Dr. Richard Bruno is Chairperson of the International Post-Polio Task Force and Director of The Post-Polio Institute and International Centre for Post-Polio Education and Research at Englewood (NJ) Hospital and Medical Center. His new book, The Polio Paradox: Uncovering the Hidden History of Polio to Understand and Treat "Post-Polio Syndrome" and Chronic Fatigue, will be published by Warner Books in June 2002. Please e-mail questions directly to him at ppsforum@newmobility.com.

Note: This column is for information purposes only and is not intended as a substitute for professional medical advice.

Q: I saw a recent article that alcohol actually decreases the possibility of having a heart attack. I am very sensitive to alcohol. My husband calls me a cheap date. One drink and I'm asleep. Other polios tell me they're like this, too. Since alcohol has so many bad effects, is drinking good for polio survivors?

A: Recent research suggests that the answer may be "yes"--but it's important to remind ourselves of the dangers of alcohol. In the short-term alcohol can trigger headaches and decrease both attention and coordination. Over time alcohol is the number one cause of liver disease. The perils of alcohol addiction are all too well-known.

But moderate drinking may be good for polio survivors and almost everyone. First, alcohol makes you and your muscles relax, slows your heart rate and your breathing--all good things. Alcohol is said to do these things by "depressing" the brain, discharging neurons' internal batteries and making them less able to fire. Of course, if you discharge the batteries too much you have a falling-down, snoring drunk. Too much muscle relaxation isn't good in polio survivors whose muscles aren't so strong to begin with. And, as your experience makes clear, polio survivors' damaged brain activating systems make them more sensitive to anything that causes brain "depression." So you need to be careful about how much and when you drink, especially if you have post-polio fatigue and if you're taking medications that themselves cause sedation.

But just as alcohol can be a dangerous drug, we are now discovering that it can also be a helpful medication. A 2003 study of older Americans found that those who drank between one and six alcoholic drinks throughout the week were half as likely to have dementia than those who abstained. (A drink was defined as a 12-ounce beer, a 6-ounce glass of wine or a shot of liquor.) A 2002 study found that daily drinkers had a 42 percent lower risk of developing dementia than the nondrinkers. Those who weren't daily drinkers but had more than one drink per week had a 25 percent lower risk, and those who drank less than a glass a week were only 18 percent less likely than nondrinkers to develop dementia.

Alcohol has also been found to be good for the heart. In 1997 a survey of 22,000 physicians found those who had one drink a day had about half as many heart attacks. A 2002 study found that men who had a drink at least five days a week had a 35 percent lower risk of heart attack than men who did not drink. In 2003 a 10 year follow-up study of nearly 500,000 men and women reported that those who averaged one drink a day had a 21 percent lower risk of death from heart disease than did nondrinkers. Drinkers also had lower rates of clogged arteries in the legs. Notably, the benefits decreased in those who averaged at least four drinks a day.

How does alcohol protect against dementia and heart disease? Alcohol seems to keep your arteries clear and free flowing. Wine and hard liquor were found to raise levels of high density lipoprotein, the "good" cholesterol. Beer has been found to increase HDL, decrease low-density lipoprotein (the "bad" cholesterol), and reduce the amount and activity of fibrinogen, a blood clot-producing protein. Healthy postmenopausal women who had two drinks a day showed lower triglyceride levels and increased insulin sensitivity, the later known to protect against adult-onset diabetes.

Unfortunately, there are also side effects of these "medical" uses of alcohol. In doses found to help prevent dementia and heart disease, alcohol has been associated with cancer. Male physicians in the 1997 survey who had more than two drinks a day had a higher rate of cancer. Women who had even one drink a day had a 30 percent higher risk of dying from breast cancer. And alcohol provides "empty" calories that put on weight. One drink equals about 100 calories. If you have 12 drinks a week you're adding the equivalent of almost one extra day's worth of food!

Should you have drunk a fifth on the Fourth? Absolutely not. But the moderate use of alcohol--possibly as little as one drink a day--appears to confer significant health benefits. Maybe they had it right back in the 1950s? Dad partaking with Mom in a before-dinner martini might just be the cure for a number of ills. Especially for hard-driving, tightly-wound, type A polio survivors, an early evening visit with good ol' Jim Beam may relax the body and brain in the short term, and in the long term may actually help to save your life. But please talk to your doctor before changing your alcohol intake.