ALCOHOL ABUSE AND ASSOCIATED HEALTH CONDITIONS

Alcohol and cardiovascular disease

The studies regarding the beneficial effects of alcohol on heart disease risk remain controversial. No beneficial relationship was seen in the 6000 men who were followed for 20 years; in fact, an increased overall risk of mortality from all causes was seen in men who drank more than 22 drinks/week. In addition, men who drank more than 35 drinks/week had twice the risk of dying from stroke. Grape juice, rather than red wine, is probably a better choice for lowering blood pressure.

While it is reported that wine contains phytochemicals, which act as antioxidants, it is important to note that alcohol itself may cause oxidative stress that may damage the liver and pancreas. Alcohol causes an increase in triglycerides. At autopsy, the heart of a person who suffered from alcoholism will weigh twice as much as a heart of a nonalcoholic. Still, some researchers recommend a moderate alcohol intake for reduction of cardiovascular disease. At any rate, it is not recommended that a man consume more than two drinks/day or a woman more than one drink/day. 

Alcohol and cancer

A correlation exists between alcohol consumption and breast cancer in young women. In addition, relationships between alcohol usage and cancers of the liver, mouth, throat, esophagus, colon/rectum (especially in beer drinkers), and the lungs is documented. Once cancer has developed, alcohol appears to spur progression. 

Alcohol and the elderly

Having an alcoholic drink 20 minutes before mealtime is shown to improve appetite. It also seems to improve morale, stimulate sociability, and help with sleep. Improved staff-resident relations are reported in nursing homes that allow residents to drink a moderate amount of wine. 

Alcohol and the brain

The brain shrinks in people who drink moderately or excessively. The extent of the shrinkage correlates to the amount of alcohol consumed. Alcoholics who abstain from all alcohol and eat a healthful diet can reverse some, or all, of the brain damage. However, the damage is sometimes irreversible, if the person has drank alcohol in excessive amounts for a long time, and permanent harm to memory, vision, and learning ability may occur. 

Alcohol and mineral loss

The dehydration caused by alcohol consumption may lead to deficiencies of magnesium, selenium, phosphorus, potassium, calcium, and zinc, if proper nutrition is ignored. A long list of health issues may result from these deficiencies, including damage to the nervous and muscular systems and inappropriate fluid balance. 

Other nutritional issues associated with alcoholism

  • Failure to absorb thiamine, vitamin B12 , and vitamin B6 (in addition to the destruction of existing B6)
  • Failure to activate vitamin D
  • Failure of rod cells in the retina and liver cells to process vitamin A
  • Expulsion of folate from storage and excretion into the urine, in addition to an inability of the intestine to retrieve any—folate deficiency is the cause of Wernicke-Korsakoff syndrome in alcoholics
  • Protein-energy malnutrition
  • Scurvy

Alcohol and the liver

Alcohol causes the liver to make more fatty acids, which results in fat accumulating in the liver, even after a single night of heavy drinking. Of course, if a person is not drinking heavily every night, within a few days the fat will clear out of the body. However, in heavy drinkers, fatty liver is the first stage of liver damage.

If a person has a fatty liver for long enough, fibrous scar tissue will form, known as fibrosis. Even fibrosis is curable with abstinence and a healthy diet. However, if a person continues to drink, cirrhosis develops, which has no cure. With cirrhosis, the liver cells die and the body cannot regenerate them. 

Other health conditions associated with alcohol abuse

  • Ulcers
  • Nonviral hepatitis
  • Kidney, bladder, pancreas, and prostate damage
  • Impaired immunity
  • Sexual impotence in men
  • Reproductive issues in both sexes
  • Bone deterioration and osteoporosis
  • Central nervous system damage

Determining how much alcohol is in your drink

The percentage of alcohol is stated as “proof.”  Proof equals twice the amount of alcohol in the drink. For example, 100-proof liquor is 50% alcohol. A standard serving of alcohol delivers ½ fl oz of ethanol. One standard drink is:

o        Wine: 3-4 fl oz

o        Wine cooler: 10 fl oz

o        Beer: 12 fl oz

o        80-proof whiskey, gin, brandy, rum, or vodka: 1½ oz

Unless you are mixing your own drinks, it is hard to determine how much ethanol each drink contains. It is important to note that a woman will absorb one third more alcohol than a man of the same size. 

Alcohol and weight
 

  • Alcohol should count as a “fat” in the diet, even though many alcoholic beverages are fat free, because alcohol most likely promotes fat storage, which leads to the “beer belly” effect that we have all have heard about. Alcohol contains 7 calories of energy/gram (g). Carbohydrate and protein contain 4 calories/g, and fat contains 9 calories/g.
  • To calculate how many calories are in a drink, use the following equation:
    • calories=fluid ounces (fl oz) of beverage x proof x 0.8 calories

 

Calories in common beverages

Beverage

Calories

Wine, dry red or white (4 fl oz) 85
Bloody Mary (5 fl oz) 116
Beer, regular (12 fl oz) 150
Martini (2½ fl oz) 156
Whiskey sour (4 fl oz) 164
Gin and tonic (8 fl oz) 182
Wine cooler (12 fl oz) 215
Daiquiri (4 fl oz) 222
Piña colada, no ice (4 fl oz) 228
Margarita, no ice (4 fl oz) 267

 

  

References and recommended readings

Sizer F, Whitney E. Alcohol and nutrition. In: Graham L, ed. Nutrition Concepts and Controversies (annotated instructor’s edition). Belmont, CA: Wadsworth/Thompson Learning; 2000:167-174.
 

US Dept of Agriculture, Agricultural Research Service. What’s in the Food You Eat search tool. Available at: http://www.ars.usda.gov/Services/docs.htm?docid=7783. Accessed September 13, 2008.