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Long term alcohol intake and risk of rheumatoid arthritis in women: a population based cohort study
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BMJ
2012;345:e4230
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6 August 2012
Daniela Di Giuseppe and coworkers, in a large population based cohort study, evaluate the association between long term alcohol consumption and incidence of rheumatoid arthritis among women(1).
In accordance with the inverse association between moderate alcohol consumption and risk of cardiovascular disease(2), the authors conclude that moderate alcohol consumption is not harmful and can be protective against rheumatoid arthritis.
This would be a further support to adopt the moderate alcohol consumption as a healthy behaviour practice.
The major concern against this conceivable evolution is the growing evidence that low levels of alcohol consumption may be associated with a small increase in breast cancer risk (3,4,5).
Since the study was performed inside the Swedish Mammography Cohort, the authors have the unique opportunity to verify in the same group of patients the incidence of breast cancer and to couple the rheumatoid arthritis risk and the breast cancer risk.
Hopefully, the evaluation of these two parameters in such a large amount of subjects will help to reach a more firm position about the healthy effects of moderate alcohol consumption in females.
1) Di Giuseppe D, Alfredsson L, Bottai M, Askling J, Wolk A. Long term alcohol intake and risk of rheumatoid arthritis in women: a population based cohort study. BMJ.2012;345:e4230 doi:10.1136/bmj.e4230;
2)Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis.
BMJ.2011;342:d671 doi:10.1136/bmj.d671;
3) Chen WY, Rosner B, Hankinson SE, Colditz GA, Willet WC. Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk. JAMA.2011;306(17):1884-90;
4)Tjønneland A, Christensen J, Olsen A, Stripp C, Thomsen BL, et al. Alcohol intake and breast cancer risk: the European Prospective Investigation into Cancer and Nutrition (EPIC). Cancer Causes Control.2007;18(4):361-373;
5) Mørch LS, Johansen D, Thygesen LC, Tjønneland A, Løkkegaard E, et al. Alcohol drinking, consumption patterns and breast cancer among Danish nurses: a cohort study. Eur J Public Health.2007;17(6):624-629.
Competing interests: None declared
Ospedale per gli Infermi, Viale Stradone 9, 48018 Faenza, Italy
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15 July 2012
Di Giuseppe and colleagues found that women who drink moderately are less likely to develop rheumatoid arthritis over a 10 year period. They interpret this as showing that alcohol may be protective.1 However, their data could equally mean than non-drinkers are more likely to develop rheumatoid arthritis because of a higher genetic risk of autoimmune diseases and being intolerant to alcohol drinking.
The well-known epidemiological “J” curve epidemiology for alcohol drinking has long been misinterpreted as proof of benefit, such as in cardiovascular disease, rather than being due to weaker (or more sensitive) immunity in those who dislike alcohol and avoid regular drinking.
Alcohol is a cell poison which lowers zinc levels and blocks polyunsaturated fatty acid (PUFA) pathways and stiffens cell membranes. Zinc is a key immune system regulator. Alcoholic drinks contain yeast and have been described by Dr John Mansfield as taking allergens in a jet propelled vehicle. Such mistaken claims of benefit are good for the drinks industry but bad for patients – especially future parents. Lower sperm counts and increases in abnormal morphology are very common in regular drinkers. I my experience men need to avoid any alcohol for 3-4 months to before conception to improve the quality of their sperm. There are numerous
biochemical reasons for so-called “unexplained” infertility and recurrent miscarriages. Regular alcohol intake is one of the commonest.
1 Di Giuseppe D, Alfredsson L, Bottai M, Askling J, Wolk A.Long term alcohol intake and risk of rheumatoid arthritis in women: a population based cohort study. BMJ2012;345:e4230
Competing interests: None declared
Retired, KT2 7JU, UK
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