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.

All 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

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?
Inflammation 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

How You Can Get More Sleep Tonight

Sleep is more important now than ever.  Unfortunately, due to the current situation in the world, many of us are spending our nights tossing and turning.  We need sleep more than we might realize, especially when our lives have been disrupted.  Let's talk about why sleep is important and how you can get enough sleep to stay healthy.

Why is sleep important?

Getting 7-8 hours of sleep at night helps to keep our immune system working well by supporting the release of proteins that help the immune system respond quickly to foreign substances.

Getting only 4-6 hours of sleep on a regular basis causes your body to develop higher levels of stress hormones, which can lead to higher blood pressure, lower immune response, and other health issues.

Getting less than adequate sleep is associated with cognitive problems such as poor memory, lower reaction times, and mental confusion.

Getting less sleep is also associated with hormonal changes that lead to weight gain.  We all want to avoid that!

Here are some things that you can do to help you get a good night's sleep.

Create a sleep schedule and stick to it.

When you are not going to work, or working from home, it is easy to let schedules go by the wayside.  You need to know that keeping a schedule is vital to your health.  The more consistent bedtime and wake-up time you have, the more consistently your body functions, including your immune system.  It is also true that the more consistent sleep schedule you have, the better quality sleep you are able to get.   If you are not going in to the office, this may be the perfect time to get a little more sleep!

Set an alarm not only for waking up in the morning, but also for getting to bed at night.  Don't just set the alarm, but use it as you should.  

If you do not sleep well at night, it is ok to take a short nap midday.  Just don't let a nap wreck your nighttime sleep schedule.  Make your nap short, 15-30 minutes, and do not nap after 3 pm.

Set the stage in your bedroom for quality sleep.  Here are some things that might help:

• Darkness – Use heavy curtains to block light from outside, cover lights on electronics that are in the room, or use a sleep mask to block light from both inside and outside.  

• Quiet – Use a fan or white noise machine to block background noise that is not in your control.

• Temperature – Most people don't sleep well when the room is too hot or too cold, but you may prefer a cold room with more covers, or a slightly warmer room with fewer covers.  Find the ideal temperature for you. 

Set a bedtime curfew for all electronics and stick to it.

Ideally, you should have 60-90 minutes before bedtime without electronics.  This includes TV, smart phones, computers, etc.  Being more isolated, as we all are these days, does make it more important to stay connected electronically.  Just don't use those devices before bedtime.  Turn on the "Do not disturb" feature on your phone for the hours that you set aside for sleep.  

This time without electronics can help your sleep in multiple ways.

• You need less direct light, especially less blue light, hitting your eyes in the evening to help trigger your body to produce melatonin.  Your own melatonin works best to help promote sleep.

• Getting onto your social media account, or watching the news or an exciting TV show engages your brain in a way that can inhibit your sleep.  If you really feel like you need to watch a TV show, make it something very relaxing and comforting, turn the volume down low, and lower all of the other lighting in the room.  Never leave the TV on while you sleep.

Don't read the news right before bed.

This includes electronic news, but also traditional newspapers as well.  Get your coronavirus news once a day, early in the day.  The news can increase your anxiety level, which is not good for sleep.

Get some exercise every day.

It may be harder to do your usual exercise routine right now, but there are ways that you can move your body and raise your heart rate every day.  Here's why it's important.

• Exercise during the day helps drive our sleep at night.  Just don't do it too late in the evening.  

• Exercise also helps to improve the chemical balance in our brains, helping us to ward off depression and anxiety.  

• Knowing that exercise has improved your immune function might help you sleep better at night.

Practice some relaxation before bed.

• Try the breathing exercises I mentioned in last week's Health Tip.  

• Consider meditation or progressive relaxation before bed, or as part of your falling asleep routine.  

• Take a hot bath or shower about 90 minutes before bedtime.   This is not only a form of relaxation, but the process of getting really warm, then slowly cooling down is another way to trigger your body to produce melatonin.  You might want to use the bath or shower as the start of your electronics curfew.

Be careful of what you eat and drink.

• Avoid caffeine too close to bedtime.  

• Don't eat right before bed.  Heartburn or indigestion is more likely if you lie down with a full stomach, and that can interfere with your sleep.  

• Avoid excessive alcohol in the evening.  While alcohol might make you sleepy initially, too much can cause fragmented sleep, which results in less sleep overall, and poor quality sleep.

Wash your sheets.

Who doesn't love the feel of fresh, clean sheets on the bed?  I know that helps me sleep better.

If you have any questions about getting more sleep, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor