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Tuesday, May 29, 2018

August 21, 2018 by Shawn

Is alcohol affecting my health?

Trade offs of consuming alcohol

The evening “unwinder”.  A wine glass that holds the entire bottle.  A few beers out in the garage or around the fire.  Very quickly, the alcohol adds up. This may or may not be a problem.  Can drinking hinder or harm your health and fitness? Should you quit drinking to improve your health? Or change your body composition?  Wait, don’t the headlines say that alcohol is good for you?

Let’s explore it.

Personally, I’ve never needed to quit drinking.  My consumption is low by most accounts, 2-3 drinks per month.  But many folks fall into the “moderate” or “heavy” zone often by accident.

Adult beverages (and their effects) can add up quickly. Maybe a beer after a crappy day at work, Friday night happy hour,  a celebration or holiday over the weekend. A little something to take the edge off and next thing you know, quite a few drinks are consumed.

A brief overview of alcohol metabolism may help. Ethanol is the form or alcohol fit for human consumption. Ethanol is toxic as it produces substantial oxidative stress and provokes an inflammatory response damaging and dysregulating neurons.  Your body metabolizes ethanol into acetaldehyde (which happens to be more toxic than ethanol) so a second metabolic process converts acetaldehyde to acetate which is less toxic. So yes, alcohol is a poison that our body must convert to less-harmful substances for us to enjoy the good buzz.  This conversion is very technical and quite the burden for our physiology to handle.

If we view ourselves as healthy, fit, active, young or “on vacation” alcohol is easy to justify.  We exercise, we eat good food, we have a coach and are working on ourselves. Maybe we tell ourselves we’ve “earned” it.

But let’s ponder for a moment…is denial more than a river in Egypt?  Lite beer isn’t a better choice and resveratrol in wine won’t save your heart.

No I don’t tell my clients not to drink.  First, most of them are adults and deserve the respect to make their own decisions.  I like to review the truths and help my clients align their values and priorities with their goals.  This empowers them to make their own informed choices and feel good about those decisions.

Alcohol will absolutely affect your health, but how much and for better or worse is less clear.  And like most things, it depends, as it is individual to each person. Yes there are studies indicating moderate alcohol intake is associated with lower risk of diabetes, gallstones, and heart disease.  BUT it’s important to note that if you don’t already drink, health experts agree and recommend that you don’t start.

If you are pregnant or breastfeeding a child, it’s recommended you don’t consume alcohol. You don’t see alcohol sitting next to the MyPlate.gov recommendations.  All these statements seem to infer that alcohol may not be associated with eliciting optimum human health.

Most research on alcohol and health effects are large epidemiological studies.  This type of research never proves anything and is straight up terrible science only showing correlations not causations.  Physiological effects caused by alcohol varies from person to person. And what is “moderate” consumption anyway?

The definition of moderate alcohol intake from the US DGAC (United States Dietary Guidelines Committee) means simply “average”.  For women, up to seven drinks per week and no more than 3 drinks on a single day. For men, the numbers are 14 drinks per week and no more than 4 drinks on a single day.  But those numbers don’t account for individual differences such as body size, metabolism, genetics, allergies, family history, sleep status, or any number of factors that will alter the effects of alcohol on you. Both short term and long term.

And because nobody pours their wine into a measuring cup, tallys their weekly drink total, or adjusts their tally to account for the high ABV craft beer, it’s widely accepted that folks often drastically underestimate their alcohol consumption. So yeah, there may be a problem since heavy drinking raises the risk of health problems.

The biochemistry is less important than the core concepts:

We have to change/convert alcohol to tolerate it
Dose matters
Our ability to process alcohol depends on many factors, such as:
Natural individual genetic tolerance
Ethnicity
Body size
Sex
Individual enzymatic properties

So what’s the sweet spot?  Again, it’s completely individual.  But I really like Robb Wolf’s recommendation of “just enough to optimize your love life, but not so much to negatively affect your health.”  The guidelines are experts’ best guess at the amount of alcohol that can be consumed with statistically minimal risk.  It doesn’t mean drinking is risk free.  But drinking can be fun.

Here in our society we often separate physical well-being from our emotional state when really, quality of life, enjoyment and social connections are all important part of the health equation.  So it’s very important to enjoy ourselves and if it takes a drink to loosen up or take the edge off, cool, there are some undeniable potential benefits:

Pleasure
Leisure
Creativity
Social connection

If you choose to drink, drink because you genuinely enjoy the experience.  Drink if it truly adds value and pleasure to your life.  This is opposed to drinking because you’re stressed, it’s a habit, other people are drinking, or you heard it was “good for you”.

Drinking alcohol is about tradeoffs.  Choosing to improve your physical performance might mean saying no drinking at Sunday BBQ’s.  Choosing to improve sleep, mental focus, or mood might mean saying no to wine with dinner. Choosing to improve body composition might mean saying no to the post bike ride pale ale.  Choosing to improve your health might mean saying no to all alcohol for a period of time allowing the body to heal. Choosing to drink once in awhile might help avoid stress triggers (or human stressors).  Maybe you become more aware and drink slower or more mindfully and choose to reduce your total consumption.

Observe your drinking habits and track your consumption for a couple weeks. Review the trends and asses the results.  Decide whether your actions align and support your goals.

Observe your habits
Notice how you feel PHYSICALLY the next day or two after drinking
Notice how you feel EMOTIONALLY the next day or two after drinking

Do you see any bothersome patterns or practices?  This is great information to empower you to make choices that support long-term progress.  Maybe delay your next drink for a short time, say 10 minutes and see if you still want it. Find ways to change any patterns that lead you toward the bar or beer coolers in the store.  Savor your drink. Exchange quantity for quality and only drink the good stuff.

References
Obad A, et al. Alcohol-Mediated Organ Damages: Heart and Brain . Front Pharmacol. (2018)

Schroeder DJ, Collins WE. Effects of congener and noncongener alcoholic beverages on a clinical ataxia test battery . Aviat Space Environ Med. (1979)

Thompson T, et al. Analgesic Effects of Alcohol: A Systematic Review and Meta-Analysis of Controlled Experimental Studies in Healthy Participants . J Pain. (2017)

Armstrong LE, et al. Mild dehydration affects mood in healthy young women . J Nutr. (2012)

Ganio MS, et al. Mild dehydration impairs cognitive performance and mood of men . Br J Nutr. (2011)

van Schrojenstein Lantman M, et al. Total sleep time, alcohol consumption, and the duration and severity of alcohol hangover . Nat Sci Sleep. (2017)

Ebrahim IO, et al. Alcohol and sleep I: effects on normal sleep . Alcohol Clin Exp Res. (2013)

Cederbaum AI. Alcohol metabolism . Clin Liver Dis. (2012)

Jones AW, Jönsson KA, Kechagias S. Effect of high-fat, high-protein, and high-carbohydrate meals on the pharmacokinetics of a small dose of ethanol . Br J Clin Pharmacol. (1997)

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