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What about alcohol - will it derail your health goals?

The short answer – possibly, but not necessarily. But it’s never really a short answer when it comes to science and nutrition! An appropriate amount of alcohol can absolutely be part of a healthy diet that maintains weight. We need to define “appropriate” based on two health factors – what’s good for certain body systems, and what’s good for your weight.  And in order for it all to make sense let’s start by reviewing how we process alcohol.


Alcohol metabolism


Our bodies view alcohol calories differently than all other calories.  It’s got its own category. While carbohydrates and proteins each have 4 calories per gram, and fat has 9 calories per gram, alcohol is a unique beast and has 7 calories per gram.


There are several ways in which alcohol is metabolized and removed from the body, but the main process occurs in the liver.1  Our bodies have no capacity to “store” alcohol – the liver works hard for the money to get it on outta there!


This need for the liver to quickly tackle metabolizing alcohol is important for the weight loss question, not so much for what it does but for what it PREVENTS the liver from doing. Think about it – if our body has to use those alcohol calories then it’s stopping it from using other sources of energy (such as fat stores).  Beyond weight gain, acute excessive consumption of alcohol may lead to (reversible) fatty liver, while chronic consumption may lead to alcoholic hepatitis or cirrhosis.3


Since the liver also plays an important part in maintaining blood sugar levels, a process also disrupted by alcohol metabolism, alcohol intake can be a risk factor for hypoglycemia if a meal is not consumed with it (not to mention intoxication occurs much faster without food to slow absorption.)2


No matter what, your body still has a certain amount of calories it needs to maintain function and weight. If you consume enough alcohol to push that calorie limit over the edge then weight gain can occur.  And trying to even out calorie intake by removing other healthy food items isn’t a good idea – it is low on the list of nutrient-dense foods.


Beyond alcohol calories


Beyond the actual calories from alcohol there are two other factors that could contribute to weight gain. First, consider the other contents of the alcoholic beverage you are consuming – wine and beer contain carbohydrates in addition to alcohol, and mixed drinks often contain soda, juices, or syrups (also carbohydrates). This can add up – quickly!


Second, there is the common phenomenon of increased food intake while imbibing – something research has been attempting to clarify. Some studies point toward a direct affect on appetite while others indicate reduced inhibitions and some form of positive feedback model – in other words, you’re more likely to let your “healthy” guard down and pick foods you wouldn’t normally consume, or consume them in greater amounts.4,5 But there is still no definite answer.


Aren’t there ANY health benefits?


There appear to be some benefits to moderate alcohol consumption. In fact many studies have shown it may have a cardio-protective effect.6 One possible explanation is the increase in HDL cholesterol associated with moderate alcohol intake, but it seems a more complex process may be at play.6, 7  In fact, proponents of the Mediterranean-like diet suggest the social aspect (family and friends gathering for lunch or dinner and consuming 1 to 2 glasses of wine) is an important contributor to the health benefit.


The important take home: moderate consumption. All those benefits go out the window with heavy alcohol consumption (which is defined differently in studies but generally more than 3 or 4 drinks per day.)6


So what’s a moderate amount?


Don’t look to Mad Men for an example of moderate alcohol intake. Per the Dietary Guidelines for Americans developed by the United states Department of Agriculture (USDA) and Department of Health and Human Services (DHHS) a moderate alcohol intake for women is 1 drink per day, and for men it’s 2 drinks per day (a drink being 1.5 oz spirits, 5 oz wine, or 12 oz beer).


For those looking to manage weight, intake may need to be less than this.  If you want to enjoy your favorite drink but keep within your healthy weight range consider the following:


  • When going out to dinner make a choice between one alcoholic beverage OR an appetizer OR dessert.

  • Limit the mixed drinks with lots of juice, soda, and syrups to special occasions.

  • Choose light beers or wine spritzers if you enjoy them – but it’s still not a green light to overindulge. And if you DON’T enjoy them why drink them – it’s better to limit yourself to just one of your favorite drinks and skip dessert rather than not be satisfied by the light version and continue to eat or drink other things until you find that satisfaction.

  • Eat something when drinking, both for you liver’s sake and your waist’s sake. You’re more likely to splurge on more drinks and less healthy foods if you quickly become intoxicated on an empty stomach.

So just like most other things in life, moderation seems to be the key!


References

  1. U.S. Department of Health and Human Services, National Institutes of Health, , National Institute on Alcohol Abuse and Alcoholism. Alcohol Alert. Number 72; 2007. http://pubs.niaaa.nih.gov/publications/AA72/AA72.pdf

  2. Suter PM. Is alcohol consumption a risk factor for weight gain and obesity? Crit Rev Clin Lab Sci. 42(3): 1970227; 2005. http://www.ncbi.nlm.nih.gov/pubmed/16047538

  3. Fairbanks K. Alcoholic Liver Disease. The Cleveland Clinic Center for Continuing Education.http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/alcoholic-liver-disease/. Accessed on April 10, 2014.

  4. Yeomans MR. Alcohol, appetite and energy balance: is alcohol intake a risk factor for obesity. Physiol behave. 100(1):82-9; 2010. http://www.ncbi.nlm.nih.gov/pubmed/20096714

  5. Yeomans MR. Effects of alcohol on food and energy intake in human subjects: evidence for passive and active over-consumption of energy. Br J Nutr. 92: S1-4; 2004. http://www.ncbi.nlm.nih.gov/pubmed/15384320

  6. Alcohol and Heart Disease. Harvard School of Public Health. http://www.hsph.harvard.edu/nutritionsource/alcohol-and-heart-disease/. Accessed on April 10, 2013.

  7. Matsumoto C, Miedema MD, Ofman P, Gaziano JM, Sesso HD. An expanding knowledge of the mechanism and effects of alcohol consumption on cardiovascular disease. J Cardiopulm Rehabil Prev. 2014. Epub ahead of print (PMID: 24667667.)

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