The Truth About Alcohol

We get these questions all the time. Is alcohol good or bad for me? Does alcohol cause me to gain weight? How much can I drink? Does it matter what kind of alcohol I drink? Here’s the truth about alcohol…

It depends. How alcohol affects you, your waistline, and your heart depends on your genetics, your eating habits, your gender, and how much and how often you drink.

 A Drink, Defined

The Dietary Guidelines for Americans define one ‘drink’ as 12 ounces of beer, 5 ounces of wine, or 1½ ounces of 80-proof spirits, like vodka or whisky. Each serving delivers about 12 to 14 grams of alcohol.  The U.S. Department of Agriculture and the Dietary Guidelines for Americans recommend no more than one to two drinks per day for men, and no more than one drink per day for women. This is defined as ‘moderate drinking.’

Health Benefits of Alcohol

More than 100 studies show moderate drinking can reduce the risk of heart attack, stroke, vascular disease, sudden cardiac death, and death from all cardiovascular causes by 25 to 40 percent. Moderate amounts of alcohol raise levels of HDL (good) cholesterol, which helps protect against heart disease, improves insulin sensitivity, and helps prevent blood clots which can cause heart attacks and strokes. Studies also show moderate alcohol consumption can also help prevent gallstones and type 2 diabetes.

Your genes and your age impact the benefits of alcohol on your health.

The social and psychological impact of alcohol may also play a role in its health benefits. A drink before a meal can improve digestion.  A drink at the end of a busy day can be relaxing and help to relieve stress. And meeting friends for a drink helps to reinforce connection and community, which has been shown to increase longevity.

Does the Type of Alcohol Matter?

Research suggests that all types of alcohol—wine, beer or spirits—have similar health effects. Red wine may hold an additional benefit, because it contains phytochemicals that help prevent blood clots, relax blood vessel walls, and prevent plaques in arteries.

Alcohol can be Harmful

Heavy drinking (loosely defined as more than four drinks at a time) can be harmful to both your body and your life.  Heavy drinking can cause inflammation and/or scarring of the liver, increase blood pressure and damage heart muscle, and has been linked to cancer of the mouth, pharynx, larynx, esophagus, breast, and colon and rectum in men, and liver, colorectal and breast cancer in women. The risk is multiplied for drinkers who also smoke tobacco.

Women with a family history of breast cancer should consider the risks of a daily drink. Studies show that women who have two or more drinks a day are at higher risk for developing breast cancer. Adequate daily intake of folate (at least 600 micrograms a day) appears to reduce this risk.

Alcohol interacts in potentially dangerous ways with a variety of medications, including acetaminophen, antidepressants, anticonvulsants, painkillers, and sedatives. It can also disrupt sleep.  Alcohol abuse can also wreak havoc on social and family life.  It is addictive, especially for people with a family history of alcoholism.  Obviously, alcohol also clouds judgment. One in three cases of violent crime is related to alcohol and more than 16,000 people die each year in alcohol-related automobile accidents.

Alcohol and Weight

The relationship between alcohol and weight is not entirely clear.

Alcohol does contain calories. However, depending upon our habits and genetics, our bodies may handle those calories differently.  Research suggests moderate drinkers gain less weight and have a smaller waist size than non-drinkers. The Nurses' Health Study found women who drank between two and four drinks a day had a lower body mass index and seemed to eat fewer carbohydrates, particularly in the form of candy, than nondrinkers or heavy drinkers. Some studies suggest that women who drink alcohol eat fewer sweet foods, possibly because alcohol stimulates the same pleasure center in the brain as sweets. The affect doesn’t seem to be the same in men.

Researchers suspect that regular, moderate drinkers (one or two drinks per day) may adjust their metabolism to burn the extra calories from the alcohol without gaining weight. This effect is not seen in those who ‘binge drink’ once or twice a week.

However, studies also show that both men and women make unhealthier food choices when they drink, so beware of the food choices you make with your cocktail.   Also, while the calories from alcohol may or may not contribute to weight gain, the sugar in sweet alcoholic drinks—like a margarita or rum and coke—is metabolized as extra calories.

Recommendations

• There are no one-size-fits-all recommendations for alcohol consumption. Since each person is different, with different medical histories, genetics and habits, the question of whether or not to drink alcohol is individual. If you have a history of alcoholism in your family, you should carefully weigh the risks of drinking.

• If you are unable to drink moderately (one drink per day for women, two for men), the risks outweigh the benefits.

• If you are at risk of heart disease, a daily alcoholic drink could reduce the risk of developing heart disease.

• If you have low HDL (good) cholesterol that won’t increase with diet and exercise, moderate drinking might help to increase HDL cholesterol.

• Ten times more women die each year from heart disease than from breast cancer.  So, if you are at risk for heart disease, the benefits of a daily drink must be balanced against the increase in risk of breast cancer. If you already drink alcohol or plan to begin, keep it moderate—no more than one drink a day—and make sure you get at least 600 micrograms of folate a day.

• If you drink daily, both men and women should make sure they get 600 micrograms of folate per day, either through food or a supplement of folic acid.  Dietary sources of folate include dark greens (like spinach and kale), nuts, beans, peas, dairy products, poultry and meat, eggs

References

The Harvard School of Public Health: http://www.hsph.harvard.edu/nutritionsource/alcohol-full-story/

Journal of the American Medical Association (JAMA) Internal Medicine, Alcohol Consumption, Weight Gain, and Risk of Becoming Overweight in Middle-aged and Older Women: http://archinte.jamanetwork.com/article.aspx?articleid=415737

National Institute of Health Folate Fact Sheet:  http://ods.od.nih.gov/factsheets/Folate-HealthProfessional/