Health benefits of moderate drinking may not apply to African Americans

The widely reported health benefits of drinking a moderate amount of alcohol do not extend to African-Americans, according to a new study.
These findings follow a widely reported Jan. 9 New England Journal of Medicine article saying that moderate daily or near-daily alcohol consumption could decrease a man’s risk of heart disease. The researchers in the new study, published in the January issue of the journal Alcoholism: Clinical and Experimental Research, suggest that the difference in protective benefits of alcohol for black men could also be a result of not how much people drink but how they do it.

The critical factor for the African-American men studied may be binge drinking, which could be associated with the targeted marketing of large-volume containers of alcoholic beverages, the researchers say.

Moderate drinkers have been shown to have a lower risk of dying early than lifetime abstainers, and heavy drinkers show a higher risk of dying prematurely than both of the other groups.

“One of the most discussed findings in alcohol epidemiology is the J-shaped curve,” says study author Christopher T. Sempos, professor and director of graduate studies in the Department of Social and Preventive Medicine at the University of Buffalo. “Essentially, what it tells us is that some kind of drinking is beneficial to health.”

He adds, “In our study, however, this beneficial effect could not be found in African-Americans. ? We believe that patterns of drinking – that is, how alcohol is consumed – explain the differences between African-Americans and whites.” Sempos notes that a person who drinks heavily, but only once or twice a week, can drink the same overall amount as someone who has just one or two drinks each day, and would therefore be classified as a “moderate” drinker.

Researchers looked at data collected for 2,054 African-Americans (768 men, 1,286 women) who were part of a large national health study conducted between 1971 and 1992.

“Basically, all alcohol has the same risk associated with it,” Sempos says, “with no differences between beverage types, once alcohol content is the same. There are, however, cultural differences in consumption. For example, grape wine is most often consumed moderately and regularly with meals. If consumed in irregular binges outside meals, however, the same amount of alcohol may be much more detrimental.”

Tom Greenfield, director of the National Alcohol Research Center at the Alcohol Research Group, calls the findings striking.

“Such a drinking style has no beneficial health outcomes,” Greenfield says. “We know that African-Americans have more binge drinking than whites or Hispanics. In addition, in some subgroups, such as those that are socio-economically disadvantaged, special kinds of drinks like malt liquor that come in large serving sizes prevail.”

Approximately two decades ago, according to Greenfield, the major ethnic groups in the United States consumed alcohol at comparable levels. However, he says, “during the late 1980s and early 1990s, as the country experienced a ‘drying’ trend, there is good evidence that frequent heavy drinking fell among white men and women, but not so among African-American and Hispanic individuals.”

“In addition, other researchers have found evidence that because of larger containers and higher alcohol content products marketed to African-Americans, these surveys may even underestimate the heavy quantities consumed by ethnic minorities. These factors are just some of those that help explain the higher risks of liver cirrhosis, for example, among African-American and Hispanic populations compared to whites.”

The study was funded by funded by the University of Buffalo in New York State, the Centre for Addiction and Mental Health in Toronto and the Addiction Research Institute in Zurich.