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Alcohol is a unique energy-supplying substancelinked with several aspects of human life. It isconsumed for social, spiritual, emotional, psycho-

logical and physiological reasons. It is suggested that in theUnited States alcohol actually accounts for 6-10% of totalenergy intake. According to the National Clearinghouse forAlcohol and Drug Information 51% of people over 12 years ofage consumed alcohol in the last 30 days. The spectrum ofalcohol consumption covers a broad range, from those whocompletely abstain from its use to those who becomephysiologically dependent alcoholics. But for mostAmericans alcohol is a social product used to relax orcelebrate, or as a pleasant accompaniment to a meal. Sowhat actually is alcohol and what role does it play in health,if any?

If you were to ask a chemist, alcohol would be defined asa class of chemical compounds ending in “– ol” such asethanol, methanol and iso-propanol. Alcohols have adramatic affect on living organisms because they act as lipid(fat) solvents. Alcohol easily penetrates a cell’s outer lipidmembrane and can rapidly denature proteins to the extent ofactually destroying the cell, as seen in the effects commonantiseptics and disinfectants have on bacterial cells. Thealcohol found in beverages such as beer, liquor and wine isethanol. It is less toxic than other alcohols with the key wordbeing less. In most cases of human consumption the alcoholis significantly diluted and its actions reduced, often causinga pleasant euphoria for the consumer. When ethanol isconsumed in high concentration, its effects can be deadly.So with regards to the use of alcohol in the body for a positiveoutcome, the amount consumed will play a major role on theimpact it will have.

Before identifying any positive role alcohol may have onthe body it is important to analyze any negative outcomes ofalcohol consumption to determine if the negatives actuallyoutweigh the positives. For the purposes of this review theconsumption quantity will be consistent with what isaccepted as moderate consumption; 6-15 drinks per week(=1-2 per day).

The first possible consequence of alcohol consumptionis the added calories to the diet. Due to the fact that alcoholhas the second highest energy yield of calorie containingsubstances at seven (7) calories, it would make sense thatmonitoring this intake would be prudent for the purposes ofweight management. Many critics of alcohol suggest thatconsuming alcoholic beverages contributes to obesity. Theyare probably correct in some cases. Alcohol has thepotential to increase adiposity in several ways. The first wayit can add unwanted weight is simply by contributing to apositive caloric balance. Alcohol containing drinks are oftenvery high in calories. A mixed drink with soda or orangejuice is often between 200-400 calories depending on sizeand mixer. A regular beer is 150-200 calories per 12 ouncesand light beer reaches 100 calories per serving. Even withthe added marketing, the low-carb, light beers are around 95calories a piece. The reality is that light beer was low incarbs before the commercials. Other alcoholic beveragemanufacturers have hopped on this marketing ploy includingthose that produce vodka and rum, but almost all thecalories come from alcohol, so the low-carb means little tonothing with regards to calories. Wine is a bit morereasonable at 80-100 calories per four (4) ounces, but muchhigher in caloric content when compared ounce to ouncewith beer. A person who consumes one glass (4 oz) of wineper day will have little concern with weight gain. But whenalcohol is consumed at the normal two-three servings, thecalories can really add up.

If a person consumes two drinks per day at the end ofthe week the calorie tilt may lean to the positive side ifphysical activity does not counter balance the shift.

Daily Consumption Total Calories1-2 glasses of wine = 595 – 1190 extra calories/wk1-2 light beers = 665 – 1330 extra calories/wk1-2 regular beers = 1050 – 2100 extra calories/wk1-2 wine coolers = 1183 – 2366 extra calories/wk1-2 servings liquor = 1225 – 2450 extra calories/wk 1-2 mixed drinks w/soda = 1379 – 2758 extra calories/wk

CEUQuiz

Drink to your

health?Drink to your

health?

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A person who consumes two glasses of wine or light beerper day is looking at an additional 17-19 lbs of fat energy atthe end of the year (fat energy calculated by dividing totalcalories consumed by the 3500 calories in a pound of fat).This is one reason alcohol in moderation makes more sense.This is particularly true with weekend binge drinkers. Manypeople feel if they abstain from alcohol all week they haveearned the right to consume all their dietary alcohol in a twoor three day period. This thought process may lend itself toa social life but has negative consequences with regards tometabolism.

Calories aside, alcohol can contribute directly to fat gainbecause the body metabolizes alcohol preferentially to fat.Presented with both energy-yieldingsubstances, the body will store thecomparatively harmless fat and rid itself ofthe toxic alcohol by burning it off as fuel.Alcohol related studies suggest thatalcohol consumption increases risk ofcentral adiposity, hence the “beer belly”.Since alcohol is burned as a fuel andreleased in small amounts through theskin and respiration the net caloriccontribution is often equated to each gramof alcohol having the physiological impactof .5 grams of fat. Simplified, for every 100calories of alcohol consumed 50 calories ofpotential fat storage exists. This fact iscompounded by the foods that oftenaccompany alcoholic beverage consump-tion. High in fat and salt, nuts and chipsoften represent finger food when drinking,and most bar menus are loaded withadditional calories, often very high in fat.These calories will be preferentially storedas the body tries to burn off the alcohol.This is not to suggest avoiding food when consuming alcohol,but rather lends itself to better food decision making whendrinking alcoholic beverages. The irony is the alcohol oftenreduces our natural inhibitions and tends to lead us to thewrong decision.

The liver works very hard to metabolize the alcohol to getback to normal metabolic homeostasis. The liver is armedwith two weapons that deal with alcohol metabolism. Themain weapon is the enzyme alcohol dehydrogenase (ADH),which accounts for 80% of the metabolic activity. Thesecondary weapon comes in the form of additional enzymesknown as the MEOS which handle up to 10% of the metabolicfunction. This accounts for only 90%, the other 10% isexcreted through the breath and perspiration. The alcoholin the breath is directly proportional to the alcohol in theblood. This is how breathalyzers work to identify levels ofintoxication in field sobriety tests. The processing speed of

alcohol is dependent upon the ADH concentrations in theliver. Some ADH exists in the stomach but at far lessconcentrations than found in the liver. Women produce lessADH than men relative to body size so they absorb nearly 1/3more alcohol than men.

ADH goes to work at a diligent pace, metabolizingapproximately one drink every 60-90 minutes, depending onthe amount of alcohol in the drink, food in the stomach atthe time, and on physical size and consumption experienceof the individual. As a person continues to consume alcoholat a pace faster than the body can metabolize it, the extraalcohol has to wait in circulation. It circulates in the bloodcontributing to elevations in blood alcohol content (BAC).

The liver works very hard to contendwith alcohol to the point that it altersnormal metabolic function. Alcoholmetabolism interferes with the distri-bution of nutrients and oxygen to the liver,in particular speeding up the synthesis offatty acids producing excess fat in theliver. When this occurs routinely it is thefirst stage of liver deterioration (fattyliver). The presence of alcohol also altersamino acid synthesis. This can impedeupon the formation of proteins importantfor the immune system. This isparticularly detrimental to recovery fromphysical activity. Additionally, the bodyexperiences increased uric acid asalcohol contributes to the build up of acidin the body.

Routine drinking above that con-sidered moderate will dramatically affectthe body’s ability to utilize nutrients.Alcohol has significant effects on theabsorption of essential nutrients, in

particular, Vitamin B1 (Thiamin) and Folate. Thiamin isused in the formation of energy from carbohydrates andtherefore can affect cells of the nervous system which relysolely on glycolysis for energy. Furthermore, thiamin isneeded for the synthesis of acetylcholine which is theneurotransmitter used in cognitive processes in the brain,such as with memory, and the chemical messenger frommotor nerves to muscles to stimulate contraction. Sincealcohol inhibits the absorption and storage of thiamin,alcoholics often suffer from thiamin-deficiency; a diseasecalled Beriberi. Symptoms can include confusion, blurredvision, and impairments of both heart and skeletal muscles.

Alcohol increases excretion of folate, lowering levels inthe blood and liver. The alcohol-induced reduction in thisessential vitamin has been linked to increased levels ofhomocystine in alcoholics, a byproduct of the amino acidmethionine which is highly reactive and contributes to

A person

who consumes

two glasses of

wine or light

beer per day

is looking at

an additional

17-19 lbs of fat

energy at the

end of the year

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vascular oxidative stress, endothelial dysfunction and is asignificant risk factor for cardiovascular disease and manycancers. Folate is essential is the methylation of homo-cystine back to methionine. Moreover, folate plays a criticalrole in DNA, RNA, and protein synthesis and therefore isimportant during times of rapid growth and metabolism (e.g.pregnancy, lactation, and exercise). Indeed, folatedeficiency in pregnant women is associated with a greater-risk of low birth weight and a premature infant. It alsoincreases the risk of spina-bifida and neural tube defects.

Furthermore, memory is a process by which wesynthesize new synaptic connections in specific regions ofour cerebral cortex via protein synthesis. The possibilityexists that alcohol’s reduction in folate may be associatedwith inefficient protein synthesis during memory formationsince translation of RNA is needed to code amino acids inspecific sequences to form new synaptic connections that wecan recall when consciously selected (e.g. trying toremember events that happened the night before, or theorder of those events, etc.). Memory loss and fetal alcoholsyndrome are just some examples of how alcohol can inhibitthe synthesis of nascent proteins and therefore may seriouslyaffect the formation of both contractile and enzymaticproteins in response to exercise training. In addition, livercells become less efficient at vitamin D activation andexperience a reduced capacity to process vitamin A, at thesame time the kidneys excrete important minerals includingmagnesium, calcium, potassium and zinc which can lead toacute deficiencies.

While the liver metabolizes the alcohol, the circulatingalcohol in the blood bombards the brain. In fact the alcoholreaches the brain rapidly upon consumption. Brain cells areparticularly sensitive to alcohol and actually shrink uponexposure, with the actual response being dose specific. Thealcohol has many effects on the brain’s function. One keyfunction that is inhibited is the production of anti-diuretichormone. The loss of this hormone increases urineproduction which consequentially leads to dehydration. Thefluid loss also takes valuable minerals including magnesium,potassium, calcium, and zinc, often decimating the body’sreserves of these minerals. These minerals are essential tofluid balance and muscle coordination.

The last negative factor under this review is the effectthe alcohol has on the body when all the previouslymentioned factors run their course. Most people know thisphenomenon as a hangover. The headache, nausea, andgeneral feeling of discomfort are caused by severalcontributing factors. One component of the hangover is fromthe toxins released from the congeners. Congeners arecompounds that accompany the alcohol when distilled or areadded for taste or preservation. Different alcoholicbeverages have different congeners which is why a personmay experience different levels of a hangover with the same

quantity of alcohol consumption.The second key factor to a hangover is dehydration of the

brain. Headaches are often caused by the impact of braincell re-hydration on nerve cells from the swelling back tonormal size. Additionally, the hangover symptoms arefurther fueled by formaldehyde which is formed frommethanol (an alcohol) as part of a normal function in thebody. The formaldehyde is then converted to carbon dioxideand water under normal conditions by the same liverenzymes that metabolize ethanol. The problem that arises isthese same enzymes metabolize ethanol 20x more aggres-sively than formaldehyde. So the formaldehyde is ignoredand builds up during bouts of alcohol consumption. Thedetoxification of the build up contributes to a hangover.Another problem stemming from the dehydration is the lossof blood plasma used to hydrate the brain cells. This causesthe body to have difficulty moving the thickened bloodthrough circulation. Which in turn leads to blood pressureand heart rate variations, and is one reason why exercise thenext day is so difficult. A hangover can really only be curedby hydration and time.

The extent of each of these problems is dependent uponthe quantity of alcohol consumed. Again one drink is verydifferent than three or four with regards to the body’sability to manage the alcohol. These facts identify thepowerful effect alcohol can have on the body and therationale for moderation, particularly when using alcoholfor health benefits.

So the question begs, with all these negative conse-quences, “can moderate alcohol use benefit health?” Mostpeople have heard that one or two alcoholic beverages a dayhave a positive health effect. Consumption in this quantityhas been credited with reduced risk in heart disease inindividuals over sixty with risk factors. There have beenseveral studies which support this claim, but there have alsobeen long term (20 year) studies analyzing alcoholconsumption and mortality from heart disease showing nobeneficial relationship. Some doctors suggest that red wineis much preferred over general alcohol consumption forhealth benefits. Red wine has been well received for itshealth supporting properties to the extent that U.S. winebottles may include on their label pre-approved statementsof health benefits. But many scientists have not beencompletely sold on the benefits of red wine over its non-alcohol counterpart.

Grape juice has a high potassium content and maypositively affect blood pressure. But when alcohol isconsumed in larger amounts it raises blood pressure. So itmay be more beneficial to consume grape juice than wine ifyou are hypertensive. Non-alcohol wine also facilitates theabsorption of potassium, calcium, phosphorus, magnesium,and zinc. In the alcohol version the beneficial absorptionproperties may be neutralized by the increased effect alcohol

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has on the excretion of these minerals from the body. Wine has been acclaimed for its containment of phenols

and phytochemicals that may act as antioxidants that serveto be cardio-protective, defending the tissue against damagefrom oxidative stress. This possible effect is used to explainthe reduced mortality from heart disease in red winedrinking countries such as France. But alcohol itself hasbeen linked to oxidative stress, so again the non-alcohol redwine may better serve for this purpose. Red wine has alsobeen studied as a sleep aid. If benefits of a more restfulnight’s sleep do exist, as it would seem from these studies,the grounds for the benefit from the consumption of wine aremore alcohol related than that of any unique chemical.

It would seem that although alcohol is damaging to bodycells there may be some beneficial components, particularlyin wine, that may warrant using it in conjunction withhealthy lifestyle habits. The article did not review the socialand emotional benefits, as it is outside the scope of thepaper, but there have been links of well-being tied tomoderate alcohol use in socially comfortable settings.A person’s decision to consume alcohol is solely based ontheir own discretion and therefore may, or may not be, aconsideration for their personal health.

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