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The Paradox of Alcohol

Are the benefits worth the risks?
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What is “one drink?”

1.5 oz. spirits

12 oz. beer

5 oz. wine

You might argue that pale ale is better than stout, martinis beat Manhattans, or pinot is superior to cabernet, but there’s one thing we can all agree on when it comes to alcohol: heavy drinking and binging is bad for us. That much is undeniable.

But the case for moderate consumption isn’t quite so straightforward. In fact, it’s a paradox. Moderate intake — one serving per day for women, two for men — reduces your risk of heart disease, but raises your risk of cancer. It helps you relax, but wrecks your sleep. It lowers the risk of Alzheimer’s, but can damage brain structure and impair thinking.

Here’s what researchers have discovered about the benefits and perils of moderate drinking.

Will a nightcap help me sleep?

Alcohol helps you fall asleep, but it disrupts your balance of REM and non-REM sleep cycles. As a result, you’ll sleep fitfully in the second half of the night — a time when you should be getting your deepest, most restorative sleep. 

Not only will you feel tired the next day, but your mental performance will suffer. This is because alcohol disturbs sleep phases in which your brain solidifies memories and processes newly-learned information.

Drinking also relaxes airways, making you snore more, and worsening sleep problems like apnea. And of course, it causes more trips to the bathroom, as your body flushes alcohol from your system. 

The effects are dose-dependent, so the more you drink, the more your sleep patterns will be disrupted.

“If you’re going to drink,” advises Erica Vessells, licensed acupuncturist in Truckee, “the best times are happy hour and around dinner. That way, the alcohol has time to clear your system, and you can rehydrate with water before sleep. The worst thing you can do is go to bed with a buzz.”

Is red wine the best drink for reducing heart disease risk?

Surprisingly, all types of alcohol, including white wine, beer, and spirits, appear to be similarly protective. Harvard University looked at more than 100 studies and concluded that consuming one to two drinks per day of any alcohol was linked to a 25 to 40 percent lower risk of heart attack, stroke, and death from cardiovascular problems. Another new study of more than 300,000 people echoed these results, confirming that it’s not just the antioxidants in red wine that offer protection — it’s the alcohol itself.

In other studies, moderate intake of all types of alcohol was linked to a lower risk of type 2 diabetes and osteoporosis.

Do one or two drinks a day benefit the brain?

This is where alcohol is truly a conundrum. Moderate intake lowers risk of both ischemic stroke (the kind caused by clotting) and Alzheimer’s disease, possibly by decreasing inflammation. Yet the same amount of alcohol may damage the brain’s structure and performance. That’s what the University of Oxford found when scientists tracked the habits of 500 men and women for 30 years. Subjects who had about seven drinks per week showed no perceptible difference in brain health. But those who consumed eight to 12 drinks per week — well within the recommended limits for men — were three times more likely to have an atrophied hippocampus and deterioration of white matter (nerve fibers that help the brain communicate), both of which are linked to impaired thinking skills.

Can one or two drinks raise cancer risk?

Yes. Even moderate drinking is linked to a higher risk of breast cancer, as well as mouth, esophagus, larynx, and throat cancers. Risk is high in the oral cavity because the tissues come in direct contact with the ethanol — a proven mutagen.

Once alcohol is broken down by the liver, a carcinogenic by-product called acetaldehyde is formed. Although most is eliminated by the liver, this carcinogen is believed to effect breast and other cancers. If you’re a breast cancer survivor, any alcohol intake significantly increases your risk of relapse.

So … what’s the verdict?

If you enjoy moderate drinking, should you drink less, or not at all? This is a highly individual choice — one that only you and your doctor can decide, using information about your current state of health, lifestyle, and family history.

But all the experts agree: if you don’t already drink, don’t start. There are much better ways to protect your cardiovascular system without increasing your risk of devastating diseases like cancer, or impacting your brain function: eat a mostly plant-based diet, exercise, don’t smoke, control your blood pressure, and maintain a sensible weight.

 
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February 8, 2018