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June 12, 1972

Wages of Sin and Fruits of Labor

JAMA. 1972;220(11):1492-1493. doi:10.1001/jama.1972.03200110070016

Six years ago The Journal published two reports1,2—one from Quebec, the other from Nebraska—of puzzling outbreaks of cardiomyopathy with a high mortality rate in heavy beer drinkers. A third report,3 which appeared two years later, told of a similar occurence in Belgium. The cause of the cardiomyopathy was subsequently traced to the cobaltous sulfate which had been added to the beer.4

Cobalt is thought to inhibit enzymes by competing with magnesium and calcium ions, with resulting interference with the metabolism of pyruvate, fatty acids, and electron transport mechanisms. Cobalt may also interfere with muscle metabolism by replacing calcium at sites of contraction. Other factors besides the metal must be involved in the causation of the cardiomyopathy, since only a minority of those who drank the contaminated beer manifested this complication.

Forewarned about the danger of such additives, brewers have since taken care that no recurrences of