Alcohol and Wellbeing
If you have decided to go without alcohol and participate in Dry January, what are you going to do afterwards? Go back to your usual habits or try to drink less in 2023?
What are the current facts about alcohol consumption, health and wellbeing?
Ethanol is the ‘alcohol’ we consume. It can rapidly be adsorbed by the stomach and gut into the bloodstream that then spreads throughout the body. A lot of that blood also goes to our brain. Ethanol is a small molecule that can easily pass through the blood-brain barrier where it can easily disrupt the brain’s normal functions. Hence, the rapid sense of pleasurable euphoria (the initial dopamine buzz). But the increasing presence of ethanol leads to intoxication which can dramatically reduce our behavioural inhibitions, cognitive abilities and motor skills. Other symptoms can include inane grinning, shouting and excessive hugging of strangers; likely to be followed by a tendency for either falling over or falling asleep or both.
Levels of inebriation will depend upon the following factors:
Quantity consumed, age, sex, body weight, individual biochemistry and alcohol tolerance.
Many of us have experienced some or all of these effects at some time in our life.
Anything we either eat or drink in excess has a downside to our health and wellbeing. The cumulative ill-health effects associated with drinking alcohol will only become apparent as the time frame of regular consumption increases into decades. These effects are more pronounced for people who are classed as ‘heavy drinkers’.
Our own perception of how much we drink and reasons why we drink is problematic and many ‘regulars’ believe they don’t have a problem with drinking alcohol. Former TV presenter Adrian Chiles has described his habitual drinking in the BBC documentary, ‘Drinkers Like Me’ shown in 2018. Over the course of the programme, medical examinations of Adrian indicated the onset of alcohol-related illness to which he was unaware. More than 30-years of regular drinking was taking its toll.
The NHS website www.nhs.uk/live-well/alcohol-advice explains the types of illness drinkers like Adrian Chiles could face in the future.
There is an increased risk of adverse long-term health effects arising from regular consumption of alcohol, for example:
Liver disease and cirrhosis.
Pancreatic disease – alcoholic pancreatitis or diabetes or both.
Heart disease.
Stroke.
Impairment to the Central Nervous System (CNS).
Brain damage that may lead to dementia.
Cancer of either the mouth, throat, larynx, oesophagus, liver, colon or rectum.
Women can also have an increased risk of breast cancer for women.
Many of us may only think liver disease is the main risk but puzzled why alcohol can also cause cancer?
The metabolic pathway of ethanol in the body leads to its conversion to acetaldehyde. This mostly happens in the liver but can also take place in the stomach, gut and pancreas. Acetaldehyde is a toxic substance and is also listed as a Group 1 carcinogen by the International Agency for Research of Cancer (IARC). This is also stated in the current HSE publication EH40/2005 workplace exposure limits.
Repeated and prolonged ingestion of a carcinogenic substance can cause damage to DNA in human genes that can lead to the formation of cancer cells. Risk increases with the dose rate, more booze the bigger the chance it happens.
Therefore, ethanol is a substance hazardous to health. The NHS advice is there is no ‘safe’ drinking level. If you drink less than 14 units a week, this is considered as low-risk drinking advice for both men and women. Exceeding this advisory level either by binge drinking 14 units over 1 or 2 days or generally drinking more than 14 units a week regularly will push up the risk of ill health significantly. Moreover, alcohol becomes prejudiced against women when you go over the 14 units level. Studies have recognised increased medical problems in women with alcohol-use disorders when compared with men.
Current medical research and opinion is that there are no physical health benefits derived from drinking alcohol.
As a man of late middle-age, I am now regularly subjected to health surveys that ask, ‘how much alcohol do I drink on average each week?’. The honest answer is, not much, but I can only guess how many units is ‘not much’.
Therefore, to figure out weekly consumption in terms of ‘units of alcohol’ look at the following:
1 unit of alcohol = 10ml of pure ethanol.
The strength of alcoholic drinks sold in the UK are displayed on the label as % Alcohol By Volume (ABV).
A regular pint (568ml) of draught beer can typically range between 3.3 to 4.5 % ABV, or 1.9 to 2.6 units.
A 750ml bottle of wine can typically have an ABV of between 11 to 14%, 8.3 to 10.5 units per bottle.
The volume for a glass of wine sold at the bar is 125ml, “Do you want a large?”, that’s 250ml or 3 units.
Spirits sold in the UK, such as, rum, gin, whisky, vodka, etc. can range between 38 to 57% ABV.
Standard for a single measure is 25ml, equivalent to 1 unit at 40% ABV.
In summary:
14 units = 6 pints of beer or 1½ bottles of wine (4½ large glasses) or 7 doubles.
Adrian Chiles seriously underestimated his weekly consumption which turned out to be approximately 100 units/week. How many of us may be drinking more than we should?
The British attitude towards drink and the complex social ties that can connect us to drinking alcohol are beyond scope of this blog. But ‘Dry January’’ could be a time for each of us to reflect on our personal exposure to ethanol and think about ways to reduce our intake over the rest of 2023.