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过年了,为酒说几句好话

更新时间:2016-2-5 10:47:11 来源:纽约时报中文网 作者:佚名

Drink to Your Health (in Moderation), the Science Says
过年了,为酒说几句好话

Over the past year, I’ve tried to clear up a lot of the misconceptions on food and drink: about salt, artificial sweeteners, among others, even water.

在过去的一年里,我试图澄清很多关于食品和饮料的误解:其中包括食盐、人工甜味剂,乃至于水。

Now let me take on alcohol: wine, beer and cocktails. Although I have written about the dangerous effects of alcohol abuse and misuse, that doesn’t mean it’s always bad. A part of many complex and delicious adult beverages, alcohol is linked to a number of health benefits in medical studies.

现在我来说说酒:葡萄酒、啤酒和鸡尾酒。虽然对于酒精滥用和误用导致的危险后果,我曾写过一些文章,但并不意味着它毫无可取之处。很多复杂而美味的成人饮料里都混合了酒精,医学研究也发现,合理摄入酒精有益健康。

That doesn’t mean the studies provide only good news, either, or that the evidence in its favor is a slam dunk. You won’t be surprised to hear that, once again, my watchword — moderation — applies.

但这并不意味着这些研究得出的都是好消息,也不是说饮酒有益的证据已经确凿无疑。再一次听到我用“适度”这个词,你肯定也不会感到惊讶。

Research into how alcohol consumption affects health has been going on for a long time. A 1990 prospective cohort study included results of more than 275,000 men followed since 1959. Compared with those who never drank alcohol, those who consumed one to two drinks a day had a significantly reduced mortality rate from both coronary heart disease and “all causes.” Those who consumed three or more drinks a day still had a lower risk of death from coronary heart disease, but had a higher mortality rate over all.

对饮酒影响健康的方式的研究已经进行了很长时间。1990年,一项前瞻性队列研究纳入了27.5万名从1975年就开始跟踪调查的男性的结果。和从不饮酒的人相比,每天喝一两杯的人死于冠心病和“所有死因”的几率更低。每天饮酒三杯或以上的人死于冠心病的几率也要低一些,但总体死亡率更高。

A 2004 study came to similar conclusions. It followed about 6,600 men and 8,000 women for five years and found that compared with those who drank about one drink a day on average, those who didn’t drink at all and those who drank more than two drinks a day had higher rates of death. Results like these have been consistent across a number of studies in different populations. Even studies published in the journal Alcoholism: Clinical and Experimental Research agree that moderate drinking seems to be associated with a decreased risk of death over all.

2004年的一项研究得出了类似的结论。该研究对6600名男性和8000名女性进行了五年的跟踪调查,发现和每天平均喝大约一杯酒的人相比,完全不喝酒和一天喝两杯以上的人的死亡风险都更高。在不同人群中进行的大量研究都得出了和它们一致的结果。就连发表在期刊《酗酒:临床与实验研究》(Alcoholism: Clinical and Experimental Research)上的研究论文也认同适量饮酒似乎和总体上的死亡风险降低有关联。

However, alcohol seems to have different effects on different diseases. Almost all of the major benefits of drinking are seen in cardiovascular illnesses. In fact, with men, even consumption of a surprisingly large amount can seem protective.

然而,酒似乎对不同疾病有不同的影响。饮酒的几乎所有主要的好处都体现在了心血管疾病上。实际上,对男性来说,即便饮酒量大得惊人可能看上去也会起到保护作用。

When it comes to cancer, the picture isn’t as rosy. For instance, a 2007 study involving the Women’s Health Study cohort found that increased alcohol consumption was associated with an increased risk of breast cancer. More broadly, a 2014 systematic review of epidemiologic and experimental studies looking at alcohol and breast cancer found that the overall consensus is that each additional drink per day increases the relative risk (comparing the risk in two groups) of breast cancer by a statistically significant, but small, 2 percent — although not the absolute risk.

不过在癌症方面,情况就没有这么美妙了。举例来说,2007年的一项涉及妇女健康研究(Women’s Health Study)队列的研究发现,饮酒量增加与患乳腺癌的风险增加相关。再宽泛一些,2014年的一项系统性综述在审查了关于饮酒与乳腺癌的流行病学和实验研究后发现,总体共识认为,每天多饮一杯酒,患乳腺癌的相对风险(通过比较两组的风险得出)就会增加2%。该数字并非绝对风险,虽然小,但具有统计学显著性意义。

A meta-analysis of colorectal cancer and alcohol found that heavy drinkers, but not light or moderate drinkers, were at increased risk of the disease. No relationship is seen with respect to bladder cancer or ovarian cancer. A study that included all cancers found that light drinking was protective; moderate drinking had no effect; and heavy drinking was detrimental.

一项关于大肠癌与饮酒的荟萃分析发现,大量饮酒者的患病风险增加,但少量或中度饮酒者并非如此。关于膀胱癌或卵巢癌的研究没有发现类似的关联。一项纳入了所有癌症的研究发现,少量饮酒具有保护作用,中度饮酒没有影响,而大量饮酒有害。

Moderate alcohol consumption has been found to be associated with other benefits, though. A cohort of about 6,000 people followed in Britain found that those who consumed alcohol at least once a week had significantly better cognitive function in middle age than those who did not drink at all. This protective effect on cognition was seen in people who drank up to 30 drinks a week.

不过,现已发现,中度饮酒还与其他效益相关。在英国,研究人员在随访了一个约6000人的队列后发现,每周至少饮酒一次的人在中年时的认知功能明显优于完全不饮酒的人。这种对认知功能的保护作用在每周饮酒多达30杯的人身上依然存在。

A 2004 systematic review found that moderate drinking was associated with up to 56 percent lower rates of diabetes compared with nondrinkers. Heavy drinkers, though, had an increased incidence of diabetes.

2004年的一项系统性综述发现,与不饮酒者相比,中度饮酒与糖尿病发生率降低56%相关。不过,大量饮酒者的糖尿病发生率有所增加。

This is where savvy readers should be asking: What about randomized controlled trials? After all, epidemiologic evidence and associations only go so far; they cannot get us to causation.

于是聪明的读者就要问了:那随机对照试验的结果又如何呢?毕竟,流行病学证据和相关性的意义也仅止于此了;它们无法帮我们得出其中的因果关系。

Recently, in Annals of Internal Medicine, such a trial was published. Patients with well-controlled Type 2 diabetes were randomized to drink 150 milliliters of water, white wine or red wine with dinner for two years. The beverages were provided to patients free of charge. They were all placed on a Mediterranean diet with no calorie restrictions.

近日,《内科医学年鉴》(Annals of Internal Medicine)上发表了这样一项试验。控制良好的2型糖尿病患者被随机分为三组,分别在两年期间伴随正餐饮用150毫升水、白葡萄酒或红葡萄酒。这些饮料对患者免费。所有患者的膳食均为没有热量限制的地中海饮食。

Researchers found that those who drank the wine, most notably red wine, had a reduction in cardiometabolic risk factors, or those for heart disease, diabetes or stroke. This was especially true in patients who had certain genotypes. Further, no one had any significant adverse effects from being randomized to drink the alcohol.

研究人员发现,饮用葡萄酒,尤其是红葡萄酒者的心脏代谢风险因素有所减少,心脏病、糖尿病及中风的风险因素亦然。在具有特定基因型的患者中效果尤其明显。此外,被随机分配入饮酒组的人无一出现显著的不良反应。

In another analysis of that randomized control trial published this year, the most interesting finding was about blood pressure. In this study, some people saw a reduction in systolic blood pressure. Again, the alcohol was not associated with significant adverse effects. This contradicts the findings from systematic reviews of epidemiologic studies that show alcohol intake may be associated with a small but significant increase in blood pressure.

在对今年发表的这项随机对照试验的另一分析中,最有趣的发现是关于血压的。这项研究发现一些人的收缩压降低了,且饮酒同样与显著不良反应无相关性。这与对流行病学研究的系统性综述的结果恰好矛盾——那些综述表明,饮酒可能与血压出现小而显著的升高相关。

Adding further complications was a shorter-term trial looking at red wine consumption that found it had no effect, positive or negative, on blood pressure in patients with atherosclerosis. A different analysis of that study found that it did result in improved cholesterol levels, even though many patients were already being treated with statins.

另一项短期试验让情况变得更加复杂了:该试验发现,饮用红葡萄酒对动脉粥样硬化患者的血压没有任何影响(无论好坏)。对该研究的其他分析发现,饮酒确实改善了患者的胆固醇水平,即使许多患者已经在接受他汀类药物治疗也依然如此。

A 2011 meta-analysis examined 63 controlled trials of wine, beer and spirits, and found that all of those beverages increased levels of HDL cholesterol (the good cholesterol). There was even a dose-response, with more alcohol consumed having more of an effect.

2011年的一项荟萃分析审查了关于葡萄酒、啤酒和烈酒的63项对照试验,结果发现,所有这些饮料均可增加HDL胆固醇(高密度脂蛋白胆固醇,亦即“好胆固醇”)的水平。甚至还显示出了剂量-效应关系,也就是说,饮酒越多,效果越大。

Synthesizing all this, there seems to be a sizable amount of evidence that moderate alcohol consumption is associated with decreased rates of cardiovascular disease, diabetes and death. It also seems to be associated with increased rates, perhaps to a lesser extent, of some cancers, especially breast cancer, as well as some other diseases or conditions. The gains from improved cardiovascular disease deaths seem to outweigh all of the losses in other diseases combined. The most recent report of the U.S.D.A. Scientific Advisory Panel agrees with that assessment.

综合所有这些,我们应该可以说,有相当多的证据表明,中度饮酒与心血管疾病、糖尿病和死亡率降低相关。不过,饮酒似乎也与某些癌症(尤其是乳腺癌)以及一些其他疾病的发生率小幅升高相关。减少因心血管疾病死亡带来的收益超过了在所有其他疾病方面造成的损失的总和。美国农业部(U.S.D.A.)科学顾问小组(Scientific Advisory Panel)的最新报告也对上述评估持赞同意见。

But alcohol isn’t harmless. Many people with certain diseases or disorders, and women who are pregnant, need to avoid it. Others who can’t keep their consumption to acceptable levels need to abstain. Alcohol is very harmful when abused, so much so that it’s difficult for me to tell people to start drinking for their health. That’s rarely the conclusion of any studies about alcohol, no matter how positive the results. Nor is it the advice any doctors I know give.

但饮酒也不是全然无害的。众多身患特定疾病的患者以及孕妇都需要避免饮酒。其他人若是无法将饮酒量保持在可接受的水平,也需要戒酒。酗酒贻害无穷,以至于我很难开口劝说人们为了健康而开始饮酒。也因此,不论研究取得了多么积极的结果,它们几乎都不敢下结论支持人们饮酒;在我认识的医生中,也没有人会给出这样的建议。

However, the evidence does seem to say that moderate consumption is safe, and that it may even be healthy for many people. If you’re enjoying some drinks this holiday season, it’s nice to know that they may be doing more than just bringing you cheer.

然而,证据确实表明中度饮酒是安全的,对许多人来说甚至还可能有益于健康。如果你打算在这个假期里喝点小酒的话,你一定很高兴能知道它们除了可以让你舒心,还有点别的好处。

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