Health is Wealth
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.”
Even when we have the best of intentions, we can tend to overindulge in … well, everything. Whether it’s a second helping of dinner, snacking on sweets or a venti-sized coffee, we often go a little too far. And that’s especially true — and risky — when it comes to alcohol.
Overdoing it with booze occasionally, like at a wedding or birthday party, might be fine (though your headache the next morning might make you think otherwise). But when does drinking frequently cross the line into being problematic? And what are the health risks of alcohol overconsumption? To gain some insight into these concerns, we spoke with hepatologist Jamile Wakim-Fleming, MD.
It’s first best if we understand some of the dietary guidelines around alcohol. The U.S. Department of Agriculture and U.S. Department of Health and Human Services’ “Dietary Guidelines for Americans, 2020-2025” recommends adults of the legal drinking age should either not drink or limit their drinking to two drinks a day or fewer for men and one drink a day or fewer for women.
The guidelines say those who shouldn’t consume any alcohol under any circumstances include:
As for how much alcohol is considered standard, the guidelines define a standard drink as:
There are nuances to consider with these guidelines, though. While major American brands of beer have a 5% ABV measurement, many popular craft beers have higher alcohol content. That IPA you love might have an ABV of 7% or higher, so keep an eye on it when you’re knocking them back at your next summer barbecue.
But, as Dr. Wakim-Fleming explains, we also have to be cautious when applying these guidelines to our own habits for several reasons that go beyond the alcohol content of your beverage.
According to Dr. Wakim-Flemings, there are a few factors to consider when it comes to alcohol affecting you because each person is different. She outlines the following as the main ones when weighing alcohol consumption.
Those factors are largely outside of our control. But other things we can control should also be considered, Dr. Wakim-Fleming advises. For instance, she says, “Drinking on an empty stomach is more toxic than if you’ve had something to eat. There’s no food to help absorb the alcohol so more goes into your blood system.”
And, again, there’s that percentage of alcohol to consider. “Remember that the percentages of alcohol vary among the types of alcohol,” she says. “Drinking 12 ounces of wine contains far more alcohol than 12 ounces of most common beers.”
Taking into account all of these factors, Dr. Wakim-Fleming says there are still ways to figure out where a person crosses the line into overindulging in alcohol, and separating what’s considered “binge” drinking, “heavy” drinking and “excessive” drinking.
Studies have shown that even if you only occasionally drink alcohol, drinking regularly over a long period can have negative outcomes on your health. “It’s a cumulating effect caused by drinking over time,” says Dr. Wakim-Fleming.
But a more present danger is binge drinking. According to the U.S. Centers for Disease and Prevention (CDC), binge drinking is classified for men as consuming five or more standard drinks within a few hours and four or more standard drinks within a few hours for women.
That kind of alcohol consumption can lead to severe reactions in your body, including:
The loss of judgment that comes from binge drinking can cause you to make poor choices, too, including driving under the influence, physical altercations and even further physical injury.
Dr. Wakim-Fleming says excessive drinking is essentially the same as binge drinking. The CDC also includes underage drinking and drinking by women who are pregnant.
Most excessive drinking — more than 90%, according to the CDC — is binge drinking. Additional statistics on binge drinking from the CDC include:
Excessive drinking is something that’s thought of more in the short term, but can still be extremely damaging to your body, especially as it becomes a habit and potentially leads to more long-term, heavy drinking.
While considered part of excessive drinking by the CDC, heavy drinking is applied to drinking over a longer period than binge drinking; while binge drinking is measured in an increment of two-to-three hours, heavy drinking is measured over a week.
“For women, heavy drinking is eight standard drinks a week or more,” says Dr. Wakim-Fleming, “While for men, it’s 15 drinks a week or more.” And, yes, multiple binges within a week do equal heavy drinking.
And no matter which category you fall into, there are consequences. “You subject your body to more health risks, to more toxicity and you begin a cycle of withdrawal problems,” she adds.
So, more about those consequences. “Alcohol affects the body in two ways,” says Dr. Wakim-Fleming. “The initial stage occurs right after drinking. Drinking causes inflammation of your swallowing tube [esophagus], stomach and gastrointestinal tract. Additionally, your liver is also inflamed which causes it to become enlarged and tender.”
If you stop drinking at this stage, she says, that inflammation is reversible. But if you continue to drink excessively over time or become a heavy drinker, that leads to serious complications.
“If your drinking and inflammation continues daily, it leads to scarring and becomes irreversible, as in cirrhosis, which can lead to cancer,” notes Dr. Wakim-Fleming.
Both the American Cancer Society and the American Society of Clinical Oncology advise that alcohol directly raises the risk of cancer. The types of cancer of the gastrointestinal system that drinking alcohol can lead to include:
“The important thing to remember is that these organizations consider alcohol a modifiable risk factor for cancer, which means you can do something about it,” adds Dr. Wakim-Fleming. “That means following their guidelines and avoiding drinking.”
You may not realize it, but the most common consequence of overconsumption of alcohol — the hangover — is the alcohol directly affecting your brain. In the immediate aftermath, your hangover can include poor concentration, lagging reflexes, headache, nausea and vomiting.
Over time, though, excessive amounts of alcohol do far more damage to your brain, resulting in consequences beyond just an unpleasant morning after. “You can end up with alcohol dementia and a type of nerve damage we call neuropathy,” cautions Dr. Wakim-Fleming.
Some of the symptoms of neuropathy include:
Chronic alcoholism has also been linked to poor diets, which deprive your body of necessary vitamins and nutrients, which can compound issues with many parts of your body, including your brain and central nervous system.
Alcohol can adversely affect muscles, and your heart is a muscle. Heavy drinking can lead to a poor diet, which means your muscles are using empty calories from alcohol rather than healthy foods.
The result can be a dilated heart muscle and, eventually, dilated cardiomyopathy. Your heart weakens and can’t pump blood as strongly, which can cause your kidneys to retain more fluid. That can lead to fluid build-up in your extremities and lungs, and even to congested heart failure.
Excessive and heavy drinking can lead to cirrhosis and liver cancer. But, says Dr. Wakim-Fleming, the risks go beyond that.
Cirrhosis of the liver, which causes scar tissue that prevents your liver from functioning properly, is often caused by alcoholism. “Because that scarring affects the ability of the liver to function, it can lead to life-threatening conditions. And that’s why alcohol is one of the most common reasons for a liver transplant.”
Excessive drinking in one night can lead to acute damage and cause alcohol poisoning, which has severe consequences including, at its most extreme, death.
But if you drink only occasionally and in moderation — say, a glass of wine with dinner or a beer at a ballgame — it’s not going to create long-term damage. It’s all about moderation and avoiding chronic use, says Dr. Wakim-Fleming.
And while following recommended guidelines is important, it’s also about knowing yourself and your limits. “We don’t have personalized medicine when it comes to alcohol because everyone responds differently,” she says.
Even if you’re not overdoing it, consider taking a break or several breaks throughout the year. “Any break is good because your body needs time to reduce that inflammation. Taking a month or two off from consuming alcohol can help,” she suggests.
“Know your body, know your personal and family history and know your limits,” she continues. “Know what’s good for you because what works for others won’t necessarily work for you. Take charge of your health and if you need, seek help, whether from family, friends or other support groups and always discuss with your doctor.”
health.clevelandclinic.org
How Much Alcohol Is Too Much?
Learn how much alcohol is overdoing it in one sitting or over time.
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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
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There are many health benefits related to abstaining from alcohol. If you’re looking to cut back or stop drinking altogether, here are 11 tips that can help. #HarvardHealth
Are you concerned about your alcohol intake? Maybe you feel that you’re drinking too much or too often. Perhaps it’s a habit you’d like to better control.
It’s always wise to check with your doctor — she should be able to help you decide whether it is best for you to cut back or to abstain. People who are dependent on alcohol, or have other medical or mental health problems, should stop drinking completely.
But many people may benefit simply by cutting back. If your doctor suggests that you curb your drinking, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) suggests that the following steps may be helpful:
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