What about alcohol?

We know you would prefer to read that alcohol is safe in moderation, but the truth is that alcohol is toxic in any dose, and the more you drink the greater the risk – Dr Malcolm Mackay

Australian guidelines to reduce health risks from drinking alcohol (NHMRC 2020)  recommend that healthy men and women drink no more than 10 standard drinks per week and no more than 4 standard drinks on any one day. This is harm minimization advice, not ‘safe’ drinking advice. Any amount of alcohol increases the risk of many types of cancer, including breast cancer (13% greater risk with only one drink per day). What is one standard drink of wine? Approximately 100ml, so a typical glass of wine is usually 1.5 standard drinks. There seems to be little public awareness of the cancer risks of drinking alcohol.

The alcohol industry has downplayed the risks of alcohol in much the same way that the tobacco industry downplayed the risks of smoking, promoting the perception that it is only heavy drinking that causes health problems. They established bodies like DrinkWise to advise the public on how to drink safely and in moderation. Advertising promotes alcohol as glamorous and fun, a normal part of social activity and as a reward for hard working men and women. Industry has waged a successful campaign to obfuscate the harmful effects of alcohol, influence public perception of alcohol and prevent effective legislation to reduce alcohol consumption (Lim et al. 2019). There was quite a fight over the recent introduction of stronger pregnancy warnings on alcoholic beverages.

When considering the adverse effects of alcohol, you may think of organ damage and accidents but the impact on our collective mental health aspects may be even greater. Doctors never prescribe alcohol for depression and anxiety because it worsens these conditions and increases the risk of suicide. Self-treatment with alcohol often leads to a downward spiral of increasing alcohol and worsening mental health. At a community level, alcohol reduces productivity and increases health care costs. Alcohol fuels fights and assaults and is often a catalyst for domestic violence.

There is a popular belief that a small amount of alcohol is beneficial to health, and people love to hear good news about their bad habits. Health professionals are familiar with the ‘J-curve’ of alcohol consumption versus mortality, suggesting that small amounts of alcohol were beneficial. However, reanalysis of the data behind the J-curve found that the greater mortality risk in non-drinkers versus light drinkers was due to reverse causation – poor health led to abstinence rather than abstinence leading to poor health. When researchers controlled for these factors there was no ‘J-curve’, just a dose related increase in health risks beginning at the lowest intakes. Similar data led to the idea that alcohol was protective against heart disease and research found that alcohol raised HDL (good cholesterol). However, this was not associated with a reduction in risk and alcohol raises blood pressure, a major risk factor for strokes and heart disease. While it is true that red wine contains some protective phytonutrients, you can get these from grapes and berries with none of the downsides of alcohol.

Alcohol displaces nutrients from the diet. Alcohol has more calories per gram than protein or carbohydrates (and alcoholic beverages also often have a lot of sugar calories) – for every glass you drink, you either gain weight, or you eat less calories worth of nutrient rich whole plant foods. Alcohol may also be associated with less healthy food choices. High intake of alcohol impairs nutrient absorption and depletes nutrients within the body, such as folate, a nutrient that protects against cancer. Alcohol detoxification generates free radicals which deplete antioxidants throughout the body. One study observed a rapid decrease in skin carotenoids and an increase in UV lamp induced sunburn (Darvin et al. 2013).

What happens to alcohol used in cooking? That depends on the cooking method. Alcohol content diminishes with cooking time. 40% of the alcohol remains after 15min of baking or simmering, and only 25% remains after one hour.

While the liver is busy detoxifying alcohol, it becomes less efficient at getting rid of excess oestrogen hormones, causing an oestrogen imbalance. The resulting increase in oestrogen may be part of the mechanism by which alcohol increases breast cancer risk. Male heavy drinkers often develop breast tissue.

While there is some debate about whether cheese and other hyperpalatable foods are truly addictive, there is no question over alcohol. It hijacks the brain reward systems and leads many otherwise functional individuals into a low-grade addiction as defined by “continued use despite evidence of harm”. If moderation in alcohol is not your talent, then the best solution may be alcohol abstinence. You would not be the only non-drinker in your social circles.

Alcohol free challenges (eg. ‘dry July’), like vegan challenges (eg. Veganuary) are becoming popular and are a great way to reset our habits. Andy Ramage (interviewed in the New Normal Podcast) set up a support organization in the UK to help moderate drinkers to break free from their alcohol culture. Don’t be intimidated by the web domain name One Year No Beer, there are one-month and 3-month programs. Hello Sunday Morning is a Sydney based program which claims to be “the largest online community in the world for people looking to change their relationship with alcohol”.

How alcohol free do you need to be? From a health science perspective, the answer is 100%, but you may really enjoy the effects of alcohol and find it difficult to abstain in social situations. We suggest that if you are going to drink alcohol, that you do so infrequently and in small quantities. If your alcohol intake is having an adverse effect on your life, then you may wish to reset your behaviour patterns with a 28 day or longer ‘no alcohol’ challenge. If you are someone who has no off button for alcohol, you need to accept this, and draw the line at zero. People often tell us that their desire for alcohol waned as their diet became more whole food plant-based. Get the nutrition right and many of the other domains of healthy lifestyle fall into place – improved mood, more energy for physical activity and less need for alcohol.


Peer-reviewed articles


Page created 25 August 2020
Last updated 25 August 2020