Alcohol – The Good, The Bad & The Ugly

Article by Gill Cummings-Bell BA (Hon’s), M.Sc. MBA.PGCE.MIfL

At this time of year, many of your clients will partake in a tipple or two and probably a little more besides. We don’t want to spoil the fun so of course indulge over Christmas but to help your clients set New Years resolutions share this article with them. Scary facts on alcohol. You of course will help them pick up the pieces and get back to full fitness in the New Year. It would be helpful for your clients to understand the ‘good, bad and ugly’ side of alcohol and therefore limit the damage they may do over the festive period.

There are various alcohol products made of different compounds of alcohol. Ethyl alcohol (ethanol), which is the alcohol found in our beverages such as beer, wine, whiskey, etc. isn’t the same alcohol that the you find in products such as cleansing rubbing solutions — that’s isopropyl alcohol.

Alcohol proof is a measure of how much ethyl alcohol is contained in an alcoholic drink. The term was originally used in the UK and was defined as 7/4 times the alcohol by volume (ABV). The UK now uses the ABV standard instead of alcohol proof.

The grams of alcohol in an alcoholic drink are dependant on the ABV. It is defined as the number of millilitres of pure ethanol present in 100 millilitres of beverage at 20 °C. The ABV standard is used worldwide.

Ethanol is formed by the fermentation of plants that are dense sources of carbohydrate (e.g., barley, wheat, corn etc.).  Ethanol is not an essential nutrient and provides 7 calories per gram of alcohol.

Here is a guesstimate chart of approximate calorie content for a range of ABV and serving sizes.

Alcohol is easily absorbed through the gastrointestinal track, heads to the liver, which metabolizes more than 90% of it.  The ethanol that isn’t metabolised then enters the bloodstream.

The liver will displace other fuel sources when alcohol is available; in other words, it will use alcohol first.  Liver alcohol dehydrogenase (LADH) is a rate-limiting enzyme that oxidizes ethanol at 15 grams per hour (equal to one regular beer).  A 70 kg adult male will be legally drunk after four drinks in one hour.

While ethanol itself isn’t toxic, its primary metabolite acetaldehyde and secondary metabolite acetic acid, are.  Ethanol is thought to cause harm partly as a result of damage to cellular DNA by its metabolites.

These by-products can make you feel quite ill and create nausea after drinking.

In the UK, a standard drink ranges between 8 and 12 grams of alcohol.  “Moderate drinking” is broadly defined as the consumption of about 1 – 3 drinks per day for women, or between 10 – 30 grams of alcohol and 1-4 drinks per day for men.

Women

Men

It is also recommended that you should have two alcohol free days per week. Download this alcohol tracker which is free and an easy way to keep check of your consumption.

Alcohol possession and consumption is illegal for those under the age of 18 in the UK.  Nonetheless, alcohol is commonly used among youth with British teenagers rating as the third worst binge drinkers in Europe. Recent research from the University of the West of England showed that as many as half of 15 and 16 years olds admitted drinking to excess. Binge drinking accounts for half of all alcohol consumed in England.

Drinking more than the amount suggested by the guidelines can damage a person’s health. For example, alcohol is one of the biggest behavioural risks for disease and death (as well as smoking, obesity and lack of physical activity).

The crime and violence it causes drains hospital resources, generates madness on our streets and harms our communities.

In 2010 to 2011 there were 1.2 million alcohol-related hospital admissions and around 15,000 deaths caused by alcohol. In England alcohol-related harm costs society £21 billion per year.

The UK Government estimate that in a community of 100,000 people, each year:

• 2,000 people will be admitted to hospital with an alcohol-related condition;
• 1,000 people will be a victim of alcohol-related violent crime;
• Over 400 11-15 year olds will be drinking weekly;
• Over 13,000 people will binge-drink;
• Over 21,500 people will be regularly drinking above the lower-risk levels;
• Over 3,000 will be showing some signs of alcohol dependence; and
• Over 500 will be moderately or severely dependent on alcohol.

Some researchers claim that alcohol is a critical part of a well-functioning society, as the alcohol beverage industry employs millions of people, contributes large sums in taxes and venues create social get together sites.

The Bad – Alcohol And Health Problems

Alcohol directly affects the stomach, brain, heart, gallbladder, and liver. It affects body weight, levels of lipids (cholesterol and triglycerides) and insulin in the blood, as well as inflammation and clotting to name just a few. It also alters mood, concentration, and coordination. A few of the health problems are explored below.

Obesity

Adding alcohol to one’s usual food intake can lead to obesity if total calories are regularly in excess of daily needs.

Moderation is the key. You can see from the ABV chart that even 1oz of alcohol has a calorie value in excess of a fruit drink. Take a a day that involved a beer with lunch, 3 or 4 pints in the evening. Add them up and it can easily be over 1500 calories added for the day, equivalent of more than two-thirds of your total metabolism target for the day. That doesn’t leave much room to add the food calories you will consume on top of it. Therefore more calories go in and than our body needs which places you in a positive energy balance and you gain excess weight.

Even if you exercise four days per week, burning two thousand calories through those workouts, drinking within the limit of 3-4 units per day, will still equal an over consumption of calories by a couple of thousand per week. A pound of body fat is roughly equivalent to 3500 calories so do the math for 52 weeks of the year. You can put a 1lb of fat on per fortnight.

Alcohol also releases your inhibitions and often you will engage in problematic eating behaviours while drinking. A big plate of chips on the way home seems like a great idea at the time.

Alcohol and Digestion Of Nutrients

Chronic alcohol intake interferes with pancreatic enzyme secretion and can alter nutrient absorption causing particular problems with the mal-absorption of fat and protein. Alcohol consumption may lead to poor amino acid uptake and the generation of new proteins in the liver (e.g. lipoproteins, albumin, fibrinogen).

Pancreatic endocrine function can also be affected: Insulin resistance is a common side effect of alcoholism, which results in a lack of glycogen formation and energy store depletion and can lead to metabolic syndrome and ultimately type 2 diabetes.

The liver is a major storage organ for vitamins and minerals and converts them into forms used by the body for homeostatic metabolism.  Heavy alcohol consumption affects the uptake and asborption of folate, vitamin B6, vitamin B1, E, and vitamin A.  Folic acid deficiency is the most common vitamin deficiency among alcoholics, most likely due to the increased demand for nucleic acids needed for regeneration of injured liver cells.

The Ugly – Alcohol and Hangovers

Alcohol also affects your blood vessels and fluid volume.  This can result in a headache after excessive drinking particularly because of de-hydration. Alcohol can suppress the anti-diuretic hormone (ADH) release.  This means you will wee more. For every 100ml of alcohol you can wee out 150 ml in urine.  Dehydration can lead to bad headaches and feeling nauseas. Is it really worth it?

If for no other reason, consider your alcohol consumption and your sex drive. Ethanol is a testicular toxin and can increase the activity of aromatase, an enzyme that converts testosterone to estrogen in the body.  Chronic male alcoholics have been seen to present with health problems, including infertility, gonadal atrophy, and feminization. Is that what you really want?

The Good – Health Benefits

It’s safe to say that alcohol is both a medicine and a poison. The difference lies mostly in the dose. Moderation is the key. Moderate drinking may be good for the heart and circulatory system, and may protect against type 2 diabetes and gallstones. The greatest benefits occur with small amounts of alcohol consumption several times per week, and those with the highest risk of developing heart disease seem to benefit the most. Moderate drinking guidelines are laid out above.

The latest consensus for health benefits places moderation at no more than one to two drinks per day for men, and no more than one drink per day for women.

Cardiovascular Disease

More than 100 prospective studies show an inverse association between moderate drinking and risk of heart attack, ischemic (clot-caused) stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes. The effect is fairly consistent, corresponding to a 25 percent to 40 percent reduction in risk. (Harvard 2014)

In the Nurses’ Health Study, the Health Professionals Follow-up Study, and other studies, gallstones and type 2 diabetes were less likely to occur in moderate drinkers than in non-drinkers.

What you drink (beer or wine) doesn’t seem to be nearly as important as your drinking behaviour. Having all your weeks units on a Friday and Saturday night and then not drinking the rest of the week is still classed as alcohol abuse and will bring the negative effects of alcohol. The weekly total units may be the same, however the health implications aren’t.

Studies show that, consumption of alcohol on several days a week is inversely associated with the risk for heart attacks and cardiovascular incidents. The amount consumed, (under 10 grams a day or more than 30 grams), didn’t seem to matter as much as the regularity of consumption.

So drinking one glass of wine several days of the week is the better option. If more people drank only one glass of wine per day we would not need to so many health professionals who deal with alcohol, liver and cardiovascular problems.

Odd Facts

• The consumption of alcohol is so worldwide that it is considered a universal language
• The worlds oldest known recipe is for beer
• The body produces its own alcohol as well 24 hours per day
• In 2012 in the Uk 58% of adults drank an alcoholic drink in the last week
• Alcohol now costs the NHS £3.5bn per year, equivalent to £120 for every tax payer
• 15% of people who ever use alcohol become addicted
• Alcohol carries a greater danger of fatal overdose than LSD
• 90 – 100% of heavy drinkers develop fatty liver
• In the Russian Federation, 75% of individuals arrested for homicide in 1995 had consumed alcohol
• One of the arguments related to alcohol is suicide and depression.  The risk of suicide among alcoholics is 50 to 70 percent higher than in the general population.
• 9% of men and 6% of women drank very heavily (at least three times the recommended limits) on at least one day in the last week. Excluding those who didn’t drink at all in the last week, the figure rises to 14% for men and 12% for women.

The Good The Bad Or The Ugly – You choose.

Given the nature of alcohol’s effects on the body, blanket recommendations about alcohol are not easy. Alcohol offers each person different benefits and risks. Whether or not to drink alcohol, especially for “medicinal purposes,” or just to be social, requires careful balancing of these benefits and risks.

If you aren’t using alcohol, then don’t start.  If you are using, then drinking small amounts more often rather than all in one or two nights will likely offer you the greatest health benefits without promoting fat gain.

Any alcohol consumption above recommended levels can cause health problems, increase disease risk, and can make you cause mayhem socially.

Remember that alcohol is a poison and a drug.  Be careful out there!