Alcohol – Balancing Risks & Benefits

Humans have been drinking fermented beverages for over 10,000 years and yet, to this day, the debate about its merits and demerits still remains. Alcohol is both a tonic and a poison. There are many scientific studies showing the benefits of alcohol consumption, and at the same time, there are just as many that indicate its health hazards.

What Is Alcohol?

The active ingredient in alcoholic beverages is ethanol which affects the body in many different ways.

• It directly influences the stomach, brain, heart, gallbladder, and liver.
• It affects levels of cholesterol, triglycerides (fats), and insulin in the blood, as well as inflammation and blood clotting.
• It also alters mood, concentration, and coordination.

Whether alcohol is a tonic or a poison depends mostly on the dose. The Dietary Guidelines for Americans recommend those who do drink alcoholic beverages do so in moderation. Moderation means no more than one drink per day for women and two for men. A standard drink is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits. The recommended amount is smaller for women than men because women are usually smaller in size and they have less of an enzyme that helps metabolize alcohol in the body.

Health Hazards Of Heavy Drinking

If all drinkers limit themselves to one drink a day, we probably would not need as many cardiologists, liver specialists, mental health professionals, and substance abuse counselors. However, not everyone who likes to drink can stop at just one. Heavy drinking is the major cause of preventable death in most countries. In the U.S., alcohol is implicated in about half of all fatal traffic accidents. It plays a role in one in three violent crime cases.

• It contributes to depression, violence, and relationship issues.
• It causes inflammation of the liver (alcoholic hepatitis) and leads to scarring of the liver (cirrhosis) which is potentially fatal.
• It increases blood pressure and damages heart muscle (cardiomyopathy).
• It is associated with various forms of cancer such as cancer of the mouth, throat, vocal cord, esophagus (tube that goes from mouth to stomach), breast, liver, colon, and rectum. The risk is multiplied for drinkers who also smoke tobacco.
• It causes fetal alcohol syndrome in an unborn child, including impaired growth and nervous system development.

Who Shouldn’t Drink Alcohol?

People with the following conditions shouldn’t drink any alcohol; even small amounts could cause problems:

• A history of hemorrhagic stroke
• Liver disease
• Pancreatic disease
• Evidence of precancerous changes in the mouth, throat, vocal cord, and esophagus.
• Family history of alcoholism
• Pregnant

Alcohol also interacts with many common prescription and over-the-counter medications:

• Antibiotics
• Anticoagulants (drugs that stop blood from clotting)
• Antidepressants
• Antihistamines
• Anti-seizure medications
• Beta blockers (drugs for managing irregular heart beats, heart attack, and high blood pressure)
• Diabetes medications
• Pain relievers
• Sleeping pills

Also, if you combine alcohol with aspirin, you face an increased risk of gastrointestinal bleeding. If you use alcohol with acetaminophen, you increase your risk of liver damage.

Possible Benefits Of Moderation Drinking

We know for a fact that heavy drinking plays havoc on your health but many studies have shown that moderate alcohol consumption can in fact, reduce the risk of the following diseases:

• Heart attack (clot in coronary artery)
• Ischemic stroke (clot in artery leading to the brain)
• Peripheral vascular disease (narrowing of blood vessels outside the heart and brain)
• Sudden cardiac arrest (sudden loss of heart function, breathing, and consciousness)
• Gallstones
• Type 2 diabetes

In addition, some studies have contributed the benefits of certain components in red wine such as reseveratrol in reducing heart disease risk. Resveratrol has shown to increase HDL(“good”) cholesterol, prevents blood clots, and relaxes blood vessel walls.

Risks of Moderate Drinking

In spite of the above benefits, moderate drinking also carries some risks:

• Alcohol is addictive, especially for people with a family history of alcoholism.
• There is convincing evidence that alcohol increases risk of developing breast cancer. However, studies also show that adequate intake of folate (a B vitamin), at least 600 mg a day, appears to mitigate this increased risk. Folate helps build DNA and is essential for accurate cell division. Alcohol blocks the absorption of folate and hence, increases the risk of breast, colon, and other cancers.
• Alcohol can disrupt sleep. Although alcohol has a sedative effect and help you fall asleep faster, it is metabolized rapidly in your body and it impairs your sleep during the second half of the night. You tend to have shallower sleep and awake more easily. Alcohol is also likely to worsen snoring and sleep apnea (a sleep disorder characterized by pauses in breathing during sleep).

Should You Drink Or Shouldn’t You Drink?

• If you don’t drink, there is no need to start. For a pregnant woman and her unborn child, a recovering alcoholic, a person with liver disease, and people taking medication that interact with alcohol, drinking offers little benefits and substantial risks. There are other risk-free ways to boost your heart health and lower your risk of diabetes, such as becoming more active, maintaining a healthy weight, and eating healthy fats and a variety of vegetables and fruits.
• If you do drink, drink in moderation. There are no conclusive studies that indicate whether wine, beer, or spirits has more health benefits. So choose whatever you like. Moderation is the key – limit to no more than one drink per day for women and two for men. However, bear in mind that having 7 drinks on a Saturday night and then not drinking for the rest of the week is not the same as having one drink a day. Also, make sure you get at least 600 mg of folate a day.
• If you are a woman, it is trickier to balance the benefit and risk. Every year 10 times more women die from heart disease (460,000) than breast cancer (41,000). Therefore, if you are a woman at risk for heart disease, it is possibly beneficial to have a daily drink in spite of the small increase in breast cancer risk. However, studies show that women are far more afraid of developing breast cancer than heart disease, something that must be taken into consideration.