Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor
To the Editor: The study by Dr Valmadrid and
colleagues1 suggested that light to moderate
alcohol intake is associated with a reduced risk of death from coronary heart
disease (CHD) for persons with older-onset diabetes.
These results may not generalize to other populations. Only 1.5% of
subjects in the study were nonwhite. This is relevant because blacks and South
Asians with diabetes appear to have a worse prognosis, especially from CHD.2 Moreover, the socioeconomic status of the subjects
was not known, an important factor because poverty (independently of ethnicity)
is known to increase mortality from diabetes and other diseases.3
An indirect detrimental effect of generalizing the perceived benefits of alcohol
consumption is based on the observation that some population groups that are
relatively poor are often poorly educated and have alcohol-related problems.
Examples include Asians in the United Kingdom, blacks and American Indians
in the United States, and Australian Aborigines.4,5
How these groups would respond to a "safe limit" for alcohol consumption is
uncertain, although the likely scenario is one of overindulgence, encouraged
by an alcohol industry working behind the scenes.
Jayasinghe S. Alcohol Consumption and Risk of Coronary Heart Disease. JAMA. 2000;283(6):745-746. doi:10.1001/jama.283.6.741