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TO YOUR GOOD HEALTH #TFB20210927

FOR RELEASE WEEK OF Sept. 27, 2021 (Col. 1)

BYLINE: By Keith Roach, M.D.

TITLE: Wine is not a health food

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DEAR DR. ROACH: I have read about the benefits of having a glass of wine per day for women, or two glasses for men. Can you please tell me how your health will be affected if you have more? My husband often drinks a bottle of wine a night, and if we go out he will have cocktails as well. -- Anon.

ANSWER: I wish nobody had ever said that a glass of wine a day is healthy. It may be true, but experts disagree.

It is true that people who drink moderately, at or below the one or two drinks level you reference, have decreased risk for some conditions compared with nondrinkers. This includes coronary artery disease, the kind of heart disease that leads to heart attacks. But it's not clear that it is the wine that is doing it. It could be that moderate drinkers have other good health behavior responsible for the better outcomes seen. The definitive study, a blinded, randomized, controlled trial, can't be done. Too many people with problem drinking justify their behavior by saying small amounts of alcohol are beneficial.

What is clear is that excess alcohol, above the level you mentioned, can cause many health problems. I can't even summarize all the potential health harms in an entire column, but some of the most important include heart rhythm problems, such as atrial fibrillation; heart failure; bone marrow suppression; liver disease; neurological and psychiatric illness, including dementia, anxiety and depression; high blood pressure; increased risk for some infections and several cancers, including breast cancer in women and esophageal cancer in both men and women; trauma; and motor vehicle accidents.

A bottle of wine a day is about five standard drinks. Cocktails on top, of course, are even more. That level of alcohol increases your husband's risk of dying from any cause by something like 20%.

If you enjoy your glass of wine, drink in moderation, but I do not recommend drinking alcohol for any health benefit.

DEAR DR. ROACH: I have COPD. Will supplemental oxygen help me to resume walking outdoors for a daily exercise? I'm referring to the over-the-shoulder oxygenator now being advertised. This equipment is pretty expensive, so I don't want to waste my money if it won't help me. -- J.H.

ANSWER: Chronic obstructive pulmonary disease is a condition of compromised lungs and is most related to smoking, although there are other causes that make up a small minority of cases.

The first consideration for your question is: What are your oxygen saturation levels, both at rest and during exertion? If a person has low oxygen levels, then there is strong evidence that giving oxygen improves both survival and quality of life. People with an oxygen saturation of 88% or less should be on oxygen full time.

People with poor exercise tolerance but with oxygen levels above 88% should be considered for evaluation of low oxygen during exercise. There is evidence that using oxygen helps exercise tolerance in people who develop low oxygen during exercise, but less than half of participants in one key study had a "clinically meaningful" improvement.

If oxygen levels are normal at rest and during exertion, there is no evidence that supplemental oxygen is of benefit.

Some important treatments for COPD that are sometimes not given include learning how to use inhalers properly -- it's not as easy as it looks; pulmonary rehabilitation; vaccination, especially against influenza, pneumonia and COVID-19; possibly vitamin D supplements; and nutrition (weight loss is common in COPD).

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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