While heavy drinking is associated with a greater risk of stroke, light-to-moderate drinking has been linked to a lesser risk of ischemic stroke and coronary heart disease. Other studies have shown that more social support is linked to less risk of mortality and cardiovascular disease.
A Japanese examination of the effects of social support on the relationship between drinking and cardiovascular disease has found that the health benefits of light-to-moderate drinking are more pronounced in men with greater social support.
"In Japan, drinking is divided into two main patterns," said Hiroyasu Iso, a professor of public health at Osaka University and corresponding author for the study. "One pattern is drinking alone and/or with family at home during the evening. Another pattern – especially for middle-aged business men – is social drinking with co-workers, friends, and neighbors. Social drinking is common."
"Alcohol can play a key role," concurred Takeshi Tanigawa, a professor in the department of public health at Ehime University Graduate School of Medicine, "for socializing as well as some business discussions. In urban areas, alcohol consumption is often used as a business tool. In rural areas, people often have a drink with classmates and people in the same community. Alcohol consumption can be used to maintain human relationships between father and son, senior and junior, community to community. Collectively, these socializing customs may help to create a stress-free space for those persons surrounded by dozens of stresses, especially in the workplace."
"Prior to our research," said Iso, "no study had examined whether psychosocial factors modify the association between alcohol consumption and risks of stroke and coronary heart disease."
Iso and his colleagues examined 19,356 men 40 to 69 years of age who were enrolled in the Japan Public Health Center-based Prospective Study. Their alcohol consumption was classified into seven categories: never, past, occasional, 1-149, 150-299, 300-449, or ≥450 grams/week. Measures used were alcohol consumption, risk of cardiovascular disease, and social support.
"We found the reduced risks of total stroke, ischemic stroke, and total cardiovascular disease associated with light-to-moderate drinking were more pronounced in men with high social support, probably due to avoidance of unhealthy behaviors and enhancement of stress buffering," said Iso. "In our study, compared with light-to-moderate drinkers with high social support, those with low social support had more unhealthy lifestyles such as physical inactivity, no job and fewer opportunities for medical checkups. Also, a potential pathway by which poor social support may lead to cardiovascular disease is mental stress. Mental stress activates neuro-endocrine components, including the hypothalamic-pituitary-adrenal-axis and autonomic nervous system, which lead to an increased risk of cardiovascular disease."
"In short," said Tanigawa, "moderate to light alcohol consumption with high social support is good for your health. Drinking with a good friend appropriately makes you feel happy and healthy. So drink with good friends for health," he advised. Tanigawa also recommended karaoke bars as one way for business persons to cope with stress. "Singers use deep breathing, which is good for the parasympathetic nervous system. After singing, they usually receive applause. It is a good kind of social support, and helps in the face of adverse occasions or stressful events."
Iso agreed that moderate alcohol consumption and socialization is good for one's health. "But remember that this beneficial effect of social support is confined to light-to-moderate drinking," he said. "Heavy drinking is risky irrespective of social support level. We believe that this also holds for other ethnic populations."
Co-authors of the ACER paper were: Satoyo Ikehara of the Department of Social Environmental Medicine at Osaka University; Kazumasa Yamagishi of the Department of Public Health Medicine at the University of Tsukuba; Seiichiro Yamamoto of Cancer Information Services and Surveillance Division at the National Cancer Center in Tokyo; and Manami Inoue and Shoichiro Tsugane of the Epidemiology and Prevention Division at the National Cancer Center in Tokyo.
The study was funded by the Ministry of Health, Labor and Welfare Japan.
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