Alcohol. Bottoms Up
It's a love-hate thing you know: alcohol and the morning after. That feeling of waking up, thinking it's all good, but after your 2 o'clock breakfast toast and a few sips of water, it turns out to be a completely different story.
Alcohol in Sum. The Good + The Bad
Because thinking alcohol doesn't come with a more chronic set of health consequences may not be accurate considering your body, internal organs, and the possible emotional attachments you can gain from alcohol long term.
However, this isn't to say that alcohol has zero research behind it in terms of the actual health benefits it may potentially provide you. For example, things like social bonding, potential heart health (potential), and even benefits to your overall cholesterol levels are shown to be present under a more moderate intake which makes its consumption perhaps not so bad.
Therefore, weighing out the pros, as well as the cons, to the drink responsible for those good and bad times is definitely worth looking into in order for us to know for sure. So friends, the question still remains, is alcohol worth the risk for your health long term? It's a tough question to answer, but maybe this article can help.
The Effects of Alcohol Starting With the Bad
Because let's just be frank; the bad side of alcohol? Is quite apparent and is most often talked about whenever we hear the word beer, or shot. Being the 3rd preventable leading cause of death in the United States [21], as well as having a unique effect on your liver, brain, and metabolism in sum,
alcohol can do more harm than good outside of a typical post morning headache.
The Bad Point #1: Liver Health
Which is probably the most common health concern that relates to alcohol and its overconsumption. And, when taking into consideration alcohol and consuming it over the recommended amount : i.e, over 30 grams per day for men and roughly 20 grams per day for women, this intake has already been shown to be associated with liver cirrhosis/tissue scarring, development of hepatocellular carcinoma (primary liver cancer) [5], and even an increase in overall mortality when liver disease is already present [1][2][3].
diagram outlining stages of liver health In regards to alcohol consumption
And, although these findings are referring to a more chronic, longer term consequence of consuming too much alcohol, inflammation to your liver can still be an issue whenever a large amount needs to be metabolized in the short term (drinking only one night out of the week for example) [4].
In addition, fatty liver (otherwise known as beer belly) can also become an issue in conjunction with too much alcohol. This is because the creation of fatty acids in your liver are typically increased in alcohol's presence.
As a result, this can create more more visceral fat (fat surrounding our internal organs) which, by itself, is a risk factor for other chronic diseases, such as cardiovascular disease, type 2 diabetes, and even breast cancer to name a few [55].
The Bad Point #2: An Easy “Weigh” to Gain Weight
Yes. Alcohol has calories: 7 calories per gram to be exact. And just putting that on a spectrum in relation to the other macronutrients we tend to eat each day (see below):
Alcohol actually comes out in second place (just below fat) for the amount of energy it tends to provide us. This creates a situation where weight gain can can become quite easy especially when you consider that most liquid calories are a breeze to consume. And hey, not to mention, those other foods we tend to eat while having an alcoholic beverage from time to time? Yes, they’re also high in calories and also easy to eat.
Now, outside of eating (and drinking) good in the neighborhood, a study published in the journal of Clinical Nutrition showed that heavy alcohol intake at levels greater than, or equal to, 30 grams per day was already shown to contribute directly to weight gain in men aged 45-64 over the course of 5 years [26].
And, when taking into consideration that the levels of obesity worldwide has nearly tripled since the year 1975 [28], the extra calories that do come from alcohol certainly wouldn’t help to reduce these numbers.
For example, in another study published in the Journal of Health Promotion and Chronic Disease Prevention in Canada, alcohol consumption was looked at closely in grade 12 students over the course of one year. Their results went on to find that 27.2% of these students binge drank at least once per month while the other students, 4.9% of them to be exact, binge drank at least twice per month as well [27].
But here’s the kicker:
These binging episodes ended up equating to an extra 6000-13,200 calories per year in the monthly binge drinkers (which adds up to an extra 1.2lbs - 3.7lbs of fat per year) and 52,000 to 114,400 calories per year (or 14.8lb - 32.6lbs of additional fat per year) in the twice per week drinkers as well [27].
So, although the calories from alcohol might go unnoticed in the short term; it’s definitely worth noting the consequences of the extra calories down the road.
The Bad Point #3: Poor Nutrient Absorption & GI Distress
Because what’s the point of eating if you can’t benefit nutritionally? And when taking into consideration alcohol and it’s journey through your body, it’s definitely worth noting the negative effects when it comes to your digestive tract and nutrient absorption in sum.
In The Mouth
Or the place where digestion first begins, carbohydrates and fats begin breaking down courtesy of our salivary glands and the saliva they secrete [37].
However, when chronic alcohol consumption persists beyond what’s recommended by the dietary guidelines, the rate at which this saliva is secreted has actually been shown to decrease, while the glands that produce our saliva and digestive enzymes have also been shown to swell. In very extreme cases, they may also become numb [32][38][39].
In The Esophagus
Traveling down the esophagus and later into our stomach, weakening of the lower esophageal sphincter can also occur (see below) even after just one single bout of drinking [32].
This may happen due to alcohol’s relaxing effect on our skeletal muscles [43] which, over time, can lead to something known as gastroesophageal reflux disease, or GERD for short, which tends to show up in the form of heartburn, difficulty swallowing, and chest pain to name a few [32][40][41][42]. (GERD symptoms here courtesy of the Mayo Clinic).
In The Stomach
In the stomach, alcohol can also break down the gastric mucus that lines it which isn’t ideal for the cells underneath [36][42].
Being comprised of various different layers, our non-tissue stomach layers and mucus layer especially (see in blue) plays an important role for the health, maintenance, and overall protection of our stomach from any acidic juice that’s secreted.
When too much alcohol is consumed, an increase in the amount of this stomach acid can occur (depending on the alcohol content of your beverage); breaking down the mucus so important for our protection [42].
Gastritis, stomach ulcers, and bleeding can come about if the acid is able to deteriorate this mucus layer which, according to an article published in the Deutsches Ärzteblatt International, may sometimes go unnoticed depending on a person’s symptoms [45].
In The Small And Large Intestine
In the small and large intestine where nutrient absorption, electrolyte absorption, and the formation of waste products (aka stools) primarily occurs, poor absorption and formation of these chemicals/contents can also be seen since alcohol alone can affect the intestinal lining [42][44]. From glucose; to sodium; to the absorption of water and those oh-so important amino acids, studies in humans tend to show a more negative effect when too much alcohol is being consumed.
For example, in an article published by the NIAA Journal, chronic alcohol consumption led to a reduced rate of sodium and water absorption in parts of the small intestine courtesy of alcohol and its effect on folate absorption (folate plays a role in maintaining our intestinal cell lining which, in turn, can impact a nutrient’s ability to enter our blood) [42][46][47][48].
Other research dealing with the small intestine also shows that alcohol can impair amino acid processing to a significant degree while also reducing the strength and frequency of muscle contractions in parts of the large intestine (which may result in diarrhea and the possible risk of dehydration) [46][48].
The Effects of Alcohol In With the Good
But what about the pros of alcohol might you ask? Well, look no further. Because although the cons of alcohol are pretty darn striking, I think the question here still remains. Can alcohol offer any benefits at all? And are these benefits (if any) actually worth taking a look at seriously?
Because despite the cons of alcohol and the somewhat bad reputation it tends to have, there is actually some research out there to support a possible upside when alcohol is consumed in relatively small amounts. From your heart; to your brain; to the benefits you gain from socializing with others, there may just be something to alcohol to not make you go and quit cold turkey.
The (possible) Good Point #1: Increased HDL Cholesterol
Typically referred to as our “good” cholesterol, high density lipoproteins, or HDL, are helpful little particles that alcohol might increase. Known to clear up those other forms of cholesterol that tend to be harmful and reduce our blood flow, HDL works sort of like a pile up on a busy highway where HDL is the tow truck, and LDL & VLDL (typically referred to as our “bad” cholesterol, or low density/very low density lipoproteins respectively) are the smashed up cars backing things up.
HDL comes through to help chip away at the LDL particles piled up along the sides.
When it comes to alcohol and drinking it in moderation, there are some talking points to be had regarding HDL levels rising when a person’s intake is kept on the lower side of things (i.e up to 1 drink per day for women, and up to 2 drinks per day for men [11]).
For example, according to a study published in the American Heart Association Journal, alcohol intake was shown to increase levels of HDL in the body when being consumed in a dose dependent fashion [12]. This means, when subjects in the study were given .2-.81g/kg of alcohol on an already isocaloric diet, levels of HDL cholesterol actually increased by 18% with no apparent spike in LDL levels as well.
Other research around alcohol and HDL levels in the body showed similar results (here & here) [13][50], while another study published in the Journal of Clinical Nutrition showed that alcohol might even reduce the decrease of HDL levels in the body as well (the data here was limited however) [14].
The (possible) Good Point #2: Decreased Risk of Cardiovascular Disease
Because when talking about your heart and consuming alcohol in moderate doses, alcohol, when drank within reason, can possibly come with a bonus of lowering your risk of cardiovascular disease. And, since heart disease alone is the #1 leading cause of death in the United States today, reducing your intake of alcohol (granted you already consume it ) to the recommended range that’s supported by research, could very well be a step in the right direction [54].
Data taken from the CDC
For example, according to studies published by the American Public Health Association, alcohol, when consumed moderately, was actually shown to be beneficial in terms of lowering the risk of cardiovascular disease (CVD) [18].
Plus, when consuming alcohol in an even lower dose than this (up to the moderate amount presented by the American Dietary Guidelines), alcohol was also shown to be beneficial in terms of lowering the rates of myocardial infarction, heart failure, and even the risk of ischemic stroke [20].
Similar findings were also shown in the Annals of Epidemiology Journal (found here) as moderate amounts of alcohol may lead to an increase in HDL cholesterol levels [19].
Disclaimer though... For those of you who do not drink already/regularly - it’s not recommended that you start doing so in order to gain these heart related benefits. According to an article on the Nutrition Source, along with the other references cited above, not drinking at all is most likely better in the long run based on what we know in regards to liver metabolism, the calories from alcohol, and the increased rate of fatty acid synthesis from alcohol in general [51][52][53].
The (possible) Good Point #3: Social Interaction
Because being able to relax while enjoying good company? That’s definitely not a bad way to spend your evening. And although alcohol by itself shouldn't be the sole reason to let yourself de-stress from your day-to-day grind, there might just be something extra to alcohol to help you unwind just a bit further.
According to a study published in the Journal of Alcohol Research, it was noted that the relationship between alcohol and stress reduction can be quite good depending on the person and the situation they’re presently in [17].
For example, in the case where a person was drinking in the presence of a “pleasant distraction”, a reliable reduction in stress was noted to be seen. And, although more research around this finding may be needed in real world situations, it was also noted that consuming alcohol prior to a stressful event might reduce your response to that stressor to come [17].
Plus, socializing in general is fun! And whether or not you choose to consume alcohol, spending time with other humans while learning how to socialize, can potentially be a plus for both your personal and professional development.
The Skinny on Alcohol
So yes... To my surprise (and maybe to yours as well) there is definitely an argument to be had regarding alcohol and consuming it in small amounts. And, although the cons of alcohol from a physiological perspective may end up outweighing the pros, sticking to the recommended intakes of alcohol might also be fine granted your consumption doesn't get out of hand.
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