BRAIN MATTERS

There’s a range of interpretations when it comes to health data gathered around alcohol consumption KAILAS ROBERTS examines the findings.

It seems to me that most of us have a vested interest in proving that alcohol is good for us. That’s why there was an almost global cheer when studies from the 1970’s initially showed the famous ‘J-shaped curve.’ This graphical wonder, derived from the health data of many drinkers and non-drinkers, suggests that it is better for your cardiovascular health at least to drink a little than not to drink at all.

But the j-shaped curve has been hotly debated ever since. One of the main criticisms of the studies that underpin it, is that it lumps those who have NEVER drunk in with those who have GIVEN UP, perhaps because they were reformed heavy drinkers. Both groups are classified as non-drinkers, but as you can imagine, their health profiles may be very different.

These studies were observational in nature. The problem with observational studies is they don’t prove causality – i.e., here that not drinking alcohol is the cause of the worsened health compared to drinking a little. They are also subject to confounders – other ways in which the groups vary that might account for the difference in health outcomes. For instance, do heavy drinkers exercise less (probably) or might they have harder lives (again, probably)? Both a sedentary life and stress can affect health themselves, so it might not be the alcohol that’s the problem (though it probably is).

What we really need is a randomized controlled trial in which very similar groups are given different interventions deliberately (in this case, no booze, a little booze, or a lot of booze perhaps), and then the differences in health outcomes analysed. But of course, it’s hard to justify this ethically – you can’t really force people to continuously drink large amounts of alcohol when we know it is at least harmful in some ways.

When it comes to booze and the brain, it is a similar story. The weight of the evidence suggests a similar ‘j’ curve (or ‘u’ curve), with the sweet spot for dementia risk reduction being drinking 1 to 14 units per week (the equivalent of a little more than a bottle of wine). This is subject to the same sort of issues as the cardiovascular studies, however.

Alcohol in small amounts may protect the brain through improving blood flow, perhaps by dilating the vessels that carry it. Red wine is also replete with antioxidants which combat inflammation and inflammation is not good for your brain. Intriguingly, in mice at least, alcohol has also been shown to improve the efficiency of your brain waste clearance system, or glymphatics. This may help remove proteins that otherwise might lead to dementia.

What is far less controversial is that if you drink too much alcohol over a period of years, it will be deeply damaging to your brain. Alcohol is a neurotoxin and directly damages the nerve cells. It also depletes the brain of B vitamins which are critical to it functioning well, and directly affects the neural architecture responsible for learning – the cholinergic system. This might result in alcohol-related dementia, but also increases the risk of Alzheimer’s disease.

If you enjoy a drink and are otherwise healthy, you can take some solace in the findings of the numerous studies – just make sure you don’t overdo it. In Australia, the advice is not to drink more than 10 units per week, and not more than 4 in one sitting. This is for health in general, but it also seems sensible advice for your brain.

Kailas Roberts is a psychogeriatrician and author of Mind your brain The Essential Australian Guide to Dementia now available at all good bookstores and online. Visit yourbraininmind.com or uqp.com.au

DO YOU SNORE? ARE YOU TIRED? DO YOU HAVE SLEEP APNEA?

Solutions that come to you Solutions that come to you

SUNSHINE COAST

Australia’s premier provider of home sleep tests, treatment solutions, CPAP sales and ongoing management of sleep apnea.

Healthy Sleep Solutions Sleep Technicians in conjunction with your GP are able to organize overnight sleep apnea tests which will allow you to be tested for sleep apnea while sleeping in the comfort of your own home, as well as being reported on by leading Sleep Physicians. At Healthy Sleep Solutions, we offer a complete pathway for sleep apnea patients, from testing, diagnosis, introduction to therapy, ongoing support, data downloads and equipment purchases at competitive prices. Our Sleep Technicians ensure that our patients are advised and taught about sleep apnea, CPAP equipment and masks and we actively encourage our patients to trial all equipment before purchase to ensure comfort and to ensure you obtain the maximum health benefi ts. Ask your GP for more information, give our friendly Sleep Technicians a call or pop in to have a chat with one of our Sleep Technicians at the Healthy Sleep Solutions rooms conveniently located at Pelican Waters Pharmacy, or call for an appointment to see one of our Sleep Technicians at one of our many clinics conveniently located across the Sunshine Coast and Hinterland.

SLEEP APNEA TESTING, DIAGNOSIS, INDUCTION to CPAP THERAPY and CPAP Sales

TEL 1300 447 875 OR TEL 1300 4 GR8 SLEEP