Alcohol and Health: Is Alcohol Good or Bad?
What is a standard drink and what is a healthy amount of alcohol to consume?
I am an alcohol researcher and for the past 20+ years I have published extensively on this topic. There has been a variety of mixed research on whether alcohol is good for our health or poses health risks. While I will get into more specifics about some of the research in future posts, today we are going to start with the basics.
Here is information we can be confident in:
1. Choosing not to drink (or abstaining from alcohol) is not harmful. Studies that say moderate drinking may have benefits can make individuals who choose not to drink wonder whether they are missing out on health benefits. That is not the case. If you really want to take care of your health focus on exercise and healthy eating habits. The data are much more conclusive on those topics.
2. Excessive drinking leads to a variety of health problems. We do know alcohol has several deleterious effects on the body if abused. Alcohol is a central nervous system depressant (meaning it affects your brain) and because it is processed through the liver, puts a lot of strain on this vital organ. It also impacts several other body systems since it is able to penetrate every cell in our body. Simply put, alcohol is a very powerful drug. Because it is legal in our country and very accepted in our culture, we often don’t give it the respect or caution it warrants.
So, this leads to the topic of the week. If you choose to drink, how much is a safe amount and what exactly constitutes one drink? The answers to these questions may be a bit more complicated than you would guess.
What exactly is a drink?
As a researcher this is actually a challenging question. When I collect data from participants it is important everyone uses the same definition for what a drink actually is so I can accurately measure consumption. The tricky part is not all drinks are created equal. Therefore, there is a scientific definition of what a standard drink actually is. Before I give you the definition, let’s see how well you do at identifying how many “standard drinks” are in each picture below. Each drink was poured consistent with what a normal glass would hold or what you might get in a restaurant.
For illustrative purposes drinks are portrayed by water or kombucha (answer key is below).
Martini “up” =_______standard drinks
Glass of wine=___standard drinks
Margarita on the rocks=___standard drinks
Beer (pilsner glass is consistent with a normal 12 oz can)=___standard drinks
Before I give you the answers, here is a standard drink chart. It’s an illustrative tool that is helpful in defining a standard drink. The hard part, especially with mixed drinks, is knowing exactly how much alcohol is in each drink and how many ounces is in a glass. This is true with wine and beer as well. I can tell you most bartenders are not meticulously measuring out pours and most people don’t measure when they pour a drink at home either.
ANSWERS:
Martini “up” = 3 standard drinks. A martini is typically straight alcohol. A little goes a long way.
Glass of wine = 1.5 standard drinks. The pour here is larger than the “5 oz” standard drink size. According to NIH, one bottle of wine contains 5 standard drinks.
Margarita on the rocks = 3 standard drinks (based on the recipe I measured out). As you can see, the glass is not large and there is a lot of ice, however there are multiple standard drinks in this cocktail. The amount of alcohol in margaritas may range dramatically due to the recipe used, amount of mixer, size of glass, amount of ice, etc.
Beer (pilsner glass is consistent with a normal 12 oz can) = 1 standard drink…depending on the beer. Beer tends to be tricky. Craft beers have a higher alcohol content and it can have a large range. Check the “ABV” percentage to be sure. Remember, a standard drink of beer equals 12 oz at 5% ABV or 0.6 ounces of pure alcohol so that 12 oz serving of Double / Imperial IPA with 8% ABV is really 1.6 standard drinks. In reality, most high ABV content beers are consumed in 16 oz pints (at breweries, pubs, restaurants) which means that one pint of 8% ABV beer is really 2.08 standard drinks.
What is a healthy amount of alcohol to consume?
Finally, let’s talk about the recommendations for what is considered light to moderate drinking or a “healthy” amount of alcohol to consume. We often work within a time frame—typically a day or week. The answer is different for men and women based on how each metabolize alcohol (more on that in future posts). Based on the most current U.S. Guidelines and the National Institute of Health (click here for full information):
Females: One or fewer standard drinks per day, no more than 7 drinks in a week.
Males: Two or fewer standard drinks per day, no more than 14 drinks in a week.
It is important to note there are individuals for whom no safe amount is recommend such as pregnant women, individuals with a history of an alcohol use disorder, individuals with certain medical conditions or taking certain medications, and individuals under 21 years of age.
Clearly, cocktails may be pose a challenge in keeping within the guidelines, however there is some flexibility. For example, a female may not drink everyday but prefers to have two glasses of wine on an occasion (keeping total weekly drinks at 7 or under). The goal is to keep things in moderation and avoid drinking excessively (or intoxication) on a given night. For instance, a male who drinks 10 drinks on one occasion but nothing else during the week, is not engaging in moderate drinking…that would be considered a heavy drinking occasion and considered risky even though his weekly total is below 14 drinks.
In sum, many people enjoy alcohol, however the goal is to enjoy it in a way that doesn’t increase risks for chronic health problems, safety (e.g., drinking and driving, violence, accidents, etc.) or alcohol use disorders. This is a challenging topic to navigate and most people have been affected by alcohol in some form throughout their lives. I plan to write about different alcohol and substance topics periodically in Mental Tune-Ups since this is one of my areas of expertise. However if you have a specific question about alcohol or substance use and would like me to address it in future posts you can email me at mentaltuneups@substack.com. Don’t be shy!
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