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Properties of Beer and Protective Effects

Alicia Walker Mrs. Fitzpatrick 10/29/13

2 Properties of Beer and Protective Effects High consumption of alcohol has been correlated with increased risk of mortality. However, it has been questioned what the effects are of moderate consumption, and if individuals would be better off not consuming alcohol at all. Beer has several different components that may be protective of health in moderate consumption. Studies have been conducted to find the most beneficial level of alcohol consumption for the body, including nondrinkers (Arranz et al., 2012). Beer is the most regularly consumed alcoholic drink around the world. It is rich in nutrients. These include amino acids, carbohydrates, vitamins, minerals, and other components such as polyphenols (Arranz et al., 2012). It has been a hot topic of discussion, not that individuals need another reason to drink. However, the research is interesting. The protective effects that have been focused on are those concerning cardiovascular problems and cancer. Different methods of preparing beer, based on the type (lager, porter, etc.), lead to different levels of nutrient content. Therefore, some beers can have higher levels of these healthful components, including ethanol and polyphenols. Polyphenols are found in hops, so beers that use large amounts of hops are potentially more beneficial (Arranz et al., 2012). For example, India Pale Ales (IPAs). The purpose of this review is to determine the effects caused by the ethanol and those caused by the polyphenols, what level of consumption is most beneficial, which beers have the highest nutrient content, and if these components of beer act together or are they beneficial on their own. Components of Beer An article by Brien, et al (2011) conducted a systemic review and meta-analysis considering protective effects for health found in beer. Over sixty studies were evaluated. Two reviewers independently chose these articles from existing articles. Some of the tests conducted measured for

3 cholesterol, apolipoprptoein, adiponectin, and fibrinogen (Brien, Ronksley, Turner, Mukhamal, & Ghali, 2011). 63 studies were being analyzed. The results showed that alcohol significantly increased HDL cholesterol (P=0.005), apolipoprotein A1 (P<0.01), adiponectin (P<0.01). Alcohol consumption decreased fibrinogen (P<0.01), levels but didnt affect triglycerides (Brien et al., 2011). In an article by Krenz and Korthius (2011), the beneficial effects of ethanol are listed. This study was a review that summarized the epidemiologic evidence the supports the benefits of ethanol ingestion and its protective effects in cardiovascular health (Krenz & Korthuis, 2011). Another article focused on the effects of these components found in beer. It also focuses on multiple studies and pulls together information regarding the positive effects of low to moderate intake of alcohol, and the negative effects of high intake (Arranz et al., 2012). The article by Arranz et al, 2012, found that there are many polyphenol compounds in beer and wine. There are over 50 compounds found in beer, at different levels, with some being more abundant than others. Ethanol seems to account for around 50% of the beneficial attributes of beer (Arranz et al., 2012). Around 14% of polyphenols found in beer are from hops, and around 75% are originated from malt (De Keukeleire et al., 1999). Amount consumed One study measured consumption of liquor, alcohol, and wine. Individuals self-reported these amounts along with other statistical information (Foerster et al., 2009). However, tests were also conducted. These included a measurement of blood serum carbohydrate-deficient transferrin (CDT). This is a test that shows if an individual has high alcohol consumption because levels are usually low if they have low alcohol intake and is accurate. Also, this study accounted for smoking. Individuals were classified into three groups. These were former, current, and never smokers. Blood pressure and heart rate were measured. Three measurements were taken electronically of both and then averaged.

4 Triglycerides, glucose and cholesterol blood levels were also measured. This study consisted of 5,769 adults and was based on their alcohol consumption was based on the previous seven days before they arrived (Foerster et al., 2009). In an article by the De Wiel and De Lange, 2008, they look at several studies. The focus is that the amount and pattern of drinking in individuals should be of more attention than what type of alcohol is actually being ingested. This article discusses effects of the pattern of drinking and health (De Wiel & De Lange, 2008). The study concludes that moderate consumption of wine caused a 32% decreased risk for cardiovascular disease and moderate consumption of beer resulted in a 22% decreased risk for cardiovascular disease. It also showed an increased risk for cardiovascular disease in areas of high consumption (De Wiel & De Lange, 2008). In the study by Foerster et al., 2009, 73% of the individuals that participated consumed alcohol. More than half were moderate drinkers (1-14 drinks/week), 16% were high drinkers (which were classified at 14-34 drinks/week) and 2% were very high drinkers (classified as 35 or over drinks/week). Individuals who ingested alcohol had higher HDL cholesterol (P<0.01), higher triglycerides (P<0.001, and blood pressure (diastolic and systolic)(P<0.001). Levels were even higher in the very high drinkers causing unhealthful effects.(Foerster et al., 2009).

5 Figure 1

American Journal of Cardiology 2009; 103:365 (DOI:10.1016/j.amjcard.2008.09.089)

Discussion Components of Beer In the review and meta-analysis conducted by Krenz and Korthuis, 2011, they reported beneficial effects of moderate intake of alcohol. These benefits of moderate ingestion include possible cancer prevention (due to antioxidant activity), cardiovascular protection (due to lowering of LDL,

6 increase of HDL, and decrease of fibrinogen), and prevention of stroke (due to a mechanism caused by ROS; antioxidant activity)(Krenz & Korthuis, 2011). Also, there has been evidence that shows a protective effect for diabetes and hypertension, which are the top risk factors for cardiovascular health. Alcohol consumption was related to increased insulin sensitivity (Krenz & Korthuis, 2011). In the article by Arranz et al., 2012, it is also discussed that beer has protective effects for cardiovascular health; also protective effects have been seen considering alcohol and certain types of cancer. The protective effects are seen with moderate consumption (Arranz et al., 2012). Research has also been done to determine how these components of beer act in the body. After reviewing these articles, it is still unclear as to whether these components act on their own, or if it is an effect achieved by ingesting them together. Studies have found that they work synergistically in vitro, but their actions after entering the body have not been studied enough (Arranz et al., 2012).

Amount consumed The study by Foerster et al., 2009, they discuss the changes in protective effects of alcohol consumption when intake is increased. The study found that high levels of intake still increased HDL levels, but triglycerides, total cholesterol, and blood pressure also continued to increase. Therefore, at high levels of intake, beer is less protective against cardiovascular disease. Since date was self-reported, this could lead to discrepancies in the date and binge drinking was not accounted for. This study also found the moderate intake showed the most protective effects against cardiovascular disease (Foerster et al., 2009). The study by the De Wiel and De Lange, 2008, also shows evidence that light to moderate consumption of beer was seen to be the most beneficial to health. This study discusses that there are

7 confounders for healthy lifestyle, because that could also have protective effects towards cardiovascular disease. However, high intake (including binge drinking) has shown evidence that there becomes an increased risk for cardiovascular disease (De Wiel & De Lange, 2008). Conclusion While all of these articles and experiments have found very interesting results, these studies and results should not cause changes being made in recommendations towards clients. Individuals who are nondrinkers should not be encouraged to begin consumption because of potential protective effects on the body. Living a healthy lifestyle will also exert protective effects against a number of diseases. There are different ways to achieve these benefits, other than drinking alcohol. Some of the data was conflicting, regarding triglyceride levels raising or remaining unaffected with alcohol consumption. No changes in recommendations should be made. If a time comes when alcohol is being recommended, details about amount consumed and negative effects of high intake should be thoroughly explained so the client is fully aware of the line that changes the effects from protective to harmful

8 Reference List Arranz, S., Chiva, B. G., Valderas, M. P., Medina, R. A., Lamuela, R. R., Estruch, R. (2012). Wine, beer, alcohol, and polyphenols on cardiovascular disease and cancer. Nutrients, 4(7): 759-81. Doi: 10.3390/nu4070759 Brien, S. E., Ronksley, P. E., Turner, B. J., Mukamal, K. J., Ghali, W. A. (2011). Effect of alcohol consumption on biologicial markers associated with risk of coronary heart disease systematic review and meta-analysis of interventional studies. BMJ, 1-15. Doi: 10.1136/bmj.d636. De Keukeleire, D.; de Cooman, L; Rong, H.; Heyerick, A.; Kalita, J.; Milligan, S. R. (1999). Functional properties of hop polyphenols. Basic Life Science, 66, 739-760. De Wiel, A. van, de Lange, D. W. (2008). Cardiovascular risk is more related to drinking pattern than to the type of alcoholic drinks. The Journal of Medicine, 66 (11), 467-73. Foerster, Maryline, Marques-Vidal, Pedro, Gmel, Gerhard, Daeppen, Jean-Bernard, Cornuz. Jacques, Hayoz, Daniel, Pecoud, Alain, Mooser, Vincent,Waeber, Gerard, Vollenweider, Peter, Paccaud, Fred, Rodondi, Nicolas. (2009). Alcohol Drinking and Cardiovascular Risk in a Population With High Mean Alcohol Consumption. American Journal of Caridology, 361- 68. Doi: 10.1016/j.amjcard.2008.09.089 Krenz, M. & Korthuis, R. J. (2011). Moderate ethanol ingestion and cardiovascular protections: From epidemiologic association to cellular mechanisms. Journal of Molecular and Cellular Cardiology, 52l1, 93-104. Doi: 10.1016/j.yjmcc.2011.10.011