Alcohol Myth Buster

How much alcohol is recommended for a person (women) a day?

For many people drinking alcohol is a pleasant social activity. Alcohol has long been an integral part of celebrations and other happy social gatherings for centuries. However, it should be done in moderation.

The South African Heart Association recommends a maximum of 2 drinks per day for males and 1 drink per day for females.

The South African Food-Based Dietary Guidelines (FBDG) recommends that if you drink alcohol, drink sensibly and define low risk drinking as no more than 4 units of alcohol per day for men and no more than 2 units for women, with at least 2 alcohol-free days per week. However, people who do not drink alcohol are not advised to start drinking in an attempt to gain any health benefits. Many experts are of opinion that this recommendation is still too high and should be changed.

New international guidelines (UK Chief Medical Officers’ Low risk drinking guidelines, August 2016) for both men and women to keep health risks from alcohol to a low level – is safest not to drink more than 14 units a week – equivalent to six glasses (175ml) of wine or fourteen (25ml) shots of spirits per week. Ideally women should be having up to a maximum of 1 drink per day.

An additional recommendation is not to ‘save up’ the 14 units for 1 or 2 days, but to spread them over 3 or more days. People who have 1 or 2 heavy drinking sessions each week increase the risk of death from long term illnesses, accidents and injuries. A good way to reduce alcohol intake is to have several alcohol free days a week.

These new guidelines for alcohol consumption, warn that drinking any level of alcohol carries a health risk for anyone and increases the risk of a range of cancers and liver disease. This is supported by a new review from the Committee on Carcinogenicity (CoC) on alcohol and cancer risk.

The guidelines for pregnant women have also been updated to clarify that no level of alcohol is safe to drink in pregnancy. The previous advice for pregnant women to limit themselves to no more than 1 to 2 units of alcohol once or twice per week has been removed to provide greater clarity as a precaution. Although the risk of harm to the baby is low if they have drunk small amounts of alcohol before becoming aware of the pregnancy, there is no ‘safe’ level of alcohol to drink when you are pregnant.

So what does 1 unit of alcohol look like? 218ml cider or 76ml wine or 25ml whiskey or 250ml beer or 250ml alcopop.

What type of alcohol is the best option for a person?

Individual reactions to alcohol vary, and are influenced by many factors, such as age, gender, race or ethnicity, physical condition (e.g. weight, fitness level), amount of food consumed before drinking, how quickly the alcohol was consumed, use of drugs or prescription medicines and family history of alcohol problems.

The intensity of the effect of alcohol on the body is directly related to the amount consumed and how fast the alcohol was consumed. For example one 340ml beer has about the same amount of alcohol as one 150ml glass of wine. The faster you drink the higher blood alcohol levels.

There are some similarities in how alcohol affects men and women, but there are differences too. If a woman and a man drink the same amount, the woman’s blood alcohol level will almost always be higher than the man’s. There are several reasons for this…. Women tend to be smaller than men. That means, the same amount of alcohol is going into a smaller body.

Even if a woman is the same weight as a man, she will have a higher blood alcohol level if she drinks the same amount as that man. Alcohol is held in the body in body water, not in body fat. Women generally have a higher proportion of body fat than men, so have less body water. That means the alcohol is more concentrated. Other factors have also been reported that can make women more sensitive to alcohol, such as enzyme differences.

So to answer the question….. It is the amount of alcohol consumed that affects a person most, not the type of alcoholic drink.

Does alcohol make ones blood glucose drop? If yes, what does it mean?

Yes, alcohol affects blood glucose levels each time it’s consumed, regardless of the frequency of consumption.

The primary hormones involved in maintaining a healthy blood glucose level are insulin and glucagon. Normally, when your blood sugar begins to drop, your body can respond by making more blood sugar or burning up stored sugar. And when your blood sugar begins to rise, additional insulin is secreted to bring your levels back to a healthy range.

When a person drinks alcohol, it is considered a poison or toxin by the body and the body channels all energy into expelling it. This means that other processes are interrupted – including the production of glucose and the hormones needed to regulate healthy blood glucose levels.

Alcohol consumption causes an increase in insulin secretion, which leads to low blood sugar (otherwise known as hypoglycaemia). It can also impair the hormonal response that would normally rectify the low blood sugar. This causes light headedness and fatigue, and is also responsible for a host of longer-term alcohol-related health problems

Should one eat in between the drinking?

Yes, to prevent your blood glucose levels from dropping to low. We know eating is cheating, but you will be cheating your body and depriving it from much needed glucose and nutrients as well.

Is it important to eat before drinking alcohol? If so, why? And what should one eat?

Eating limits the effects of the alcohol. Research has shown that alcohol consumption increases insulin secretion, causing low blood sugar (hypoglycemia). Drinking as little as 60ml of alcohol on an empty stomach can lead to very low blood sugar levels.

So, to prevent low blood glucose levels, eat before you drink (never drink on an empty stomach).  Alcohol in general reduces self-control that causes one to snack on foods you’d normally limit i.e. chip. Eating before consuming alcoholic drinks will prevent you from losing sensibility and overeating but also ensure that you don’t miss out on essential nutrients.

Choose a meal or snack that is low in glycaemic index, high in fibre and protein. For example if the party is a day night game … make sure you have a hearty breakfast for example eggs with avocado and a slice of low GI toast. Should the party involve sundowners, it would be sensible to have a decent snack at home for example biltong and almonds or yoghurt with a tablespoon of seeds and tablespoon of oatbran alternatively have seed crackers with cottage cheese.

Does eating first delay the absorption of alcohol by your body?

Yes. Alcohol is a central nervous system depressant that is rapidly absorbed from the stomach and small intestine into the bloodstream. Alcohol is metabolized in the liver by enzymes. However, the liver can only metabolize a small amount of alcohol at a time, leaving the excess alcohol to circulate throughout the body. So, the more you drink the longer it stays in the body. When the stomach is full with food, and the alcohol remains there for longer, the lining can actually begin breaking down the alcohol as the liver does plus food in the stomach also delays the alcohol getting to the bowels to be absorbed – keeping levels in the blood lower for longer. Drinking on an empty stomach means the alcohol really is absorbed at lightning speed which of course affects our behaviour and our hangover.

Does drinking water in between drinks have any benefits attached to it?

Yes, it prevents dehydration (one of the reasons why we feel unwell or hungover after a binge session).  Alcohol is held in the body in body water. Women generally have less body water than men. Meaning men are better able to dilute alcohol than women. That means the alcohol is more concentrated in women.

The best way to avoid a hungover is to moderate your drinking and have water between alcoholic drinks. The water helps to dilute the alcohol and help your body to fight a hangover.  Thumb rule is to alternate one glass of water with one drink. The problem is that most of the times we just forget of drinking water after 2 drinks…….

You will be better off drinking several glasses of water before you start drinking. Top it up with several glasses just before you crash to bed. By doing this you will at least make an attempt at keeping your body hydrated, to fight against the ill effects of alcohol on your system. And after drinking, make sure to drink several glasses of water, to help hydrate yourself before you fall asleep. You will find that you are in a significant better situation when you wake up.

Remember that water won’t make you any less drunk or protect your liver.

There is a golden 3D rule of drinking which. Diet (don’t drink on an empty stomach), Duration (sip slowly over a longer period of time) and Dilution (make sure you stay hydrated by drinking water between alcoholic drinks). This may ease the symptoms of a hangover.

What do you recommend someone who is trying to lose weight should drink?

The fact that there are a significant number of calories in alcohol can be an uncomfortable realisation for those trying to lose weight.

Because alcohol is made from sugar or starch, it contains lots of calories. Alcohol (7kcal/g) has more calories per gram than carbohydrates or protein (4kcal/g) & similar to fat (9kcal/g).

From the table below, it is clear that cocktails, beers, ciders and sweet liqueurs contains more sugar and calories (that raises blood sugar levels) than dry spirits and low calorie beers and wine. Cocktails are the worst – you don’t know what’s in them (a combination of spirits, juice and sugary soda) and can be hiding a lot of calories.

alories from alcohol are ’empty calories’, (provides energy but very little nutrients), so don’t benefit your body in any way.

Also, when you have an alcoholic drink, you burn less fat, and more slowly than usual, because the alcohol is used as fuel instead. While we can store nutrients, protein, carbohydrates, and fat in our bodies, we can’t store alcohol. So our systems want to get rid of it, and doing so takes priority. All of the other processes that should be taking place (including absorbing nutrients and burning fat) are interrupted.

Knowing the facts can help you with calorie counting and ensure you make the right choices, both for your waistline and your long-term health.

What types of drinks should one be drinking if they are minding their weight?

Alcoholic drinks are high in calories particularly common beverages such as cider, beer and cocktails. However, by cutting back on the amount you drink, it can significantly help to reduce your calorie intake.

It can be useful to know that many alcoholic brands now have ‘light’ low alcohol alternatives containing fewer calories. Some ‘light’ wines have 80 calories in a 175ml glass compared to 159 calories in the same measure of wine. A light beer has around 100 calories per serving vs 160 calories for a normal beer. Switching to low calorie drinks can help to beat a beer belly.

Another way to drink fewer calories is to opt for a low calorie mixer such as a diet coke or soda. Drinking water or low calorie soft drinks between alcoholic drinks is not only a good way to reduce your calorie intake but also helps to reduce the amount of units you’re drinking.

Does the number of drinks you have contribute to one’s weight gain?

Yes, the more you drink the more calories you consume and alcohol also reduces self-control, making you more likely to overeat which means more calories and contribute to weight gain. Drinking too much alcohol means consuming extra calories on top of what you eat.

Also if you drank the night before, you might be less likely to exercise the next day. Over time, this can cause weight gain.

How can one successfully fit alcohol into one’s diet without sabotaging one’s weight loss goals?

If you are on a very strict weight loss regime, then it is best to avoid alcohol since it is very high in calories and it interferes with the way the body burns fat.

But life is all about balance… You can incorporate alcohol into your meal plan in order that you can still enjoy it, but lose weight at the same time. Do keep in mind that the rate of weight loss however might be slower than when abstaining from alcohol.

If you are trying to lose weight, then alcohol needs to be exchanged for starch in your diet or you need to exercise more, to compensate for the excess calories (see table provided). For example, if you braai and you are drinking a beer, then you can’t eat the ‘braaibroodjie’, because you are drinking the ‘braaibroodje’. So keep to meat and salad to compensate for the alcohol consumed. Alternatively you need to add additional exercise to your weekly regime to make up for the extra calories derived from the alcohol.

I usually tell my patients that for every drink you have, commit yourself to an additional 15-20 minutes on the treadmill to burn it off! Think of drinking as “charging” on your alcohol credit card. If you have time to pay off your debt by working out, then drink away! Otherwise, the debt will accumulate, and in this case, around your midsection!

What’s the best alcoholic drinks to go to when watching your weight? And why that particular drink?

From the alcohol and calorie table the best option would be white spirits mixed with water, soda or low calorie mixers e.g. vodka and tab or whiskey and water.

However ordering a light beer (in a bottle or can) at the bar is also a good option. This way you can control your portions and avoid the bartender overfilling your glass. That way, you know exactly how much alcohol and how much calories you are consuming. Another beer bonus, you can drink it in moderation. Beer tends to leave you feeling fuller than a mixed drink would, so you are more likely to drink less.

What are the best options for mixers?

I would suggest water (sparkling or still), you can also extend alcoholic drinks with low calorie mixers and don’t forget the ice.