To Booze or not to Booze...

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“Should I take a break from booze?”

Have you ever asked yourself this question?

I have.

I never felt like I needed to quit drinking. My consumption is normal by most accounts. It’s “moderate.”

But boozy beverages seem to show up a lot.

I like having a beer to mark the end of a work day. I like a good glass of wine or two with Sunday dinner. Friday night just seems to call for a cocktail.

Something to celebrate? Pour a little champagne. Crappy day? A martini will take the edge off.

The drinks can start to add up.

They’re easy to justify: I’m a healthy person. I work out a lot. I eat good food.

But could giving up alcohol be a tipping point? Am I missing sharper thinking and perfect sleep and hypercharged creativity and young skin and a six pack because of my six packs?

Is alcohol slowly, silently chipping away at my health?

After all, I’ve read that drinking can wreak havoc on the body and mind…

Or, wait, was it that drinking is good for your heart?

Or bad for your heart but you still live longer?

How do my wellness goals square with the delicious craft beer in my fridge?

I want to be healthy. Like most people I want to look and feel my best.

Curious about how alcohol affects that goal, I started digging. When it comes to alcohol’s effect on health, the picture is kind of confusing.

You may have heard that drinking is actually good for you.

Moderate alcohol intake is associated with a lower risk of diabetes, gallstones, and coronary heart disease.

Light to moderate drinking seems to be good for the heart and circulatory system, helping reduce your risk of cardiac arrest and clot-caused stroke by 25 to 40 percent.

And there have been several studies indicating that drinkers — even heavy drinkers — actually outlive people who don’t drink.

We see headlines about all this every time a new study comes out, which seems fairly often, judging by my newsfeed.

An important point that seems to get buried: If you don’t already drink, health experts recommend you don’t start.

Wait, what? If drinking is so good for you, then why not add that antioxidant-rich red wine to MyPlate — a nice goblet right where the milk used to be?

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No one knows if any amount of alcohol is really good for all of us.

Don’t worry, I’m not going to tell you not to drink. (Spoiler alert: I did not take a break from booze.)

Most of the research on alcohol’s potential health benefits are large, long-term epidemiological studies. This type of research never proves anything. Rather than show cause, it shows correlation.

What’s the difference between correlation and causation?

Well, imagine that every time you saw someone open an umbrella, it was raining. Because of this correlation, you concluded that umbrella opening causes it to rain. That would be mistaking cause with correlation.

So even though many studies suggest that light to moderate drinkers have lower rates of the above-mentioned health problems than non-drinkers, that doesn’t mean drinking causes those benefits.

Sure, it could be that alcohol consumption raises HDL (“good”) cholesterol. Or it could be that moderate drinking reduces stress.

Or it could be that drinking doesn’t cause any health benefit.

Rather, it could be that people who drink a light to moderate amount also have something else going on in their lives, unrelated to alcohol consumption, that keeps them healthier.

According to Dr. Spencer Nadolsky, a board-certified family physician in Maryland and Precision Nutrition coach and contributor: “It might be something inherent, like genetics or a personality trait that has them enjoying a low-stress life.”

“Maybe it’s a different lifestyle factor. We just don’t know.”

Plus, any physiological effects would vary by individual. The amount of alcohol that may help your heart health might be really detrimental to your friend’s — for instance, if he has a history of high blood pressure.

And most of the research indicates that you’d have to be a light to moderate drinker with no heavy drinking episodes (even isolated ones) to see a heart benefit.

Lots of drinkers don’t know how much alcohol they actually consume, anyway.

Moderation: We hear that word so often in conversations about health and diet that it starts to seem meaningless.

Definitions vary around the world, but according to the United States Dietary Guidelines Advisory Committee, “moderate drinking” means, on average:

• For women: up to seven drinks per week, with no more than three drinks on any single day

• For men: up to 14 drinks per week, with no more than four drinks on any single day

And here’s a guide to health-agency classified “drinks”:

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Sure, you might know you’re not a binge drinker (that’s five or more drinks for men, or upwards of four for women, within two hours).

But when was the last time you poured wine in a measuring cup, or tallied your drinks total at the end of the week, or calculated your weekly average in a given month, or adjusted your tally to account for that sky-high 9.9% ABV lager you love?

Studies show that people routinely, sometimes drastically, underestimate their alcohol consumption.

It’s easy to edge into the “heavy” category without realizing it. For example, if you’re a woman:

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That’s a big problem, since heavy drinking comes with a much higher risk of major health problems.

• Risks associated with moderate and heavy alcohol consumption:

• ModerateHeavy

• HeartArrhythmias

• High blood pressure

• Kidney disease

• Heart disease

• Stroke

• BrainDisinhibition

• Altered judgement

• Poor coordination

• Sleep disruption

• Alcoholism*Chemical dependence

• Depression

• Alcoholism

• Neurological damage

• Epilepsy

• Dementia

• Damage to developing brains

• ImmunityInfection / illness / lowered immune response

• Cancer (mouth, throat, esophagus, liver, breast)

• Damaged intestinal barrier

• Increased inflammation / flare-ups of autoimmune disorders

• Hormones Breast cancer Hormone disruption

• Impaired sexual function

• Impaired reproductive function

• Thyroid disease

• LiverWorsening of existing conditions such as hepatitisFatty liver

• Alcoholic hepatitis

• Fibrosis / cirrhosis

• Hepatocellular

• Liver cancer

• Metabolism Weight gain or stalled weight loss**

• Interference with some medications

• Loss of bone density

• Bone fractures

• Osteoporosis

• Anemia

• Pancreatitis

• Changes to fat metabolism

• Muscle damage

*Particularly if there’s alcoholism in your family **If drinking causes you to eat more food or opt for energy-dense meals

In young males especially, even moderate drinking increases the risk of accidental injury or death, due to the “Hey y’all, hold my beer and watch this!” effect, or simply the dangerous equation of youthful exuberance combined with less impulse control, combined with more peer pressure, combined with things like motor vehicles and machinery.

All drinking comes with potential health effects.

After all, alcohol is technically a kind of poison that our bodies must convert to less-harmful substances for us enjoy a good buzz relatively safely.

Through a series of chemical pathways using the enzymes alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), we convert ethanol to acetaldehyde, then to acetate. The body breaks acetate down into carbon dioxide and water.

A second system for processing alcohol, the microsomal ethanol oxidizing system (MEOS), involves cytochrome P450 (CYP), an enzyme group that chemically affects potentially toxic molecules (such as medications) so they can be safely excreted.

In light to moderate drinkers, only about 10 percent of ethanol processing is done by the MEOS. But in heavy drinkers, this system kicks in more strongly. That means the MEOS may be less available to process other toxins. Oxidative cell damage, and harm from high alcohol intake, then goes up.

The biochemistry doesn’t matter as much as the core concepts:

1. We have to change alcohol to tolerate it.

2. Our ability to process alcohol depends on many factors, such as:

• our natural individual genetic tolerance;

• our ethnicity and genetic background;

• our age;

• our body size;

• our biological sex;

• our individual combinations of conversion enzymes;

• etc.

3. Dose matters. But all alcohol requires some processing by the body.

So then the question becomes: What’s the “sweet spot”?

What amount of alcohol balances enjoyment (and your jokes becoming funnier) with your body’s ability to respond and recover from processing something slightly poisonous?

The moderate-vs-heavy guidelines are the experts’ best guess at the amount of alcohol that can be consumed with statistically minimal risk, while still accounting for what a lot of people are probably going to do anyway: drink.

It doesn’t mean that moderate drinking is risk-free.

But drinking is fun. (There, I said it.)

In North America, we tend to separate physical well-being from our emotional state. In reality, quality of life, enjoyment, and social connections are important parts of health.

I enjoy drinking.

So do a lot of other people.

In the U.S., for example, 65 percent of people say they consume alcohol. Of those drinkers, at least three quarters enjoy alcohol one or more times per week.

The wine flows at lunchtime in continental Europe (for Scandinavians, it’s the light beer lättöl). Hitting a pub or two after work is standard procedure in the UK and Japan. Northern Europeans swear by their brennivin, glögg, or akvavit (not to mention vodka). South America and South Africa alike are renowned for their red wines.

Thus, for much of the world’s population, alcohol — whether beer, wine or spirits — is something of a life staple.

And if you’re doing it right — meaning tasteful New Year’s Eve champagne toasts are more common in your life than shot-fueled bar dances to “Hotline Bling” — there are some undeniable benefits to be gained:

• Pleasure: Assuming you’ve graduated from wine coolers and cheap tequila shots, alcoholic beverages usually taste pretty darn delicious.

• Leisure: A bit of alcohol in your bloodstream does help you feel relaxed. And like a good meal, a good glass of wine should offer the opportunity to slow down for a minute.

• Creativity: There’s evidence that when you’re tipsy, you may be more successful at problem-solving thanks to increased out-of-the-box thinking.

• Social connection: Drinking may contribute to social bonding through what researchers call “golden moments” — when you all smile and laugh together over the same joke. This sense of community, belonging, and joy can contribute to your health and longevity.

So drink because you genuinely enjoy it.

Drink if it truly adds value and pleasure to your life.

Not because:

• you’re stressed; or

• it’s a habit; or

• other people around you don’t want to drink alone; or

• it’s “good for you”.

With confusing alcohol consumption categories and contradictory news headlines, many people give up trying to decide whether drinking is healthy or not.

A new study shows alcohol may be harmful? Whatever.

Or:

Drinkers live longer? I’ll hop on that horse and ride it straight to the bar!

Forget about the potential health benefits of alcohol.

There are plenty of (probably better) ways to reduce your risk of cardiovascular disease — like eating well, exercising, and not smoking.

Wanting the enjoyment of a perfect Old Fashioned or a rare sake is a legitimate — probably the best — reason to drink.

As with what you eat, what you drink should be purposeful and mindful. And delicious.

Drinking or not drinking isn’t about ‘healthy vs. not’. It’s about tradeoffs.

Alcohol is just one factor among many that affect physical performance, health, and fitness. Whether to keep drinking or cut back depends on how much you drink, what your goals are, and how you want to prioritize those things.

How to sort it all out? I touched base with Krista Scott-Dixon, Ph.D., curriculum designer for Precision Nutrition’s Coaching programs for men and women.

She said to think of it this way: In order to say “yes” to something, you have to say “no” to something else. And only you know what you are, or aren’t, willing to trade.

• Saying “yes” to six-pack abs might mean saying “no” to two drinks at the bar.

• Saying “yes” to Friday happy hour might mean saying “no” to your Saturday morning workout.

• Saying “yes” to marathon training might mean saying “no” to boozy Sunday brunches.

• Saying “yes” to better sleep (and focus, and mood) might mean saying “no” to your daily wine with dinner.

• Saying “yes” to avoiding the nacho platter might mean saying “no” to the second margarita.

• Saying “yes” to moderate alcohol consumption might mean finding a way to say “no” to stress triggers (or human triggers) that make you want to drink more.

The decisions you make will also depend on what you’re willing to do — and not willing to do.

• Maybe you’re willing to have one less beer a day, but you’re not willing to kiss it goodbye altogether.

• Maybe you’re willing to practice drinking more slowly and mindfully, but you’re not willing to decrease your total alcohol intake.

• Or, maybe you’re willing to stay sober during most social situations, but you’re not willing to endure your partner’s office party without a G&T on hand.

• Maybe you’re willing to upgrade to a fancier bottle, but you’ll bite someone’s face off if they try to take away your Australian shiraz.

Maybe there is a “best” answer for how much alcohol is okay for everyone. But we don’t know what it is yet.

At least not for certain.

As I researched this article, I became more aware of my own drinking habits. And I started to wonder whether I should improve them.

I’ve started to drink more mindfully, asking myself questions here and there about why and what I’m drinking. As I did this, I noticed myself drinking less.

A couple weeks ago when I was out with some friends, while they threw back multiple pints, I slowly sipped a single serving of the bar’s finest Scotch. It felt (and tasted) good. We’ll see if it’s a tipping point for further improvement — and even better health.