Should you put down that drink? Yea, probably

Image Credit above: John Arano, via Unsplash

Approximately 10-minute Read

When I quit drinking 21 years ago, it wasn’t because I was worried for my physical health. It was because I was loaded on a Wednesday and hit my garage while trying to park my car. So, I figured it would benefit my life to ease up a bit.

This post isn’t about the effects of alcohol on our lives, relationships, and garages.

It’s about the effect of alcohol on our bodies and health.

Let’s first dive into the effects alcohol can have on our bodies, then wrap up with the definitions of a “drink” as well as the definitions for types of “drinkers” and types of “drinking.”

Spoiler alert: you’re probably a heavier drinker than you thought.

Benefits of Alcohol on Health

So you don’t get scared off, let’s start with the benefits! Any benefits come from “light drinking” or “moderate” drinking. However, “moderate drinking” [1 drink/day for females and 2 drinks/day for males] can also cause harm.

Once you read this post, you’ll have to figure out the best balance for your lifestyle.

• Beneficial to the gut

  • Recent research by Tim Spector shows that consuming red wine can improve gut health.

  • Spector and others studied both the food/drink habits AND gut bacteria diversity of 1,000 female twins, and found that drinking red wine was linked with an increase in gut bacteria diversity. White wine drinkers and drinkers of other types of alcohol did not experience the same benefits as red wine drinkers.

  • Red wine drinkers also had lower levels of obesity and LDL cholesterol (popularly known as “bad” cholesterol).

  • The benefits of red wine are theorized to stem from polyphenols - naturally occurring compounds in plants that are associated with health benefits

  • This study was an observational study, so it can only show “associations,” not “causality.” Still interesting tho, and makes me wish I’d been drinking red wine instead of vodka all those years!

• Beneficial to the heart, or not?! (2)

  • Large prospective cohort studies* have shown that “light” to “moderate” drinking are linked with a reduced risk of heart attack, stroke, heart disease, etc. These benefits are not seen in heavy drinkers or abstainers.

  • HOWEVER, a recently published study (March of 2022) indicates that it may not be the alcohol protecting the heart, but the associated lifestyle factors common among “light” to “moderate” drinkers! The study also indicated that EVERYONE can benefit from reducing their alcohol intake, but the beneficial effects are especially important when heavier drinkers reduce their intake (3)

    • Don’t let new studies discourage you from trusting in science, because science builds on itself, and this study is not only using new technology but also new methodology.

• Other Benefits

  • Reduced risk for developing gallstones, diabetes, and osteoporosis. This beneficial effect was - again - found only for moderate drinkers, not heavy drinkers or abstainers.

  • Red wine after a meal can reduce blood sugar spikes

  • Keep This In Mind: Protective effects begin to disappear with age, and also disappear when moderate drinking is mixed with bouts of heavy drinking

• Race Differences

  • The study, “Black-White Differences in the Relationship Between Alcohol Drinking Patterns and Mortality Among US Men and Women,” from 2015 shows that the beneficial effects of moderate alcohol consumption may not extend to Blacks.

  • Among White men and women, moderate drinking most days of the week was associated with the lowest mortality (death) risk. However, Black men and women with similar drinking patterns, did NOT have the same risk reduction.

  • The different findings between race and gender in this study show that heart-health effects of moderate alcohol consumption may not benefit Black men and women. The authors believe further research is needed in this area to understand whether the effects are different for people of African ancestry, or if different lifestyle characteristics play a role. I plan to dig deeper into this and see what research has occurred on this topic since 2015. (4)

Negative Effects on Health

Alcohol consumption, especially heavy drinking, is associated with a variety of negative outcomes, including:

• Obesity

• Malnutrition

• Arthritis

• Bone loss

• Heart disease

• Fetal alcohol syndrome

• Kidney disease

• Liver disease

• Nerve disorders

• Depression and anxiety

Personally, I’m most interested in the association between alcohol use and cancer, brain health, and mortality.

Cancer (5):

• Until I took a course in the Foundations of Nutrition Science, I had no clue that alcohol consumption was associated with cancer!

  • The International Agency for Research on Cancer (IARC) classified alcohol as a class 1 carcinogen (meaning it causes cancer in humans).

  • Alcohol consumption is linked with the following types of cancers:

There is a strong “dose-response association” between alcohol use and cancer. Basically, what this means is that the more you drink regularly over time, the higher your risk of developing alcohol-associated cancer becomes. (ibid)

For accurate and reliable information on what does and does not cause cancer, check out this easy to understand Cancer FactFinder . This site identifies whether certain cancer-causing “claims” are “myth” or “fact.”

Brain Health:

• The University of Pennsylvania released a study that showed that even moderate drinking can reduce brain size. (6)

• Going from 0 drinks/day to 1 drink/day was not associated with a reduction in brain volume, but going from 1 drink/day to 2 - 3 drinks/day WAS associated with reduced brain volume:

  “To give a sense of the impact, the researchers compared the reductions in brain size linked with drinking to those that occur with aging. Based on their modeling, each additional alcohol unit consumed per day was reflected in a greater aging effect in the brain. While going from zero to a daily average of one alcohol unit was associated with the equivalent of a half a year of aging, the difference between zero and four drinks was more than 10 years of aging.”

• Really be aware of your alcohol intake, and assess it, then consider reducing your drinking to protect your brain. If you think about it, our brain is our personality, so you don’t want to muck it up.

Mortality

Alcohol related deaths are increasing - and they’ve been increasing even prior to the Covid-19 pandemic. A study, “Using Death Certificates to Explore Changes in Alcohol-Related Mortality in the United States 1999-2017,” was published in January of 2020 and showed the following trend in steadily increasing alcohol-related deaths:

• The number of death certificates that mentioned “alcohol” doubled from 36,000 in 1999 to 72,000 in 2017. (7)

• Nearly 1 million people died from reported alcohol-related causes between 1999 and 2017 (ibid)

• Alcohol-related deaths accounted for 2.6% of all U.S. deaths in 2017 (ibid) (by 2020, this percentage increased to 3.0%)

• “Alcohol is not a benign substance, and there are many ways it can contribute to mortality,” says NIAAA Director Dr. George F. Koob. “The current findings suggest that alcohol-related deaths involving injuries, overdoses, and chronic diseases are increasing across a wide swath of the population. The report is a wakeup call to the growing threat alcohol poses to public health.” (ibid)

Bearing in mind that alcohol can often go underreported on death certificates, these numbers could likely be even higher than we know.

Alcohol & the Covid-19 Pandemic

The stress and isolation of the Covid-19 pandemic was anecdotally believed to worsen the connection between alcohol and death, and that was supported in a recently published study titled “Alcohol Related Deaths During the Covid-19 Pandemic.” (8)

• The number and rate of alcohol-related deaths increased approximately 25% between 2019 and 2020. TWENTY-FIVE PERCENT!

• Prior to the pandemic, rates increased at about a 2.2% change annually.  

• The number of deaths involving alcohol increased from 78,927 in 2019 to 99,017 in 2020 (the first year of the Covid-19 pandemic) (ibid)

• But what about Covid? You may be thinking “well how many of those 99,017 deaths were actually due to Covid?” Here’s the answer given by the researchers:

  • Of the 99,017 death certificates, only 2,042 death certificates listed alcohol AND Covid-19 as causes. Thus, only a small proportion of the increase was related to Covid-19 directly.

Graph above is from the “Alcohol-Related Deaths” study.

———

Okay, so now we know that “heavy drinking” and sometimes “moderate drinking” can have detrimental effects on the body. But how many drinks constitute “heavy” or “moderate” drinking, and just how much alcohol is in a “drink” anyway?

Let’s dig in!

What’s a drink?

• The US government and researchers define “one drink” as:

  • 5 ounces of wine (likely this is much less than the standard pour at your favorite bar or restaurant)

  • 12 ounces of beer (this is usually the size of a can or bottle of beer, but if you purchase a pint at your local bar, then you’ve added a few ounces!)

  • 1-1/2 ounces of liquor (80 proof whiskey, scotch, rum, vodka) - when you order a “double,” you’re basically ordering two drinks

The gap between what is defined as a “drink” and what most people actually drink is likely wide. 

How to Drink

The U.S. Dietary Guidelines for Americans (2020-2025) recommends:

• Males:** no more than 2 drinks/day 🍷🍷

• Females: no more than 1 drink/day 🍷

However, the 2020 Guidelines Scientific Advisory Committee recommended an update to the Guidelines regarding alcohol:

• Males: no more than 1 drink/day 🍷

• Females: no more than 1 drink/day 🍷

  This recommendation was not heeded by the government. (To learn about more of the recommendations made by the Scientific Advisory Committee, check out my earlier post)

A caveat to the Guidelines for alcohol is frequency:

• 1 to 2 drinks/day for males is fine BUT

• 7 drinks on a Saturday night after a string of dry weekdays is NOT

• The former is considered moderate drinking and the latter is considered binge drinking.

Types of Drinkers

The CDC has more categories for drinkers than punk music has genres!

• Lifetime abstainer: Fewer than 12 drinks in a lifetime

• Former infrequent drinker: Fewer than 12 drinks in any year & no drinks in past year.

• Former regular drinker: At least 12 drinks in any one year in lifetime, but no drinks in past year. (That’s me!)

• Current infrequent drinker: One to 11 drinks in past year.

• Current light drinker: At least 12 drinks in the past year, but 3 drinks or fewer per week, on average over the past year.

• Current moderate drinker:

  • Females: More than 3 drinks, but no more than 7 drinks/week, on average

  • Males: More than 3 drinks but no more than 14 drinks/week, on average

• Current heavy drinker:

  • Females: More than 7 drinks/week, on average.

  • Males: More than 14 drinks/week for men, on average.

So, after a thoughtful and honest assessment, just what type of drinker are you, reader?

Types of Drinking

Binge Drinking (CDC definition):

• Females: More than 4 drinks on one occasion in the past 30 days. 🍷🍷🍷🍷

• Males: More than 5 drinks on one occasion in the past 30 days. 🍷🍷🍷🍷🍷

• NOTE: “One occasion” is considered to be approximately 2 hours.

Image credit: Jonah Brown via Unsplash

Heavy Drinking (CDC):

• Females: More than 4 drinks in a single day 🍷🍷🍷🍷

• Males: More than 5 drinks in a single day 🍷🍷🍷🍷🍷

Heavy Drinking (National Institute on Alcohol Abuse & Alcoholism - NIAAA)

• Females: More than 3 drinks/day or 7 drinks/week 🍷🍷🍷/day

• Males: More than 4 drinks/day or 14 drinks/week 🍷🍷🍷🍷/day

So if most of us aren’t considered heavy drinkers now, we sure probably were in the past!

—————

Phew! We covered a lot of ground, or bar counter if you will, and now it’s time for you to decide what this all means for you.

Is there a risk that your health could be negatively impacted by your drinking?

Are you surprised at how the amount you drink correlates with the potential for acquiring a chronic disease?

I like to think of life as a science experiment. We can gather data on our lifestyles, assess, and make any desired changes. I encourage people to gather data on their food, sleep, exercise, mood, AND alcohol.

It’s usually easier to track drinking than it is food, because we often find ourselves eating throughout the entire day, unlike drinking where we are usually drinking for short periods of time.

Thus, your alcohol data gathering should be even easier!

So keep a log of how you much you drink then cross-reference it to the CDC’s definitions for drinks/drinking.

Are you a:

• light drinker?

• moderate drinker?

• heavy drinker?

  I’m not qualified to offer advice on how to reduce your drinking. But if, after reading this post and keeping a drinking log, you’d like to reduce your alcohol intake, then find a qualified alcohol counselor or a supportive group.

  And as they say in Spanish, Salud! (in moderation)

  💲 Do you enjoy the nutrition tips I provide you? Then please consider leaving me a tip! Your generosity will be greatly appreciated, and you know I won’t spend it on alcohol ha!
  

* studies that follow a large group of people who are alike in many ways but differ in a certain behavior or characteristic, and are then compared for specific outcomes. ie a group of female nurses followed for 12 years and then assessed for heart outcomes based on their alcohol consumption)
** note, the cdc and guidelines uses “men” and “women” but i’m using the sex terminology ratehr than the gender terminology

Endnotes & Resources

(1) Roy, Caroline Le, and Tim Spector. “Why a Glass of Red Wine Is Good for Your Gut.” The Conversation. Accessed April 29, 2022. http://theconversation.com/why-a-glass-of-red-wine-is-good-for-your-gut-122072.

(2) Boston, 677 Huntington Avenue, and Ma 02115 +1495‑1000. “Alcohol: Balancing Risks and Benefits.” The Nutrition Source, September 18, 2012. https://www.hsph.harvard.edu/nutritionsource/healthy-drinks/drinks-to-consume-in-moderation/alcohol-full-story/.

(3) News, Tracy Hampton MGH, and Public Affairs. “Alcohol May Not Benefit the Heart, Researchers Say.” Harvard Gazette (blog), March 25, 2022. https://news.harvard.edu/gazette/story/2022/03/alcohol-may-not-benefit-the-heart-researchers-say/.

(4) Boston, 677 Huntington Avenue, and Ma 02115 +1495‑1000. “Blacks May Not Receive Same Health Benefits from Moderate Alcohol Drinking as Whites.” News, April 23, 2015. https://www.hsph.harvard.edu/news/press-releases/blacks-may-not-receive-same-health-benefits-from-moderate-alcohol-drinking-as-whites/.

(5) admin. “Alcohol - Cancer FactFinder,” March 15, 2022. https://cancerfactfinder.org/diet-nutrition/alcohol/.

(6) Penn Today. “One Alcoholic Drink a Day Linked with Reduced Brain Size.” Accessed April 29, 2022. https://penntoday.upenn.edu/news/one-alcoholic-drink-day-linked-reduced-brain-size.

(7) National Institutes of Health (NIH). “Alcohol-Related Deaths Increasing Nationwide,” January 24, 2020. https://www.nih.gov/news-events/nih-research-matters/alcohol-related-deaths-increasing-nationwide.

(8) White, Aaron M., I-Jen P. Castle, Patricia A. Powell, Ralph W. Hingson, and George F. Koob. “Alcohol-Related Deaths During the COVID-19 Pandemic.” JAMA, March 18, 2022. https://doi.org/10.1001/jama.2022.4308.

“ZOE Podcast: Alcohol — Can It Ever Be Healthy?” Accessed April 29, 2022. https://joinzoe.com/learn/podcast-alcohol.

Biddinger, Kiran J., Connor A. Emdin, Mary E. Haas, Minxian Wang, George Hindy, Patrick T. Ellinor, Sekar Kathiresan, Amit V. Khera, and Krishna G. Aragam. “Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease.” JAMA Network Open 5, no. 3 (March 25, 2022): e223849. https://doi.org/10.1001/jamanetworkopen.2022.3849.