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Navigating Alcohol’s Impact On Health And Wellness

In this episode of the Empower Nutrition Podcast, host Erin Skinner shares her personal journey of going alcohol-free for a year and delves into the broader discussion of alcohol consumption, its societal norms, and health implications. Erin discusses the prevalence of alcohol-related issues, including alcohol abuse disorders and associated health risks. Drawing on recent research, she explores the impact of alcohol on various health outcomes, including cancer, cardiovascular events, stroke, and dementia. Erin highlights the complex relationship between alcohol intake and health, emphasizing the need for moderation and awareness. She provides insights into the findings of an umbrella review/meta-analysis on alcohol and health outcomes, shedding light on both potential benefits and risks associated with alcohol consumption. Throughout the episode, Erin encourages listeners to reflect on their own relationship with alcohol and consider making informed choices for their health and well-being.

Reference:

https://pubmed.ncbi.nlm.nih.gov/35602135/

Zhong L, Chen W, Wang T, Zeng Q, Lai L, Lai J, Lin J, Tang S. Alcohol and Health Outcomes: An Umbrella Review of Meta-Analyses Base on Prospective Cohort Studies. Front Public Health. 2022 May 4;10:859947. doi: 10.3389/fpubh.2022.859947. PMID: 35602135; PMCID: PMC9115901.

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SUBTITLES:

Hello and welcome back to the Empower Nutrition Podcast. I’m Erin Skinner and I’m really excited to record this episode about alcohol. I just wrapped up, this is wild to me. I wrapped up an alcohol free year. The, I went the whole year of 2023 alcohol free at the beginning of the year. I didn’t know if I would be able to go a quarter to be honest. So I always do dry January. So I said, okay, I’m gonna step it up. I’m gonna try to go a whole quarter. I kind of had it back in my mind that maybe I could do a year, but when I got to the three month point, which you know, Q1, I actually, it hadn’t become too difficult. So I thought well maybe I can make it six months. And then by the time I went six months it was like, oh this is like, it’s just not a part of my like life anymore and it was too super easy to go another six months.
So no problem. Which really is wild to me because I definitely have most of my adult life fallen into this category of like, I think a lot of us have a level of drinking that from the outside world is fine. I, nobody would ever say that I’m an alcoholic or that I have an alcohol use disorder, but internally I have felt like it’s been too much alcohol and mostly the problem I’ve had is in that it feels sometimes a little bit hard to control. It’s just me being very robbed. I think a lot of you might relate to this of in most areas of my life I’m very well controlled, but then it’s like very hard to resist a glass of wine on a weeknight sometimes. Or like on the weekend I’d like to maybe have like one glass of wine but I find myself having like two or three or one once in a while I might go out socially and like really drink too much and it upsets me.
So I think a lot of us, especially through covid and like through and like just maybe like middle stage of life like this, it can kind of start to creep up with alcohol in terms of how challenging it is to keep it at a healthy level. And there is, and and I think this is really important to talk more about because at that level of drinking that we consider to be normal or even like healthy, it’s actually pretty dangerous and unhealthy. And I’m talking about really it should be for women. I mean you could make an argument that almost, that basically no alcohol is safe, but what I’m talking about is having more than maybe like four drinks a week and keep in mind that for many people a wine pour that they would normally have would be two drinks. So we might be talking about one or two of your wine pours a week. Going beyond that really has been shown to promote health risk
And be a problem. And so we, I think we need to have more of that conversation. I don’t think anybody would agree that like, like have an issue with like, oh yeah, of course if somebody is like putting down a bottle of wine every night, that’s not good for them. That’s not really what I’m talking about. I’m talking about this kind of like mommy drinking that’s so pervasive that like we all kind of like think is fine or even convince ourselves is fine and it’s really not. So that’s kind of the context of this, of this episode. So I’m gonna put in the show notes some of these statistics, but mostly I wanna go over this umbrella review that recently came out about alcohol and some of the data that that includes. But first I’m gonna include some stats from a jam article that again I’ll link.
So in in the United States one out of every 10 deaths for people age 15 to 49 years old is alcohol related. And we’re not just talking about like violent like car crash injury, we’re talking about all it all also causes some other health risks that we’ll talk more about that are more like subtle. I think that people need to be more aware of, this is kind of eye-opening. Currently 12 to 14% of adults have an alcohol abuse disorder and 29%, so about a third of adults have had an alcohol use disorder at some point in their lives.
The criteria for this is maybe not what you would expect if you haven’t looked at it, feel free to to like plug this up. We can put in the show notes too. But the questions about alcohol use disorder, like I would say most of my adult life, if I answer those I would flag as having an alcohol use disorder. ’cause it’s, it’s like definitely more, it’s more strict than you probably think. But point being, I think we think about alcohol as this like benign thing in our society that’s like harmless and actually like keep in mind that like one outta three adults has, has really struggled with this.
And right now more than one outta 10 is currently really struggling with this. So definitely people you know and people in your life. And so I think, you know, that’s part of the reason why we need to have the conversation a little bit more. More than 40 diseases and 2.8 million deaths are fully attributable to alcohol in two. And that was a statistic from 2016. There has been an increased concern about alcohol related health problems and death globally. The American Society of Clinical Oncology states that alcohol is a cause of cancer, it’s a carcinogen. So if you didn’t know that, you’re welcome. Sorry, now you know, and, and in during the pandemic I think we all kind of know there’s like a rapid increase in alcohol use and yeah there’s also a rapid increase in alcohol related deaths, about 25% increase. So this is not a benign thing that’s in our society just as some big gift to make everybody feel better and be happier.
It’s, that’s actually not the case. So, and we talk, I have made a couple previous episodes of alcohol, so I’m not gonna go too much into it here, but like in this short term sense, alcohol causes a release of something called di norphine, which is like the opposite of an o opioid. Well it causes an opioid like effect, but then in response to that, those positive neuro happy neurotransmitters, there’s di norphine release and that is, is a response. And so that, and it’s like it eclipses the original sort of like high from the drink and that’s why it’s hard to say no to the second drink. ’cause now you’ve had this kind of like short term high and then this dip from the di norphine that makes you feel like kind of worse. And when you started off and then like you’re pursuing that, getting that high back again with a second drink and now you’re just chasing neurotransmitters.
You never get the same amount of endorphins and further drinks ’cause you’re just getting more and more di norphine And over time with alcohol it takes, it takes months really. If you have like a, if you have a chronic like alcohol intake, it can take months to restabilize your neurotransmitters so that you don’t have elevated di norphine which causes low mood and in some people depression and anxiety and definitely just your not your normal neurotransmitter balance in your mood. So it’s definitely important to think about that in terms of like both the short term effect on mood, the long term effect on mood. Today we’re gonna talk more about this umbrella analysis. It’s called alcohol and health outcomes and umbrella review, a meta-analysis based on prospective cohort study. So, and we’ll link this in the show notes. So basically what they did is they looked at 49 peer reviewed studies on alcohol that were, that altogether had a total of 224 meta-analyses.
So this is like a ton of data ’cause a meta-analysis on its own statistically pools the results of multiple studies. And then they looked at 59 of these cool data collections to really get just a ton of data on outcomes in terms of alcohol. Statistically they found some things that are kind of interesting to talk about. So, so basically I’ll kind of go through some of the main findings of this paper for you guys in general. They did find that alcohol increase the risk of several types of cancer. So oral pharyngeal larynx, esophageal hepatocellular, colon cancer and breast cancer.
They did find that it was associated with a slightly lower risk of basal cell carcinoma and cutaneous squamous cell carcinoma. That that there’s, they’re not totally sure on why that is, but the net result of alcohol is definitely more cancer risk. So to me that’s, that’s the bottom line. A couple interesting things about the mechanisms for that. One is that it actually directly and ethanol directly induces oncogenes, which are cancer genes and suppresses tumor suppressing genes. So we’re kind of all like getting a little bit cancer like often. And then we have these tumor suppressor genes that like fight the cancer off before you ever know you started to get it, but alcohol like suppresses those so you have less ability to fight the cancer and it also directly triggers cancer. And that’s the main mechanism they think behind the reason why alcohol is the overall net increased cancer risk.
Also the metabolites of alcohol have high photosensitivity and so they’re, they, you’ll experience more cell damage from UV rays from the sun when you have been drinking alcohol. And then combined with that, alcohol is an immunosuppressant. So your immune system should be attacking can early cancer cells because it identifies it as like not self, just like a bacteria that infests, you know, gets you and you like your back, your immune system attacks a foreign thing. Cancer is like a foreign thing. And so your immune system is critical for, for protecting you from cancer and, and alcohol suppresses your immune system. And then it also again makes your cells more susceptible to damage because their metabolites are photo sensitive. So overall tons of, tons of data underscores the increased risk of cancer with alcohol intake. And then they talk about how much, so basically what they’re saying is they’re, they’re saying it needs to be really less, definitely less than one drink per day for women. Again, keeping in mind that a, a drink of wine is like four ounces or excuse me, five ounces of wine, one beer, one shot. So that’s like, again, half of what most people would consider an a drink.
And really when I dug into the data for some of these, it depends a little bit on like what cancer, but for some of ’em it really, it it’s, it basically is like the, the less the better. Some for some of ’em it’s like, oh, only having two drinks per week increases risk. So in general it de you know, it’s hard to make a cutoff ’cause of something that’s just generally bad for you. It’s like, well what do you, where do you finally just say it’s bad for you, it’s just bad for you. But for sure it’s important to get within that, that goal of one drink per day on average. And that’s the recommendations from the US dietary guidelines or the dietary guidelines advisory committee of the United States. Some, and this is getting like, I don’t wanna make this episode too long, but there’s some organizations for other countries have gone even more strict on alcohol and recommend lower intakes.
Another thing they found in this umbrella analysis was that low to moderate alcohol consumption. This might surprise you, but I can go into it, it can reduce cardiovascular events and are all cause mortality in hypertensive patients with high certainty. So, and the, so what they’re saying is if someone has hypertension, so you have high blood pressure and then you drink alcohol, you’ll have a lower risk of having a cardiovascular event and a lower risk of death. And the reason for that is that alcohol does reduce fibrinogen levels. So it reduces blood clotting, it inhibits platelet activation and so again and lowers the risk of blood clots and causes some changes in lipids that are overall in that positive in that situation. But what would be a mistake would be to take that as saying, oh well like heart alcohol prevents heart disease. That’s not what they’re saying.
What they’re saying is that hypertension causes heart disease, an increased risk of it, of cardiovascular event, alcohol will sort of help to reduce that. But in general, we know that hypertension net altogether is a risk for a cardiovascular event. So what you should do if you have hypertension, is really address it at the root and not try to bandaid solution it with alcohol. ’cause you’re gonna probably, you’re, of course there’s the other problems with alcohol we already talked about around like mood around cancer. The best thing is to just figure out how to better address high blood pressure and not try to use alcohol to, to be your answer to that.
Another thing that they found was that high alcohol consumption increased the risk of hemorrhagic stroke and that was with high certainty. And so they tied in, like for example, the guideline from in, in Italy should is that is similar to ours. It’s one drink a day for women up to two drink a day for men. And that was specifically though to saying that that was the cutoff needed to avoid a stroke basically. So a hemorrhagic or ischemic stroke. So alcohol is a risk factor for stroke in general. And now we’re, we’re not talking any longer about hypertension. And so that’s just another thing that’s important to understand that you don’t see in the cute commercials for, for, for wine or whatever it is. Another thing they found was that there was this association between low alcohol consumption and improved incidents of dementia. And that was a strong correlation.
Now keep in mind that these are prospective, there’s a meta-analysis study, so looking at large groups of data, so they’re not, these aren’t controlled trials, what they’re saying. So they can only look at association. So they’re saying, okay, when someone compared to someone who doesn’t drink any alcohol, someone who drinks a little bit of alcohol has lower risk of dementia. Now one thing that is a confounding problem with a, with a lot of alcohol research like this is that if someone has a health problem, they’re usually told to stop drinking alcohol. So if you just look at a group of people and, and you look at the people who drink zero alcohol, sometimes they’ll have, sometimes you’ll see higher risk of a health problem in that group. And it’s not because avoiding alcohol made them unwell, it’s because being unwell made them avoid alcohol. So you kind of have to keep that in mind with things like this of like, could it just be that like people who have some dementia just generally don’t drink alcohol.
Like maybe it’s not given to them and they’ve like, they’ve lost like control over what groceries come into their house. And also, or could it be that having some degree of social life is protective of dementia, which we actually know. And a part of having a healthy, like social life with aging is may involve like a little bit of light alcohol intake. And so it’s not that the alcohol improved their dementia risk, it’s their social life improved, their dementia risk and the social life carried with it some alcohol intake. So you’ve gotta think about things with this type of like that, with this type of research. So I don’t think you def, you definitely don’t have enough data here to say that like, oh yeah, alcohol improves dementia risk. And in fact we, there actually have been like dose response studies have shown that definitely high alcohol intake increases risk of dementia like in stepwise fashion.
So we know that the mechanism is there, whereas it’s like a lot of alcohol, the more alcohol you have, the more dementia risk you have. So it wouldn’t really follow that. Like if you had a little bit of alcohol, you have lower dementia risk. There is some kind of discussion in this article around like, well maybe like, because it’s a vasodilator it increases cerebral blood flow, maybe it reduces clotting and maybe that helps with brain cognition and improves like brain like perfusion a little bit and that improves dementia risk. This is just kind of guessing, like we don’t know that. So in general there are a lot of things that improve dementia risks that are like rock solid proven.
So, so focus on those things because there’s definitely not evidence here that like you should drink to avoid dementia, but there’s definitely evidence that you should avoid excess drinking to prevent dementia. So same answer, different, different disease. But same answer is like, look, definitely within that, like less than an average, less than one drink a day for women average less than two drinks a day for men based off of all the evidence that I’ve seen that even is I think, not conservative enough. The the healthy level of alcohol is, is probably zero. But what we teach and generally do in our groups is like, can you do two a max of two days a week, a max of two drinks per night that you drink? So that’d be a total of four drinks per week.
I think that’s probably minimal in terms of if you can stick to that, that’s probably minimal in terms of its risk compared to no drinking. For a lot of people, myself included, it’s, they’re just not gonna go to no alcohol. They’re just not in a place where that’s something that’s gonna work for them and that’s fine. So I don’t want anybody to feel like, oh, you know, you should be ashamed if you ever drink since I have my alcohol free the year I will say, I said, okay, great. I’ve been, I’ve, it’s been amazing. I have had zero compulsion with alcohol. It’s been easy. I haven’t, it hasn’t even been crossing my mind. I’ve got all kinds of fun little adaptogenic drinks that I have instead, it’s great. Now let me try just going to like a very low amount of drinking and hopefully it’ll still feel easy to avoid.
That hasn’t actually been the case. Maybe it’s my brain chemistry, maybe it’s just my like years of, of being maybe like kind of like a, the type of drinker that like we all kind of know about. So it’s like you drink maybe an average, I don’t know, maybe a, maybe four nights a week, two drinks each time kind of drinking. Maybe it’s just too much time like that. But as soon as I went back to having some, some alcohol once in a while, I think about it every night and it’s hard to avoid every night. So that’s been really frustrating for me. And so I’m considering just completely going back to zero. So for each person it’s different. I have a lot of clients where I bring this topic up and they’re like, no, I don’t drink at all. It’s no problem for me. It’s, or I have one glass of wine like once or twice a month and like it’s easy. So if that’s you, then good for you. Congrats. I’m glad it’s easy for you. But if it’s, if it’s not you, then don’t, you are not alone in it. I have a lot of clients that kind of struggle with this drinking that falls between like what society would call problem
Drinking and what is like technically for health problem drinking. And so hopefully this episode helps in terms of framing out for you what some of the research says. And yeah, again, we’ll put all the details in the show notes and would love to hear your thoughts. Hit us up with any comments you have or any topics you’d like to hear about. All right, take care.

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