The Effects of Alcohol on Our Health: An Evidence-based Review

We are all familiar with alcohol. One of the most widely consumed legal psychoactive substances in the world. It has a long tradition in various cultures, often going back to the beginning of humanity. With that in mind, the question does pose itself – how healthy is alcohol consumption ?

Article guide:

There are many things to say about this topic. I’ll start with the caloric content. As you may or may not know, one gram of alcohol has 7 calories, one of the main reasons why it is being shunned in the health eating community sometimes. To put that in perceptive, a beer usually has 5% alcohol, wine is around 10-14%, and spirits are stronger, usually 40% or more. You can calculate how many calories wine or beer has from that, but keep in mind that weaker alcoholic beverages often include other substances which can increase the caloric content, including sugar.

With that out of the way, studies have observed that alcohol has some interesting implications for our health. The French Paradox being one of the most known; it’s basically the observation that French people have relatively low numbers of heart disease, despite eating high amounts of saturated fat. Their wine consumption has been cited as a possible explanation for this low number.

This idea proposes that resveratrol, a natural phenol found in grapes, has cardioprotective effects. However, this has been definitely challenged, as the researcher who has done a great deal of research on this subject, was accused of scientific fraud. His publications were also removed. Many results from his studies are now considered to be false. [1]

With all that said, alcohol does in fact hold some health benefits, let us check the short- and long-term effects of its consumption. Considering its wide (mis)use, I am sure many of you would like to know whether your drinking habits (if you have them) will have a deteriorating effect on your health in the long run.

For now, let’s focus on the short-term effects.

 

Short-term effects

Sleep

Alcohol affects our sleeping architecture and sleeping pattern differently, it mainly depends on the amount and how close to bed time we drink it. A small amount of alcohol, one small beer, can increase how much we sleep and cut how often we wake up during the night. This is obviously a good thing; especially for people who have difficulties sleeping. [2]

This effect, however, gets diminished with moderate or higher amounts of alcohol. It’s interesting that it will manifest differently in people who are used to alcohol and those who are not. The latter are more prone to its sedative effects, while the former become more stimulated at such amounts. [2]

Moreover, alcohol at moderate doses negatively disrupts our sleep architecture. This means that the usual stages through which we would go during a night’s sleep get disrupted. While the physiological usefulness of each sleeping stage has yet to be exactly determined, we can imagine that this could have a negative effect on our general wellbeing if we would disrupt our sleeping pattern on a regular basis. [2]

Other effects

Other short-term effects of alcohol include the following:

Capture

This picture was taken straight from Wikipedia, there is no point in me rehashing what is dotted down so nicely. I’m sure many of you have gone through various stages and experienced the different acute effects. These are, however, not as vital for our physical health in the long run, granted that they are one time occurrences and not a regular indulgence.

Long-term effects

I will not be writing about alcohol-related deaths as a consequence of DUI/DWI, violence, or impaired judgment. I am writing solely about the long-term physical and mental health aspects of alcohol consumption. I consider everyone is aware of the addictive and destructive potential of alcohol.

I will also not be writing about alcohol consumption that could fit the description of classic alcoholism. Alcohol consumption in low to moderate quantities, between 1 and 4 drinks per day, depending on your sex, weight, age, and alcohol tolerance, seems to have the most beneficial effects. If you’d just like to read about the negative aspects, a compilation of diseases and outcomes connected to high or excessive alcohol consumption  can be found at the end.

There seems to be no consensus on how much is light/low or moderate alcohol consumption between researchers either, which is a bit silly to be honest. Two good ballpark estimates are the U.S. Department of Agriculture and the Dietary Guideline for Americans, these promote one to two drinks per day for a man and one drink per day for a woman.

Positive aspects

Low to moderate alcohol consumption decreases your relative mortality rate

There is an overwhelming body of evidence that low to moderate alcohol consumption in the Western culture seems to be associated with decreased mortality. Period. [4567]

Researchers in these studies have been quite thorough, Different variables, which could have affected and skewed the results, were taken in account by them. And they found the same association afterwards as well.

In India and South Asia, however, this connection doesn’t seems to exist. Moreover, people who do drink alcohol have an increased mortality rate. In India, alcohol drinkers seem to have higher blood sugar, blood pressure, and much higher tobacco use. [89]

This, of course, immediately poses the question whether there are other factors which could influence this connection; especially given the much higher tobacco use in India. Future studies will no doubt shed more light on this.

Low to moderate doses of alcohol improve various aspects of your cardiovascular system

The above mentioned reduced mortality could be a result of the fact that drinking alcohol decreases blood levels of fibrinogen. This is a protein that promotes blood clot formation and thus our chances of a heart attack. Furthermore, it increases levels of an enzyme with a key role in dissolving such clots. Both of these effects were noted in a big analysis of multiple randomized trials, the best type of study there is. [10]

To further this idea, alcohol seems to actually have significant anticoagulant properties in general. As thrombosis, blood clot formation, is lower among people who drink moderate doses of alcohol. [12, 13]

With that in mind, it’s quite possible that this is the key mechanism behind the reduced mortality in people who drink alcohol regularly. Researchers note that consuming 30 g of alcohol per day could cut our heart disease risk by around 25%. [10]

But those are not the only positive effects of alcohol consumption on our cardiovascular system. Recently, it has been implied that moderate alcohol consumption is associated with positive changes in HDL cholesterol levels and adiponectin, a protein involved in the regulation of glucose levels and fatty acid breakdown, as well as lower levels of C-reactive protein, suggesting that alcohol could have anti-inflammatory effects. [14, 15, 16]

Moderate alcohol consumption increases chance of surviving heart attacks

The effects of alcohol also translate to the chance that people will survive if they have suffered from a heart attack; people who have suffered from it are thus more likely to survive if they are moderate alcohol drinkers [17, 18, 19]. Having said that, drinking alcohol excessively leads to an increased risk of heart failure. [20]

At the same time, there is limited evidence from randomized clinical trials on this matter. All of this is observational data and connections. I’ve provided a short explanation for this in the last part.

Low to moderate doses of alcohol decrease your risk for diabetes

Similar to heart attacks and the cardiovascular system, there seems to be a protective effect of low to moderate alcohol consumption when it comes to diabetes, and an increased risk for diabetes when people are drinking higher amounts of alcohol, possibly by promoting insulin sensitivity. [21, 22]

Negative aspects

Judging by all I’ve written so far you may have asked yourself – why am I not drinking gallons of alcohol each day? Well, while there seems to be a protective effect when we drink low to moderate amounts of alcohol, there is a drastic shift to its harmful effects when these amounts become bigger, usually more than the recommended amount that I’ve stated above.

Breast and liver cancer

There is a large amount of evidence that two or more alcohol drinks increase the risk of breast cancer in women by as much as 41%, not a number to be neglected. [23, 24]

But I must immediately add that increasing amounts of folate in your diet seems to cancel out, at least partly, this increased risk for breast cancer. Alcohol inactivates and blocks the absorption of folate in our blood and tissues, therefore rendering it rather useless. However, a comparison of women with the highest and lowest intake of folate in their diet revealed that those with the lowest were around 90% more likely to develop breast cancer. [25, 26]

Chronic alcohol consumption is also the leading cause of liver cancer in the Western world as it accounts for around 30-40% of hepatic cancer.

Blood pressure, cardiomyopathy, triglycerides

Moderate alcohol consumption also seems to be associated with increased blood pressure. According to one study, if you drink more than three alcohol drinks per day you have an increased risk of increased blood pressure, cardiomyopathy; heart muscle disease, and high triglyceride levels; also known as hypertriglyceridemia. [27]

Mixed aspects

Drinking high amounts of alcohol increases your risks when it comes to:

  • Stomach inflammation (gastritis)
  • Cirrhosis
  • Hepatitis
  • Pancreatitis

On the other hand, low and moderate alcohol consumption is associated with a lower prevalence of metabolic syndrome, it reduces the risk of developing gallstones. It’s also associated with an increase in the risk for gouty arthritis and a decreased risk of rheumatoid arthritis [28, 29, 30, 31, 32, 33, 34]

I would like to point out that the study focusing on gallstones was based on self-reports, and with that subject to skewed results. While they did control certain variables that could have had an effect on the connection, it is still a bit shaky in my opinion.

All in all, we can see that alcohol has a variety of effects on the functioning of our body. It’s also worth acknowledging that the majority of the mentioned negative effects so far, a very important exception being cancer, are a consequence of high to excessive amounts of alcohol consumption which aren’t necessarily abuse yet, which is coincidentally the last part of this article.

 

Alcohol abuse

I’ve said at the start that I’d compile a list of diseases, disorders, and outcomes that are connected to alcohol before, so here they are.

Large amounts of alcohol can lead to/are connected to an increased amount of anemia, alcohol dementia, brain shrinkage, physical dependence, sexual dysfunction, hormonal imbalance in men and women, impaired prospective memory, Wernicke-Korsakoff syndrome, insomnia, higher rates of major depressive disorder, alcoholism, and different types of cancer (pharynx, larynx, esophagus, breast, and colon and rectum in men). [35]

Furthermore, I don’t think I need to explain the social implications of alcohol abuse. Destroyed families, impaired social functioning, there are multiple reports of anxiety disorder as a result, different mental disorders often co-develop with alcoholism or vice versa. It can lead to antisocial behavior and irritability, especially with increased cravings when one is addicted. Alcoholics also have very high suicide rates etc. There is a plethora of reasons not to abuse alcohol.

If you have a family history of alcohol addiction or know that you’re prone to addictive behavior, then I’d strongly recommend against it, despite the possible health effects. A healthy diet alone will bring the same positive effects to your life as well.

 

Conclusion

Granted, not all the mentioned findings were randomized controlled trials, one of the reasons being ethical implications of excessive long-term alcohol exposure. However, the majority of researchers agree that there indeed seems to be a causal link between low to moderate alcohol intake and positive health benefits for our cardiovascular system, mortality, and heart attack incidence. But we must be aware of the fact that there is an increased chance for different types of cancer, and the other mentioned diseases.

I will end with the idea that everybody should decide from themselves whether alcohol consumption is worth it. There are obvious psychological and social implications which make alcohol a more or less possible option for certain people.

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