Baby and You

Friends toasting with beer.

Most of us know that heavy drinking is harmful but there’s confusion about whether regular light or moderate drinking is good or bad for your health. Linia Patel discusses how the body deals with alcohol, the possible benefits of alcohol, the negatives of alcohol and tips for sensible drinking

Something to celebrate? Pour some champagne. Bad day? Take the edge off with a glass of wine. Sound familiar? About 90 per cent of UK adults enjoy a drink so understanding the risk and benefits of alcohol is crucial.1 Most of us know that heavy drinking is harmful but there’s confusion about whether regular light or moderate drinking is good or bad for your health. Would quitting alcohol mean a slimmer waistline and a reduced risk of cancer? Or wait, isn’t alcohol good for your heart?

How the body deals with alcohol

Once alcohol is in your system your body makes it a priority to metabolise it. Alcohol in high doses is poisonous and unlike other nutrients, our bodies cannot store it. After consumption the level of alcohol in the blood peaks 45 to 90 minutes later. Your stomach absorbs about 20 per cent. The rest is absorbed by your intestines and passes to your liver where it’s broken down into substances that can be stored or eliminated. A healthy liver takes about an hour to process one unit of alcohol, although this varies from person to person.2

After consumption the level of alcohol in the blood peaks 45 to 90 minutes later

Understanding units of alcohol

Alcoholic drinks come in different strengths and sizes. Recommendations for alcohol intakes are usually based on the number of units.

In the UK one alcohol unit is measured as 10ml or 8g of pure alcohol. This equals:

• One 25ml measure of a standard spirit (*ABV 40%)

• 1/3 of a pint of a stronger ale or lager (*ABV 5-6%)

• 76ml / 1/2 glass of wine (*ABV 12%)

*Alcohol by Volume

UK guidelines recommend that men and women drink no more than 14 units a week on a regular basis. If you regularly drink as much as 14 units a week, spread your drinking over three or more days and ensure you plan alcohol-free days. Drinking more than this is considered “at risk” or “heavy” drinking. Guidelines for alcohol intake are different for certain people including women who are pregnant or trying to become pregnant, breastfeeding women and people with diabetes.3

Possible benefits of alcohol

The biggest benefits of alcohol are seen in cardiovascular health. Light to moderate drinking is linked to a reduced risk of cardiovascular disease, while heavy drinking appears to increase the risk. Possible reasons for the beneficial effects include an increase in your HDL (good cholesterol), a decrease in blood pressure and a lower concentration of substances that contribute to blood clots.  Benefits of moderate alcohol consumption are particularly seen in middle age when heart disease begins to account for an increasingly large share of disease and deaths.4,5,6

The benefits of moderate drinking extend beyond the heart. The Nurses’ Health Study found that Type 2 diabetes and gallstones were less likely to occur in moderate drinkers than in non-drinkers.4 The social and psychological benefits of alcohol also can’t be ignored. The occasional drink can be a real tonic.7

The dark side of alcohol

Alcohol is both a tonic and a poison and the difference lies mostly in the amount you drink. Heavy drinking is bad for health. It can lead to malnutrition, inflammation of the liver and eventually liver cirrhosis which is a fatal disease. There is increasing research showing that even an occasional binge is bad for you. The risks of light to moderate alcohol intake however are less clear.4,6

Some research suggests that any alcohol at all increases the risks of some cancers. One study showed that breast cancer risk increased by six per cent for each 10 grams (slightly more than a unit of alcohol) of alcohol drunk. Alcohol blocks the absorption of folate and it’s thought that this may be the interaction as to how alcohol increases the risk of breast, colon and other cancers. Experts believe that an adequate daily intake of folate of at least 600micrograms reduces this risk.8,9,10

Even a couple of drinks can affect the quality of your sleep because alcohol interferes with rapid eye movement (REM) and deep sleep phases of your sleep cycle. Your body restores itself in deep sleep, however alcohol encourages your body to come out of deep sleep into REM sleep which is easier to wake from.11

Alcohol also affects your appetite. One study showed a 20 per cent increase in calories consumed at a meal when alcohol was drunk beforehand. There was a total caloric increase of 33 per cent when the calories from alcohol were added. Alcohol is rich in energy, packing 7 calories a gram. It also increases production of ghrelin, a hunger hormone that stimulates appetite, particularly for high fat foods. Stimulating your appetite is a recipe for disaster if you’re trying to manage your weight.12

A healthy liver takes about an hour to process one unit of alcohol, although this varies from person to person2

What’s the best drink to have?

There’s been a lot of excitement about compounds found in red wine (resveratrol) being good for you. The theory began with an observation that French people have a relatively low incidence of coronary heart disease despite a diet relatively high in saturated fat. Some animal studies have shown that resveratrol is linked to a longer life and has anti-cancer effects on cells in the lab. The truth for humans is less clear-cut. This ‘French paradox’ may involve several factors including patterns of alcohol consumption and differences in diet, physical activity and lifestyle.13 Drinking lots of red wine does not equal greater health benefits. Heavy drinking causes health problems, regardless of what type you drink.

Mixers and pre-mixed alcoholic drinks are generally made with sugary beverages like juice and fizzy drinks so are high in calories but diet drinks are not the solution. Diet drinks tend to increase the speed alcohol is absorbed yielding higher blood alcohol concentrations than the sugary drinks.14

Your choice of drink, beer or wine, diet mixer or not, matters less than how much you drink or how you drink. Having seven drinks on a Friday night and then not drinking for the rest of the week isn’t the same as having one drink a day. Although the weekly total may be the same, the health implications are not.4

To drink or not to drink?

No-one would deny the enjoyment of the odd glass of wine or a cold beer. Evidence shows some benefits of light to moderate drinking but clearly shows some risks. Currently, it’s not possible to precisely assess the ratio of risk to benefit for each person as this depends on many factors such as age, lifestyle and genetics. It’s possible that the risk to long-term health of drinking low to moderate amounts of alcohol is small. However, health risks of heavier alcohol consumption make it wise to drink within recommended limits.

Sensible drinking

1 If you don’t drink, there’s no need to start.

2 If you do drink, enjoy whatever drink you like but keep within recommended amounts.

3 Have at least a couple of alcohol free days every week.

4 Consider taking a multivitamin with folic acid if you drink regularly and have other risk factors for heart disease or colon and breast cancer.

5 Eat before you drink.

6 Keep water available to quench your thirst while drinking alcoholic beverages. Alternate alcohol with water or non-alcoholic drinks.

AUTHOR BIO
Linia Patel, MSc. Human Nutrition (specialising in Sport Nutrition), BSc. Med Hons. Nutrition & Dietetics and BSc. Biochemistry & Physiology, is a leading dietitian and sports nutritionist with extensive experience in a variety of settings. Her passion is to support people to become their most healthy and high performing selves!

References
1. Health and Social Care Information Centre (2015). Health Survey for England. Trend tables. [Online]. Available from www.hscic.gov.uk
2. Alcohol metabolism. [Online]. http://hams.cc/metabolism/
3. Drinkaware. [Online]. https://www.drinkaware.co.uk/alcohol-facts/alcohol-and-the-law/drink-driving-and-the-legal-alcohol-limit/
4. Alcohol. Balancing the risks and benefits. Nutrition Source. Harvard. [Online] https://www.hsph.harvard.edu/nutritionsource/alcohol-full-story/
5. Holmes M et al. 2014. Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data.BMJ 2014; 349
6. Britton A et al. 2016. Underestimating the Alcohol Content of a Glass of Wine: The Implications for Estimates of Mortality Risk. Alcohol. 2016 Sep;51(5):609-14
7. Churchill S et al. 2016. Persuading People to Drink Less Alcohol: The Role of Message Framing, Temporal Focus and Autonomy. Alcohol. 2016 Nov; 51(6):727-733
8. Cao Y et al. 2015. Light to moderate intake of alcohol, drinking patterns, and risk of cancer: results from two prospective US cohort studies. BMJ 2015; 351
9. Bagnardi V et al.2015. Alcohol Consumption and site specific cancer risk: a comprehensive dose- response meta-analysis. British Journal of Cancer.112. 580 – 593
10. Baglietto L et al.2005. Does dietary folate intake modify effect of alcohol consumption on breast cancer risk? Prospective cohort study. BMJ.331:807.
11. Van Reen et al. 2016. Current Alcohol Use is Associated with Sleep Patterns in First Year College Students. Sleep. 39 (6): 1321-6
12. Gee C. 2006. Does Alcohol stimulate appetite and energy intake. Br J Community Nurse. 11 (7):298-302
13. Booyse F et al 2007. Mechanism by which alcohol and wine polyphenols affect coronary heart disease risk. Ann Epidemiol. 2007; 17:S24–31
14. Wu K et al.  2006. Artificially sweetened versus regular mixers increase gastric emptying and alcohol absorption. Am J Med. 119.(9);802-4
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