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Nutrition and Coronary Heart Disease

It is also unclear whether all beverage types have the same protective effect. There is
some evidence to suggest that wine is more beneficial than beer and spirits (Gronbaek et
al, 1995). This could be due to the different forms of alcohol in the beverages, but may
also be due to the effects of different beverages on other risk factors such as weight and
trygliceride levels.

As yet, there is no a clear biological explanation of the effect that moderate alcohol
consumption has on the risk of CHD. There is evidence to suggest that it is through an
atherosclerotic process, including reducing plasma Abrinagen levels and decreased
platelet aggregation (Hendriks et al, 1994 & Rankin; 1994).

The more important of which may be the antithrombotic effect of alcohol (WHO, 1994).
This would explain why there is a low dose-response rate and why the protective effect
is greatest among older people (Anderson, 1996).

Multiple risk factors

Evidence from the Multiple Risk Factor Intervention Trial (MRFIT) suggests that the
risk associated with smoking, diastolic blood pressure and total cholesterol is additive.
For example, each of these three risk factors in isolation increases the risk of CHD by
no more than four times. However, a person who exhibits all three risk factors
concurrently, has an eleven fold increase in risk of CHD (Kannel et al, 1986)

This paper incorporated multiple risk factors into its analysis, as well as examined
multiple risk interventions.

CHERE Project Report 11 - November 1999

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