When it comes to matters of health, it may seem as though everything you love is bad for you.
For some people, it's dessert. For others, it's wine with dinner or smoking. The notion that a particular food or habit is all good or all bad is often a myth. Believe it or not, even smoking has a good side (although not nearly enough to recommend it!).
Here's more on cigarette smoking and other behaviors that may provide surprising benefits.
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Cigarette Smoking and Digestive Health
When I learned about a potential health benefit of cigarette smoking, I was skeptical. But it turns out that people who smoke have a lower incidence of ulcerative colitis, a serious condition marked by inflammation of the lower digestive tract. It often requires immune suppressing medication to control. For example, in a 2006 analysis of prior studies, researchers found that smokers had a 40% lower risk of ulcerative colitis compared with nonsmokers.
It's not clear whether it's the nicotine or some other component of cigarette smoke that might be responsible for the protective effect. However, studies of people with ulcerative colitis treated with nicotine patches suggest it's the nicotine: While wearing the patch, their symptoms improved.
Interestingly, smoking seems to have a different effect on another form of intestinal inflammation, Crohn's disease. In this condition, smoking appears to increase the risk of disease. And, among those who already have the disease, smoking is associated with recurrence.
It's important to emphasize that smoking increases the risk of many other serious health problems, including heart disease, stroke and lung disease, so no one should take up smoking or delay quitting in the hopes of avoiding colitis. In fact, besides a long list of other health problems associated with smoking, certain cancers of the digestive tract are increased by smoking. Still, it's an intriguing observation that could provide useful to the investigation of the cause of ulcerative colitis. At the current time, the cause remains undiscovered.
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Alcohol -- The Case for Moderation
Excessive alcohol ingestion is associated with a long list of health problems, including:
- Liver damage (When severe, it may cause cirrhosis (severe scarring of the liver leading to liver failure.)
- Heart failure
- Breast cancer
Even modest amounts of alcohol can be associated with motor vehicle accidents and risky sexual behavior.
But there's good evidence that people who drink in moderation have a lower risk of cardiovascular disease, including heart attack and stroke, than people who do not drink at all.
Researchers studying a representative sample of the U.S. population surveyed between 1987 and 2000 found a 38% reduction in cardiovascular death among moderate alcohol drinkers compared with nondrinkers. This has led some experts to actually recommend moderate alcohol intake to teetotalers (with a healthy dose of warnings about the risks).
And there may be other health benefits of enjoying alcoholic beverages. A study published in 2010 found that non-drinkers had four times the risk of having rheumatoid arthritis compared with those who drank at least 10 days a month. In addition, among those with rheumatoid arthritis, milder disease was associated with higher intake of alcohol.
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And Then There's Coffee...
It seems that in recent years, studies assessing the health effects of drinking coffee have found little negative impact and a number of health benefits.
For example, studies show lower rates of diabetes, gout and liver disease among regular coffee drinkers. Several groups of researchers have found up to a 60% reduction in the incidence of diabetes among heavy coffee drinkers. An 2007 analysis of prior studies found a 43% reduction in liver cancer among people drinking at least 2 cups of coffee daily compared with nondrinkers. And gout incidence was reduced by nearly 60% among heavy coffee drinkers (more than 6 cups a day) according to a 2007 study.
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Some preliminary data suggest that exposure to hookworms (parasites that live in the human intestinal tract) may lessen the incidence and severity of allergies and other conditions marked by inflammation and an "overactive" immune system. Researchers are taking a hard look at these data. Interest in studying this treatment comes from:
- Claims of cure and dramatic benefits with this approach in recent years
- Reports of a low incidence of asthma and allergies among infected people in underdeveloped countries
- Anecdotal reports of people with debilitating allergies improving when traveling to tropical locations where parasitic infections are common
One theory suggests that people raised in developed countries have had so little exposure to parasites and other infectious or foreign proteins. This causes their immune systems to "overreact" to pollen and other triggers, causing the "allergies" that make life miserable. Another theory is that parasites have figured out how to turn off our immune reactions to them. While this allows them to survive, it may also reduce the immune reaction that we experience as seasonal allergies.
While there is a significant "ick factor" associated with intentionally exposing allergy sufferers to worms, it's reminiscent of using leeches to treat certain wound infections, a practice that has seen a resurgence is recent years.
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The Bottom Line
There are many examples of everyday exposures, habits or foods that have both positive and negative effects on your health. The way they affect you may depend on your genetic makeup, the amount of the exposure or other factors we've yet to discover.
I think it pays to keep an open mind. We may someday learn that a component of cigarette smoke can safely be given to prevent ulcerative colitis in a high risk person or to treat it once it develops.
When I was a kid, I thought medication had to taste bad or else it wouldn't work. The converse also seemed true — if something was unusually fun or tasted exceptionally good, there must be a catch. Yet, there are enough exceptions to this notion to make it a myth. Not only can healthy foods be delicious and healthy habits fun, but some 'bad' habits may have an upside. The trick, of course, is moderation and balance. While I would never suggest smoking to avoid colitis, it does pay to keep an open mind about how to reasonably avoid risk while being prepared to take advantage of unexpected benefits.
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Robert H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.