The Journal of the American Medical Association (JAMA) recently detailed a debate among doctors focusing on the question of whether a patient called "Mr. Q" should continue to consume moderate amounts of alcohol for health reasons.

The 10-page article from Kenneth J. Mukumal, M.D., focuses on issues discussed at Grand Rounds at Beth Israel Deaconess Medical Center in Boston on Jan. 15, 2009.

Mr. Q's doctor suggested he cut back on alcohol use for health reasons.

The Beth Israel doctors concluded, "[The] best evidence to date suggests that his regular alcohol intake will increase his HDL-C (good cholesterol) and lower his risk of myocardial infarction, but the absolute benefit is modest, and there is unlikely to be meaningful benefit at levels beyond 1 drink every 1 to 2 days.

"If, given the totality of this information, he views alcohol intake as a desirable part of his lifestyle, he will have made a reasoned decision."

In response, Timothy J. Naimi, M.D., and Richard Saitz, M.D., of the Boston University Medical Center wrote, "If Mr. Q is enjoying alcohol, is providing reliable information about his drinking, does not currently binge drink, and had no alcohol-related problems in college, then his drinking is not of clinical concern.

"However, we agree with the U.S. Dietary Guidelines that it is 'not recommended that anyone begin drinking or drink more frequently on the basis of health considerations.'"

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