Alcohol and Your Health
Is alcohol good for your health?
For many reasons, this is a question without simple or clear-cut answers. Humans have used alcohol safely and enjoyably for thousands of years, and it continues to occupy an important place in many religious ceremonies and social celebrations. In addition, moderate alcohol use can provide certain health benefits, particularly with regard to coronary heart disease.
However, alcohol consumption is also associated with serious risks. Drinking too much alcohol is a significant cause of accidents and injuries and can lead to liver disease, certain types of stroke, abnormally high blood pressure (hypertension), various cancers, and birth defects, among other adverse effects.
Definitions:
A standard "drink" contains 12 g of alcohol, and is equivalent to 360 mL (12 oz) of beer, 150 mL (5 oz) of wine, or 45 mL (1.5 oz) of 80 proof distilled spirits.
Moderate drinking is defined as the average number of drinks consumed daily that places an adult at low-risk for alcohol problems. This number was defined as less than three and less than two drinks per day for men and women, respectively, and less than two drinks per day for those over the age of 65.
Heavy drinking is defined as the average number of drinks consumed daily that places an adult at high risk for adverse consequences. This number is greater than 14 drinks per week or 4 drinks per occasion for men, and greater than 7 drinks per week or 3 drinks per occasion for women.
Binge drinking is a particularly important problem in teenagers and young adults. It is defined as five drinks in a row for men, and four for women.
Signs that develop during or shortly after alcohol use include slurred speech, incoordination, unsteady gait, memory impairment, stupor, or coma. The degree of impairment is dependent upon the blood alcohol concentration.
Alcohol abuse is defined as a maladaptive pattern of use associated with one or more of the following:
Failure to fulfill work, school, or social obligations
Recurrent substance use in physically hazardous situations
Recurrent legal problems related to substance use
Continued use despite alcohol-related social or interpersonal problems
Alcohol dependence is defined as a maladaptive pattern of use associated with three or more of the following:
Tolerance
Withdrawal
Substance taken in larger quantity than intended
Persistent desire to cut down or control use
Time is spent obtaining, using, or recovering from the substance
Social, occupational, or recreational tasks are sacrificed
Use continues despite physical and psychological problems
Abuse and dependence are found mainly in persons who are heavy drinkers.
Binge drinking, as well as alcohol abuse and dependence increases the risk certain health conditions:
Cardiovascular Disease: several studies suggest that moderate alcohol use, as compared to heavy drinking, or abstaining, decreases the risk of coronary heart disease.
Hypertension: People who consume more than two drinks daily have up to a twofold increase in the incidence of hypertension compared with nondrinkers.
Stroke: Heavy alcohol use increases the risk of both ischemic and hemorrhagic stroke in all ethnic groups. Moderate alcohol use is associated with fewer ischemic strokes; the risk appears to be lowest with consumption of one to two drinks per day. In contrast, the risk of hemorrhagic stroke appears to rise even with minimal alcohol use.
Breast Cancer: Moderate alcohol use is associated with an increased risk of breast cancer. As an example, one study found that the risk of breast cancer was increased by 41 percent for women consuming 2 to 5 drinks daily. This increase in risk was present for all beverage types. Taking the vitamin folic acid (folate) may lessen the effect of alcohol consumption on breast cancer, suggesting that women who drink alcohol may benefit from a daily multivitamin fortified with folic acid.
Cancers of the head, neck an digestive tract: Alcohol use has been linked to several types of cancer of the head and neck and digestive (gastrointestinal) tract, even at low levels of consumption. People who drink and smoke have a greater risk than would be expected from either factor alone.
Liver Disease: It is generally believed that heavy alcohol use, at least five drinks daily, is needed to cause cirrhosis in men.
Gallstones: Moderate alcohol use has been shown to lower the risk of gallstones. However, drinking that is heavy enough to cause liver disease may reverse this benefit, as suggested by studies that have reported a high prevalence of gallstones in people with alcoholic cirrhosis.
Pancreatitis: Heavy drinking increases the risk of both sudden (acute) and long-term (chronic) inflammation of the pancreas (pancreatitis).
Osteoporosis: Heavy alcohol consumption increases the risk of hip fractures by causing both osteoporosis and falls.
Pregnancy: A spectrum of birth defects are related to alcohol use during pregnancy. There is no known benefit of alcohol use during this period. Thus, experts advise completely avoiding alcohol during pregnancy.
Perception of health and quality of life: Excessive and frequent alcohol use reduces the quality of life for patients, their families, and others around them, potentially leading to failed work or school obligations, interpersonal problems, and physically hazardous situations.
Accidents and Trauma: Alcohol use increases the risks and severity of injury from motor vehicle accidents and also increases the risk of injury from other sources.
Suicide: Alcohol abuse is associated with an increased risk of suicide. In most cases, even in alcoholics, the presence of depression is thought to be an essential contributing factor.
Reasons to avoid alcohol — Alcohol use is not recommended for individuals who:
- Are younger than the legal drinking age
- Are pregnant
- Have a personal or strong family history of alcoholism
- Have a personal or strong family history of breast cancer
- Have had hemorrhagic stroke
- Have liver or pancreatic disease
- Have precancerous conditions of the aerodigestive tract
- Operate potentially dangerous equipment or machinery (including cars, boats, or construction equipment)
An "ideal dose" of alcohol — For some people, no level of alcohol consumption can reliably be considered safe. However, for individuals without the above health conditions, the healthiest dose of alcohol appears to be in the range of 0.5 to 1 drink of alcohol daily.
Gender differences — Established recommendations for safe levels of drinking do not address an "ideal" level of alcohol consumption. However, they advise
- No more than two drinks daily for men
- No more than one drink daily for women
What is the best approach in my case? — The following guidelines may help in making an informed decision about alcohol use:
- Consult a healthcare provider for an assessment of the specific risks and benefits of alcohol use. Multiple factors must be considered in any such "risk-benefit analysis," including age, gender, personal medical history, family history, diet, physical fitness, and certain lifestyle choices such as smoking, among others.
- If alcohol consumption is appropriate, follow recommended guidelines concerning moderate drinking, ie, limiting intake to no more than one drink daily for women or two drinks daily for men.
- Women who drink should take a daily multivitamin fortified with folic acid.
- Women should not drink any alcohol during pregnancy; in addition, experts advise that women should discontinue drinking when trying to conceive.
- Never consume alcohol before or while driving or operating any potentially dangerous equipment.
- Speak with a healthcare provider about any health changes, including diagnosis of medical conditions, new or altered medication regimens, etc, that may affect recommendations for alcohol use.
- Speak with your child's doctor about preventing alcohol use and abuse in children and teenagers. Unfortunately, alcohol is usually introduced during adolescence, around the same time that the teenager is introduced to automobiles; this can be a deadly combination.
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