Your body on booze: Breaking down the good, the bad, and the unknown

The COVID-19 pandemic has taken public health hostage in countless ways.

Most notably, it has sent our stress levels through the roof… and is the root cause our infinite sleepless nights.

As a result, some have turned to alcohol.

In fact, a survey of nearly 6,000 adults found that 29 percent increased their alcohol use, in general, throughout 2020. Not to mention, people with depression were a whopping 64 percent more likely to drink more, and anxiety increased consumption by 41 percent.¹

Of course, these findings aren’t too surprising. People tend to cope with stress and trauma in two ways: Alcohol and food.

But according to some new research, this particular crutch could be sending us to an early grave…

Death by a daily drink?

A recent study from the World Health Organization’s (WHO) International Agency for Cancer Research found links between drinking and a significantly higher risk of numerous cancers. These include breast, colon, and oral cancer.

For the study, researchers combined data from international alcohol surveys with the most recent cancer risk estimates based on drinking levels.

Ultimately, they found that even moderate drinkers (people who consume up to two drinks a day) increased their cancer risk.² In fact, this population made up one in seven new cancer cases in 2020 alone.

Of course, the study authors went so far as to conclude that no amount of alcohol consumption was safe—citing, for example, that every daily glass of wine raises a woman’s risk of breast cancer by six percent.

And another new study, published in the European Heart Journal, found that just one drink a day increased the risk of atrial fibrillation (A-fib)—a dangerously irregular heartbeat—by 16 percent over 14 years.³

But before you gasp, allow me to add in a little more context…

First, it’s important to note that someone who doesn’t drink at all has a four in 100 chance of developing A-fib. With one drink a day, that jumps to five in 100. So we aren’t exactly talking big numbers here.

Not only that, but both of these studies are population-based, not controlled clinical trials. So the associations are just that—associations. And not especially clear ones, either.

In fact, plenty of existing research shows that drinking a moderate amount of alcohol is actually good for your health. So let’s take a quick look at the other side of this story…

The health-boosting benefits of moderation

More than 100 different studies show that moderate drinking can lower risk of heart attack, stroke, vascular diseases, sudden cardiac arrest, and death by any cardiovascular cause by as much as 40 percent.⁴

This connection is evident in both men and women—and in people who don’t have heart disease as well as people at high risk for heart attacks, stroke, and heart disease death. The benefit also appears to extend to people with high blood pressure, existing heart disease, and diabetes.

In addition, one research review featuring nearly 370,000 subjects showed that moderate drinking—from half a drink to four drinks daily—lowered risk of type 2 diabetes by 30 percent. Researchers also found that there was no protective effect among subjects who drank less or more than that daily amount.⁵

In other words, obviously, alcohol consumption is a tricky subject. And I’m not here to whole-heartedly defend booze. There are obvious risks, after all.

But while we can all agree that junk food and cigarettes, for example, are harmful to your health, with alcohol, the mechanisms just aren’t as clear…

Sure, there are some things we do know—like the fact that alcohol easily permeates cells where it becomes acetaldehyde. (That’s precisely what causes hangovers.) Acetaldehyde is known to damage DNA and cause cancer. So it’s not hard to put two and two together here.

Plus, heavy drinking comes with plenty of other well-documented risks. It’s a prime cause of fatty liver disease, for one—not to mention full-fledged cirrhosis and liver failure. All of which are very serious health threats, particularly if you’re overweight, obese, or struggling with blood sugar control.

There’s also the fact that alcohol disrupts hormones in large quantities. This, in turn, interferes with glucose metabolism and bone turnover processes, promotes adrenal burnout and disrupts sleep, and creates an estrogen-dominant environment (which is equally dangerous to both men and women).

All of this can—and will—add up to a perfect storm for chronic disease.

But given the mixed evidence—only some of which I’ve outlined here—I just don’t feel comfortable advising anyone that they need to give up alcohol entirely. In fact, in my opinion, this issue deserves a much more balanced approach…

How much is too much?

First and foremost, when it comes to the “right” amount of alcohol intake, we still don’t have a definitive answer.

Several studies have shown a slightly higher risk of heart problems for people who never drink alcohol—a risk that lowers with moderate drinking, yet skyrockets with high consumption.

And this is exactly what I learned in medical school: Alcohol gives you a J-shaped curve.  Too little and too much increases heart risk… but there’s a sweet spot in the middle where heart risk falls.

Of course, we’re still debating over where that sweet spot falls.

Part of the problem is that definitions of “moderate” drinking vary so widely, and from country to country. What constitutes one drink? And what, exactly, is considered “heavy” drinking?

It’s not just you and I trying to figure out those terms, either. Researchers themselves can’t even seem to agree: In some, “moderate” means less than a single drink per day, while in others, it means three to four drinks daily.

Then there’s the issue of drink size: In the U.S., a single drink usually refers to 12 ounces of beer, five ounces of wine, or 1.5 ounces of hard liquor. But in the age of microbrews, you’ll find a lot of variation among liquor content, making it nearly impossible to accurately measure across studies.

It’s also true that none of the studies I mentioned here made any distinction between different types of alcohol. Though what you drink doesn’t seem to be as important as how you drink. And by that, I don’t just mean how much you drink, overall.

For example, having seven drinks on a Saturday night and then not drinking the rest of the week isn’t at all the equivalent of having a single drink a day. If you want to have a meaningful impact on your heart health, you have to spread consumption out over time.

That said, there’s a huge difference in sugar content between popular drinks like beer, wine, champagne, margaritas, and whiskey sours—and a simple dry gin martini or vodka and club soda with a twist of lime.

Because while I’m not prepared to say that light or moderate drinking kills, you know my stance on sugar… that it most certainly does. So with that in mind, let me offer my own personal guidelines for responsible drinking—during the age of coronavirus, and beyond.

Five strategies for safer drinking

When it comes alcohol, I have five rules of thumb for maximizing the benefits, while minimizing its most serious risks:

1.) Stick with spirits. As I said, the dangers of alcohol may be up for debate—but the lethal effects of sugar are not. Clear alcohols and sugar-free mixers (like club soda) are best. Meanwhile, beer, wine, champagne, and any cocktail that uses juices, sugar-sweetened sodas, or simple syrups all deserve a hard pass in my book.

2.) Take your B vitamins. Alcohol depletes your body’s B vitamin supply, which also hampers your ability to detox naturally. This contributes to the buildup of dangerous acetaldehyde, and it’s one reason why a few too many drinks can leave you wincing the next morning.

Help keep your bases covered by taking B vitamins. I recommend a B100 complex, at the very least. You can also take 2,000 mcg of B12, 5 mg of folic acid, and 100 mg of B6 daily. (And remember to drink plenty of water to stay hydrated.)

3.) Call it quits after two. Even if your cocktails aren’t filled with sugar, your body still puts everything on hold to metabolize alcohol first. So stopping at two drinks is just plain good sense, which will help minimize metabolic and sleep disruptions. In other words, if you’re feeling “buzzed”, you’ve had more than enough.

4.) Engage in exercise. If you’re still worried about the health risks of drinking, you should know that research suggests that the effects appear to be largely reversible… simply with regular exercise (to the tune of about 35 minutes of brisk walking per day).

In fact, one study showed that subjects who drank moderately but also exercised had as much as a 20 percent lower risk of death compared to teetotalers.⁶ And since I always recommend regular movement, hopefully, regular exercise is something you’re already in the habit of doing—whether or not you’re indulging in alcohol.

5.) Build in some breaks. While I’m not suggesting that you abstain from alcohol completely, it is important to be mindful of your intake—not just to protect your health, but to protect your judgment, too.

In general, men should limit themselves to 210 milliliters of alcohol per week (no more than 40 mL at once). Women should stick to 140 mL per week (no more than 30 mL at once). Aim to get at least two alcohol-free days per week.

It’s no lie that we’re all struggling through a year of turmoil. And for some, alcohol helps escape pandemic perils. Perhaps it helps you to relax and fall asleep. Or maybe you use it as a way to remain social. No matter what, the bottom line is this…

It’s important to understand the adverse health risks associated with consistent overindulgence. But moderate (or light) alcohol consumption may offer protective benefits. In other words, use common sense when it comes to alcohol use and your health. And remember to be open and honest with your healthcare practitioner about your consumption habits, too.

References:  

1. CapassoA, et al. “Increased alcohol use during the COVID-19 pandemic: The effect of mental health and age in a cross-sectional sample of social media users in the U.S.” Preventive Medicine, 2021; 106422. 
2. RumgayH, et al. Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study.” Lancet Oncology, 2021 DOI: 10.1016/S1470-2045(21)00279-5 
3. CsengeriD, et al. “Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes.” European Heart Journal, 2021; DOI: 10.1093/eurheartj/ehaa953 
4. Goldberg IJ,et al.“Wine and your heart: a science advisory for healthcare professionals from the Nutrition Committee, Council on Epidemiology and Prevention, and Council on Cardiovascular Nursing of the American Heart Association.” Circulation. 2001 Jan 23;103(3):472-5. 
5. Koppes LL,et al. “Moderate alcohol consumption lowers the risk of type 2 diabetes: a meta-analysis of prospective observational studies.” Diabetes Care. 2005 Mar 1;28(3):719-25. 
6. Perreault K, et al. “Does physical activity moderate the association between alcohol drinking and all-cause, cancer and cardiovascular diseases mortality? A pooled analysis of eight British population cohorts.” Br J Sports Med. 2016 Aug 31