No level of alcohol consumption is safe for our health. The WHO

4 January 2023 

News release

Reading time: 3 min (759 words)

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The risks and harms associated with drinking alcohol have been systematically evaluated over the years and are well documented. The World Health Organization has now published a statement in The Lancet Public Health: when it comes to alcohol consumption, there is no safe amount that does not affect health.

It is the alcohol that causes harm, not the beverage

Alcohol is a toxic, psychoactive, and dependence-producing substance and has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer decades ago – this is the highest risk group, which also includes asbestos, radiation and tobacco. Alcohol causes at least seven types of cancer, including the most common cancer types, such as bowel cancer and female breast cancer. Ethanol (alcohol) causes cancer through biological mechanisms as the compound breaks down in the body, which means that any beverage containing alcohol, regardless of its price and quality, poses a risk of developing cancer.

The risk of developing cancer increases substantially the more alcohol is consumed. However, latest available data indicate that half of all alcohol-attributable cancers in the WHO European Region are caused by “light” and “moderate” alcohol consumption – less than 1.5 litres of wine or less than 3.5 litres of beer or less than 450 millilitres of spirits per week. This drinking pattern is responsible for the majority of alcohol-attributable breast cancers in women, with the highest burden observed in countries of the European Union (EU). In the EU, cancer is the leading cause of death – with a steadily increasing incidence rate – and the majority of all alcohol-attributable deaths are due to different types of cancers.

Risks start from the first drop

To identify a “safe” level of alcohol consumption, valid scientific evidence would need to demonstrate that at and below a certain level, there is no risk of illness or injury associated with alcohol consumption. The new WHO statement clarifies: currently available evidence cannot indicate the existence of a threshold at which the carcinogenic effects of alcohol “switch on” and start to manifest in the human body.

Moreover, there are no studies that would demonstrate that the potential beneficial effects of light and moderate drinking on cardiovascular diseases and type 2 diabetes outweigh the cancer risk associated with these same levels of alcohol consumption for individual consumers.

“We cannot talk about a so-called safe level of alcohol use. It doesn’t matter how much you drink – the risk to the drinker’s health starts from the first drop of any alcoholic beverage. The only thing that we can say for sure is that the more you drink, the more harmful it is – or, in other words, the less you drink, the safer it is,” explains Dr Carina Ferreira-Borges, acting Unit Lead for Noncommunicable Disease Management and Regional Advisor for Alcohol and Illicit Drugs in the WHO Regional Office for Europe. 

Despite this, the question of beneficial effects of alcohol has been a contentious issue in research for years.

“Potential protective effects of alcohol consumption, suggested by some studies, are tightly connected with the comparison groups chosen and the statistical methods used, and may not consider other relevant factors”, clarifies Dr Jürgen Rehm, member of the WHO Regional Director for Europe’s Advisory Council for Noncommunicable Diseases and Senior Scientist at the Institute for Mental Health Policy Research and the Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health, Toronto, Canada.

We are missing the bigger picture

Globally, the WHO European Region has the highest alcohol consumption level and the highest proportion of drinkers in the population. Here, over 200 million people in the Region are at risk of developing alcohol-attributable cancer.

Disadvantaged and vulnerable populations have higher rates of alcohol-related death and hospitalization, as harms from a given amount and pattern of drinking are higher for poorer drinkers and their families than for richer drinkers in any given society.

“So, when we talk about possible so-called safer levels of alcohol consumption or about its protective effects, we are ignoring the bigger picture of alcohol harm in our Region and the world. Although it is well established that alcohol can cause cancer, this fact is still not widely known to the public in most countries. We need cancer-related health information messages on labels of alcoholic beverages, following the example of tobacco products; we need empowered and trained health professionals who would feel comfortable to inform their patients about alcohol and cancer risk; and we need overall wide awareness of this topic in countries and communities,” adds Dr Ferreira-Borges.

Kickstart your health resolutions with these top nutrition tips from our Senior Dietitians at Blackrock Health Hermitage Clinic.

Blackrock Health

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Kickstart your New Year’s health resolutions this month with these top nutrition tips from our Senior Dietitians at Blackrock Health Hermitage Clinic. Prioritise your health this year by following some simple guidelines:

– Prioritise whole foods: Swap processed snacks for nourishing, nutrient-dense snacks such as nuts and dried fruits, fruit and yogurt, cheese and crackers, nutty flapjacks, oat snacks. When opting for convenience snacks be aware of the ingredient list, some snacks which may label themselves as ‘healthy’ alternatives may have a long list of ingredients, generally the more whole ingredients and the shorter the list the better!

– Stay hydrated: Start each day with a glass of water and aim for 8 glasses throughout the day. Proper hydration is key for energy and overall well-being.

– Limit alcohol: Alcohol dehydrates and can cause fatigue which leads to poorer food choices as well as negatively impacting overall health. Swap alcoholic drinks for non-alcoholic alternatives where possible and aiming for at least three alcohol free days per week.

– Stay active: Incorporating some daily movement (outside if possible) will support overall mood, energy levels and health.

– Plan ahead: Try not let busy schedules derail your healthy eating goals. Meal prepping, batch cooking and planning snacks will help you stay on track.

At Blackrock Health, our Dietetics and Clinical Nutrition department is made up of Registered Dietitians who help manage and support a variety of nutritional and medical concerns to patients across our clinics.

If you are interested in outpatient dietetic support please visit our Dietetics & Nutrition pages (https://www.blackrockhealth.com/treat…/dietetics-nutrition) where you will find the many options available.

New High Blood Pressure Guidelines @American_Heart

Get your blood pressure checked at least once a year and understand what the numbers mean. Severe high blood pressure combined with symptoms such as chest pain or trouble speaking may be a hypertensive emergency, according to the new high blood pressure guideline, and you should call 911 immediately.

Researchers don’t know as much about the direct effects of long-term stress on blood pressure.  But they do know that stress can impact lifestyle habits and increase your risk of heart disease and other chronic health issues. Luke Laffin, MD. @ClevelandClinic

How Stress Is Linked to High Blood Pressure

Daily stressors can increase BP in the moment, as well as contribute to habits that can feed long-term hypertension

Feeling stressed? If so, you’re hardly alone, given that stress has been called the health epidemic of the 21st century. But have you ever wondered what all this stress means for your blood pressure?

The answer, it turns out, is more complex than you might think. Let’s take a closer look with preventive cardiologist Luke Laffin, MD.

Does stress raise blood pressure?

Stressful moments can totally send your blood pressure (BP) skyrocketing. You feel it deep in your core, too, as your heart thumps harder and your nerves jangle with a fight-or-flight response.

“If we’re in a stressful situation, the normal physiologic response is to increase blood pressure,” explains Dr. Laffin. “But your body can handle these sorts of acute changes in blood pressure pretty well.”

And once the immediate stressor is gone, your BP should return to its typical level.

Of course, not all stress clocks out like it’s a shift worker. Chronic stress tends to linger — and that can contribute to a long list of physical symptoms, including high blood pressure (hypertension).

The connection between stress and hypertension

Researchers don’t know as much about the direct effects of long-term stress on blood pressure. But they do know that stress can impact lifestyle habits and increase your risk of heart disease and other chronic health issues.

“Stress itself doesn’t necessarily cause sustained elevations in blood pressure,” says Dr. Laffin. “But it often has an impact on lifestyle factors, which can absolutely contribute to long-term elevations in blood pressure.”

When you’re chronically stressed, you can fall into habits that can lead to higher blood pressure and increase your risk of heart disease. These include:

  • Sleeping too little, too much or poorly
  • Not exercising as much
  • Make unhealthy food choices
  • Smoking
  • Drinking alcohol

It can be difficult to see when acute stress transitions to chronic stress. But seemingly “temporary” stressors that last for weeks can turn into chronic stressors that need to be addressed for the sake of your heart health.

“What we’re really worried about is chronically elevated blood pressure,” states Dr. Laffin.

Can lowering stress lower your BP?

Finding ways to better manage your stress can help keep your blood pressure from rising and staying at elevated levels, suggests Dr. Laffin. He suggests:

  • Focusing on fitness: “Working out regularly is a great way to feel better, decrease stress levels and better adapt to difficult situations,” says Dr. Laffin. The positive effects of exercise on heart health are also important for your blood pressure.
  • Catching ZZZs: The quantity and quality of your sleep matter for your BP. “For stable blood pressure, you need to get about six to eight hours of uninterrupted sleep at night,” he advises.
  • Minimizing stressors: To reduce stress, you need to address its causes. Of course, that can be easier said than done when stressors involve your job or family. In these cases, additional steps, like therapy, may help you find coping strategies.
  • Adopting a heart-healthy diet: Foods high in sodium and saturated fats can increase blood pressure even before you add stress to the mix. Embracing a Mediterranean-style diet and eating more antioxidant-rich foods can help keep your BP down.
  • Calming techniques: Various forms of meditation can help you calm your mind and tamp down stress. There’s evidence that mindfulness-based stress reduction can lower BP within a few months.

Medications like beta-blockers may also be an option if stress seems to be driving blood pressure into danger zones. Antihypertensives can help bring down high blood pressure, too.

“But managing stress-related hypertension usually comes down to lifestyle,” clarifies Dr. Laffin. “Diet, exercise, sleep — those are all factors that play a big role in keeping your heart healthy.”

Brownout vs. Blackout from drinking @ClevelandClinic #encephalopathy

Excess alcohol and substance use can cause temporary and permanent memory loss

What are blackouts and brownouts?

Blackouts involve complete memory loss caused by your brain’s inability to record new memories for a period of time due to the effects of excessive alcohol, substance misuse or some other condition.

But sometimes, auditory or visual cues can help a person piece together memories of what happened during a blackout. These cues could come in the form of texts, pictures or conversations with people who were present while you were blacked out. The medical term for blackouts is called transient loss of consciousness (TLOC).

The difference between a brownout and a blackout is that brownouts involve partial memory loss. With a brownout, you may be able to remember certain details from the period of time you were affected, but other portions of time can’t be recalled.

“The hippocampus is a part of your brain that takes our experiences and the awareness of all our senses and processes those into memories,” explains Dr. Streem. “It’s sensitive, and it’s the same part of the brain that deteriorates in people with Alzheimer’s disease.”

Excessive alcohol use isn’t the only thing that can cause blackouts or brownouts. Substance misuse on its own or with alcohol can increase your likelihood of experiencing a blackout. Hypnotics or sedatives and benzodiazepines like flunitrazepam (also known as Rohypnol or roofies) can also lead to blackouts or brownouts.

There are other medical conditions that cause blackouts or brownouts, too, including:

“Anything that causes damage to the brain, whether temporary or permanent, can cause memory loss if the damage is in the right spot,” states Dr. Streem.

Is a blackout the same as passing out?

Blackouts are not the same as passing out. When you pass out or faint, you experience a temporary loss of consciousness.

“When you’re passed out, you’re not awake. A blackout happens to someone who’s still conscious but they’re not coding any new memories,” explains Dr. Streem. “A person who has a blackout is still awake and they have some ability to think, but other parts of their brain may not be working well enough. Often, this is because of intoxication.”

Understanding these definitions and the difference between blackouts and passing out is incredibly important, as it may be difficult for other people to recognize someone is having a blackout because of their seemingly aware state.

How much alcohol can cause a blackout?

How much alcohol or substance use is needed to cause a blackout varies based on a person’s height, weight, sensitivity and assigned sex at birth.

“We know females absorb more alcohol in their bloodstream than males,” says Dr. Streem. “But for most people, it’s going to involve more than the legal blood alcohol limit. In almost all states in the U.S., the blood alcohol limit for driving is .08. Blackouts usually appear at blood alcohol levels that are twice the legal limit or higher.”

Studies have shown that young adults under the age of 25 are particularly vulnerable to experiencing blackouts. Additionally, blackouts may occur at far lower thresholds among younger populations. That’s largely because the parts of your brain responsible for decision-making aren’t fully matured until around age 25. Despite this, intentional binge drinking has been a common practice among young adults.

Regardless of age, recent studies show more frequent blackout experiences are related to an increase in memory lapse and cognitive difficulties even after alcohol misuse is corrected. This means that even after a blackout occurs, you can continue to experience memory loss and other difficulties recalling memories.

Blackout effects on your body

If you’re experiencing a blackout or brownout, you’re at higher risk for falling, injury and unwanted or unsafe sexual experiences. A person who is blacked out may also throw up while sleeping, which could lead to an increased risk of choking or suffocating.

It can be hard to determine when you’re going to have a blackout or brownout. But some signs it may be happening to you in the moment include:

  • Difficulty standing.
  • Nausea.
  • Lightheadedness.
  • Loss of vision or shrinking of your field of view.

Other signs of substance-related blackouts, specifically blackouts caused by sedatives, hypnotics or benzodiazepines, include:

  • Loss of bowel or bladder control.
  • Difficulty breathing.
  • Feeling drunk when you haven’t consumed alcohol or consumed less than your usual amount.
  • Sudden body temperature changes.
  • Sudden increase in dizziness, disorientation, loss of vision or difficulty speaking.

“Hypnotic drugs are prone to cause this kind of impairment and memory loss,” states Dr. Streem. “Sadly, people sometimes use them to take advantage of other people.”

Strategies for managing blackouts

A blackout ends when your body has absorbed the alcohol you consumed and your brain is able to make memories again. Sleep often helps this process along.

Alcohol is dehydrating by nature, so making sure you’re drinking plenty of water and staying hydrated is important. Being aware of potential signs of intoxication can also be helpful in understanding your limitations.

But what if you end up having a blackout anyway?

“The experience of a blackout can sometimes be an opportunity to learn about our bodies and our brains, and what we can and can’t handle,” says Dr. Streem. “But the most important thing to do when you have a blackout is to try and piece together as best we can what happened and whether we were injured. It also might be necessary to try to assess whether you’ve been taken advantage of in some way.”

If you think you’ve been injured, sexually or physically assaulted, it’s important that you get medical attention immediately and talk to the police about everything you can remember.

Other measures you can take to reduce the likelihood of blackouts and brownouts and increase your own safety include:

  • Drinking with people you trust.
  • Pairing up with a close friend or group of friends and leaving together.
  • Not drinking on an empty stomach.
  • Not taking drinks from other people.
  • Opening containers yourself or watching your drink being poured.
  • Taking your drink with you when leaving a room.
  • Not drinking anything that tastes or smells odd.
  • Asking for help when you start to feel drunk or intoxicated.

“There’s no way to prevent a blackout or brownout from happening other than to stop consuming so much alcohol or other substances that cause them,” says Dr. Streem. “Beyond that, safety and general physical care can be very helpful in making sure this doesn’t happen to you.”

Can stripping down for bedtime help you catch some ZZZs?  Michelle Drerup, PsyD, DBSM. @ClevelandClinic

Cleveland Clinic

Is It Healthy To Sleep Naked?

Wearing no clothes could lead to cooler skin temperatures that put ZZZs within reach

Many people believe they were born with the only pajamas needed for a good night’s sleep, but here’s the naked truth: No research directly confirms that sleeping in the buff leads to better slumber.

There is, however, some validity behind the idea of sleeping naked — namely regarding how a cooler skin temperature improves sleep quality.

So, should you consider stripping down at bedtime before sliding under the sheets? Let’s look at the potential benefits (and risks) with behavioral sleep disorders specialist Michelle Drerup, PsyD, DBSM.

Is sleeping naked better?

There are some possible perks to nude sleeping … so, maybe? Here are a few reasons why you might want to slip off your clothes before slipping off to sleep.

Falling asleep faster

Your body naturally works to lower its thermostat to doze off at night through its circadian rhythm, which regulates your sleep/wake cycle. The faster you cool off, the faster you typically catch some ZZZs, says Dr. Drerup.

That’s also one of the reasons why sleep experts recommended that you keep your bedroom temperature between 60 degrees Fahrenheit and 67 degrees Fahrenheit (15.5 degrees Celsius to 19.44 degrees Celsius) for optimal snoozing.

Improved sleep quality

Ever toss and turn in bed because you’re too hot? Sleeping naked certainly removes any possibility of pajama-induced overheating interfering with a good night’s rest. It’s the absolute final move in shedding layers to stay cool.

“There’s no question that cooler is better than warmer for overall sleeping,” says Dr. Drerup.

And getting enough rest is key to … well, just about everything in day-to-day life. Waking up refreshed can help you manage stress more effectively, improve focus, boost performance and make you a more pleasant person.

For women: reduced risk of yeast infections

Tight-fitting underwear can trap heat and moisture between your legs. What makes a yeast infection thrive? Yep — heat and moisture.

Sleeping naked (or even in loose-fitting cotton bottoms) allows for some air circulation around your vagina. Keeping the area cooler and drier may help reduce your chances of getting a yeast infection, too. 

For men: potential fertility boost

Heat isn’t a friend of male fertility. Regular exposure to higher temperatures for your testicles can cause sperm counts to drop. Wearing underwear that keeps things packed tight doesn’t exactly offer a cooling effect.

Studies show that men who wear boxers have a higher sperm count than their buddies in briefs. So if loose-fitting boxes help that much, imagine what 8 hours of no clothing might do.

Reasons to keep your PJs on

Sleepwalkers may want to give the idea some extra thought to going au natural to avoid any potential awkward encounters, notes Dr. Drerup.

And if you’re not a fan of doing laundry, consider this: Your washing schedule for bedding may need to increase with more skin-to-sheet contact. (Gross fact: The skin cells you shed in a day can feed 1 million dust mites. You don’t want to turn your bed into their buffet.)

Can you be cool and clothed?

Going to bed “nearly” naked while wearing lightweight and loose-fitting garments can bring you similar quality sleep results as taking everything off. “Tank tops and boxer-style briefs don’t possess a ton of warming qualities,” says Dr. Drerup.

And while being cool is desirable for sleep, you also don’t want to be cold. There’s even evidence that wearing socks to bed to warm your tootsies can help you drift off to sleep.

So, which is it: off or on?

Ultimately, what you wear to sleep is a personal choice. “There’s no proven benefit or harm to sleeping naked,” says Dr. Drerup. “Just do what feels right and then rest easy with your decision.”