A small, regular quantity of alcohol is good for us. The healthiest form is red wine with good aging potential that is not easy drinking. However, there are benefits to be gained from moderate intake of all forms of alcohol and these are lower risk of heart disease1 improved cognitive function2; as a digestive aid34; it is associated with a lower rate of obesity5 ; helping with PMT; a small amount is relaxing and, of course, the J curve of health – teetotallers are less healthy than those who drink regularly but moderately. To enjoy these gains it is important to drink regularly (which means from about 3 times a week to daily) but only ever in moderation, which equates to 3 -4 units a day for a man and 2 – 3 units a day for a woman6. The reasons for moderate intake will become apparent.
- 175ml wine, 12%: 2.1 units,
- 1 pint lager, 3.6%: 2 units,
- 1 pint lager, 5.2%: 3 units,
- a small shot (25 ml) of 40% spirits: 1 unit.
Binge drinking and regular over consumption of alcohol are associated with a rapidly rising list of ills from cancers to obesity and addiction.
Erratic drinking is worse than regular drinking, the reason being to do with how we break down alcohol. Alcohol is a poison to the body and all efforts turn to excreting it. Alcohol is not digested like a normal sugar. It is absorbed through the digestive tissues passing into the bloodstream and on to the liver for detoxification. The metabolisation of alcohol is dependant upon various enzymes and if we drink regularly, we produce more of these enzymes, so can metabolise it more efficiently. If we regularly drink too much, the body starts to develop an additional detoxification system, which is why heavy drinkers can drink 8 glasses of wine with little apparent effect.The footnote links to a video explaining the metabolisation of alcohol7 if you are interested. In the process of metabolisation, acetaldehyde is produced. Acetaldehyde is toxic and if we drink faster than we can metabolise, levels of acetaldehyde build in the tissues and lead to feeling nauseous etc. It is a good idea to eat something fatty, like nuts, just before starting to drink since this slows down the rate of absorption and gives the liver more time to deal with the drink.
How well we metabolise alcohol is individual and some people genetically lack the right enzyme, for instance this is common in people from East Asia. Also women do not produce as much of the metabolising enzyme, so really need to drink more slowly and not as much. So although alcohol carries some definite health benefits, these do not apply to everybody.
With this brief explanation of how wine is metabolised it can now be clear as to why the first drink is the best: alcohol docks into the GABA receptors in the brain and makes us feel happy, relaxed, less inhibited etc. If GABA levels are low, we will want to drink more, hence why it can be hard to stop at 1 glass. As we continue to drink, unless consumption rate is slow, acetaldehyde levels build and we start to feel drunk and increasingly worse. Alcohol’s relaxing effect is due to GABA, and so yes, it is good to reduce stress levels and small amounts can relieve the symptoms of PMS.
As mentioned in the blog, Red wine is good for you, the million women study8 linked alcohol consumption to an increased risk of over 15 cancers per 1000 women up to the age of 75. However, a previous study9 had found that ‘clearly further data are required but our findings suggest that the adverse effects of alcohol on breast cancer risk might be ameliorated by adequate intake of folate from dietary sources alone’. This whole thing is complicated by the gene causing poor methylation which means that for some women eating loads of sprouts10 whilst quaffing the evening G & T will have little effect since it is hard for them to uptake the folate. See the blog can taking a daily multi be bad for your health? Basically, if in doubt and you enjoy a drink, then take a vitamin B supplement containing folate as L-5-methyltetrahydrofolate, B6, B12, TMG and riboflavin.
The benefits mentioned above of alcohol apply to all alcoholic drinks: wines, beers and spirits. It still seems that wine is the most beneficial alcoholic drink, including white wine. In the next blog on alcohol, I will go into some of the ins and outs of beers and spirits. But for now I will leave you with this fascinating piece of info for the next pub quiz: apparently the human digestive system produces about 3 gm alcohol daily. 11
- Rimm EB, William P, Fosher K, Criqui M, Stampfer MJ. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ 1999 Dec 11; 319(7224): 1523-1528 [↩]
- Britton A, Singh-Manoux A, Marmot M. Alcohol consumption and cognitive function in the Whitehall Study. AM J Epidemiology 2004;160:240-7. Part of the ongoing Whitehall study on civil servants. The study found this effect was slightly more pronounced in women than men – but that social position was also a factor, with the higher grade civil-servants benefitting more. There are many other studies showing [↩]
- Daglia M, Papetti A, Grioli P, Aceti C, Dacarro C, Gazzini G. Red and White wine effective at controlling several strains of streptococci baceria involved in tooth decay and some sore throats. This study found that common Italian wines, red and white, are good at killing some strains of streptococci found in the mouth. [↩]
- Weisse M, Eberly B, Person D. Wine as a digestive aid: comparative antimicrobial effects of bismuth salycylate in red and white wine. BMJ. 1995 Dec 23; 311(7021):1657-1660. This study compared the antimicrobial effects of red and white wine, bismuth salicylate and tequila. It found that wine was better than bismuth salicylate or tequila and this is due to the low pH of wine more than the alcohol in the wine – take home message white wine spritzers will help protect against common food pathogens. Wine also increases secretion of gastrin, vital in lowering the pH of the stomach to aid digestion [↩]
- Lukasiewicz E, Mennen LI, Bertrais S, et al. Alcohol intake in relation to body mass index and waist-to-hip ratio: the importance of type of alcoholic beverage. Public Health Nutr 2005;8:315-20. Abstract. This study found that wine was best for improving the waist/hip ratio in men and women and lowering their BMI but with a J -shaped curve. Beer had no good effect and spirits had a linear effect – the more of it we drink, the fatter we are. [↩]
- These are the guidelines for the UK. Different countries vary [↩]
- http://youtu.be/Ti81HUegslg [↩]
- NE Beral V, Casabonne D, Kan SW, Reeves GK, Brown A, Green J. J Natl Cancer Inst 2009;101:296-305 [↩]
- Rohan TE, Jain MG, Howe GR, Miller AB. Dietary folate consumption and breast cancer risk. J Natl. Cancer Inst. 92 (2000): 266-69 [↩]
- a very good source of folate [↩]
- See Wiki link on Ethanol metabolism. [↩]