Health is Wealth
February 15, 2024
Alcohol affects your whole body, from your liver and immune system to your brain and mental health
You probably already know that excessive drinking can affect you in more ways than one.
There are the empty calories that can lead to weight gain. There’s the potential for injury and regrettable choices. And don’t forget about the hangovers of course.
Heavy drinking can also lead to a host of health concerns, like brain damage, heart disease, cirrhosis of the liver and even certain kinds of cancer.
And that’s on top of the toll that alcohol use can take on relationships, not to mention the potential for financial strain and legal troubles.
But even moderate alcohol use changes the way your body functions.
We talked with hepatologist Shreya Sengupta, MD, about how alcohol use affects your body and your emotional health.
“Some people think of the effects of alcohol as only something to be worried about if you’re living with alcohol use disorder, which was formerly called alcoholism,” Dr. Sengupta says.
“But when you consider how alcohol is metabolized and used by your body, we can start to see that even moderate and social drinking affects our health to some degree.”
Dr. Sengupta shares some of the not-so-obvious effects that alcohol has on your body.
Your liver detoxifies and removes alcohol from your blood through a process known as oxidation. When your liver finishes that process, alcohol gets turned into water and carbon dioxide.
But when you ingest too much alcohol for your liver to process in a timely manner, a buildup of toxic substances begins to take a toll on your liver.
If alcohol continues to accumulate in your system, it can destroy cells and, eventually, damage your organs.
“When your liver is overwhelmed by oxidizing alcohol, it generates molecules that inhibit fat oxidation,” Dr. Sengupta explains. “The fats build up. Over time, it can lead to a condition known as steatotic liver disease.”
Steatotic liver disease used to go by the name fatty liver disease.
Steatotic liver disease develops in about 90% of people who drink more than 1.5 to 2 ounces of alcohol per day. That’s about one shot glass worth.
With continued alcohol use, steatotic liver disease can lead to liver fibrosis. Eventually, you can develop permanent and irreversible scarring in your liver, which is called cirrhosis.
“The good news is that earlier stages of steatotic liver disease are usually completely reversible in about four to six weeks if you abstain from drinking alcohol,” Dr. Sengupta assures.
Cirrhosis, on the other hand, is irreversible and can lead to liver failure and liver cancer, even if you abstain from alcohol.
You probably are keenly aware of the so-called “beer belly.” That’s shorthand for a round midsection that some people associate with drinking too much beer.
In reality, there’s no evidence that drinking beer (or your alcoholic beverages of choice) actually contributes to belly fat.
But there’s plenty of research to back up the notion that alcohol does lead to weight gain in general. Even for people who aren’t particularly heavy drinkers.
“Drinking gives your body work to do that keeps it from going about its other processes,” Dr. Sengupta notes. “Alcohol distracts your system from its regularly scheduled duties, including things like metabolizing carbohydrates and fats.”
Once you take a drink, your body makes metabolizing alcohol a priority — above processing anything else.
That’s because your body already has processes in place that allow it to store excess proteins, carbohydrates and fats. But there isn’t a storage tank for alcohol. So, your system prioritizes getting rid of alcohol before it can turn its attention to its other work.
That allows excess calories from the foods you eat to sit around, leading to weight gain.
Your gut microbiome is a hotbed of bacteria that help keep your digestive system happy and healthy. The trillions of microbes in your colon and large and small intestines are critical to proper digestion. They also help fend off inflammation and support healthy metabolism.
When you drink too much alcohol, it can throw off the balance of good and bad bacteria in your gut.
“Alcohol can kill the good bacteria that live in your gut, allowing bad bacteria to grow unchecked,” Dr. Sengupta explains. “That can lead to problems with digestion, inflammation and even organ damage.”
Having a glass of wine with dinner or a beer at a party here and there isn’t going to destroy your gut. But even low amounts of daily drinking and prolonged and heavy use of alcohol can lead to significant problems for your digestive system.
Too much alcohol is bad for your heart. Alcohol can cause:
Warnings from the World Heart Federation go so far as to state that no amount of alcohol is safe for your ticker.
But wait, you may be thinking, what about those headlines that claim red wine is supposed to be good for my heart?
There are a few studies that associate red wine with improved heart health in lab tests. But no research proves that red wine causes any improvements in heart health in people.
“The reality is that alcohol causes more health troubles than it could ever help,” Dr. Sengupta reinforces. “And that goes for your heart, as well as the rest of your body.”
Your pancreas helps your body digest food and manage your blood sugar. Drinking alcohol changes how your pancreas works.
“Your pancreas secretes fluids. Alcohol use can thicken those fluids, which can clog the ducts that those fluids flow out of,” Dr. Sengupta explains.
Like a clog in a drain, those thickened fluids can jam up your ducts. That can lead to pancreatitis, which is inflammation of the pancreas.
Pancreatitis can be a short-term (acute) condition that clears up in a few days. But prolonged alcohol abuse can lead to chronic (long-term) pancreatitis, which can be severe.
The U.S. Centers for Disease Control and Prevention (CDC) has a clear warning regarding the connection between drinking and cancer: “The less alcohol you drink, the lower your risk for cancer.”
Why?
Your body breaks alcohol down into a chemical called acetaldehyde, which damages your DNA. Damaged DNA can cause a cell to grow out of control, which results in cancerous tumors.
Alcohol use has been shown to raise your risk for several kinds of cancer. That includes cancers of the:
If you drink every day, or almost every day, you might notice that you catch colds, flu or other illnesses more frequently than people who don’t drink. That’s because alcohol can weaken your immune system and make your body more susceptible to infection.
“We see lower levels of a specific kind of white blood cells called lymphocytes in people who drink heavily for long periods of time,” Dr. Sengupta reports. “That can leave them more vulnerable to infectious diseases.”
The morning after a night of over-imbibing can cause some temporary effects on your brain. Things like trouble concentration, slow reflexes and sensitivity to bright lights and loud sounds are standard signs of a hangover, and evidence of alcohol’s effects on your brain.
Long-term alcohol use can change your brain’s wiring in much more significant ways. Ways that your standard hangover cures won’t even begin to touch.
“Excessive alcohol consumption can cause nerve damage and irreversible forms of dementia,” Dr. Sengupta warns.
Alcohol is a depressant. And prolonged alcohol use can lead to mental health conditions like anxiety and depression. Chronic misuse can also lead to paranoia and hallucinations.
Even drinking a little too much (binge drinking) on occasion can set off a chain reaction that affects your well-being. Lowered inhibitions can lead to poor choices with lasting repercussions — like the end of a relationship, an accident or legal woes. Each of those consequences can cause turmoil that can negatively affect your long-term emotional health.
“Alcohol tends to cause more problems than it solves for a lot of people,” Dr. Sengupta emphasizes. “If drinking is affecting your health, your relationships, your work, your finances, it’s time to make some serious changes.”
Ready to stop drinking and improve your health? These tips may help.
If you need more guidance to quit drinking, the Substance Abuse and Mental Health Services Administration (SAMHSA) offers a hotline, 24/7, 365 days a year. Call 1.800.662.HELP (4357).
Alcoholics Anonymous is available almost everywhere and provides a place to openly and nonjudgmentally discuss alcohol issues with others who have alcohol use disorder.
You likely know that drinking alcohol too often or to excess isn’t a good idea, health-wise. But when it comes to alcohol and heart health, you may have heard different sides. Is drinking all that bad for your heart? Can a glass of wine help reduce your risk of heart disease — or make it worse?
First things first: If you drink alcohol, you should do so in moderation to avoid alcohol-related heart issues. And you should never intentionally use alcohol to try to reduce your risk of heart disease.
To further explore the relationship between your ticker and your favorite glass of merlot or IPA, we chatted with cardiologist Leslie Cho, MD.
Here are some of the effects of alcohol on your heart:
One of the most important things your heart does is keep a rhythm. On average, a regular heart rate is about 60 to 100 beats per minute when your body is at rest. But alcohol can lead to your heart rate temporarily jumping up in speed, and if it goes over 100 beats per minute, it can cause a condition called tachycardia. Too many episodes of tachycardia could lead to more serious issues like heart failure or going into irregular rhythms, which can cause heart attack and stroke.
That fourth drink at the bar may feel like it’s relaxing you, but it’s actually affecting your body differently than you might think. Alcohol can affect your blood pressure, causing it to go up temporarily. This is especially true when you engage in binge drinking (that’s defined as four or more drinks within two hours for women and people assigned female at birth, and five or more drinks within two hours for men and people assigned male at birth).
And sure, we’ve all had a night here or there where we’ve had one too many and we know it. But it’s important to make sure those nights of overindulgence are the exception and not the rule. If you’re not sure, make a note to tune into how much you’re having over the course of the next month or so. If it’s more than recommended, try to consciously pace your drinking to help reduce the spike in your blood pressure that excessive alcohol causes.
And if you have a history of high blood pressure, it’s best to avoid alcohol completely or drink only occasionally, and in moderation.
Whether it’s a glass of red wine with your turkey or toasting champagne for the new year, alcohol definitely becomes more present during the holiday season. And while enjoying celebratory spirits in moderation is alright for most people, it’s important to be aware you can fall victim to holiday heart syndrome if you overdo it. This is when overeating and overindulging in alcohol lead to an irregular heartbeat.
Holiday heart syndrome can happen if you don’t typically drink alcohol, but then have a few at a holiday party or if you binge drink. This can cause you to develop an irregular heartbeat, called atrial fibrillation, which can increase your risk of stroke, heart attack and heart failure.
The short-term effects of alcohol (headache, nausea, you know the rest) are easy to pinpoint. But there are ways that alcohol affects your body over time that are important to understand. One of the long-term effects of alcohol on your heart is alcoholic cardiomyopathy. This is when your heart-pumping function gets weaker and your heart gets larger due to changes from heavy alcohol use over a long period of time.
OK, don’t panic. If you’re an occasional drinker, there’s no cause for worry. But it may be worthwhile learning about what counts as binge drinking and whether or not you may be drinking too much and don’t even know it.
It’s true, red wine is a better choice than hard liquor. But can a trip to the wine bar boost your heart health?
You should never consider wine or any other alcohol as a way to lower your heart disease risk. And, in fact, the study also showed that drinking one or fewer drinks per day was related to the lowest likelihood of dying from a stroke. However, Dr. Cho points out that more recent data shows that there may be no amount of alcohol that is truly safe. “The myth that wine is beneficial for heart health is no longer true,” she states.
“It’s not a good idea to start drinking alcohol in an effort to lower your risk of heart disease,” Dr. Cho continues. “It’s better not to drink any alcohol at all.”
The American Heart Association recommends the same.
It’s also important to know that the ways in which alcohol affects your heart will vary from person to person, depending on your age and other conditions you may have.
Let’s face it, a hangover in your mid-40s doesn’t feel the same as one in your early 20s. This is because your age plays a factor in how well you tolerate alcohol. While some people develop a tolerance to alcohol over time, this isn’t true for everyone — and this ability doesn’t last forever, Dr. Cho notes.
“As we get older, our ability to clear alcohol definitely decreases and our sensitivity to alcohol probably increases,” she explains. “Also as we get older, we end up having more diseases, so we could be on medicines that can interfere with the way our bodies metabolize alcohol.”
In many ways, your medical history (and present) can tell you a lot about your future with alcohol. That means, if you’re living with other medical conditions and/or taking certain medications, this will all have an impact on how alcohol affects you.
“Certain health conditions can make drinking alcohol more dangerous,” Dr. Cho says.
For example, some people who are on cholesterol-lowering medicines may experience muscle aches when they drink alcohol. Because alcohol and cholesterol medicine both are processed through your liver, they are, in a sense, competing for clearance. So, it’s important to think about your overall health and talk to a healthcare provider about your personal risk factors.
“Alcohol is made out of sugar,” Dr. Cho points out. “So, if you’re predisposed to diabetes or if high triglycerides are one of your issues, it’s not a good idea to drink alcohol.”
Dr. Cho also warns that if you have liver dysfunction or take other medicines that are processed through the liver, your risks might be different. Talk to your healthcare provider about how alcohol might interact with your prescription medicines.
The last thing you want is for that casual drink after work or glass of wine at dinner to negatively impact your heart health. There’s a way to have a healthy, balanced relationship with alcohol that lets you enjoy a drink occasionally and celebrate with friends and family. But your heart is an important organ that should also be cared for, so be sure to drink in moderation, learn about binge drinking and know what your body can (and can’t) tolerate before opening that tab.FACEBOOKTWITTERLINKEDINPINTERESTEmailalcoholalcohol and healthalcoholic beveragesbinge drinkingheart health
Set a date, avoid triggers, and get help and support along the way
Looking to take on a sobriety challenge, like Dry January? Or maybe it’s a pregnancy that made you realize it’s time to stop drinking. Or maybe you’re just looking to improve your health, wake up hangover-free and give your liver (and your heart) a break.
Whatever your reason to quit drinking, know that you’re doing yourself a favor. Alcohol impacts our sleep, relationships, weight, risk for serious chronic conditions and more.
“Increasingly, I’m hearing from a lot of people who don’t necessarily have alcohol use disorder but who realize that they feel better when they drink less or stop drinking altogether,” says addiction psychiatrist David Streem, MD.
But you probably have questions about how to quit drinking. Is it better to wean off gradually? Go cold turkey? How will you keep up a sober lifestyle?
Whether you’re sober curious, know for sure you’re ready to quit, or fall somewhere in between, Dr. Streem shares advice for how to stop drinking. If you’re living with alcohol use disorder (also known as alcoholism), you’ll likely benefit from additional medical interventions. We’ll talk about that, too.
When you consider how to go about giving up alcohol, account for factors like how much you drink and your reasons for drinking.
“At its core, quitting drinking is a behavioral change,” Dr. Streem says. “It’s about breaking a habit and starting new habits.”
But if you’re living with alcohol use disorder, drinking is more than a habit. It’s a medical condition. People with alcohol use disorder can’t stop drinking even when it causes problems, like emotional distress or physical harm to themselves or others.
“If you drink every day — if you crave alcohol and have a compulsion to continue drinking even when the effects of alcohol are obvious — it’s best to seek medical treatment rather than stop drinking on your own,” Dr. Streem advises. “In many cases, it may not be safe for someone with alcohol use disorder to stop drinking without professional support, and you’re less likely to be successful on your own, too.”
In order to change your drinking habits, your first step is to take a close look at your current behaviors and find patterns.
Dr. Streem suggests starting with the World Health Organization’s Alcohol Use Disorders Identification Test (AUDIT). It can be a particularly helpful way to help you get a clearer understanding of your drinking habits and your relationship with alcohol. It’s a 10-question screening test that gives you research-backed, personalized advice for quitting or reducing your intake of alcohol.
Making lists can help, too. Ask yourself questions like:
Laying it all out in black and white can take time and some serious self-examination. That’s OK. Understanding your habits and your motivations to quit drinking can help you understand the change you’re making in your life and reinforce why it’s important.
Dr. Streem says that if your goal is to stop drinking altogether, you’re more likely to have success quitting all at once, rather than weaning off alcohol. But that advice changes if you’re living with alcohol use disorder.
“If a person with alcohol use disorder stops drinking suddenly, it can be dangerous,” Dr. Streem reiterates. “If you’re choosing to quit drinking for your health or for other reasons, though, you have a better chance of success if you choose a date to quit and don’t look back.”
He suggests setting a concrete start date for when you’ll quit drinking. Leading up to that date, talk with your family, friends and other important people in your life. Tell them your plan and ask for their support as you make this life change.
We all become conditioned to have certain responses to triggers throughout our lives. It’s normal for certain stimuli to cause a reaction in your mind and body without even being aware of it.
You smell a pot of chili simmering on the stove and then suddenly feel ravenously hungry. You feel your phone vibrate and then anxiously reach to see who texted. Even dogs do it — you say “walk” and they high-tail it to get their leash.
Drinking works in a similar way, Dr. Streem says. You can become conditioned to reach for a drink when your environment offers up certain cues.
So, when you’re trying to quit drinking, steering clear of triggers will help.
There’s a saying in the Alcoholics Anonymous (AA) community that sums up the triggers that can derail sobriety: “people, places and things.” And it’s not only people in recovery from alcohol use disorder who are well-advised to avoid drinking triggers when trying to quit.
People: If there are certain friends or other people in your life that you typically drink with, you may want to take some time away from them while you’re working on creating new, sober habits. At least, let them know your intentions to quit drinking so they can be supportive.
Places: Here’s another AA saying: “If you hang out in a barbershop long enough, you’re going to get a haircut.” In other words, if you go places where the alcohol is flowing — like bars or house parties — chances are, you’re going to drink. It’s almost inevitable. When you’re cutting alcohol out of your life, you’re best off if you can avoid places where alcohol is abundant.
Things: As you prepare for the date you set to quit drinking, Dr. Streem advises getting rid of all alcohol and drinking accessories (wineglasses, tumblers, flasks, cocktail recipes and so on) — the ol’ “out of sight, out of mind” technique. These physical reminders of drinking can prompt a trigger response that can be counterproductive to your goal of quitting drinking.
A sober life doesn’t have to mean more time at home as you try to block out triggers. It can mean more time for your other interests, and even new interests. More time to meet new people, catch up with old friends and try new things.
Try these alcohol-free ways to enjoy time with new (and old) friends:
Talk therapy is an important part of treatment for alcohol use disorder, but Dr. Streem says just about anyone who is making a life change, like quitting drinking, can benefit from therapy.
“You may learn things about yourself and about your relationship to this substance that you never even thought about,” he adds.
Therapy can help you understand why you drink and learn new habits so you can live a healthy lifestyle that doesn’t rely on alcohol as a crutch. It can also help you gain a new perspective as you consider how your life will change without alcohol.
If your body is used to a certain amount of alcohol, you may feel certain effects when you stop. How you feel when you stop drinking is largely based on how often and how heavily you drink. People who only drink occasionally probably won’t notice any physical or psychological symptoms. If you drank heavily, you may have some mild symptoms. People who have a severe reaction to quitting alcohol should seek emergency treatment.
Emotionally, you may feel some anxiety or sadness about ending a chapter of your life and nervousness about the future. You may feel irritable or have trouble thinking clearly.
Physically, people who drink heavily may experience some mild symptoms like:
Again, severe alcohol withdrawal symptoms, including pain, passing out, hallucinations and more may be a sign that you’re living with alcohol use disorder and should seek professional medical intervention before quitting alcohol.
If you’re living with alcohol use disorder, quitting drinking is important for your health. But quitting on your own can pose risks to your health and is unlikely to be successful. Rehabilitation facilities can help you on your path to sobriety by addressing alcohol withdrawal symptoms and becoming involved in sober living support groups, like AA.
But Dr. Streem knows that it can be hard to recognize signs of alcohol abuse in ourselves. Often, people with alcohol use disorder find that other people in their lives spot their addiction long before they do.
“If there are people around you who are encouraging you to make this change, that should be a big red flag that your alcohol use is problematic,” he says. “People often see us better than we see ourselves, so if someone is telling you that you need to stop drinking, that should be taken seriously.”
Another clue that can be an indication of an unhealthy relationship with alcohol is if you make “rules” around drinking.
“If you say things like, ‘I don’t have a drinking problem because I never drink on Mondays,’ or, ‘I only drink X or Y … never Z,’ and so on, that can be an indication of alcohol use disorder,” Dr. Streem says. “Rules are a way of trying to create an illusion of control when you are, in fact, out of control. People who don’t have an alcohol use disorder don’t make rules about drinking. They don’t have to.”
Other signs of alcohol use disorder include:
If you’re living with alcohol use disorder, treatment at a medical rehabilitation facility is your best option. Through therapy, support groups and medication, you’ll be supported on your path to recovery.
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It’s a warm summer day and you’re hanging out with friends and family for the first time in over a year, celebrating being vaccinated and just being together. And to help beat the heat, you reach in the cooler for an ice-cold beer.
While that might be refreshing at the moment, though, there’s good reason to grab some water, too. The heat of summer can be brutal, sometimes, and its effects are amplified when you’ve had a little too much alcohol.
To better understand the risks you face when drinking alcohol during this hot vaccine summer, we spoke with registered dietitian Julia Zumpano, RD.
Whenever you’re outside in the heat for prolonged periods – like at the beach or picnic – you’re at risk of dehydration. Consuming alcohol only heightens that risk.
Alcohol reduces the release of the hormone vasopressin, which keeps your body fluids balanced. At the same time, alcohol is also a diuretic which means more urinating and that can lead to dehydration even without the heat. Add in all that sweat from the hot sun and it’s a recipe for dehydration disaster.
One thing Zumprano points out, too, is that caffeine – whether via coffee, soda or as a mixer for liquor – heightens that dehydration risk even further.
Dehydration can also compound certain aspects of intoxication, she notes. “Altered thinking, altered abilities to drive and make reasonable decisions or even just to have conversations are all things that intoxication can cause.”
Given that alcohol content is usually higher in spirits than in your average beer, it makes sense that drinking beer instead of mixed drinks might help you avoid dehydration. But the reality is a little more complex, according to Zumpano.
“If you’re consuming liquor at a volume equivalent to the volume of beer, like 12 ounces of margaritas compared to 12 ounces of an average beer, you will get drunk a lot quicker,” she says. “But if you’re drinking what’s considered an alcoholic drink equivalent, there’s not much of a difference because your alcohol intake is the same.”
According to the National Institute of Health, one alcoholic drink equivalent, also referred to as a “standard drink,” contains around 14 grams of pure alcohol. By those measurements, an average 12-ounce can of beer contains the same amount of alcohol as a 5-ounce glass of wine or a typical shot of distilled spirits like rum, vodka, gin or whiskey.
One thing to keep an eye on, though, is the alcoholic content of your beer. While major brands generally run between 4% and 5% alcohol per 12-ounce can or bottle, certain styles of craft beer are as much as 9% alcohol per the same volume. In other words, one can of your favorite local IPA delivers almost twice the amount of alcohol to your system.
Another mistake you should avoid, Zumpano says, is thinking that drinking all that liquid rehydrates you. “If you’re drinking a lot of beer or alcoholic seltzer, it can feel like you’re drinking a lot of liquid and staying hydrated, but the alcohol offsets that because it’s the dehydrating factor,” she points out.
Not that drinking mixed drinks is any better, according to Zumpano. “If you’re drinking a sugary, sweet mixed drink, you run into the same thing. It feels like you’re staying hydrated because they go down so much smoother than drinking spirits on the rocks. But it’s the same effect as with beer: The alcohol is still dehydrating you unless you’re also drinking enough water.”
All of these drinks have other adverse health effects, too. They can pack a bunch of calories into a single serving – as many as 400 to 500 calories in some mixed drinks and craft beers – and they can come loaded with carbs.
There’s more, though. “If you’re drinking high sugar, high caloric intake beverages and you’re drinking a lot of them, they can be very filling,” Zumpano says. If you’re feeling full, you might not eat any food which can otherwise help absorb some of the alcohol.
So what can you do to avoid dehydration troubles when you’re sipping your favorite boozy beverage by the pool? “To counteract the dehydration risk of alcohol,” Zumpano says, “drink 8 to 12 ounces of water for every alcoholic drink. It slows your intake, keeps you hydrated and can mitigate negative hangover effects.”
She suggests keeping a reusable water bottle with you that you can refill as the day goes on, taking time to drink the necessary water between beers or margaritas. Another option is to buy a pack of 8-ounce bottles of water and alternate with your booze. And you can always infuse your water with fruit to keep it flavorful.
“It’s also important to know what your trigger for over-consumption is,” she adds. “If you’re triggered by over-consuming beer or alcoholic seltzer, you want to be mindful of that. Try to switch a drink you have better control of and keep the water bottle handy.”
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