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Tuesday
Mar172015

Is Drinking Alcohol Healthy?

Although not everyone partakes, two-thirds of Americans drink alcohol. Those who drink average four drinks per week. 

We've all seen the headlines suggesting moderate alcohol consumption can aid heart health in particular. But is this all we need to know?

What are the real health benefits, and and what are the lesser disclosed drawbacks? 

When we know the full picture, we can make the best choice whether we'll choose to imbibe or abstain.

Before we explore the pros and cons of alcohol consumption, an important point to consider is a person's individual relationship with alcohol. Like any other food, if you need it in order to feel good, it could become more of a psychological issue than a physiological one. If you were told you should stop consuming alcohol, would you want to argue the point? Would you become defensive or feel “I could never do that?”

If there are certain foods or alcoholic beverages you feel you’d have a hard time giving up indefinitely, you may have more of a psychological dependence on them than you realize. While that issue is beyond the scope of this article, it's a critical point to weigh. As you read through the pros and cons, if you find yourself ignoring the negatives and only holding onto the benefits of alcohol, you may want to assess your relationship to alcohol. 

Health Benefits of Alcohol

In his best-selling book, Blue Zones, Dan Beuttner highlights several cultures where alcohol consumption is a regular part of each day. In these "blue zones," people tend to live much longer than people in other cultures around the globe. It’s just one of the many associations seen in these particular cultures. There are other practices common among them, such as higher levels of activity, lower levels of stress, less reliance on modern technology and shorter work weeks. Regular consumption of low to moderate amounts of alcohol, especially wine, is a common practice among these groups.

Heart Health

Research on alcohol and cardiovascular disease shows a strong association between alcohol consumption and less development of cardiovascular disease (CVD). Those who drink low to moderate amounts of alcohol appear to have a 20-40% lower chance of developing CVD.

Is it that those who drink are able to lower stress levels better? Is it the antioxidants found in some alcoholic beverages? To date, there is no research showing that drinking alcohol causes less CVD. Current research only shows an association. Associations show a couple things happen together, but associations never prove one causes the other. Other research is required to show causation.

Some alcoholic beverages may lead to some reduction in CVD (mixed drinks are another story), but red wine has the most support. Resveratrol is a powerful phytonutrient found in red wine that may provide additional heart health benefits beyond the alcohol itself. Red wine also has other antioxidants which may provide some benefit.

Alcohol is also a vasodilator, meaning it helps to increase the size of blood vessels, which can provide some short-term benefit in terms of blood pressure and vascular function.

While regular consumption of light to moderate amounts of alcohol may benefit the cardiovascular system, irregular (weekly or monthly) high level ("binge") drinking increases the risk of cardiac events and other causes of death. This means having four or five drinks on a weekend night poses a serious risk, so you shouldn't "save up" your drink "quota" throughout the week and binge just once a week. If it fits with your lifestyle and nutrition program, a small amount with one meal on a daily basis could be beneficial, but if you’re more into weekend heavy drinking (even if it’s just once a week) you could be asking for trouble.

Reduced Diabetes Risk

Observational studies, like the Nurses Health Study, suggest low to moderate amounts of alcohol may reduce the risk of developing diabetes. Unfortunately, these studies can only say there is an association between those who regularly drink low to moderate levels of alcohol and the development of type 2 diabetes. As we’ll see below, drinking can begin to raise blood sugar levels, which would contradict this finding.

Detrimental Effects of Alcohol

Though there appears to be a reasonable number of associated health benefits in low to moderate alcohol consumption, we can’t forget that alcohol is a toxin. As such, the liver carries the burden in metabolizing it. Individuals vary greatly in their ability to process alcohol, which is why some people can drink far more than others without seeming to be affected. This also shows the importance of being aware of other toxins you’re exposed to while consuming alcohol. Even mixing over-the-counter medications with alcohol can put a significant burden on the liver and other organs.

Effects on Appetite

People don’t realize the profound effect alcohol has on what they eat. It's not uncommon for health conscious individuals to eat well most of the week but on weekends (once drinking begins) see their good habits go out the window. Part of the reason for this is alcohol stimulates the release of ghrelin, a hormone that increases appetite (I always remember it by “ghrelin” sounding like a “growling stomach”). As appetite increases, so does food consumption.

Since alcohol also impairs peoples’ judgment, they end up eating foods they would not otherwise consume. In a matter of hours, they’ve loaded up on highly processed, low-quality foods without realizing it. If you’re dining out, you're better off drinking water, tea or club soda at the beginning of the meal. If you choose to have a drink, do so with your meal rather than before it. For those trying to lose weight or body fat, drinking alcohol can be a huge roadblock to their success. 

Effects on Physical Performance

Alcohol consumption negatively affects performance in a number of ways. First, it reduces calcium function in muscle contraction, which reduces strength (not that most people would drink just before a training session or event). It also lowers hydration levels and impairs the ability to maintain body temperature.

Each gram of alcohol consumed leads to production of 10 mL of urine. As mentioned above, it also causes vasodilation. This is seen as a potential benefit in terms of heart health, but it can also lead to an increase in fluid loss.

The effects of fluid loss might be most obvious the morning after a night of drinking to excess. As the body becomes more and more dehydrated, it can changes the fluid levels in the skull. When the tissues inside the skull become dehydrated, it shrinks in size and the tissue attached to the inside of the skull gets tighter, which causes the painful feeling of a headache.

Alcohol also disrupts the body’s ability to regulate core temperature. If it can’t maintain an optimal internal temperature, cooling itself in heat or warming itself in cold, performance drops.

A major goal of post-exercise recovery is to increase protein synthesis. Simply put, increased protein synthesis means creation of new muscle. Alcohol reduces protein synthesis, and the more one drinks, the less protein synthesis they’re able to achieve.

Unfortunately, people often see gifted, professional athletes in the news making poor decisions involving alcohol consumption and assume if they can drink and perform as well as they do, that it’s okay to drink. A better way to look at it is to wonder how much better they’d be if they refrained from drinking.

Blood Sugar Regulation

Alcohol can disrupt the body’s ability to maintain ideal blood glucose levels.  In the short-term, drinking can cause hypoglycemia or low blood sugar. Consuming high doses of alcohol also shuts down the muscles' ability to store glycogen (or carbohydrate) as efficiently as it should. When alcohol is consumed with a high-carbohydrate meal, insulin secretion can be exaggerated, which drives blood sugar levels lower than they should be. If an individual drinks heavily on a periodic basis, it’s possible their fasting blood sugar levels could rise.

Sleep

Though many people think drinking helps with sleep, research doesn’t support this. Those who drink a light to moderate amount on a daily basis seem to adapt to the effects of alcohol over time. On the other hand, those who drink on a more periodic basis are more likely to have disrupted sleep following alcohol consumption. They may fall asleep quickly, but the quality of sleep will be worsened, especially by a reduction in REM sleep. Personally, I've noticed that a glass of wine at night won't change the total time I sleep, but measures have shown that it does reduce the time I spend in REM and deep sleep.

Hormones

Even though some people may adapt over time to regular alcohol consumption and attain the normal sleep stages, their release of hormones does not adapt. Whether an individual drinks periodically or regularly, hormone production is negatively affected. Alcohol consumption, especially in the evening, has a negative effect on growth hormone production. Growth hormone production peaks early in the night following the onset of sleep. Alcohol consumption lowers growth hormone production in a dose-dependent way. As more alcohol is consumed, growth hormone is suppressed even more. Growth hormone is important for physical recovery, fat metabolism, cortisol regulation and development or maintenance of lean body mass.

Breast Cancer

Alcohol consumption in women is associated with an increased risk in the development of breast cancer. This association has been shown to be dose-dependent, meaning breast cancer risk increases with increasing levels of alcohol consumption. One drink per day is associated with a 10% increased risk of the cancer. For each additional drink, risk has been shown to increase by 12%. There are a few possible ways alcohol could contribute to the development of breast cancer. It has been shown to increase estrogen levels, could be carcinogenic and could lead to nutrient deficiencies.

Other Issues with Alcohol Consumption

Since alcohol is a vasodilator, it increases the size of blood vessels, which can lower blood pressure in the short-term. However, over the long-term, the consumption of alcohol seems to increase blood pressure. If additional research proves that point, it would mean regular alcohol consumption could increase one of the most significant risk factors for cardiovascular problems.

As mentioned above, the liver bears much of the burden of alcohol metabolism. Compared to those who never drink alcohol, light drinkers (<20 g/d for women, <40 g/d for men) are 1.45 times more likely to develop liver cancer. Moderate drinkers (20-40 g/d for women, 40-60 g/d for men) and heavy drinkers (>40 g/d for women, >60 g/d for men) are 3.03 and 3.6 times more likely to develop liver cancer, respectively.

The metabolism of alcohol has been shown to disrupt the metabolism of vitamin A. Heavy drinkers may develop severe deficiencies, which can lead to a number of problems, including a decreased ability to see in the dark.

Alcohol also causes a reduction in the body’s stores of magnesium, a mineral critical to brain, muscle, liver and vascular function. Magnesium is already a common deficiency for the population as a whole, but in regular or binge drinkers, it can be even more severe.

How much should I drink?

The majority of benefits from alcohol are seen at a drink per day in women and up to two drinks in men. Classifying a “drink” can be as difficult as understanding how much a “cup of coffee” is as well. According to the USDA, a 12-ounce serving of beer has an average of 13.9 grams of alcohol, a 5-ounce serving of wine contains 15.4 grams of alcohol and a 1.5 ounce serving of 80 proof liquor has 14 grams of alcohol. Since alcohol concentration can vary among brands and types of alcohol, the amount found in a serving can vary.

Daily "limit" recommendations vary, but most suggest for women up to 20 grams per day, and men, up to 40 grams per day of alcohol as potentially beneficial for heart health.

Again, you have to ask whether the potential heart health benefits will outweigh the potential risks in other areas?

For heavier drinkers, there’s no doubt that cutting back is a good idea. For those who rarely or never drink it would be hard to justify drinking daily. There’s some evidence drinking can be beneficial in small amounts, but there needs to be more research done to see if alcohol actually causes these benefits, and if so, if those benefits outweigh the negatives alcohol has been shown to cause.

Also, to be clear, if a drink or two a day is associated with some health benefits, you cannot save those up during the week and have seven to fourteen drinks on Friday and Saturday.

Personally, the more awareness I've gained around how I feel from various food and drinks, the less appealing alcohol has become. If you find you can maintain great health and and optimal body fat levels while having a drink or two, feel free. If you're not happy with where you're at, consider dropping the drinking for a while. From personal experience, I saw dramatic changes in body fat levels with clients I trained when they stopped drinking. You don't need to drink to be healthy. If you need to drink to be happy, you may find  alcohol is hampering both your physical and mental health.

If you'd like more information about alcohol and the role it should play in your healthy way of eating, talk with a dietitian today. Thanks for reading, everyone.

Written by Tom Nikkola – Former Director of Nutrition & Weight Management 

This article is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations in this and other articles is at the choice and risk of the reader.

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