Eichner E R
Am J Med. 1985 Aug;79(2):231-40. doi: 10.1016/0002-9343(85)90014-2.
Both alcohol and exercise have been said to protect against coronary heart disease. The epidemiologic data suggest exercise, per se, does, but alcohol, per se, does not protect against coronary heart disease. Recent longitudinal data suggest teetotalers, especially those who have never smoked, have the lowest coronary heart disease mortality of all. Other cross-sectional and longitudinal studies that suggest light drinkers have the lowest coronary heart disease mortality may be biased because: (1) the teetotalers include some ex-drinkers who may have quit drinking because of coronary heart disease; and (2) the light drinkers include some who drink very rarely, and/or drink very small amounts, and/or have a lower risk of coronary heart disease independent of alcohol because they are more health-conscious in general. The metabolic data also suggest exercise, but not alcohol, protects against coronary heart disease. Exercise increases the level of high-density lipoprotein 2, which correlates well with coronary heart disease risk; alcohol in moderation seems to increase the level of high-density lipoprotein 3, which correlates poorly with coronary heart disease risk and may merely reflect hepatic enzyme induction. Exercise and alcohol influence blood pressure, body weight, and glucose tolerance in opposite directions; in each instance, the influence of exercise is beneficial, that of alcohol detrimental, to the prevention of coronary heart disease. There seems to be no reason to use alcohol for coronary protection.
酒精和运动都被认为对冠心病有预防作用。流行病学数据表明，运动本身确实有此作用，但酒精本身并不能预防冠心病。近期的纵向数据显示，滴酒不沾者，尤其是那些从不吸烟的人，冠心病死亡率在所有人中是最低的。其他横断面研究和纵向研究表明轻度饮酒者冠心病死亡率最低，这些研究可能存在偏差，原因如下：（1）滴酒不沾者中包括一些因冠心病而戒酒的人；（2）轻度饮酒者中包括一些很少饮酒、饮酒量极少，和/或由于总体上更注重健康，独立于饮酒因素之外患冠心病风险较低的人。代谢数据也表明，运动而非酒精可预防冠心病。运动可提高高密度脂蛋白2的水平，该指标与冠心病风险密切相关；适量饮酒似乎会提高高密度脂蛋白3的水平，该指标与冠心病风险相关性较差，可能仅反映肝酶诱导作用。运动和酒精对血压、体重和糖耐量的影响方向相反；在每种情况下，运动的影响对预防冠心病有益，而酒精的影响则有害。似乎没有理由用酒精来预防冠心病。
