinkers comprised 9.4% (227/2405) and 0.5% (33/7373) of the Belfast and France samples, respectively. A total of 683 (7.0%) of the 9778 participants experienced ischaemic heart disease events during the 10 year follow-up: 322 (3.3%) hard coronary events and 361 (3.7%) angina events. Annual incidence of hard coronary events per 1000 person years was 5.63 (95% confidence interval 4.69 to 6.69) in Belfast and 2.78 (95% CI 2.41 to 3.20) in France. After multivariate adjustment for classic cardiovascular risk factors and centre, the hazard ratio for hard coronary events compared with regular drinkers was 1.97 (95% CI 1.21 to 3.22) for binge drinkers, 2.03 (95% CI 1.41 to 2.94) for never drinkers, and 1.57 (95% CI 1.11 to 2.21) for former drinkers for the entire cohort. The hazard ratio for hard coronary events in Belfast compared with in France was 1.76 (95% CI 1.37 to 2.67) before adjustment, and 1.09 (95% CI 0.79 to 1.50) after adjustment for alcohol patterns and wine drinking. Only wine drinking was associated with a lower risk of hard coronary events, irrespective of the country. Conclusions Regular and moderate alcohol intake throughout the week, the typical pattern in middle aged men in France, is associated with a low risk of ischaemic heart disease, whereas the binge drinking pattern more prevalent in Belfast confers a higher risk.
Le due versioni dell’intero articolo ad accesso libero
http://www.bmj.com/content/341/bmj.c6077.full.pdf+html
http://www.bmj.com/content/341/bmj.c6077.full
