A Question of Health: When is drinking alcohol good for you?

I often read in the press and hear on the radio that a little alcohol is good for me - does this mean that I should drink small amounts to improve my health? Or am I better off not drinking alcohol at all?

JUST A LITTLE ONE?

I do not drink alcohol of any kind. I gave it up when I could see I was on the way to becoming an alcoholic. I am now 53 and I do not really miss it. I think I drank mainly to impress other people. I often read in the press and hear on the radio that a little alcohol is good for me. Does this mean that I should drink small amounts to improve my health? Or am I better off not drinking alcohol at all?

The health benefits of a small amount of alcohol have been discovered by looking at the life expectancy of a large number of people and comparing this to their alcohol intake. People who drink no alcohol do not seem to live quite as long as people who drink moderately. Heavy drinkers die younger than moderate drinkers. There is no reliable information on the effects of starting drinking in your fifties. My suspicion is that, for you, the health benefits of starting drinking now would be greatly outweighed by your risk of becoming a heavy drinker. If you do start drinking again, you should regularly ask yourself the following four questions:

1. Do you think you should cut down on your drinking?
2. Have people annoyed you by criticising your drinking?
3. Do you ever feel bad or guilty about your drinking?
4. Do you ever have a drink first thing in the morning to steady your nerves?

If the answer to more than one of these is yes, then you are on the slippery slope again, and should stop drinking for ever.

NAILS SEND SOS

For the last 10 years, my fingernails hate winter as much as I do. They flake, split and break. Nail-strengtheners make them worse. They come back to life in the spring, and are strong and healthy in the summer. This year, in spite of far more sun than usual (glorious Greece, fabulous Canadian weather), they are as bad as ever. My GP suggests a villa in the south of France. While I am saving up for this, can you possibly suggest a more practical approach? Even more curiously, why are my toenails strong and happy. Don't they belong to the same family?

You are suffering from onychoschizia, which is the medical term for nails that split. The only clue that you give to a possible cause for your problem is the fact that your toenails are healthy. This suggests that there is some external cause that is specific to your hands. The humidity in centrally heated houses is low in the winter and this may be contributing to the problem. Try to avoid getting the nails wet, as repeated wetting and drying makes this problem worse. You should also avoid acetone-based nail varnish remover, as this has a drying effect as it evaporates. Even if you can't quite afford a villa in the south of France, you might want to consider paying your children or your husband to do the washing-up, as detergents will also make the problem worse. There is a small amount of scientific evidence that suggests that a daily supplement with biotin will help splitting nails. Biotin is a vitamin that is present in many foods and it is also made by bacteria that live in the intestine. True biotin deficiency is rare, although long courses of antibiotics can sometimes kill off the bacteria that produce biotin. You can also become deficient in biotin if you eat too many raw eggs.

CHROMIUM QUANDARY

What is your opinion of chromium 100 mcg as a dietary additive to help the body maintain normal blood-sugar levels? I read about it on a "new products" page of a healthy-living catalogue, which claims that it can affect the possible development of adult-onset diabetes.

There has been quite a lot of research into the role of chromium in diabetes. Chromium is needed to make glucose tolerance factor, which helps to improve the action of insulin. Some studies have shown that chromium supplements help people who already have diabetes. There is no reliable research that shows you are less likely to develop diabetes if you take chromium supplements. One of the difficulties in studying this is that no one knows exactly how much chromium the human body needs. The NHS Direct Online has a website devoted to diabetes. It includes a page of questions and answers about chromium and diabetes. Go to www.nhsdirect.nhs.uk and click on the link to diabetes.

HAVE YOUR SAY

NC writes:

I am astonished that in your answer to the gentleman who has had a couple of blackouts, you did not point out the most important fact of his condition – namely, that if he has a blackout while driving he could easily kill someone. He will not seemingly face this himself, but someone ought to make him do so. My father-in-law had a blackout while driving, and went straight into a brick wall – luckily for him, injuring no one in the process. Is the car so important now that someone's licence (I realise that it is this man's livelihood in question) is of more moment than lives?

LA from Oxford warns about the danger of hidden ingredients:

Please advise the reader who asked about shellfish allergy to be very careful of Thai food. The final ingredient listed on a Thai chicken curry that I purchased from a major supermarket was "shrimp sauce". This resulted in a frightening 24 hours. I have been allergic to shellfish all my life, but unfortunately did not read the small print on the packet until it was too late.

Please send your questions and answers to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax to 020-7005 2182; or e-mail to health@independent.co.uk.

Dr Kavalier regrets that he is unable to respond personally to your questions