Drinking spirits, rather than wine or beer, appears to increase the risk for acute (sudden) pancreatitis — says a large Swedish study

The distinction between the effects of hard liquor versus beer and wine is interesting

Swedish researchers looked at three different classes of alcoholic beverages and their correlation to the onset of acute pancreatitis.  They found that drinking hard liquor increased the risk for developing acute pancreatitis.  Beer and wine appear not to.

From the abstract:

Results: In total, 84 601 individuals [taken from the Swedish Mammography Cohort and the Cohort of Swedish Men], aged 46-84 years, were followed for a median of 10 years, of whom 513 developed acute pancreatitis.

There was a dose–response association between the amount of spirits consumed on a single occasion and the risk of acute pancreatitis.

After multivariable adjustments, there was a 52 per cent (risk ratio 1·52, 95 per cent confidence interval 1·12 to 2·06) increased risk of acute pancreatitis for every increment of five standard drinks of spirits consumed on a single occasion.

The association weakened slightly when those with gallstone-related pancreatitis were excluded.

There was no association between consumption of wine or beer, frequency of alcoholic beverage consumption including spirits, or average total monthly consumption of alcohol (ethanol) and the risk of acute pancreatitis.

Conclusion: The risk of acute pancreatitis was associated with the amount of spirits consumed on a single occasion but not with wine or beer consumption.

© 2011 O. Sadr Azodi, N. Orsini, Å . Andrén-Sandberg, and A. Wolk, Effect of type of alcoholic beverage in causing acute pancreatitis, British Journal of Surgery, DOI: 10.1002/bjs.7632 (early online publication, 03 August 2011)

The study set a “standard drink” as equivalent to 12 grams of ethanol

In turn, this is equivalent to:

(a) 15 centiliters (5.07 U.S. fluid ounces) of wine,

(b) 33 centiliters (11.16 U.S. fluid ounces) of beer,

and

(c) 4 centiliters (1.35 U.S. fluid ounces) of spirits.

These measures appear to be essentially the same as U.S. standard drink equivalents:

(a) 5 ounces of 12 percent alcohol wine,

(b)  12 ounces of 5 percent alcohol beer,

and

(c) 1.5 ounces of 80 proof whiskey, gin, and vodka.

The study’s details are worth reading

The authors do a good job of covering the weaknesses of this kind of cohort study, which was conducted by telephone over a period of years.

Medical findings are not dramatic

From my perspective, the incidence of pancreatitis was low — 513 cases among  84,601 patients is only about 0.6 percent.

Oxidative stress as the mechanism of injury?

The researchers hypothesized that:

The metabolism of alcohol (ethanol) is known to induce oxidative stress, which in turn depletes cellular glutathione storage and results in lipid peroxidation and damage to pancreatic tissue.

However, in animal models it seems that ethanol alone is not enough to induce acute pancreatitis.

Beer and wine include polyphenols with antioxidant capabilities.

In experimental studies, other constituents in spirits such as long-chain alcohols have been shown to be more potent than ethanol in inducing oxidative stress.

Comparing the same amounts of alcohol, spirits deplete the antioxidant capacities more readily than beer or wine. Thus, there might be other constituents in spirits that induce acute pancreatitis, in combination with ethanol or alone.

© 2011 O. Sadr Azodi, N. Orsini, Å . Andrén-Sandberg, and A. Wolk, Effect of type of alcoholic beverage in causing acute pancreatitis, British Journal of Surgery, DOI: 10.1002/bjs.7632 (early online publication, 03 August 2011) (paragraph split, footnotes omitted)

The moral? — Beer and wine may be better

If you are diabetic, wine would arguably be the better choice of the two.

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