By Louise McDevitt, Nurse Practitioner, Grace Cottage Family Health
as originally appeared in the April 21 Brattleboro Reformer Graceful Health column
Let’s start by looking at some common beliefs about alcohol. How would you answer the following questions, true or false? A moderate amount of alcohol each day is good for your health. The United Nations has established a standard portion size for alcoholic drinks that is honored in most countries worldwide. Drinking may decrease the risk of heart attack and strokes. Drinking decreases a woman’s risk for getting breast cancer. Women who are pregnant should not drink. Wine is better for you than other alcoholic beverages. Your chances of having a car accident are doubled even if your blood alcohol limit is only half the legal limit.
You can find a variety of opinions out there. As a medical provider, I review the scientific evidence. One source that I rely on is www.uptodate.com, which offers detailed articles for medical providers, by subscription, and free articles for the general public. I recommend it.
First, is it healthy to drink a moderate amount of alcohol every day? It depends. Some people should abstain completely, especially those with liver disease, gastritis, esophagitis, pancreatitis, hepatitis C, patients taking sedating medications, and those who identify as alcoholics or who have a strong family tendency of alcoholism.
Second, there is no recommended daily dose of alcohol, nor is there any standard portion size worldwide. One study found that drinks served in the U.S. tend to have nearly twice as much alcohol than those served in Great Britain, most notably when people prepare their own “standard-size” drinks at home.
In the U.S., standard sizes served at restaurants and bars are a 12-ounce beer, a five-ounce glass of wine, or a 1.5-ounce shot of 80-proof liquor. Moderate drinking is defined as one to two drinks a day, or three to nine servings a week, using these standard sizes. Women and those of smaller stature should stick to the lower range.
Next, while it is true that some studies show that moderate amounts of alcohol consumption on a regular basis may lower one’s risk of heart attacks and the type of strokes caused by blockages, they also show that even a minimal amount of alcohol seems to increase the risk of other types of strokes.
Drinking several alcoholic beverages at once can increase the risk of atrial fibrillation (rapid and irregular heart rate), even among those who usually drink moderately. Also, those who regularly consume more than two drinks a day are twice as likely to have high blood pressure, excessive weight, high triglycerides, and high-risk behavior, compared to nondrinkers. Regular drinking above the recommended level cited above can also cause cardiomyopathy (enlarged heart), a serious condition affecting the heart’s ability to pump blood.
Men who drink regularly have an especially increased risk for certain types of cancer. In a large European study, the alcohol-related risk for men and women, respectively, was 44 and 25 percent for upper gastrointestinal cancer, 33 and 18 percent for hepatocellular cancer, and 17 and 4 percent for colorectal cancer. The increased risk was largely found in individuals who drank more than the recommended upper limit.
Regarding breast cancer, studies have consistently shown that it occurs more often in women who drink moderately or heavily. As little as one to two drinks a day appears to increase this risk, and the risk increases with the amount consumed.
Is it safe for a pregnant woman to drink alcohol? Alcohol consumption during pregnancy is common, which highlights the importance of educating women about the potential harms to the developing fetus. Heavy drinking can lead to fetal alcohol syndrome, causing developmental delay and other birth defects. The general consensus is that no amount of alcohol in pregnancy is recommended. My best advice is avoid it.
Wine versus beer? There is no conclusive evidence proving that wine is healthier for you than other alcohol. The so-called “French paradox,” based on the fact that death from chronic heart disease is lower than expected in France, considering the high rate of smoking and the amount of saturated fats in the diet, is often attributed to regular consumption of red wine. Other studies, however, do not support this conclusion, and researchers tend to conclude there is no difference.
How much can you safely drink before driving? Most states, including Vermont, have a legal blood alcohol concentration (BAC) limit of 0.08 percent. However, the risk of having an accident while driving doubles at half that amount, and driving ability is impaired with a BAC as low as 0.02 percent. So the correct answer is: do not drink and drive, fly a plane, operate a snowmobile, ride a bike, operate machinery, tweet, or go on a dating website!
One last idea: the best way to avoid abusing alcohol is by being involved with your community.
Two very significant behavioral studies were done using rats. In the first, a group of rats were separated into different cages, then offered two sources of liquid: regular water and water infused with cocaine. They had nothing else in their cages, no fellow rats, no mazes or toys for diversion. These rats invariably chose the cocaine water.
In the second study, the rats were caged as a community and were given exercise wheels and other engaging activities to do. They too had a choices of liquids, but they preferred the regular water and avoided the cocaine water. Social connections and pleasant activities made all the difference. Something to think about as we approach the issue of addiction.
Having a sense of community, mutual support, and purpose can help people overcome addictions and all kinds of unhealthy habits. Grace Cottage offers several health-related support groups and wellness activities. We’re here to help!
Bio: Louise McDevitt has been a certified Nurse Practitioner since 1989 and has practiced at Grace Cottage since 2003. She is triple certified as an Adult Nurse Practitioner, a Family Nurse Practitioner, and an Acute Care Nurse Practitioner, and is a Fellow in the American Academy of Nurse Practitioners. She is also a Senior Lecturer for Fitzgerald Health Education Associates, offering licensing preparation and continuing education for NPs, and she is an assistant clinical instructor at the UVM Medical School and its Graduate School of Nursing FNP Program.
