The accepted wisdom in relation to alcohol consumption guidelines was, for many years, that the risks and benefits of alcohol consumption followed a “J curve” in which low levels of alcohol consumption were more beneficial than abstinence or moderate and higher levels of consumption. This led to debates between proponents of abstention and those that favoured alcohol consumption over the quality of the studies on which the guidelines were based. By 2016, however, the NHS had decided that the evidence for any benefits from low levels of alcohol consumption were limited to cardiovascular benefits only in women over the age of 55, thus leading to the publication of new guidelines on the 8th of January, 2016.
The latest salvo against the J-curve comes in the form of a well-researched Lancet study that begins with an acknowledgement of complexities and beliefs in relation to alcohol use:
Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.
The authors reviewed “694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use” and come out with the following conclusions:
Alcohol use is a leading risk factor for disease burden worldwide, accounting for nearly 10% of global deaths among populations aged 15–49 years, and poses dire ramifications for future population health in the absence of policy action today. The widely held view of the health benefits of alcohol needs revising, particularly as improved methods and analyses continue to show how much alcohol use contributes to global death and disability. Our results show that the safest level of drinking is none. This level is in conflict with most health guidelines, which espouse health benefits associated with consuming up to two drinks per day. Alcohol use contributes to health loss from many causes and exacts its toll across the lifespan, particularly among men. Policies that focus on reducing population-level consumption will be most effective in reducing the health loss from alcohol use.
If you would like to read the full article in context, it is attached as a PDF below.
I think the statement emphasised above is worth pondering. If you want to implement any cardiovascular protective measures, you are better off with regular exercise at the recommended levels, sticking to a healthy diet, maintaining a healthy body weight, managing your stress levels, getting adequate rest and taking any essential medication to manage your cardiovascular risk. The safest level of drinking is none.
Cephalosporins are broad-spectrum antibiotics whose pharmacology is similar to that of the penicillins. They bind to and inactivate penicillin-binding proteins (PBPs) located on the inner membrane of the bacterial cell wall. PBPs are enzymes involved in the terminal stages of assembling the bacterial cell wall and in reshaping the cell wall during growth and division. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This results in the weakening of the bacterial cell wall and causes cell lysis.
The excretion of Cephalosporins is principally renal.
They are classed as first, second, third, fourth or fifth generation; as indicated on the table below. Their spectrum of activity will be presented in a future post.