Insights

A Month Without Alcohol

When my sister asked “Are you in again?”, I confess I hesitated. When I agreed to Juiceless January 2 years ago, I found it more difficult than I anticipated. As an emergency medicine physician, I know the consequences of alcohol and alcoholism as well as anyone, but my own alcohol consumption has rarely come under my own scrutiny. It’s unclear where and how the Juiceless January trend began, but in promoting no alcohol consumption for the month of January, it is endorsed by many health experts as an alcohol consumption awareness and education campaign. [ 1 ] I took it as an invitation to so some self-examination.

I remember 2 years ago, the leftover hangover from New Year’s was all I needed to get me through a week or so of non-alcoholic thirst quenching. Then, life picked up its pace, and I began to yearn for a glass of Pinot Gris while I was frantically stir frying vegetables and unloading my briefcase at the same time. Dinner with friends brought raised eyebrows when I asked for sparkling water and not wine, because, let’s face it: people don’t like to drink alone.

Still, I hung on tight until January 31, then celebrated with a couple of glasses of Chardonnay. Technically, I’m not a heavy drinker, although in a period of profound grieving, I polished off a bottle of wine myself once last year. Two years ago, I was 47. At 49, I find there are more and more reasons for me to consider abstaining from alcohol more often. Furthermore, when I looked into how much I should be consuming, I was in for a not–so-pleasant surprise.

For a woman of my age and weight, I should consume no more than 5 oz of wine per day, 12 oz of beer (1 bottle or can) or 1.5 oz of distilled liquor (ie vodka, whiskey or gin). The surprise came when I actually measured 5 oz of wine: it fills one half of a wine glass! So, when I told myself I was only drinking 1 glass of wine per day, my typical pour (a full glass) was at least one and a half! I was further alarmed to find that heavy drinking is defined by the CDC as 8 or more drinks per week for women.[ 2 ] Thus, if my pour habits continued, my “glass of wine 3 -4 times per week” would come perilously close to the heavy end of the spectrum.

Now, I’m not a “drink until you are drunk” kind of person and I don’t think anyone who knows me would identify me as someone who has any kind of problem with alcohol, nor is there much alcoholism in my family. However, there are some very compelling reasons I should pay attention to my alcohol intake going forward.

  1. Our bodies don’t process alcohol as well as we age:
    I am 49 years old, so this is no surprise to me. Just 2 glasses of red wine can wake me up in the middle of the night feeling lousy. This is because my liver and kidneys aren’t processing alcohol or its metabolites efficiently as it used to, and my total body water content is lower, making the relative alcohol in my blood higher. So, my usual intake is relatively higher with every year that passes.
  2. It is putting me at risk for some cancers:
    It is well established that alcohol is a risk factor for mouth and throat, and esophageal, colon and liver cancers but it is less well known that it is a risk factor for breast cancer too. It’s true that my consumption ten-twenty years ago is more of a risk for cancer than my consumption today (due to the nature of carcinogenesis) but looking ten to twenty years down the road, I want to give myself a chance of a cancer-free old age. To be fair, the National Cancer Institute also says that it may lessen the risk of 2 cancers: kidney cancer and Non Hodgkins Lymphoma. However, these two cancers are far rarer than colon, and breast cancer and the protective effect is small. [ 3 ]
  3. In high doses, it might cause premature heart disease or stroke:
    Having more than one drink per day (for a woman) leads to higher risk for hypertension, high triglycerides and stroke. This is due to the direct and indirect effects of alcohol on the heart. While alcohol in high doses is a direct cardiac toxin, it also raises some fats (triglycerides) in the bloodstream and is linked to obesity and weight gain, risks for coronary artery disease. People who binge drink (4 drinks in 2 hours for women) are at risk for atrial fibrillation, which is a major cause of stroke. [ 4 ]
  4. It is not helping me keep weight off:
    The FDA reports that one glass (5oz) of wine has 124 calories, all carbohydrates. It’s easy to see how 2 glasses of wine could significantly add to your total daily calorie intake! Furthermore, it is known that alcohol stimulates the appetite. People who drink alcohol with dinner consume 20% more calories (excluding the alcohol calories) than those who consume non-alcoholic beverages with their meal. [ 5 ]
  5. Regular consumption will not help my mood or mental acuity:
    While alcohol definitely helps one’s sense of well-being in the moment, the after-effects of drinking have the opposite effect. Studies have shown that people report more depression and less sense of well being the day after drinking alcohol. This is likely more than the physical discomfort of a hangover and could be due to a depletion of certain “happy” neurotransmitters. More important to my particular concerns, alcohol accelerates loss of brain matter, leading to earlier cognitive decline in older adults. [ 6 ]

The good news is that by abstaining from alcohol for the month of January, I am re-setting the effects of alcohol on my body both physically and psychologically. Getting out of the habit of opening a bottle of wine when I come home from work to prepare a meal or reflexively ordering an alcoholic beverage at a restaurant is making me a more thoughtful drinker. Like any habit, the brain is physically wired to repeat the behavior, and re-wiring those circuits takes time. On a physiologic level, my liver is also re-wiring, down-regulating my levels of the enzyme alcohol dehydrogenase, so the next time I have a drink, I will feel its effects sooner than I did a month ago. Getting an alcohol “glow” after less consumption will help me drink less overall (at least for a while). The key to maintaining a healthy alcohol intake may be to build periods of abstinence into my schedule year round. Taking a week off per month or limiting myself to just a few days per week may be an effective way to drink healthily. The trick will be to maintain a moderate intake dose on the days I do imbibe. The truth is that it is probably healthier to abstain completely from alcohol. But, I really enjoy a good glass of wine and the very occasional gin martini. While I wish that I could continue the drinking habits of my youth, I realize that as I get older, alcohol consumption is one of the many trade-offs I will have to make to ensure I live the longest and best life possible. Juiceless January is a great way to start my 49th year, but I admit that I am really looking forward to a glass of Petit Syrah in 14 days!

[1] http://www.today.com/health/holiday-hangover-heres-case-dry-january-1C7802000?franchiseSlug=todayhealthmain

[2] http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm

[3] http://www.cancer.gov/cancertopics/factsheet/Risk/alcohol

[4] http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Alcohol-and-Heart-Disease_UCM_305173_Article.jsp

[5] http://www.medicinenet.com/alcohol_and_nutrition/page3.htm

[6] http://www.webmd.com/depression/alcohol-and-depresssion

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