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More than 100,000 deaths per year are attributed to alcohol, in the United

States. Alcohol-related auto accidents account for approximately 24,000 of these

deaths (most often the victims are under 30 years of age), while alcohol-related

homicide account for 11,000 and suicide 8,000 deaths. Certain types of cancer,

which are partly associated with the consumption of alcohol, contribute to

another 17,000 deaths. Alcohol-related strokes are responsible for 9,000 deaths.

25,000 lost lives are due to 12 alcohol-related diseases including cirrhosis of

the liver. All these deaths combined are the equivalent of 200 jumbo jetliners

crashing and taking the lives of everyone onboard, in just one year. Such

numbers are staggering until you realize that it is Coronary Heart Disease that

is the number one killer in the United States, not alcohol. There are roughly

900,000 persons admitted to U.S. hospitals for strokes annually and 830,00

admitted for Congestive Heart Failure. Though they are not always fatal, these

diseases will leave its victims at varying levels of incapacitation. Looking at

specific age groups, cardiovascular disease is the #1 killer of those age 65+

and #2 killer of those age 25 ? 64 This is a political issue for the U.S. with

so many lives lost to alcohol-related disease and accidents. Leaders will not be

perceived favorably by designating research money to study the health benefits

of a drug responsible for damaging so many lives. I believe it is this political

climate which limits research in this area, and I believe it is this climate

that limits the amount of coverage the media provides about its possible

benefits. As I began to research this subject I was intrigued by the vast number

of articles and studies on the health benefits of wine. The industry has

submitted a number of press releases attempting to counter the negative social

stigma alcohol had developed circa 1992 – 98. These articles aside, I found

reputable sources, with published reports, from such respected names as Harvard,

UC Davis, Georgetown, and the Mayo Clinic. Several of these studies have been

published in the American Medical Journal, and the New England Journal of

Medicine. I found articles referring to the ?French Paradox.? This is an

occurrence where the French diet contains equal levels of fat as the U.S.

however the coronary disease related mortality rate of France is 1/3 that of the

U.S. diet. I believe we must investigate and prove or disprove the assertion

that wine is somehow involved. Either we are letting hundreds of thousands of

people die or become severely debilitated senselessly by not taking advantage of

wine?s possible benefits, or we are allowing an industry to spread half-truths

with the potential of hurting unsuspecting consumers. Mounting evidence

continues to suggest that when taken with a balanced diet, moderate amounts of

wine can reduce the level of LDL cholesterol in the bloodstream, reduce the risk

of heart disease, reduce the risk of stroke, and thus lower mortality rates.

DEFINING THE PROBLEM Are there health benefits to drinking moderate amounts of

wine, which will reduce the mortality rate in humans? HYPOTHESIS Even though fat

intake in France is similar to the American diet, the liberal consumption of

wine in France protects the French against coronary heart disease by lowering

LDL cholesterol and thereby lowering the risk of blockage, thus reducing

mortality rates. EVIDENCE First, mounting evidence continues to suggest that

when taken with a balanced diet, moderate amounts of wine can reduce the level

of LDL cholesterol in the bloodstream. The human body manufactures approximately

80% of the cholesterol used and stored in its cells. The remaining 20% is

derived from eating animal products. Cholesterol is transported through the body

via the bloodstream. To allow this, the body attaches a protein to the

cholesterol. This combination is called a lipoprotein. The body requires

high-density lipoprotein (HDL) cholesterol (?good cholesterol?) to assist in

the removal of low-density lipoprotein (LDL) or ?bad? cholesterol from the

blood vessels. Failure to remove excessive amounts of LDL cholesterol will

result in a plaque buildup and blockage of the body?s main arteries. Blockages

may occur gradually or suddenly. Plaque can break off and create a blood clot,

with the consequences of a possible heart attack or stroke. Doctors at the Mayo

Clinic suggest a low-fat diet and exercise to lower and maintain the correct

balance of cholesterol. If the balance can not be achieved through diet and

exercise, drugs are now available to reduce levels of HDL cholesterol; drugs for

this treatment however are costly (up to $200 per month) and are associated with

some risk of liver damage. In a Mayo Clinic Dietician report the clinic sites a

1997 American Journal of Cardiology report that alcohol provides the greatest

benefit by raising high density lipoprotein? and by decreasing the stickiness

of blood, making it less likely to clot.? The report continued by saying red

wines contain the antioxidants: flavonoids and phenols, which hinder plaque from

forming. These antioxidants also possess an anti-clotting quality. Wine contains

approximately 200 different phenolic compounds, but only a handful are

considered antioxidants. The antioxidant flavonoids are water-soluble plant

pigments. First discovered by the Nobel Prize winning scientist Dr. Albert

Szent-Gyorgyi (who first discovered Vitamin C), Dr. Szent-Gyorgyi found that

flavonoids strengthened capillary walls even better than Vitamin C. The main

sources of flavonoids include fruit, tea, and soy. The report stated that ?the

flavonoids in these foods protect against heart disease and cancer.? Dr Andrew

Waterhouse of the University of Davis, Department of Viticulture, and Enology

says wine ?is one of the best sources of phenolic antioxidants available to

Americans.? Davis researchers believe wine to possess five times the phenolic

levels of fresh grapes. Researchers at the Mayo Clinic as well as those at the

University of California at Davis did stress alcohol is a highly addictive drug,

and may not be appropriate for all persons (including children, adolescents and

persons with addiction issues). If used however, they believe wine should be

used only in moderation. Because of differing opinions on its benefits, the

researchers did not suggest that any patient ?start? drinking. Evidence is

mounting however that wine has the ability to lower LDL cholesterol, and reduces

the damaging affects of the ?bad? cholesterol. Next, mounting evidence

continues to suggest that when taken with a balanced diet, moderate amounts of

wine can reduce the risk of heart disease, and thus lower mortality rates. A CNN

report by Hacsi Horvath said on the benefits of wine, ?Several studies have

shown that drinking a glass or two with meals may indeed help to protect against

heart disease.? The report referred to what some call the ?French Paradox?

a phenomenon where out of 21 affluent countries studied, France has the highest

wine consumption rate, and the second lowest cardiovascular disease mortality

rate. Others have given credit for this healthful success to the

?Mediterranean Diet,? which includes:  Low red meat  Low

lard or butter, higher olive oil  High in fish  High in cheese,

low in whole milk  High in breads, fruits, and vegetables  Light

to moderate wine drinking Horvath says other studies have shown that wine

drinkers may simply be more concerned about their health, as compared to

non-drinkers, beer drinkers, or hard liquor drinkers. Some studies have shown

wine drinkers tend to eat less fat, and more fruits, vegetables, and fish. This

would coincide with the Mediterranean Diet. So why not simply drink more grape,

or other dark fruit juices? Horvath?s report said this would be beneficial,

however other reports have suggested the concentration of phenolic compounds was

greater in red wines because the juice is actually fermented with the grape

skins, pulp, and stems. In addition, during the processing of ordinary juices

the juice is exposed to much oxygen, greatly reducing the healthful benefits.

Winemaking on the other hand is an anaerobic process; the healthful properties

of the compounds are maintained. So, juice is good but wine is better. Dr.

Jean-Paul Broustet of Haut Leveque Hospital in Pessac, southern France, writing

an editorial for the British medical journal Heart noted red wine as one of the

best components contributing to a healthy heart. He states its beneficial traits

of lowering LDL cholesterol, but also notes the presence of resveratrol a

compound that heightens the production of HDL cholesterol. Red grapes produce

resveratrol to protect themselves from fungus. ?The highest concentrations of

resveratrol? are found in the red wines, particularly in Cabernet Sauvignon

grapes of Bordeaux.? Because red wines ferment with grape skins and stem

parts, the red wines have higher concentrations of resveratrol than do white

wines. It is believed that some phenolic compounds including resveratrol act as

antioxidants to prevent cell damage from oxygen-containing chemicals known as

free radicals. The CNN report concluded that there was still much evidence

however that it is primarily the alcohol, which acts to lower LDL protein by

thinning the blood. Yet, wine with a balanced low fat diet, maintained lower

levels of LDL cholesterol which contributes to a lower frequency of heart

disease and lower mortality rates. Lastly, mounting evidence continues to

suggest that when taken with a balanced diet, moderate amounts of wine reduce

the risk of stroke, and thus lower mortality rates. A CNN review of a study

recently published in the Journal of the American Medical Association it says,

?alcohol consumption appears to protect against ischemic strokes, which occur

when the blood supply to the brain is blocked by a blood clot.? Dr. Salvatore

says that 80% of all strokes are ischemic strokes. The study group included 677

people forty years of age and older, from Manhattan, who had suffered an

ischemic stroke. Test results were compared to 1,139 subjects from the same

community; those who drank up to two drinks per day had a 45% lower risk for

suffering a stroke. Another study found similar results. Dr. Michael Elkind of

Columbia University said, ?Our study showed that having a drink a day or

perhaps two drinks per day can reduce the risk of stroke perhaps as much as

50%.? Yet another, and much larger 16-year study of 13,000 test subjects in

Denmark just one year earlier found similar results (32% less chance of stroke)

from drinking one glass of wine per day. The study had not gained much attention

in the United States because the sample included only one ethnic race. Dr.

Stuart Seides, a cardiologist with the American Heart Association noted ?that

the study is based on one ethnic population, while Americans are a diverse lot

with many dietary habits.? In Dr. Salvatore?s more recent study however,

test results were consistent across white, African American, and Hispanic

groups. The Danish test contrasted the variables of wine, beer, and hard liquor.

The same positive results were not achieved for the beer or hard liquor

drinkers. Another researcher, Jane Freedman conducting a study at Georgetown

University Medical Center introduced grape juice to cells that cause clotting,

and said, ?they have a much less tendency to form clots.? Two other studies

supporting the benefits of moderate consumption of wine include the

Harvard-based Nurses Health Study and the Physicians Health Study. These studies

found moderate drinking lowers women?s risk of death by 17% and men?s risk

by 22%. Possibly because of its antioxidant value, and/or its blood thinning

effects, but evidence from studies continues to grow showing the moderate use of

wine has a positive influence on decreasing the risk of stroke. CONCLUSION A

drink is commonly defined as 12 ounces of beer or wine cooler, 5 ounces of wine,

or 1? ounces of 80-proof distilled spirits. Researchers all agree moderation is

an important control. Evidence exists that wine in moderation (1 ? 2 drinks

per day) as part of a healthy diet does provide health benefits. However like

other drugs, abuse of wine can prove destructive. If a greater number of persons

with heart disease may benefit from moderate consumption of wine, should we

limit further research because of those who may abuse the drug? If we apply this

logic to all controlled substances, we would not have access to many of the

life-saving (or pain-killing) drugs available today. Existing research seems to

indicate that further studies are required to determine the comparative levels

of effectiveness between overall diet, the moderate consumption of wine with

meals, and though not addressed in this report: exercise. Lower LDL cholesterol

levels seem to be an important factor to reducing the risk of stroke and heart

attack. The studies I reviewed indicate each of these factors contribute to a

healthier life.

Rodger Doyle, Deaths Due to Alcohol, (Scientific America, 1996) www.health.org

American Heart Association, Cardiovascular Diseases Biostatistical Fact Sheets,

(American Heart Association, 1996) www.americanheart.org Mayo Clinic, Mayo

Health Oasis, (Mayo Clinic, 1997) www.mayohealth.org Jack Challem, The Color of

Health: Why Nutrients Called Flavonoids Are Good For You, (The Nutrition

Reporter, 1994) Dr. Andrew Waterhouse, Wine Antioxidants May Reduce Heart

Disease and Cancer, (Washington, DC: American Chemical Society, 1994)

www.wineinstitute.org Hacsi Horvath, Will Wine Help Your Heart?, (Web MD, Inc,

1999) www.cnn.com CNN interactive, Cabernet Sauvignon Wine Called Good for

Arteries, (Atlanta: CNN, 1999) www.cnn.com CNN interactive, Cabernet Sauvignon

Wine called Good for Arteries, (London: CNN, 1999) www.cnn.com Dr. Steve

Salvatore, Study: Moderate Alcohol Consumption May Protect Against Stroke, (New

York: CNN, 1999) www.cnn.com Dr. Steve Salvatore, Study: Moderate Alcohol

Consumption May Protect Against Stroke, (New York: CNN, 1999) www.cnn.com Louise

Schiavone, Study Links Moderate Wine Drinking, Lower Stroke Risk, (Washington:

CNN, 1998) www.cnn.com Louise Schiavone, Study Links Moderate Wine Drinking,

Lower Stroke Risk, (Washington: CNN, 1998) www.cnn.com CNN interactive, A Drink

A Day Keeps the Grime Reaper Away, (Boston: CNN, 1997) www.cnn.com

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