Alcohol – It’s good for you!! Right?
With the Holidays, alcohol seems like an appropriate topic for my next blog!
In this blog, I plan to address the health benefits of alcohol in moderation. But I also want to call to mind the dangers of excessive drinking, lest we forget.
In order to distinguish moderate drinking from excessive drinking, refer to the chart below. When looking at moderation, keep in mind that the allowance doesn’t transfer to the next day. In other words, you can’t “save” up and drink 14 drinks on Saturday night (for those who like to find the loopholes):
I find it unfortunate that the message of alcohol’s health benefits has caused some people who didn’t drink before to start drinking for health reasons. The 2015-2020 Dietary Guidelines does not recommend that anyone who does not drink alcohol start drinking for any reason. I couldn’t agree more. I’ve actually had clients apologize for not enjoying the taste of alcohol; “I know it’s good to have a glass of wine each night, but I just don’t like wine,” as though they are choosing to die early because they just don’t like wine.
Yes, there are benefits of drinking, and I will discuss these in this blog. But the nice thing about discovering these benefits has been more to justify drinking rather than to encourage drinking!
Let me remind you of the health dangers of excessive drinking (as defined in the chart above). I feel certain that each of us has a loved one or family member who suffers from alcoholism. Many of us have personally seen the devastation of chronic heavy drinking. The dangers of excessive drinking not only develop over time, but there are dangers in drinking too much on a single occasion!
Alcohol is a toxin and too much can be problematic. Heavy drinking negatively affects the following:
- The brain
- The heart
- Cancer risk
- The immune system
- The liver
- The pancreas
Allow me to explain the dangers of heavy drinking and clarify the benefits of moderate drinking.
What are the dangers of heavy drinking on the brain?
The effects of excessive drinking – less inhibitions, slowed reaction time, slurred speech, unsteady gait (a person’s manner of walking), and hangover the next day (headache, dizzy) – illustrate how quickly and dramatically alcohol affects the brain. Most people don’t realize how extensively alcohol can affect the brain.
The brain is so complex; we still have a lot to learn. Researchers are constantly discovering more about how alcohol interrupts communication pathways (neurotransmitters) in the brain and changes in the brain structure. The physical affects can be seen through brain scans (i.e. MRI, PET, etc.). The psychological effects include mental functioning, emotions, personality, learning, and memory skills.
Areas of the brain most vulnerable to alcohol include:
- Cerebellum – controls motor coordination; damage to the cerebellum results in a loss of balance and stumbling.
- Limbic System – monitors tasks like memory and emotions. Damage to the limbic system results in memory and emotional impairment.
- Cerebral Cortex – Our abilities to think, plan, behave intelligently and interact socially stem from this part of the brain. This part of the brain also connects the brain to the nervous system. Damage to the cerebral cortex can impair problem solving, memory, and learning.
One night of heavy drinking can result in damage to the neurotransmitter (brain’s messenger) balance, which can trigger mood and behavioral changes. Possible changes include depression, agitation, memory loss (including blackouts, where memory of the night’s events are completely wiped out), and even seizures.
You’ve probably noticed that these symptoms are consistent with being intoxicated. So, while we may dismiss these behavior changes as the result of “just being drunk”, the reality is these symptoms stem from a malfunction in the brain due to too much alcohol. Being drunk means damage to the brain has occurred!
Long-term heavy drinking cause’s alterations in the neurons (brain cells that send and receive messages) and can reduce the size of brain cells. As a result, brain mass can shrink and the brain’s inner cavity grows bigger. This affects motor coordination, temperature regulation, sleep, mood, and various cognitive functions like learning and memory.
Over time, the body tries to compensate for these disruptions and neurotransmitters adapt to the presence of alcohol. In other words, our body begins to accept persistent alcohol intake. These adaptations result in increased alcohol tolerance, alcohol dependence, and alcohol withdrawal symptoms.
Abstaining from alcohol for several months to a year, may allow structural brain changes seen through MRI and PET scans to partially correct. Abstinence can also reverse negative effects on thinking skills including problem solving, memory, and attention.
Doesn’t drinking reduce stress, which benefits the brain?
Many people drink alcohol to reduce feelings of stress and/or anxiety in their lives. There is some research that has shown that alcohol, in low doses, may lessen the body’s response to stressors. Drinking causes an increase in the neurotransmitter, serotonin, as well as endorphins that may spark feelings of relaxation and euphoria.
However, in contrast, many studies show that alcohol increases the stress response by stimulating production of the same hormones the body produces when under stress.
At this point, there is no conclusive information about the relationship between alcohol and stress for the general population. In my opinion, the conflicting information may be due to the body’s adaptation to persistent alcohol intake. In other words, maybe the first few times you have a drink or two, you experience the benefits of stress reduction. But, if drinking becomes a nightly routine, adaptions to regular drinking may nullify this benefit after a while. Who knows?
What are the dangers of heavy drinking on the heart?
Researchers have known for centuries that excessive alcohol intake can damage your heart. This heart damage includes:
- Alcoholic Cardiomyopathy – Long-term heavy drinking can weaken the heart muscle, which causes it to not contract effectively. As a result, it can’t pump enough blood to sufficiently nourish the organs. Symptoms include shortness of breath and other breathing difficulties, fatigue, swollen legs and feet, and irregular heartbeat.
- Arrhythmias – Binge drinking (4+ drinks in 2 hours for women and 5+ drinks in 2 hours for men) and long-term heavy drinking (4+ drinks per day or 8+ drinks per week for women and 5+ drinks per day or 15+ drinks per week for men) can affect the internal pacemaker system (the rate at which the heart beats). Alcohol can cause the heart to beat too fast or to beat irregularly.
- A-Fib – where one chamber does not fully contract. This can lead to stroke or pulmonary embolism.
- Ventricular Tachycardia – alcohol induced damage to the heart muscle cells causes electrical pulses to circle through part of the heart too frequently. This increase in contraction does not allow the heart to fill with enough blood between contractions. This causes dizziness, light headedness, unconsciousness, cardiac arrest, and even sudden death.
- Strokes – Recent studies show people who binge drink are ~56% more likely than people who never binge drink to suffer ischemic stroke (where a blood clot prevents blood flow to the brain). And binge drinkers are more likely to suffer any type of stroke than people who never binge drink.
- Hypertension – Chronic alcohol abuse, as well as binge drinking, can cause high blood pressure.
What about the recommendation to drink a glass of wine every night?
In particular, red wine contains resveratrol, a compound in grape skins that is associated with an increase in good (HDL) cholesterol. But all forms of alcohol seem to raise HDL cholesterol. Experts are not sure that red wine has any more health benefits over other forms of alcohol.
Research shows that healthy people who drink moderate amounts of alcohol (not just red wine) may have lower risk of developing Coronary Heart Disease (CHD) than non-drinkers. In Western countries where chronic diseases such as CHD, cancer, stroke, and diabetes are the primary causes of death, results from several, large studies show that alcohol reduces mortality. This reduced mortality is linked to the protective effects of moderate alcohol consumption on CHD, diabetes, and ischemic stroke.
It is estimated that 26,000 deaths were averted in 2005 because of moderate consumption of alcohol and its role to reduce ischemic heart disease, ischemic stroke, and diabetes.
Further research is warranted to get a better understanding of these benefits and, more so, to determine who can expect to experience these benefits. Alcohol may not benefit everyone who drinks moderately.
Can heavy drinking increase your risk for cancer?
Numerous studies show the more you drink, the more you increase your chances of developing certain types of cancer. In fact, the National Cancer Institute identifies alcohol as a risk factor for Mouth, Esophagus, Pharynx, Larynx, Liver, and Breast Cancer.
At least 7 out of 10 people with mouth cancer drink heavily. A recent report by The World Cancer Research Fund indicates that women who drank 5 standard alcohol drinks per day have a 1.2 times greater risk of developing colon and/or rectal cancer than those who don’t drink.
Because drinking is often associated with smoking, studies look even further into the risk of cancer with the combination of drinking plus smoking. People who drink and smoke are 15 times more likely to develop cancer of the mouth and/or throat than those who don’t. Studies suggest that drinking and smoking are responsible for 80% of throat and mouth cancer in men, 65% of throat and mouth cancer in women, 80% of esophageal squamous cell cancer, and 25-30% of all liver cancer.
Studies show that you can reduce your risk for cancer, especially head and neck cancer, by drinking less.
How does heavy drinking compromise the immune system?
Our immune system is designed to protect our bodies from foreign substances, like germs and bacteria that can make us sick. There are two systems to speak of:
- Innate – made up of white blood cells, natural killer cells, and cytokines.
- Adaptive – made up of T-lymphocyte cells, B-lymphocyte cells, and antibodies.
Drinking too much alcohol suppresses both systems. Chronic drinkers are more susceptible to infections like pneumonia and tuberculosis. It also increases susceptibility to contracting HIV and/or allows faster development of the virus.
The immune system can be suppressed for up to 24 hours after a single occasion of excessive drinking.
What are the effects of heavy drinking on the liver?
More than 2 million Americans suffer from alcohol-related liver disease. In general, liver disease affects people who drink heavily over many years.
The job of the liver is to break down harmful substances, including alcohol. Unfortunately, the process of breaking alcohol down generates toxins that are even more harmful than the alcohol itself. These toxins damage the liver cells and promote inflammation and weaken the body’s natural defenses.
- Steatosis (aka fatty liver) – Heavy drinking, even for just a few days at a time, can cause fat to build up in the liver.
- Hepatitis – Excess fat in the liver can cause inflammation that leads to hepatitis. This can be asymptomatic or it can cause fever, nausea, loss of appetite, abdominal pain, and even mental confusion. It can enlarge the liver and it can also cause jaundice, excessive bleeding, and clotting difficulties. One in five heavy drinkers will develop hepatitis.
- Fibrosis – Alcohol can cause scar tissue to build up on the liver.
- Cirrhosis – Once fibrosis occurs and drinking persists, the scar tissue continues to build. Cirrhosis is a slow deterioration of the liver, as the scar tissue prevents the liver from performing critical functions; including managing infections, removing harmful substances from the blood and absorbing nutrients. Cirrhosis can lead to jaundice, insulin resistance and type II diabetes, and even liver cancer. One in four heavy drinkers will develop cirrhosis.
Quitting drinking will prevent further damage to the liver but usually does not reverse damage.
What are the effects of heavy drinking on the pancreas?
The pancreas sends enzymes into the small intestine to digest nutrients. It also makes the hormones insulin and glucagon, which regulate glucose.
Many people who suffer from pancreatic problems are heavy drinkers – usually from habitual and excessive drinking. When you drink, alcohol damages pancreatic cells and influences the metabolic process involving insulin. This damage leaves the pancreas open to inflammation.
- Acute pancreatitis – sudden onset, may cause symptoms; abdominal pain (which may radiate up the back), nausea/vomiting, fever, rapid heart rate, diarrhea, and sweating.
- Chronic pancreatitis – decreased pancreatic function over time may cause the above symptoms, in addition to blood sugar problems. It can slowly destroy the pancreas and lead to diabetes. In some instances it can even lead to death.
Only 5% of people with alcohol dependence develop pancreatitis. Complete abstinence can slow the progression of pancreatitis and decrease painful symptoms.
In addition, damage to the pancreas can be a risk factor for pancreatic cancer.
What’s the final conclusion with regards to alcohol intake?
Heavy drinking has negative effects on the brain, the heart, the immune system, the liver, and the pancreas, plus it increases the risk for developing cancer. On the other hand, moderate drinking decreases mortality by providing heart health benefits.
Not to mention that, in this article, I have simply touched on the health implications of excessive drinking. I have not discussed other dangers related to excessive drinking, like accidents/injuries, birth defects, and dependence.
Based on the list of health problems from excessive drinking, compared to health benefits of moderate drinking, anyone who is not able to drink in moderation should abstain from drinking completely. In addition, all women who are pregnant or trying to get pregnant should abstain from drinking because we don’t know the acceptable amounts of alcohol for pregnant women.
If you drink for health reasons or otherwise, look closely at the chart to ensure that you are within the boundaries of moderate drinking. Be accountable, should your drinking exceed moderate amounts.