Alcohol – good or bad? How’s best to approach it?

Is your favourite tipple doing you harm or is it ok to include?



Qualified Nutritionist (BSc, MSc, RNutr)
@emmatalkshealth
@EmmaThornton
Ask Emma


10 October 2018

What is alcohol and how does our body use it?

Alcohol is produced during a process called fermentation whereby yeast convert some of the simple sugars found in fruit, vegetables or grains into an ingredient called ethanol. As a result of the ethanol content of beverages we get a distinctive taste and an unmistakeable fuzzy feeling if we drink too much! This is a result of the effects ethanol can have on our nervous system. 

Alcohol is often described as being ‘empty calories’ and this is partly true. Although alcohol makes up one of only 4 macronutrients that can provide us with energy, alcohol is actually processed quite differently from say, carbohydrates or fats. It isn’t an efficient energy source, so it’s used up quickly for energy, producing more metabolic heat than useable energy, as it’s basically seen as a toxin which your body has to process quickly. 

Why would there possibly ever be any good in it then? Well, rather than the pure alcohol content, remembering that most alcoholic beverages only contain a certain percentage of alcohol, beer being 5% and wine being 12%, on average, for example, could it be that the other portions of these drinks contain some beneficial components since they came from plants in the first place, after all? 

We’ll explore that theory in a little more detail throughout. 

Health risk vs the benefits of alcohol

So, where are we in the current day and age in terms of the verdict on the potential risks vs the proposed benefits of alcohol? Well let’s be honest – still quite confused! However, I’m going to try and help by summing up and rationalising some of the evidence that’s out there.

Firstly, in terms of the short term effects of alcohol, many of us will enjoy the feeling of being that little bit more confident in public, or social settings, as your inhibitions and insecurities seem to gradually melt away a little. However, have you ever ended a night more teary than you set out, or perhaps the next morning you’re not so eager to start the day with a spring in your step? This is because ultimately alcohol is a depressant so the longer lasting effects may not be as pretty as that initial buzz1.

The next quandary on the list is the traditional belief that teetotallers may be more at risk of cardiovascular events that those who drink moderately. So could alcohol really be protective in some way when it comes to your heart? It seems that we may not want to get too excited just yet. 

It seems that the design of some of the earlier studies may have been a little biased, in that, a proportion of the ‘non-drinkers’ may have refrained from alcohol (A) Because they had drank lots in the past and had now abstained (but some damage in terms of their health may already have been done) or (B) they had some other underlying health conditions or were on medication which may interact with alcohol putting them at risk of ill-health anyway2

However, some of the more recent studies have corrected this and there may still be the need to be as drastic as to go completely teetotal3, well if you’re considering your heart health that is. 

See, being teetotal may create a slight increase in your risk of cardiovascular death, however, generally alcohol, especially when consumed in excess, can increase your risk of death by all other causes. A new-large scaled study helps put this into perspective: one drink daily was found to increase the risk of all causes of death by 0.5%4. So the risk was there, fairly minimal, but of course, is still worth considering. Then as this the daily consumption went, so did they risk of death.

The bottom line? There may just be a sensible approach to alcohol intake and here’s my take on it all... 

1 - Choose your tipple

It seems that there is some truth in certain types of alcohol being better than others. Although we wouldn’t go as far as hailing Guinness as a health tonic (as was common back in the day), it seems that when it comes to potential health benefits of alcohol, red wine continually comes up trumps. Red wine is particularly rich in an antioxidant resveratrol which has anti-inflammatory effects and may also benefit heart health5. Gin comes second to red wine, it seems, with some similar health benefits also being exerted5, however, it’s worth remembering that these benefits are most likely taken over by negative effects, if consumption is too high.

In terms of beer or spirits, research has suggested that these aren’t such healthy options. But interestingly, these options also collate with lower socio-economic status. This means people opting for these drinks may have other factors to content with; from diet, to quality of life, so this should also be considered carefully. 

2 - Know your limits

Traditionally it was thought that moderate drinking may be ok for health, and may even exert some extra benefits over those who don’t drink at all. However, now we know some of the studies influencing these guidelines may have been slightly flawed where does that leave us?

The new evidence has found that having even one drink a day increases your risk of disease, albeit only marginally. However, how many of us really only stick to one drink? As the daily consumption increases, the risk unsurprisingly goes up and up too. 

The latest government advice is to drink no more than 14 units of alcohol per week. This is equivalent to no more than six medium glasses of wine or 5 pints of cider. However, some conclusions from this latest study suggest the safe limit is slightly less than this, at around 12.5 units per week, or just under 6 glasses of wine or 5 pints4. This suggests that drinking every day, even only one, may still be too much.

3 - It’s all about lifestyle

The other thing to consider when it comes to studies looking at alcohol, both past and present, is that in many cases, other lifestyle factors may be having an influence. 

Some of the original positive messages when it comes to alcohol came from the idea that alcohol was a prominent feature in many of the healthiest diets in the world, such as the Mediterranean diet (where in places such as France or Italy they love a glass of red wine with their evening meal).

But there’s the key right there, how can we compare a typical Mediterranean person who most likely has copious amounts of sunlight, hoards of fresh fish and vegetables on hand, who jogs to work in a stress free environment, to a stressed business man running on convenience snacks and caffeine in London? 

Although that’s an extreme example right there, generally, lifestyle influences could be at play when it comes to alcohol consumption, so it can be hard to control for them all.

From the research out there, the best approach still isn’t clear cut. However, if we simplify it rather than getting too bogged down by facts and figures, a little good quality alcohol, alongside as healthy a diet as possible, whilst getting regular exercise, good quality sleep and managing stress as best you can, sounds like a sensible approach to me. 

Happiness is also an important point to make. Research suggests that happy, sociable people tend to live longer. So if you’re happy, sociable and enjoy a glass of wine in good company, could this be healthier than refraining from a glass of wine, but being miserable? Quite possibly! 

4 - Don’t fall into the habit

Ok, so it’s a good assumption that getting into the habit of binge drinking isn’t a good idea. Although very occasionally exceeding the recommended limit doesn’t seem to have significant effects on long-term health, if binge drinking is frequent, you’ll be more likely to exceed the recommended weekly limits which we know can up our risk. Plus, research has shown that even light drinkers who binge on a monthly basis are unfortunately upping their risk of ill-health6

However, what about more habitual drinking habits, is it ok to drink every day if only a little? We’ve discussed the stats behind it all and it seems that even a small drink a day, may still be too much. In my honest opinion, it’s important to aim for a good balance in terms of enjoying life and supporting your health, so as the research suggests, an occasional drink isn’t likely to have negative effects on your health and may even be good thing if you opt for red wine, (although, taking up drinking red wine solely for the health benefits isn’t so likely to be the way to go). 

However, if you’ve fallen into the habit of habitual drinking - perhaps you feel you need a drink of an evening to relax or sleep (the benefits may not be as they seem) or you feel it’s your only release at certain times - then this is when bad habits can start. By trying to break the habit and exploring other ways to relax, you could hopefully learn to manage your stress more effectively, and you won’t need to worry about your intake of booze creeping up.

5 - Don’t worry about tinctures 

We often get asked why our tinctures contain alcohol and are they safe? Although our tinctures do contain alcohol this is medicinal grade alcohol which is used for two reasons. Firstly, the alcohol is used in the extraction process to help remove all the beneficial active ingredients from the herbs themselves. Water just won’t cut it when it comes to the fat soluble constituents and the type of herb will decide on the exact percentage of alcohol we need to use. 

Next, alcohol is extremely well absorbed in our bodies, so it helps you to make the most of the remedy rather than tablets which can in some cases, be trickier. Per dose, our tinctures contain well below 1ml of alcohol – this means the effects of the alcohol component itself in the body are minimal and some ripe fruits may even give you more of a hit! 

Plus, let’s not forget the herbal remedies suspended in the alcohol may actually be beneficial, Milk Thistle has been used traditionally to help support and protect the liver after episodes of over indulgence. 

 

1. https://www.ingentaconnect.com/content/ben/cdar/2010/00000003/00000002/art00005

2. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1360-0443.1990.tb03710.x

3. https://link.springer.com/article/10.1007/s10654-017-0313-4

4. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30134-X/fulltext

5. https://www.sciencedirect.com/science/article/pii/S0021915004001467

6. https://academic.oup.com/aje/article/153/1/64/107807

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