Thursday, January 19, 2017

Cheers! The Ups and Downs of Alcohol Intake

The average American consumes 6-10% of their calories as alcohol.  The average represents those who never drink, those that drink socially (those who prefer an alcoholic beverage over water, tea, milk, etc.. with a meal or social engagement), binge drinkers (those who drink 4 or more drinks in a short period), and problem drinkers (those who prefer to become intoxicated as often as possible; may be due to psychological and physiological issues).

Moderate drinking is defined by one drink per day for a woman and two drinks per day for men.  This does not mean that a female can abstain from alcohol for 6 days, and on day 7 enjoy seven alcoholic beverages (this would be considered binge drinking as describe above). 

An alcoholic drink is defined as 1 ounce of hard liquor, 12 ounce beer, or 3.5 ounces of wine.  The amount of calories in alcoholic beverages can be significant ranging from 90-600 calories per beverage, depending on the mixers in which the alcohol is combined.

We have all heard that we should not drink on an empty stomach (and some of my readers may have actually participated in their own "scientific experiment" with regard to this).  When alcohol is consumed without food, the alcohol can be absorbed directly from the stomach into the blood stream, where it travels quickly to the brain, lowering inhibitions and limiting judgement ability.  The alcohol in the blood will eventually make it's way to the liver for metabolism or break down.  The liver views alcohol as a toxin and the main goal of to dismantle the alcohol and excrete it from the body.  When alcohol is consume with or after food intake, alcohol absorption is slowed and the intoxication effects are lessened. 

An enzyme, alcohol dehydrogenase (ADH), is secreted n the liver when alcohol is present.  A nondrinker will have a smaller amount of ADH available as compared to a binge drinker or a problem drinker.  Alcohol dehydrogenase is the enzyme that is typically associated with what the average person refers to as "tolerance", meaning the more an individual drinks, the more alcohol dehydrogenase the individual will produce in anticipation of needing it to break down future alcoholic beverages.  This explains why some people can be 'drunk' on 2 drinks, while others can tolerate a case of beer or a fifth of hard liquor in a single day. 

Once alcohol dehydrogenase has been activated, it will begin a cascade of physiological processes to rid the body of the toxin.  First, antidiuretic hormone (controls fluid balance in the body by regulating urine output) is deactivated resulting in increased urine output in order to rid the body of the alcohol .  This explains why it is much easier to find an empty bathroom stall at a school that in it is at a concert or bar.  This excessive urine output will dehydrate the body, leading to increased thirst, and if followed up with additional alcohol intake, will further dehydrate the body.  The eventual result of this dehydration will cause many of the symptoms associated with the hangover including headache, nausea, and muscle weakness and lack of coordination.  if the alcohol consumption continues to an excessive amount, vomiting is likely to occur, furthering the dehydration.

The dehydration process will continue until the alcohol is completely metabolized.  The body will also attempt to use the excessive calories from alcohol for energy.  If more calories are consumed than can be utilized, those excessive calories will be converted into fat.  In fact, drinkers have increased body fat compositions compared to nondrinkers.  Excessive body fat and dehydration may be especially contraindicated for athletic performance, decreasing cardiac output, lessen ability to perform for long durations, and fatigue more quickly.

Over the long term, drinkers are more likely to suffer from more conditions than nondrinkers including
`cirrhosis and liver disease
`bladder, kidney, pancreas, and prostate damage,
`bone deterioration and osteoporosis
`brain disease, central nervous system damage, and stroke
`deterioration of the testicles
`type 2 diabetes
`heart disease
sexual impotence in men
`impaired immune response
`impaired memory and balance
`malnutrition
`nonviral hepatitis
`severe psychological  depression
`skin rashes and sores
`ulcers and inflammation of the stomach and intestines

It should be noted that there are populations that SHOULD NOT consume alcohol including:
`children and adolescents
`individuals that cannot restrict intake
`women who may become pregnant, women that are pregnant or breastfeeding
`people that are driving
`people that are taking medication that can interact with alcohol
`people with medical conditions worsened by alcohol, such as liver disease

So is there an upside to drinking?  Yes, in some situations.

1.  Drinking alcohol (in moderation) decreases inhibitions.  This can be a particularly positive for individuals that experience social anxiety or generalized anxiety disorder.

2. Drinking alcohol increases appetite.  Appetite is the psychological need for food, meaning that food looks good, sounds good, and smells good.  In fact, we generally eat about 15-20% more after consuming 1 cocktail before dinner.  In addition, the cocktail drinkers rank the food quality and enjoyment of the meal higher than nondrinkers at the same meal.  For individuals with decreased appetite, such as cancer patients, HIV/AIDS patients, and nursing home residents, alcohol may be helpful in increasing oral intake.  However, if you are trying to lose weight, it is important to remember that alcohol intake will likely result in eating more calories as well as drinking them. 

3.  In individuals over 65 (that have been moderate drinkers during adulthood), switching their alcohol choice to red wine may be cardio-protective.

So when evaluating your food and beverage choices, be sure to include your alcohol intake.  It may be beneficial in moderation for you, however, it could increase your body fatness, negatively impact you athletic performance, or even harm your health.  Remember, like all of our dietary choices, moderation is key with alcohol intake!

Happy eating (and drinking)!

For more information or to schedule an appointment with Leslie Goudarzi, MS, RD, LD, call 903-239-1551.

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