Sunday, September 26, 2021

A leading Australian doctor has made a surprising finding regarding alcohol - and the best type of alcohol to drink for your health

Dr Paul Gow

Socially, when I say I’m a liver specialist, people imagine me to be a puritanical teetotaller. But I am actually quite the opposite. I enjoy a drink. I don’t enjoy all types of alcohol. Spirits remind me of bad hangovers as a younger man, beer makes me feel bloated, but wine? Wine, I thoroughly enjoy.

The fact that people are surprised that a liver specialist enjoys alcohol relates, of course, to the fact that alcohol causes liver disease and therefore people think I should know better.

The truth though, is that for most individuals, alcohol can be beneficial – rather than detrimental.

For decades we have heard the message that alcohol causes cirrhosis, alcohol is a drug of addiction and alcohol ruins lives and, of course, all of these things are true. But it doesn’t have to be like that. Modest alcohol intake almost certainly does more good than harm.

Keep in mind, that when I talk about moderate alcohol intake, I mean up to 2 units of alcohol for women and up to 3 units for men on any given day, with a maximum of 7 units for women and 14 for men over a week.

A healthy liver can manage moderate alcohol intake. The job of a normal healthy liver is to filter bad chemicals from the blood and manufacture good chemicals.  Most of the bad chemicals the liver filters out are broken down remnants of what we’ve eaten. There’s nothing to worry about – this is, after all, the liver’s primary role.

All the blood from the gut (including chemicals we have eaten) drains through the liver – and the liver takes out the bad stuff, keeps the good stuff and manufactures essential chemicals. Alcohol therefore (in moderation), is metabolised by the healthy liver without any issue.

The French embrace.  Two decades ago, an article in the prestigious medical journal The Lancet coined the term ‘The French Paradox’. The paradox was that the French – despite a diet high in saturated fats – had a low incidence of death from cardiac disease.

The explanation for this apparent disparity was the moderate alcohol consumption typical of the French diet – and the premise that moderate alcohol intake protected the heart.

Ever since, there has been growing evidence moderate alcohol intake doesn’t just protect individuals from fatty liver disease and heart disease, but also against diabetes, dementia and numerous other conditions.

Although we still don’t know why, alcohol has been shown to be antioxidant, anti-inflammatory, blood pressure lowering and have anticoagulant properties. All these are good.

It is well recognised that heavy alcohol consumption can increase the risk of all sorts of cancer – the most common being liver cancer and throat (laryngeal) cancer.

What is less clear, but still crucially important, is whether moderate amounts of alcohol increase the risk of cancer. For most (but not all) cancers, there is no evidence that moderate alcohol has any effect on cancer risk.

However, there is evidence that moderate alcohol increases the risk of cancer of the mouth, throat (oral and pharyngeal cancer), breast, liver and oesophagus. Given the high rates of breast cancer in our population, this is certainly troubling.

On the other hand, moderate alcohol appears to be protective with respect to the risk of certain other cancers – including kidney cancer and lymphoma.

The Million Women Study reported no increase in the risk of breast cancers in women having 3 or fewer drinks/week.

But in women having 3–6 drinks per week, the rate of breast cancer increased slightly compared to non-drinkers, by about 8 per cent.

It is now well accepted that even small volumes of alcohol increase the risk of breast cancer in women. It also appears that there is a gradient of increasing risk with increasing alcohol intake.

Alcohol and longevity

Statistically, moderate drinkers live on average, 2 years longer than non-drinkers.  Some report a survival advantage of more than 3 years, while others report as little as 6 months.

All the studies however, report that moderate drinkers live longer than non-drinkers.

One other very important piece of information gained from these reports is that life-years gained by moderate drinkers are typically years of good health.

It’s also important to put the health benefits of moderate alcohol in context compared with other powerful public health messages such as exercise, stopping smoking and avoiding obesity.

Of these issues, the one that exerts the greatest effect in terms of life-years gained is to avoid or stop smoking.

Non-smokers live on average about 6 years longer than smokers. Regular exercise offers a survival benefit of about 3 years, while avoiding obesity adds an extra 12 months.

When considered like this, some data suggests that moderate alcohol intake is perhaps two- or three-fold more powerful as a lifestyle choice to increase longevity than avoiding obesity. The lifestyle measures discussed here are generally addictive in their effect on longevity.

For example, a non-smoking, regular exerciser who drinks moderately and isn’t obese lives between 8 and 15 years longer on average than their counterpart who smokes, doesn’t exercise, doesn’t drink and is obese.

Which type of alcoholic drink has the greatest health benefits?

From the existing data, all types of alcoholic drinks are associated with potentially positive health benefits, with the proviso that they are consumed in moderation. However, red wine appears to be associated with slightly greater health benefits.

The occasional binge

Don’t be tempted to binge drink. Drinking alcohol with the specific intention of getting drunk, typically leads to alcohol- induced harm.

Having more than 4 standard drinks at one sitting for women, or 5 for men, has negative social consequences such as increased risk of trauma, traffic accidents and violence.

And for your liver, repeated episodes of binge drinking are detrimental and associated with a marked increase in the risk of developing cirrhosis.

Binging also appears to have specific detrimental effects on heart health and is associated with an increased risk of death from heart disease.

My recommendations

The scientific evidence surrounding moderate alcohol intake and health is not totally resolved. I, personally, am a believer that moderate alcohol offers net benefits to a person’s health but there are many others in the scientific community who interpret the data differently.

There’s a term in astronomy known as ‘the Goldilocks zone’.

The Goldilocks zone is the region around a star where planets are at just the right temperature to have liquid water. Not so hot that all the water is burnt off, and not so cold that the water is frozen, but just right.

A glass of wine at Christmas probably isn’t enough to reap the metabolic benefits that moderate alcohol intake has been associated with.

If, however, you have a glass of wine with your evening meal 3, 4 or even 5 nights a week, you are definitely in the Goldilocks zone.

Tuesday, September 14, 2021

Alzheimer's could be stopped or even reversed by putting patients in oxygen chambers, study claims

An oxygen therapy given to patients in pressurised rooms could halt or even reverse Alzheimer's disease, a study has found.

A small-scale trial of six older people with early stage of memory loss called Mild Cognitive Impairment (MCI) saw their symptoms improve from five 90-minute oxygen treatments a week for three months, researchers at Tel Aviv University found.

The treatment - called hyperbaric oxygen therapy (HBOT) - involves patients inhaling oxygen through a mask in a pressurised chamber.

It significantly increases the amount of oxygen in the body's tissues, which has previously been found to encourage healing.

And when the treatment was administered to mice, it removed amyloid plaques from the brain, which are a tell-tale sign of Alzheimer's disease.

The experts believe the therapy works by changing the structure of vessels in the brain and allowing for increased blood flow. Reduced blood flow to the brain has already been linked with the onset of dementia.

Dementia - the name for symptoms linked with ongoing memory decline - is the UK's biggest killer and someone develops the condition every three minutes, according to the Alzheimer's Society. There is currently no cure.

Some 850,000 Britons have the condition - with one and six of them aged over 80 - and the figure is expected to reach 1.6million by 2040.

The study, published in the journal Aging, examined six patients aged around 70 who did not have Alzheimers, but suffered from severe memory loss called MCI, which can act as an early sign of Alzheimer's.

Researchers administered 60 daily HBOT sessions to the group over three months and measured the blood flow in their brain before and afterwards through an MRI scan.


A hyperbaric chamber is a highly-pressurized room or tube where a patient is given pure oxygen to breathe.

The air pressure in these chambers is three times higher than normal pressure outside.

Lungs operate on gas exchange, which happens more or less efficiently at different pressures.

At this higher air pressure, the lungs are able to take in more oxygen than under normal conditions.

All the body's tissues require oxygen to live and stay healthy, so in a hyperbaric chamber the lungs take in more oxygen which is then carried throughout the body to restore tissues that may be struggling or infected.

Oxygen also help to reduce inflammation and encourage new blood vessels to grow.


Hyperbaric oxygen therapy is a proven treatment for decompression sickness, a condition that some people develop after SCUBA diving, wherein the high pressure of being deep under water causes nitrogen to form in their blood vessels.

This typically causes muscle and joint aches and fatigue, but in rare cases can prove fatal. Hyperbaric oxygen therapy reverses the process that allows the dangerous nitrogen bubbles to form.

According to the Mayo Clinic, doctors may also recommend hyperbaric oxygen therapy for:   

Anemia, severe
Brain abscess
Bubbles of air in your blood vessels (arterial gas embolism)
Decompression sickness
Carbon monoxide poisoning
Crushing injury
Deafness, sudden
Infection of skin or bone that causes tissue death
Non-healing wounds, such as a diabetic foot ulcer
Radiation injury
Skin graft or skin flap at risk of tissue death
Vision loss, sudden and painless  
Although claims have been made that the therapy helps a whole hosts of other medical issues, there is only scientific evidence to support the above uses.

There isn't significant reason to believe it treats conditions like fibromyalgia, depression or chronic fatigue syndrome.

The volunteers also completed memory tests before and after the treatment.

HBOT is used to treat a host of conditions including injured or infected tissue and decompression sickness, which usually affects deep-sea divers who emerge from deep water too quickly. Studies have also found it could help men suffering from impotence.

Justin Bieber revealed last year that he sleeps in a hyperbaric chamber to get more oxygen to his brain, which he said reduced his stress levels.

After the HBOT sessions, the researchers spotted 'significant' increases of 16 to 23 per cent in blood flow in several parts of the brain.

This suggests that the treatment expanded the width of blood vessels and reduced the thickness of blood vessel walls, the experts said.

And the participants scored 16.5 per cent higher on subsequent memory tests, six per cent more on concentration and 10.3 per cent higher on information processing.

Professor Uri Ashery, an expert in neurobiology at Tel Aviv University, told the Telegraph: 'Elderly patients suffering from significant memory loss at baseline revealed an increase in brain blood flow and improvement in cognitive performance, demonstrating hyperbaric oxygen therapy's potency to reverse core elements responsible.'

They also tested the treatment on mice with Alzheimer's and found it slashed the number of amyloid plaques - which stop brain cells from communicating with each other - by nearly 30 per cent.

And the plaques that weren't removed shrunk by 18 per cent, according to their paper.

The mice also built better nests and moved through mazes faster.

Professor Ashery said: 'We have discovered for the first time that hyperbaric oxygen therapy induces degradation and clearance of pre-existing amyloid plaques, and the appearance of newly formed plaques.'

But the researchers said the treatment needs to be tested on a larger number of patients to confirm their findings.

And as it stands, oxygen therapy would be very difficult to routinely administer across the UK. as there are very few hyperbaric chambers.

Professor Tom Dening, an expert in dementia at the University of Nottingham, told the Telegraph: 'Presumably to be useful, the treatment would have to be continued indefinitely, so any patients would have to be very highly motivated and have good transport links to the treatment facility.

'If we consider that the number of people with dementia in the UK is approaching one million, it is hard to see how hyperbaric oxygen could ever be available on this scale.

'In short, it's an interesting idea but a long way off meeting the usual criteria to become a standard treatment.'

Dr Susan Kohlhaas, the director of research at Alzheimer's Research UK, said: 'Many of the Alzheimer's treatments that are currently being tested are drugs that target the hallmark disease proteins directly, but it's important we maintain a broad spectrum of potential approaches.

'Larger scale clinical trials with many more people are needed to ascertain whether this treatment is effective, particularly when measuring longer term benefits to memory and thinking.

'We know the diseases that cause dementia begin in the brain many years before symptoms like memory loss show and it's likely for treatments to be effective at slowing down the diseases that cause dementia, they need to be given earlier rather than later.'

Thursday, September 09, 2021

Antibiotics may raise colon cancer risk, massive study suggests

Taking antibiotic drugs may raise the risk of developing colon cancer five to 10 years down the line, according to a new study of more than 40,000 cancer cases in Sweden.

Past studies hinted that antibiotics can cause lasting changes to the gut microbiome — the community of microbes that live in the digestive tract — and that these changes may be linked to a heightened risk of colon cancer. Now, in the largest epidemiological study to ever explore this link, researchers report that the heightened risk may be specific to cancers in the so-called proximal colon, the part of the colon that connects to the small intestine and starts in the lower-right abdomen.

"It's very clear, when we looked at the data, that it's very confined to the proximal, or right-sided colon," senior author Sophia Harlid, a cancer researcher at UmeƄ University in Sweden, told Live Science. And in fact, the antibiotic-related cancer risk was greatest at the start of the proximal colon, called the "ascending colon," which extends from the lower- to upper-right abdomen.

People who took antibiotics for more than six months bore the highest cancer risk, according to the research, published Wednesday (Sept. 1) in the Journal of the National Cancer Institute. Compared with people who'd taken no antibiotics, these individuals had a 17% higher chance of developing cancer in the ascending colon.

That said, even short courses of antibiotics carried an associated cancer risk, albeit a far smaller one than what was seen with the months-long regimens, the team found. This data may provide yet another reason to rein in the overprescription of antibiotics, besides preventing the emergence of antibiotic-resistant superbugs, Harlid said.

These new findings echo the results of a similar, but smaller, U.K.-based study, published in 2019 in the journal Gut. The Swedish study "came right in line with other data that was emerging … which actually improves confidence that there's an association," Dr. Cynthia Sears, senior author of the U.K. study, who was not involved in the newest research, told Live Science.

It's important to note that these studies only identify a correlation; they don't show that antibiotics directly cause the subsequent colon cancer, said Sears, who is a professor of medicine and oncology at the Johns Hopkins University School of Medicine and a professor of molecular microbiology and immunology at the Bloomberg School of Public Health. That said, there are theories as to how the drugs may make the proximal gut more vulnerable to cancer growth.

"Our thinking is that you're disrupting the balance of the microbiota," and this may allow infectious bugs like Escherichia coli and Klebsiella pneumoniae to gain prominence where they'd usually be outcompeted by other microbes, Sears said. This in turn may ramp up inflammation in the colon, generating reactive chemicals that could damage DNA and generate tumors. In addition, the inner lining of the intestine may then become more permeable, allowing bacteria to infiltrate the colon walls and join together in slimy structures called biofilms. Studies suggest that almost all proximal colon cancers — nearly 90% — are associated with such biofilms, Sears said.

The proximal colon may be particularly vulnerable to these changes because it endures the greatest spillover of antibiotic drugs from the small intestine, Sears said. Then, as the drugs move through the colon, their molecules steadily break down. That said, these potential mechanisms still need to be studied further, but for now, the new study strengthens the case that some link exists between antibiotics and colon cancer, she said.

The new study used data from the Swedish Colorectal Cancer Registry to identify tens of thousands of colorectal cancer patients who had been diagnosed between 2010 and 2016. Data from the Swedish Prescribed Drug Register allowed the team to track these patients' antibiotic use between 2005 to 2016, to see if any patterns emerged. They also compared the cancer patients to more than 200,000 cancer-free people from the wider Swedish population.

While the team uncovered a clear link between antibiotics use and cancer in the ascending colon, they found no such link to cancers in any part of the distal colon or rectum.  

The team wanted to pin down why the drugs might drive cancer in the proximal colon. To do so, they searched the prescribed drug register for methenamine hippurate — a medicine that helps prevent urinary tract infections in people who get them frequently.

Although it has antibacterial effects, the drug doesn't alter the gut microbiome because it can only be activated by the high acidity of urine, Harlid explained. So based on the theory that antibiotics raise the risk of cancer by messing with gut bugs, methenamine hippurate should not be linked to the same increased risk. And in sifting through all their data, the team found that this was the case: only antibiotics that affect gut bugs, not methenamine hippurate, showed a link to colon cancer.

These results further support the antibiotics-cancer link, but the study still has its limitations. For instance, the datasets didn't include any information on individuals' diets, smoking habits or alcohol use, all of which can also raise the risk of colon cancer. Similarly, the authors could not determine which patients might be taking antibiotics for an underlying condition like inflammatory bowel disease, also linked to colon cancer. In addition, the Swedish Prescribed Drug Register provides information on drug prescriptions, but cannot reflect whether individuals finished their complete course of antibiotics, for instance.

But because the study is so large, it "definitely hints in the right direction," Harlid said.

In a few years time, the team hopes to perform an even larger follow-up study, when more data has accumulated, and they're interested in seeing whether specific colon cancer subtypes show a stronger association with antibiotics. Cancers can be split into subtypes based on the behavior of their tumor cells and what genetic mutations they carry, and these subtle differences affect where the cancer grows and how it responds to treatments, according to the National Cancer Institute.

Meanwhile, Sears and her colleagues are currently collecting data on the microbiomes of individuals with early-stage colon cancer, to pinpoint specific gut bugs that are unusually depleted or overgrown. As scientists continue to study why microbes make a difference in colon cancer, for now, doctors should be selective in when and how they prescribe antibiotics, Sears said.

In theory, for those who do have to take antibiotics, dietary supplements could potentially be designed to help bring their microbiome back into balance, Sears said. One such supplement was recently trialed in malnourished children and helped them cultivate a diverse assortment of gut bugs, Live Science previously reported. But again, for now, the best course of action is simply to avoid taking antibiotics when they're not needed, she said.