Raise a glass or set it down?
For many of us, a glass of wine or a cold beer is an enjoyable part of a good meal. We drink for the taste and the experience, with the health benefits—and risks—a secondary consideration. As we consider how best to manage our health, however, we owe it to ourselves to understand the effects of alcohol on the body.
There is so much conflicting information about alcohol. We’re told that a little red wine is good for the heart, but too much alcohol can increase our risk of cancer and heart disease. But how much is too much?
What is Moderate Alcohol Intake?
One drink is commonly defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of distilled spirits. For women, the Dietary Guidelines for Americans define moderate drinking as no more than one drink per day.1 For men, moderate drinking is defined as no more than two drinks per day.
Why should women drink less than men? For one thing, women tend to weigh less than men and also tend to have proportionately less water in their bodies to disperse the alcohol; this means that a single drink will, on average, have a greater effect on a woman than on a man. Furthermore, some studies have suggested that women tend to have lower levels of an enzyme that breaks down alcohol (alcohol dehydrogenase) in their stomachs.2 This would also increase the amount of alcohol that reaches the blood stream.
Alcohol and Health Problems
Although moderate alcohol consumption is considered somewhat safe, alcohol has been linked to numerous health concerns, including cancer, heart disease, high blood pressure, and even stroke.3 High levels of alcohol also have adverse effects on the liver and the brain. An important point for women is that many of these adverse effects tend to develop earlier in women than in men and at a lower level of alcohol intake.4
In addition, drinking during pregnancy can cause a range of problems in the child, including Fetal Alcohol Syndrome. Finally, alcohol use can lead to alcoholism in some individuals. Individuals with a family history of alcoholism will need to be particularly cautious.
Alcohol and Health Benefits
The well-publicized link between moderate alcohol intake and a reduced risk of heart disease applies to both men and women.5 This is an important benefit because heart disease is the number one killer in the United States. Alcohol is not the only way to reduce your risk of heart disease, however. Engaging in regular physical activity, avoiding tobacco smoke, and eating a healthy diet will reduce your risk even if you abstain from alcohol. It’s also important to realize that young women (those under the age of 40 or so) have a very low risk of heart disease and are therefore unlikely to derive a heart benefit from moderate alcohol intake. This means that in young women the risks of alcohol likely outweigh the benefits.
Another measure of alcohol’s health effects is total mortality (risk of death from any cause). Numerous studies have reported that there is a “J-shaped” relationship between alcohol intake and risk of death: overall risk of death declines with light-to-moderate drinking but rises with heavier drinking.6
Balancing the Risks and Benefits
Although many people view red wine as a healthier choice than other types of alcohol,7different types of alcohol appear to have similar health effects. For many women the decision about occasional use of alcohol will remain a personal one that’s best made in consultation with a physician. There are both risks and benefits, but the balance of risks and benefits varies by a woman’s health history and family history (including history of alcohol abuse), age, risk of conditions such as heart disease and breast cancer, and other medications she is taking. If you don’t currently drink, however, be reassured that there do not appear to be compelling reasons to start.
1 Dietary Guidelines for Americans, 2005. US Department of Health and Human Services Web site. Available at: http://www.health.gov/dietaryguidelines/dga2005/document/default.htm. Accessed September 22, 2010.
2 Frezza M, di Padova C, Pozzato G, Terpin M, Baraona E, Lieber CS. High blood alcohol levels in women. The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism. New England Journal of Medicine. 1990;322(2):95-99.
3 Kloner RA, Rezkalla SH. To drink or not to drink? That is the question. Circulation. 2007;116(11):1306-17.
4 Alcohol: A Woman’s Health Issue (NIH Publication No. 04-4956). National Institute on Alcohol Abuse and Alcoholism Web site. Available at: http://pubs.niaaa.nih.gov/publications/brochurewomen/women.htm. Accessed September 22, 2010.
5 Hanksinson SE, Colditz GA, Manson JE, Speizer FE, eds. Healthy Women, Healthy Lives: A Guide to Preventing Disease from the Landmark Nurses’ Health Study. New York: Simon & Schuster Source; 2001.
6 Di Castelnuovo A, Costanzo S, Bagnardi V, Donati MB, Iacoviello L, de Gaetano G. Alcohol dosing and total mortality in men and women: An updated meta-analysis of 34 prospective studies. Archives of Internal Medicine. 2006;166(22):2437-45.
7 Wright CA, Bruhn CM, Heymann H, Bamforth CW. Beer and wine consumers’ perceptions of the nutritional value of alcoholic and nonalcoholic beverages. Journal of Food Science. 2008;73(1):H8-11.