EtAOK: Journal Impact

So for you fans out there of my ramblings, you may have noticed I don't drink. I've actually blogged before about it. Multiple times.

Anyway, the other day I was driving to an interview somewhere and heard a radio ad that reminded me of the whole issue. They were selling a supplement that was "red wine extract pills with no alcohol." So it obviously peaked my interest as knowing what it is in red wine that isn't in vodka is obviously what gives red wine its FDA/AMA stamp of approval over, say, moonshine.

Now I call this update journal impact because I'm all too aware of what journal impact factor is and what it means. So if I were to, hypothethetically of course, cite a study published by FASEB (that's the Federation of American Societies for Experimental Biology) I already know that it doesn't carry the same weight as something in, for example, The New England Journal of Medicine.

That said, the FASEB came out just recently and talked about what exactly it is in red wine that makes the difference. Turns out it's "polyphenols". There's a decent summary you can read about it here. After being tortured through organic chemistry anything with the word "phenol" in it just sounds dangerous, but apparently there's an exception to every rule. You can now buy polyphenol supplements on eBay (not that I am in any way, shape, or form endorsing this product. I personally think most supplements are garbage even more overpriced than the proven pharmaceuticals they "replace" - all without that pesky FDA who is always trying to stamp out American ingenuity).

One thing that's helped me support the belief that alcohol is heart unhealthy is the fact that the mormon population overall has a lower rate of heart disease compared to non-mormon countparts. In the off chance you're reading this and aren't mormon and don't know anything about mormonism, mormons are pretty well known for their abstinence from, among other things, alcohol.

Well, it turns out that it's the abstinence from one of those other things that seems to play one of the biggest factors. While I know that Deseret News is also not exactly a high impact journal, the story actually was broken across the AP wire and showed up on most credible news sites today (i.e. MSNBC, CBC, The London Free Press, etc). The study showed that fasting may actually be more cardioprotective than all that other stuff. Traditionally the first Sunday of every month is "Fast Sunday" worldwide in the LDS church. On fast Sunday, those whose health permits abstain from a meal or two and are encouraged to donate the money saved from not eating those meals to the Church's Fast Offering fund, which is specifically used to to provide welfare to the poor. While the study certainl by no means proves that fasting is cardioprotective, it certainly is suggestive.

But I still think alcohol is not good for the heart.

Et-AOK revisited [update 1]

Those of you who have been reading my blog since its previous address may remember my EtAOK post. Without reposting it, a quick summary is that despite its many ill effects and the huge cost it creates within society, alcohol (a.k.a. EtOH) is consistently and preferentially ignored throughout medical education. I like to therefore call it Et-AOK because despite the huge medical burden it places on society, since most doctors seem to enjoy drinking more than the average individual it is passed off as being totally OK, or EtAOK.

We all know smoking is bad. It causes cancer of many kinds. It causes significant decrease in lung function. It causes birth defects. It even carries a surgeon general's warning that using the product will cause these problems.

Alcohol can cause cancer, specifically hepatocellular cancer and stomach cancer. Alcohol can cause you to die from just about any organ system failing. Alcohol is the #1 cause in America of birth defects. Nobody seems to care.

Not only does alcohol cause all these things, it also causes a lot of trauma. You might remember my ER rotation posts "Life Lessons" and "Chief Complaint". A lot of those people also came in with pretty notably elevated blood alcohol levels. Anyway, the whole reason for me revisiting this post is I spotted this article in the news today. You might notice a few things about this guy. Like his use of a mixture of "stupid stuff" right before inserting the snake in his mouth. A poisonous western diamond back rattlesnake. Into his mouth. Because it was a "nice snake". Not that this one case report among many would change the fact that in medical school you will hear more about "the beneficial effects of drinking one glass of red wine daily" than anything other consequence of drinking alcohol.

Oh yeah, and this case is double awesome because it's anesthesia related because his tongue was so swollen as to totally occlude his airway requiring an emegency trach.

[update 1]: Who could ask for such luck in a single day?! Not just one story of inibriated madness, but two. This one is the story of a 54 year old drunk man who got in trouble with the law for throwing an onion at his 27 year old wife. I'm sure there's more than one story of "night's I can't remember" in that family. Your first clue might be that when the man was his wife's age she was but an embryo.