Balancing the Risks & Benefits of Alcohol


The questions and answers about the pros and cons of drinking alcohol have been debated throughout history. How do we define moderation? Why does how much we drink and when (aka drinking patterns) matter? Why do the French, consumers of lots of wine, butter and cheese have lower cardiovascular disease than most? What’s the connection between alcohol and cancer? Do genetics play a role?

Leave it to the Harvard T.H. Chan School of Public Health to put out this largely encompassing piece about the risks and benefits of alcohol, how to balance them and just about everything in between. Read on…

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Throughout the 10,000 or so years that humans have been drinking fermented beverages, they’ve also been arguing about their merits and demerits. The debate still simmers today, with a lively back-and-forth over whether alcohol is good for you or bad for you.

It’s safe to say that alcohol is both a tonic and a poison. The difference lies mostly in the dose. Moderate drinking seems to be good for the heart and circulatory system, and probably protects against type 2 diabetes and gallstones. Heavy drinking is a major cause of preventable death in most countries. In the U.S., alcohol is implicated in about half of fatal traffic accidents. Heavy drinking can damage the liver and heart, harm an unborn child, increase the chances of developing breast and some other cancers, contribute to depression and violence, and interfere with relationships.

Alcohol’s two-faced nature shouldn’t come as a surprise. The active ingredient in alcoholic beverages, a simple molecule called ethanol, affects the body in many different ways. It directly influences the stomach, brain, heart, gallbladder, and liver. It affects levels of lipids (cholesterol and triglycerides) and insulin in the blood, as well as inflammation and coagulation. It also alters mood, concentration, and coordination.

What’s Moderate Alcohol Intake? What’s a Drink?

Loose use of the terms “moderate” and “a drink” has fueled some of the ongoing debate about alcohol’s impact on health.

To read the entire article, click here.


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Drinking and Memory Loss in Later Years

42-20045584Yesterday, I walked through the garage at the assisted living development where my mother lives. When I got to the elevator, I bumped into a 20-something pushing a cart loaded with six cases of wine, two of which were alcohol free. We waited side by side for the elevator to take us up to the lobby, when he said, “Boy, these old people can drink.” I agreed, then pointed out that my mother is one of the non-alcoholic wine drinkers. Didn’t feel the need to explain the how or why, and after we exited we said our “Have a good day” and walked in our separate directions.

Over the last several years, I have watched my mother’s memory come and go, lapse and return. She has had an MRI of her brain and does not have Alzheimer’s. But she does have a form of dementia that is, according to her doctor, related to heavy alcohol use in past  years.

study conducted in Brazil focused specifically on cognitive problems caused by heavy alcohol use among 1,145 people who were 60 years old or older. The study found that 8.2 percent of the 419 men and 726 women studied were heavy drinkers, or drinking at levels that are considered high risk. (For women, heavy drinking is four drinks or more during a day or more than seven drinks a week.)

One of the more surprising findings of the study was that heavy drinking affects the cognitive function of women more than men. “The effects of heavy alcohol use on memory and other cognitive functions were more evident in women,” said Marcos Antonio Lopes, the author of the study. “Our findings suggest that alcohol use does not have a linear relationship with cognitive decline.”

In other words, women who continue to drink heavily into their senior years run the risks of losing cognitive function and are more prone therefore to falls and significant memory loss.

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How Do You Feel After Three Glasses Of Wine? (It Depends)

drinking wine and dancingRecently, I had a girls’ weekend with my sister, which involved walking around Manhattan, then eating, drinking and dancing before crashing at our hotel. I had one glass of white wine at the hotel bar before we went out, one glass of Pinot Grigio with dinner, and then one glass of wine at the dance place, before switching to water. That’s three glasses of wine. More than my normal quota of two, but still…

The next morning, I could barely get out of bed I was so hungover. I had the kind of hangover I used to get in college after a room’s party, where I drank all night, mixing vodka and gin and beer and god-knows-what-else.  I starting getting paranoid that someone had slipped me a roofie.

I never understood that hangover until I came across an article in the May issue of The Atlantic: “Drunk and Drunker.”

“Most of us know, for better or for worse,” James Hamblin writes, “that drinking on an empty stomach…can leave us unduly inebriated. Less familiar is a series of external cues that may determine how much we’re affected by alcohol and other substances.”

In other words, WHERE we are when we drink influences how we feel. One study found that heart rates rose more (indicating intoxication) when people drank alcohol in an unfamiliar situation than when they were in a familiar situation.  According to the Atlantic article, “people who were given alcohol in an office setting suffered more from its deleterious effects (meaning motor and cognitive impairment) than people who drank the same amount in a bar.” (So THAT’S why people who drink act like idiots at office parties!)

And maybe the context theory explains my drunk-on-3-glasses-of-wine night: I was doing things I don’t normally do—namely, spending the weekend in the city and staying up till two in the morning, dancing.

Has that ever happened to you, where you drink the same amount you normally do, except in a new setting, and it has a totally different effect?

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Does Exercise Make You Drink?

In an article on The New York Times’ “Well” blog, Gretchen Reynolds begins her piece, “Does Exercising Make You Drink More,” with these questions: “Can regular exercise avert or undo some of the harm associated with binge drinking? Perhaps even better, could exercising beforehand pre-emptively reduce your urge to overindulge in alcohol later?”

For some, it seems the sweaty and invigorating high that goes with a great workout may be enough, staving off the desire for drinking alcohol. But for others, a cold beer or glass of wine seems the ideal reward after having run all those miles, skied for 6 hours, or spun at the gym for 50 minutes.

The article goes on to discuss the latest studies being conducted in an effort to understand the cloudy relationship between drinking and exercise. And in particular, a recent, large-scale study published in the American Journal of Health Promotion, the answer to the article’s title–“Do Alcohol Consumers Exercise More”–was an emphatic yes. The more people drink, the more they exercise. But why?

Reynolds writes: “The authors [of the study] don’t have a definitive answer. The survey results do not ‘follow expected patterns’ they admit, in which people who indulge in one unhealthy habit tend to indulge in others and vice versa. Smokers, for instance, statistically are less likely than average to exercise regularly and eat well. But this is not the case when it comes to drinking and exercise.  Maybe, the authors speculate, some of the drinkers are drawn to a ‘sensation-taking lifestyle’ that includes adventurous, extreme styles of exercise. Alternatively, imbibers could be “socializing and drinking after participating in organized group sports.” Or they might be trying “to compensate for the extra calories gained through drinking or to counterbalance the negative health effects of drinking.’”

Because I typically exercise in the morning, a post-workout cappuccino is more often my reward of choice. But after my husband plays 1 1/2 hours of tennis with some buddies in a weekly evening game, his ritual always entails plenty of beer and wings at a local pub.

What about you? We’d love to hear your thoughts on how exercise and drinking relate in your life…

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A Month With No Drink–Six Days To Go

Just over three years ago, I wrote a post on Drinking Diaries, announcing that my husband and I were going to be alcohol-free on Mondays. It sounds like no big deal–and it wasn’t–but it was the first time we had made a conscious decision to keep wine off the dinner table. We’re not big drinkers, but it wasn’t strange for us to have a glass of wine with dinner nearly every night. Three years later, we’ve stuck to our alcohol-free Mondays, and often opt for seltzer or iced tea on other days too.

In my continued effort to explore the role drinking plays in my life–and in celebration of our new Drinking Diaries anthology–I decided to go alcohol-free for the month of September. I’d been looking for an excuse to try abstaining for a month, ever since I interviewed Carrie Wilkens, PhD, cofounder and clinical director of the Center for Motivation and Change in New York City, for an article I wrote called “The Art of Mindful Drinking,” During our interview, I remember Dr. Wilkens saying that one of the first things she suggests patients do is to take time off of drinking. And so, I did.

Here’s what I learned:

  • It wasn’t as hard as I thought it would be.
  • I missed drinking most on Friday nights, a sacred evening for our family when we have a longer-than-normal dinner and always stay home.
  • I strangely enjoyed the challenge of saying “no,” particularly during occasions when I would normally have had a glass of wine or two, such as during our book party and at a gourmet dinner out with my husband.
  • All this time, I thought it was wine that was making me tired. But it turns out I still doze off in front of the TV–even without any alcohol in my system.
  • Last weekend, I had to tell a waiter several times that I wasn’t drinking, as he refreshed the glasses at our table from a giant pitcher of red sangria. It made me empathize with other abstainers.
  • I’d expected to feel more clear-headed and energetic without the alcohol, but I basically feel the same. Perhaps the amount I normally drink isn’t enough to make me feel fuzzy and lethargic?
  • I miss drinking when I’m eating a good dinner. There is no doubt that for me, wine not only takes the edge off, but also enhances flavors, adding to my enjoyment of food.
During that same interview with Dr. Wilkens, she explained that “It’s not unreasonable to have alcohol as a part of your life, as long as you are able to assess whether or not you are relying on it too much.” The key, she added, is learning to consume consciously enough to know how you’re being affected.

Consciously is the key word here. And taking the month off of drinking has made me more aware than ever of when and how much I’m consuming. Another positive factor came from a parenting perspective–it felt beneficial showing my kids that I wasn’t drinking, allowing them to see that I am mindful of my alcohol consumption.

A month without drinking has me feeling refreshed and triumphant, and I’ll probably do this again at some point in the future. I’d be lying, though, if I said I’m not looking forward to the end of the month. I can already “taste” the tannins of a full-bodied cabernet in my mind. But first, I still have six more days to go.

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