Saturday, June 13, 2020

Adverse Health Effects of Heavy Alcohol Use

Last time we talked about the guidelines regarding alcohol consumption.  This week we'll focus on the adverse health consequences of excessive alcohol use.  Remember that moderate alcohol consumption is considered one drink a day for women and two drinks a day for men.
 
Adverse Health Effects of Heavy Alcohol UseLight to moderate alcohol consumption is considered safe for most people, although there are some people who should not drink alcohol at all.  We talked about this briefly last week, and we'll touch on it again today.
 
Drinking too much alcohol can cause both physical and mental harm to your body in a number of ways.   Let's go through it by body system.
 
Liver:  Heavy drinking can certainly take a toll on the liver.  The metabolism of alcohol creates a toxic compound call acetaldehyde.  This toxin contributes to inflammation in the liver and other organ systems.  Your liver functions to remove toxins from the body, so it has to work overtime when you drink alcohol.   If you drink heavily, either too many drinks in one sitting, or too many drinks over a long period of time, your liver can't keep up.  This excess alcohol can damage your liver in different ways.
  • Fatty liver – Fat builds up in the liver, leading to poor function.
  • Cirrhosis – Liver cells are killed, leading to scarring and fibrosis.  This damage, referred to as cirrhosis, significantly damages the ability of the liver to function properly.  
  • Alcoholic hepatitis – Often caused by binge drinking or heavy drinking over short periods of time, this is an acute inflammation of the liver that can lead to loss of liver function and death.

Pancreas:  Alcohol can cause inflammation in the pancreas, called pancreatitis, which can be acute or chronic.  It can be a very serious condition that causes significant pain and digestive problems.
 
Heart and Cardiovascular System:  Damage to the heart can be caused by excessive alcohol consumption on a single occasion or heavy drinking over a long time.  Heart problems that can be caused by alcohol include:
  • Cardiomyopathy - The heart muscle becomes stretched thin and the heart becomes enlarged and cannot pump adequately.
  • Arrhythmias - Several abnormal heart rhythms can be associated with alcohol use, some fatal.
  • High blood pressure - Increases your risk for cardiovascular death from heart attack and stroke.
  • Brain and Neurologic system:
  • Stroke - Stroke risk is increased by heavy alcohol use, which can lead to significant disability or death.
  • Memory - Alcohol interferes with the pathways in the brain.  Intoxication, especially heavy intoxication prevents your brain from moving short term memories into long term storage, so you may remember what happened when you were drunk for a few days, but you will not be able to remember weeks or years later, even really important things that happened.
  • Encephalopathy - Usually caused by chronic heavy drinking.  This is an inflammation within the brain, which causes confusion, loss of motor coordination, short-term memory loss, involuntary eye movements, and other symptoms.
  • Neuropathy - Also caused by chronic heavy drinking, neuropathy causes damage to sensory nerves, causing tingling, numbness, and pain in the feet and hands.  It can also cause poor function of motor nerves, leading to foot drop, abnormal gait, and frequent falls.

Immune System:  Drinking too much can weaken your immune system.  This is true for chronic excessive drinking, which increases your risk for several infections.  Drinking a lot on a single occasion weakens your immune function for up to 24 hours after getting drunk.  This is certainly not something you want to happen right now!
 
Cancer:  There has been extensive research on the effects of alcohol on cancer risk.  There is strong scientific evidence of an association between alcohol consumption and several types of cancer.  Alcohol is actually listed as a known human carcinogen by the National Toxicology Program of the US Department of Health and Human Services.  The more alcohol a person drinks over time, the higher the risk of developing an alcohol-related cancer.  
 
Here are the types of cancers that have a clear association with alcohol:
  • Head and neck cancer – People who drink 3.5 drinks per day or more have at least a two to three times greater risk of developing head and neck cancers than non-drinkers.  This includes cancers of the tongue, tonsils, larynx and others.  This risk is substantially higher among heavy drinkers who also use tobacco products.
  • Liver cancer – Alcohol consumption is an independent risk factor for liver cancer.
  • Esophageal cancer – Alcohol consumption is a major risk factor for certain types of cancer in the esophagus.
  • Breast cancer – There have been more than 100 studies that looked at the association between the risk of breast cancer and the consumption of alcohol.  These studies have consistently found an increased risk of breast cancer associated with increasing alcohol intake.
  • Colorectal cancer – There is a modestly increased risk of cancers of the colon and rectum associated with alcohol consumption.

For most people, moderate alcohol consumption is not associated with significant health risks.  However, this may not be true for everyone.  Here are just a couple of examples.  If you have a strong family history of breast cancer, you might want to avoid alcohol use, or reserve alcohol for rare special occasions.  If you have high blood pressure that is hard to control, eliminating alcohol consumption might allow you to take fewer medications. 
 
If you have questions about your own alcohol consumption, be sure to talk with your family doctor about your risk.  If you have any questions about the effects of alcohol use, please log into your account and send us your question. We are here to help.  

Dr. Anita Bennett MD - Health Tip Content Editor

Friday, May 29, 2020

Alcohol Consumption Guidelines

People drink alcohol to celebrate occasions, socialize, and for many other reasons.  In this time of quarantine and stay-at-home orders, many people have been drinking more alcohol than they usually do, and maybe more than they should.  While drinking alcohol is itself not necessarily a problem, too much alcohol consumption has many potentially serious health consequences.  I thought this might be a good time to revisit the recommendations for alcohol consumption.

Alcohol Consumption GuidelinesAll alcohol is NOT equal.

Alcohol (ethanol) is found in beer, wine, and liquor.  The percentage of alcohol in those drinks varies, not only between each category but also within each category.  Some beers have a higher percentage of alcohol than others.  The same applies to wine and liquor as well.  You should be familiar with the percentage of alcohol present in the alcohol that you drink.

What is a standard alcoholic drink in the United States?

The recommended guidelines for alcohol intake include a specific number of "drinks" of alcohol, which we will discuss below.  A standard drink is equal to 14.0 grams (or 0.6 ounces) of pure alcohol.  

Here are some examples of what constitutes a standard drink:
  • 12 ounces of beer - with a 5% Alcohol by Volume (ABV)
  • 8 ounces of malt liquor - with a 7% ABV
  • 5 ounces of wine - with a 12% ABV
  • 1.5 ounces (one shot) of 80 proof (40% ABV) distilled spirits or liquor, such as gin, rum, vodka, or whiskey
Remember that some beer may have a higher ABV than others.  If your beer has a 9% ABV, a 12 ounce serving would be equivalent to 1.8 drinks. 
 
If you order a mixed drink cocktail, it may contain 2 or even 3 different spirits, and may be equivalent to 2 standard drinks or more!  You should know what is in the cocktail that you order.

What are the recommended amounts of alcohol consumption?

According to the Dietary Guidelines for Americans, if alcohol is consumed, it should be in moderation.  Moderation is defined as up to one drink per day for women, and up to two drinks per day for men, and only by adults of legal drinking age.  The Dietary Guidelines do not recommend that anyone start drinking who does not already drink alcohol.  These guidelines also recommend that if alcohol is consumed, the calories from alcohol should be accounted for in your planning a healthy eating pattern.
   
Is one type of alcohol safer than another?

The short answer is no.  As long as you are aware of the alcohol content, and base your measurement of alcohol consumption accurately, one type of alcohol is not safer than another.  It is the amount of pure alcohol consumed that affects your health, not the type of alcohol.

Can you average your alcohol consumption by the week?

Some people like to think of the guidelines as a recommendation for the week, for instance, a woman should have no more than 7 drinks per week, and a man no more than 14 drinks per week.  This is often the way the guidelines are represented.  If a woman drinks 2 drinks every other day, and does not drink any alcohol on the alternate days, that would average out to one drink a day.  This seems like a harmless idea.  However, there is a limit to this ability to average.  It is not healthy to drink all of your weekly alcohol "allowance" in one or even two days.  This could be considered binge drinking.

What is considered excessive alcohol use?

Excessive alcohol use includes:
  • Binge drinking 
  • Heavy drinking (8 or more drinks a week for women, 15 or more drinks a week for men)
  • Any alcohol use by people under the age 21 minimum legal drinking age 
  • Any alcohol use by pregnant women
Who should not drink alcoholic beverages at all?
  • Anyone younger than 21 years old
  • Women who are or may be pregnant
  • People who are planning to drive or operate machinery, or are participating in other activities requiring skill, coordination, or alertness
  • People taking certain prescription and OTC medications that can interact with alcohol
  • People with certain medical conditions
  • People who are recovering from alcoholism or who are unable to control the amount they drink
What can you do to lower your alcohol intake?

This sounds obvious, but you can drink less often or drink less alcohol on the days that you drink.  Here are some ideas for doing this.
  • Make sure you have 2 days a week that you do not drink at all.
  • Plan ahead regarding how much alcohol you will drink, and stick to the plan.
  • Sip your drink slowly, so that one drink lasts longer.
  • When making cocktails at home, use half the alcohol that is called for in the recipe.  At a bar, ask the bartender for half the alcohol in your cocktail.  Substitute a soft drink or fruit juice to make up the difference.
  • Choose beer with lower ABV.
Next week we will talk more about the adverse health effects of alcohol.  In the meantime, If you have any questions about alcohol consumption, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Friday, May 15, 2020

The Anti-Inflammatory Diet

Do you struggle with chronic pain, GI complications, depression, fatigue or other symptoms? These things could be related to chronic inflammation. The foods you eat in your diet can help lower inflammation. Let's talk about how this works and why it is important. 

What is Inflammation?
The Anti-Inflammatory DietInflammation is one of the body's defense mechanisms used to fight infections and promote healing. An increase in inflammation often occurs in response to certain diseases; however, in these situations there is no infection or foreign body to fight. Inflammation can remain elevated due to these disease states causing chronic inflammation which can increase disease states and issues like pain.

What are some of the diseases that are related to chronic inflammation? 
  • Alzheimer's disease
  • Asthma
  • Autoimmune disease – rheumatoid arthritis, lupus
  • Cancer
  • Chronic obstructive lung disease
  • Chronic pain (back, neck, headaches, arthritis)
  • Depression
  • Heart disease
  • Inflammatory bowel disease
  • Type 2 diabetes
  • Obesity
How can what I eat affect my inflammation?

The Standard American Diet tends to be high in simple sugars, unhealthy fats, and processed foods while low in fruits, vegetables and fiber. This diet tends to promote chronic inflammation in the body. Changing what and how you eat has been shown to decrease the inflammation in your body. It does not take the place of medications and treatment, but can decrease flare-ups, pain and other symptoms. The anti-inflammatory diet does not focus on weight loss, but healthy choices to improve your overall health.

What is the anti-inflammatory diet?
  • Protein 
    • Choose plant-based proteins like nuts, beans, peas, legumes and whole grains
    • Choose lean meats – white meat poultry without skin, wild caught fish (tuna, salmon, mackerel, sardines), eggs, wild game
    • Choose low fat/fat free milk and yogurt and no added sugar plant milks 
    • Avoid high fat red meats, processed meats (hot dogs, sausage, spam, bologna), and high fat dairy products (cheese, whole milk, cream, butter)
  • Fruits and Vegetables
    • Choose a variety of colors of fruits and vegetables. 
    • Increase non-starchy vegetables especially dark green leafy vegetables
    • Increase fruits especially berries, cherries and oranges
    • Olive oil has been shown to reduce inflammation and have other health benefits 
    • Avocados are a healthy fat that can help reduce inflammation 
  • Increase Fiber Intake
    • Fiber helps reduce inflammation 
    • Whole grains, beans, oatmeal, fruits, vegetables, popcorn, brown rice, nuts (especially walnuts and almonds) are all good sources of fiber
  • Limit Simple Sugars and Unhealthy Fats
    • Sugar and fats like saturated fats and Omega-6 fatty acids cause the body to increase inflammation 
    • Limit sugary drinks including fruit juice
    • Limit cakes, cookies, pies, donuts, and other high fat/high sugar baked goods
    • Limit high fat snacks like chips, crackers, and snack mixes
    • Limit fried foods like French fries, fried meat, and fried vegetables
    • Avoid all trans fats (check the label for 0 trans fats)
  • Omega-3 and Omega-6 fatty acids are essential fatty acids you get from your diet. You need a good balance of these. Our diet tends to have significantly more Omeg-6 fatty acids than Omega-3 fatty acids which increases inflammation.  
    • Sources of Omega-6 fatty acids – plant oils like corn, soybean, and sunflower, nuts, and seeds. 
    • Sources of Omega-3 fatty acids – fatty fish, whole grains, walnuts, flax seed, and green leafy vegetables
  • Herbs and Spices 
    • Turmeric, garlic, ginger, and many other spices can lower inflammation and help flavor food without adding sodium.
A bonus – the anti-inflammatory diet is a good option for all types of people of all ages so it can benefit the whole family!

Do I have to make all these changes at one time?

No, you do not have to make all these changes at one time to see the results of lowered inflammation. Pick 1-3 changes to make at a time. Once you have mastered those changes, pick 1-3 more things to work on.  Over time, you will get into a new lifestyle that promotes choosing a variety of whole foods while reducing inflammation and improving your overall health.

If you have any questions about The Anti-Inflammatory Diet, please log into your account and send us your question. We are here to help.

Libbi Calloway, MS, RD, LD