By Dr. Mercola
According to a recent report1 by the U.S. surgeon general, substance abuse is skyrocketing in the U.S., and that includes alcohol. In fact, substance abuse in general has eclipsed cancer in terms of prevalence.
According to this report, more than 66 million — nearly 25 percent of the total adolescent and adult population — reported binge drinking at some point in 2015. In terms of healthcare costs, alcohol abuse is racking up a price tag of $249 billion a year.
Drinking has become so common you might not give it much thought. Researchers have even stated that moderate alcohol consumption may have certain health benefits, which may serve as a comforting justification for some.
However, there's still plenty of controversy on this issue, and I would not use it to justify chronic drinking, regardless of the amount. As demonstrated in the BBC investigation above, drinking tends to do far more harm than good, even if you're within guidelines for "moderate" alcohol consumption.
Do Drinking Patterns Make a Difference?
The BBC segment above investigates the differences between moderate drinking and binge drinking, using identical twin brothers as guinea pigs. They each drink 21 units of alcohol over differing time scales — one consumes them all in one night while the other has three drinks per day over the course of a week.
Twenty-one units amounts to three-quarters of a bottle of whiskey, two bottles of wine, or 10.5 pints of beer. The test continues for a month. Medical tests before and after assesses the physical effects and potential damage.
Overall, the tests reveal that alcohol consumption is quite detrimental in general, no matter how it's consumed. The doctor was actually quite surprised at how bad moderate drinking was, considering it's within the U.K. guidelines for alcohol consumption.
Factors That Influence How You're Affected by Alcohol
The effect of alcohol on your body depends on a number of factors, including your gender, weight and genetic makeup. The smaller you are, the more concentrated your blood alcohol level will be compared to a larger person drinking the same amount.
Women, who tend to have more body fat than men, will also tend to be more affected by alcohol, as alcohol is soluble in fat. This is why drinking guidelines are lower for women.
Genes also play a significant role in how your body processes alcohol, which subsequently determines how likely you are to suffer a hangover as well. Enzymes that break down alcohol are determined by genes. If you have slow-metabolizing enzymes, you're more likely to get a hangover when you drink.
In essence, the hangover is your body's way of telling you it's having a hard time metabolizing the alcohol and is struggling with elevated toxicity. Continuing to drink despite such physical objections raises your risk of liver disease.
That said, if your genetic profile predisposes you to not suffer hangovers, that does NOT mean you can drink without physiological repercussions.
The breakdown products of alcohol are what cause the most biological damage, and those byproducts are produced even when your body metabolizes alcohol quick enough to avoid a buildup of toxic byproducts (which causes the hangover).
Conventional Drinking Guidelines
In the U.S., the 2015-2020 dietary guidelines2 suggest women consume no more than one drink per day (equivalent to no more than 0.6 ounces of pure alcohol, 12 ounces of beer or 5 ounces of wine). Men have a two-drinks-per-day allotment.
The U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking3 as consuming five or more drinks within two hours for men, and four or more drinks in two hours for women. In the U.K. bingeing is defined as six units for women (equivalent to two glasses of wine) and eight units for men.
How Alcohol Ruins Your Health
Acutely, alcohol depresses your central nervous system, which slows down the communication between your brain cells. Your limbic system, which controls emotions, is also affected. This is why alcohol consumption lowers your inhibitions.
Your prefrontal cortex, a brain region associated with reasoning and judgment, also slows in response to alcohol, leading to more impulsive behavior and poor judgment.
At higher doses, your cerebellum, which plays a role in muscle activity, will also be impacted, leading to dizziness and loss of balance. Over time — even over as short a period as one month — alcohol:4,5,6
• Increases liver stiffness, which increases your risk of liver cirrhosis. In the film, after one month, the liver stiffness of the binge-drinking brother was increased from 3.9 to 4.9 — a 25 percent increase in liver inflammation that leads to cirrhosis.
The moderate-drinking brother fared nearly as badly. His liver stiffness increased from 3.9 to 4.8, so spreading the drinks out did not make any significant difference in terms of the liver damage caused by 21 units of alcohol per week.
• Diminishes the formation of memories due to ethanol buildup in the brain. This is why you may not remember what you did while you were drunk. Alcohol also causes your hippocampus to shrink, which affects memory and learning.
• Promotes systemic inflammation. The two brothers both had significant increases in five different inflammatory markers, although binge drinking caused a more dramatic rise.
Studies have shown even a single binge causes a dramatic rise in inflammation. In other words, your body reacts to alcohol in the same way as it reacts to injury or infection.
• Increases stress on your heart, raising your risk for cardiomyopathy, arrhythmias, high blood pressure and stroke.
Blood alcohol levels spike two to three hours AFTER your last drink, which means it may occur in the middle of the night during sleep. This raises your risk of accidental death due to choking on your own vomit and/or suffering cardiac failure or stroke while sleeping.
• Significantly increases endotoxin levels. In other words, alcohol causes gut damage allowing bacteria to escape from your gut into your blood stream.
The film showed that bingeing caused significantly worse damage, suggesting one week between binges is nowhere near enough to heal the gut damage caused by high amounts of alcohol. That said, regular consumption also led to elevated endotoxin levels, suggesting 21 units of alcohol per week is too much, and "sensible" drinking limits likely need to be much lower. How low is still unclear.
These are just a handful of the physical effects of alcohol. In reality, alcohol affects every part of your body, as shown in this Healthline infographic.7 In terms of chronic disease, studies have linked excessive alcohol consumption with an increased risk for poor immune function (which raises your risk for most diseases), pancreatitis and cancer.
Source: Healthline June 30, 2014
Cancer Risk Rises With Alcohol Consumption
One recent study found alcohol was routinely linked to cancers in the rectum, liver, colon, esophagus, oropharynx, larynx and, in women, the breast.8 Overall, it found that alcohol is a causative factor in nearly 6 percent of all cancer deaths worldwide. The research did not identify the biological causation between alcohol and cancers in these seven sites, but according to the researchers:9
"Confirmation of specific biological mechanisms by which alcohol increases the incidence of each type of cancer is not required to infer that alcohol is a cause."
The percentage of deaths related to alcohol and cancer increased by 62 percent in the past 12 years, up from 3.6 percent in 2003 to 5.8 percent in 2015 worldwide.10 This increase may be the result of other factors in the lives of people who suffer from cancer triggered by alcohol, such as poor dietary choices, lack of exercise and poor sleep quality.
In order to assign causation of cancer to alcohol, study participants would have to randomly be assigned to drink or abstain over the course of their life. Instead, researchers have studied a large body of epidemiological data that comes as close as it can to linking alcohol with cancer.
Another study linked even light drinking to the same list of cancer types.11 The American Cancer Society also warns that even a few drinks each week can increase your risk of breast cancer.12 The risk is higher in women who have low folate levels. Other research links the recurrence of breast cancer with alcohol intake.13
Both of these links appear to be related to alcohol's ability to raise your estrogen level. Alcohol also affects hormones in men. Chronic alcohol use is associated with testicular failure and male infertility.14,15
Feminine symptoms in men suggest that alcohol may also contain biologically active phytoestrogens.16 Studies such as these suggest that if you have been diagnosed with breast cancer or prostate cancer, and especially if you are overweight or postmenopausal, it would be a good idea to cut back or eliminate your alcohol intake.
In the Big Scheme of Things, Less Alcohol Is Better
I generally define "moderate" alcohol intake (which is allowed in the beginner phase of my nutrition plan) as a 5-ounce glass of wine, a 12-ounce beer or 1 ounce of hard liquor, with a meal, per day. As you progress further in the nutrition plan, I recommend eliminating all forms of alcohol. Even if it provides some benefit, it's unlikely that alcohol will add much to an otherwise healthy diet and lifestyle.
That said, if you're currently a drinker — whether your consumption is moderate or you tend to overdo it — research suggests exercise can go a long way toward mitigating the health risks, including reducing your risk for heart disease.
This makes sense when you consider the fact that exercise may be one of the most effective strategies for protecting and strengthening your heart. So much so, research shows regular exercise can significantly lower your health care costs if you have heart disease. In one study, 30 minutes of vigorous exercise, five times per week, resulted in annual health care savings of more than $2,500 per person.17
Exercise May Mitigate Risks of Alcohol Consumption
Exercise is a foundational aspect of good health, but may be even more important if you drink alcohol on a regular basis. According to recent research,18 chronic drinkers who exercise five hours a week have the same rate of mortality as those who never drink alcohol, in large part by counteracting the inflammation caused by alcohol.19,20,21
The study looked at data from 36,370 British and Scottish adults — 85 percent of whom drank "occasionally" or "often." Thirteen percent of them were heavy drinkers, consuming 14 or more units of alcohol per week.
Interestingly, those who got at least 2.5 hours a week of moderately intense exercise significantly reduced the biological impact of their drinking. Those who exercised for five hours a week had the same mortality risk as teetotalers, even if they were heavy drinkers. The only ones who could not cancel out the harms of their alcohol consumption were those who drank dangerous levels of alcohol each week (20 or more standard drinks for women and 28 or more for men). As reported by The Daily Mail:22
"[The study concluded:] 'Our results provide an additional argument for the role of physical activity as a means to promote the health of the population even in the presence of other less healthy behaviors.' Professor Matt Field, [Ph.D.,] from the U.K. Centre for Tobacco and Alcohol Studies at the University of Liverpool said:
'This is a rigorous piece of research with some clear conclusions. The relationship between drinking alcohol to excess and increased risk of death is significantly weaker in people who are physically active. Therefore, it appears that physical activity may partially offset some of the harmful effects of drinking, particularly alcohol-attributable cancers.'"
Exercise Also Diminishes Risk of Alcohol Abuse
Previous research23 has also found that long-time drinkers who exercise regularly have less damaged white matter in their brains compared to those who rarely or never exercise. The white matter is considered the "wiring" of your brain's communication system, and is known to decline in quality with age and heavy alcohol consumption.
In addition to helping protect your brain, if you know you're prone to alcohol abuse or have a family history of alcohol addiction, exercising regularly may also reduce your risk of becoming dependent. The cravings for alcohol can become all-consuming, and eventually alcoholics do not feel "normal" until they've had a drink. The alcohol abuse inevitably throws off your circadian rhythm — the normal times you eat, sleep and wake up — as well, leading to a downward spiral of health and emotional effects.
Alcohol chemically alters your brain to release dopamine, a chemical your brain associates with rewarding behaviors. Exercise also triggers the release of dopamine, along with other feel-good chemicals, which means you can get the same "buzz" from working out that you can get from a six-pack of beer, but with far better outcomes for your health.
Exercise is also beneficial for those who are already addicted, and may actually help to lessen cravings. In one study,24 hamsters that ran the most consumed less alcohol, while less active hamsters had greater cravings for and consumption of alcohol. By replacing drinking with exercise, you may find that the rewarding feeling you get from exercise provides you with a suitable alternative to the rewarding feeling you previously got from alcohol.
On the other hand, chronic alcohol consumption also tends to IMPEDE your fitness goals. Working out is typically not high on the list of priorities when you're feeling hung over. In higher doses, alcohol can also affect testosterone production, muscle protein synthesis and leucine oxidation, thereby impeding your ability to build muscle and reach your fitness goals.
So, on the whole, thinking exercise will cancel out the harmful effects of alcohol is unrealistic, and such a program may be difficult to maintain in the long run.
Helpful Protocol to Minimize Damage of Alcohol
While I don't recommend drinking alcohol, if you know you'll be having a few drinks, taking this natural protocol beforehand can help "pre-tox" your body, thereby minimizing the damage associated with alcohol consumption. Just beware that this protocol will NOT make you less susceptible to alcohol poisoning or other acute adverse events associated with binge drinking, so please use common sense and drink responsibly.
• N-acetyl cysteine (NAC): NAC is a form of the amino acid cysteine. It is known to help increase glutathione and reduce acetaldehyde toxicity that causes many hangover symptoms.25 Try taking NAC (at least 200 milligrams) 30 minutes before you drink to help lessen the alcohol's toxic effects.
If you're wondering just how powerful NAC can be, consider that, like alcohol, one way that Tylenol causes damage to your liver is by depleting glutathione. If you keep your glutathione levels up, the damage from the acetaminophen may be largely preventable. This is why anyone who overdoses on Tylenol receives large doses of NAC in the emergency room — to increase glutathione.
• B Vitamins: NAC is thought to work even better when combined with vitamin B1 (thiamine).26 Vitamin B6 may also help to lessen hangover symptoms. Since alcohol depletes B vitamin in your body, and the B vitamins are required to help eliminate alcohol from your body, a B-vitamin supplement taken beforehand, as well as the next day, may help.
• Milk Thistle: Milk thistle contains silymarin and silybin, antioxidants known to help protect your liver from toxins, including the effects of alcohol. Not only has silymarin been found to increase glutathione, but it also may help to regenerate liver cells.27 A milk thistle supplement may be most useful when taken regularly, especially if you know you'll be having cocktails on more than one occasion.
• Vitamin C: Alcohol may deplete your body of vitamin C, which is important for reducing alcohol-induced oxidative stress in your liver. Interestingly, one animal study showed vitamin C was even more protective to the liver than silymarin (milk thistle) after exposure to alcohol.28
Making sure you're getting enough vitamin C, either via supplements or food, is another trick to use prior to indulging in alcoholic beverages. Vitamin C is actually such a powerful detoxifier that if you take large doses prior to receiving dental anesthesia, the anesthesia will be significantly weakened and may not work.
• Magnesium: Magnesium is another nutrient depleted by alcohol, and it's one that many are already deficient in. Plus, magnesium has anti-inflammatory properties that may help to reduce some hangover symptoms. If you don't eat a lot of magnesium-rich foods, taking a magnesium supplement before an evening involving drinking may be helpful.