Alcohol

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Alcohol is a toxic liquid that kills brain cells and causes cancer, yet drinking a glass of red wine every night is good for the heart...how is that possible? Red wine contains “resveratrol”, a natural fungicide found in grape skins, which is supposed to have magical antioxidant properties—is that true? If so, is drinking wine worth the risk?

Alcohol is toxic to the brain and body.

Alcohol will not solve any of your health problems, because no health problem is caused by a lack of alcohol.

What is alcohol?

Alcohol is first and foremost a toxin and is treated by the human body as a poison. It damages your cells—especially stomach cells, liver cells, and nerve cells in the brain and throughout the body. More than 1 drink per day for women, and more than 2 drinks per day for men, significantly increases risk for high blood pressure, stroke, liver disease, many types of cancer, and cardiomyopathy (heart muscle dysfunction), among many other health problems. Some types of cancer, such as breast cancer, are associated with even lower levels of drinking.

Alcohol is not a necessary nutrient, but it is found in nature, so our bodies have developed a way to protect us from it. Our ancestors would have encountered small amounts of alcohols in naturally fermenting plant foods such as fruits. For example, when the skin of a fruit is damaged, yeasts invade to eat the fruit sugars. You are probably familiar with this problem—at the bottom of a container of fruit you are likely to find a squashed fruit or two with white fuzz growing on it—that’s yeast. Yeasts enjoy eating the fruit sugars, and in a process called fermentation, they create alcohol as a waste product:

 Yeast + Sugar  → ALCOHOL + Carbon Dioxide Gas

So, when we eat yeasty fruits, we are also taking in tiny amounts of alcohol. Humans developed a special enzyme system devoted solely to the rapid detoxification of alcohol to minimize the damage that it can do to organs. This enzyme system is located primarily in the liver, but also in the stomach and lungs. Below you can see the two-step process that our enzymes use to turn toxic alcohol into harmless acetate:

ALCOHOL (toxic)Acetaldehyde (toxic)Acetate

Notice that the chemical in the middle—acetaldehyde—is also toxic. Acetaldehyde causes a variety of unpleasant symptoms, including flushing, nausea, and headache. The final product, acetate, is then either burned for energy or turned into fat.

How much alcohol can the body handle?

Mother Nature probably didn’t predict that we would go out of our way to create big bottles of alcohol for voluntary consumption (silly humans), because we weren’t designed to be able to handle large amounts of alcohol. Our enzymes can only process 7 grams of pure alcohol (ethanol) per hour, which is about one drink (one beer, one 1.5 oz shot, or 5 oz of wine) every 2 hours. There are natural variations in the activity of these enzymes in the human population, so some people metabolize alcohol more easily than others. For example, most men process alcohol faster than most women do. Many Asians have a genetic difference in the second enzyme (acetaldehyde dehydrogenase), so they break down acetaldehyde more slowly and can quickly feel sick if they drink alcohol. Only you know what your tolerance is.

If your tolerance is average, and you drink more than one drink every 2 hours, your enzymes will become overwhelmed. Alcohol will then spill over into an emergency backup detoxification system, hijacking critical anti-oxidant molecules needed for normal body function. This throws off your internal oxidant/anti-oxidant balance, tipping it into oxidation mode. Alcohol is, therefore, a “pro-oxidant.” Oxidation damages healthy DNA, which is the first step on the road to cancer. Alcohol is a known carcinogen, raising the risk of many types of cancer.

Is alcohol good for the heart?

While there is no such thing as a safe amount of alcohol to drink, you may have heard that drinking modest amounts of alcohol, especially red wine, might be good for your heart. While most physicians, and the American Heart Association, strongly advise against it, some researchers do recommend alcohol in moderation to reduce risk of heart attacks.

Interest first arose in this connection in the 1990’s because of the “French Paradox”, which was the observation that people in France had a lower risk of heart attacks than people in other Western countries, despite eating significant amounts of saturated fat. [To understand why this is not a surprising paradox at all, see: cholesterol]. When scientists noticed that the French had fewer heart attacks, their minds jumped to the tempting possibility that red wine was the magic ingredient, and launched all kinds of studies to try to prove that their guess was right.

Anyway, there are two reasons why we are told that alcohol in moderation is good for the heart: epidemiologic studies and resveratrol.

Epidemiological studies

Epidemiological studies are simply observational studies which attempt to describe differences in patterns of diseases between large groups of people; they are not capable of determining cause and effect, and therefore they can’t tell us what we really want to know—whether alcohol is good for us or not.

Many epidemiological studies find that “moderate” drinkers tend to have fewer heart attacks. Moderate drinking means: ½ to 1 drink per day for women and 1-2 drinks per day for men. The observed reduction in risk varies, depending on the study, from 17% to 29%. Keep in mind that just because two things appear to be associated doesn’t mean that one causes the other—there may be other reasons why people who drink moderately have lower risks of heart attacks.  [To read more about the problems with epidemiological studies, click HERE.]

So, how could a poison be good for your heart?

It is not entirely clear why alcohol appears to be associated with reduced risk for heart attacks. If the association is real, we can only guess as to how the two are related. It would be nearly impossible to design a study that proves the connection, because that study would have to compare moderate drinkers to people who don’t drink at all, and who have no other major differences in their lifestyles, follow them for years, and watch to see which group develops more heart attacks.

Instead, what researchers have done is conducted short interventional studies to see how alcohol affects various markers of heart disease. In these types of studies, researchers give one group of people alcohol and the other group (the control group) a non-alcoholic beverage, and then test their blood for markers associated with heart attack risk, like cholesterol levels. The best available analysis of these short-term, clinical intervention studies (Brien 2011) found that moderate alcohol intake:

Raises HDL by an average of 4 points.

HDL is the so-called “good cholesterol.” 4 points is not much, but theoretically it is associated with up to a 17% reduction in heart attack risk. The most effective way to raise HDL is to reduce the amount of carbohydrate in your diet (see: Cholesterol).

Reduces fibrinogen by an average of 0.2 g/L.

Fibrinogen is a protein that helps your blood form clots. Studies find that a reduction in fibrinogen of 0.2 g/L is associated with up to a 36% reduction in risk for heart attack. Normal fibrinogen levels are between 1.5 and 2.77 g/L.

Raises adiponectin by an average of 0.56 ug/ml.

Adiponectin is a hormone produced by fat cells that improves insulin sensitivity. Normal adiponectin levels range from about 5 to 15 ug/ml, so an increase of 0.56 is rather small, and is associated with a heart attack risk reduction of only about 1.5%. A safer and more effective way to improve insulin sensitivity is to reduce dietary carbohydrate.

All of these things—higher HDL, lower fibrinogen, and improved insulin sensitivity, are associated with lower risk of heart attacks, so any or all of these may be possible reasons why moderate drinkers appear to have fewer heart attacks. Now, my way of looking at this is to ask why our HDL, fibrinogen and insulin sensitivity are not at healthy levels to begin with, but maybe that’s just me…anyway…so, is it worth it to drink toxic alcohol? My opinion is no, based on the following:

  1. The alcohol intervention studies cited above compared alcohol to a variety of “control” beverages–water, non-alcoholic beer or wine, or fruit juice, depending on the study. This means that these studies need to be taken with a grain of salt. Fruit juice in particular, due to its high content of fructose and other sugars, is a high glycemic index beverage, and the American Heart Association concluded that sweet beverages increase the risk of heart disease. It could be that the alcoholic beverages looked better by comparison because they were lower in sugar; it may have nothing to do with the alcohol content of the beverages.
  2. There are significant risks to drinking alcohol that, for most people, likely outweigh the small potential benefits. These risks include liver damage, anxiety, nerve damage, accidents, digestive tract damage, risky behaviors, breast and gastrointestinal tract cancers, depression, insomnia, addiction, and dependence.
  3. Alcohol can lower blood sugar levels in the hours following a meal containing carbohydrate, by raising insulin levels. While reductions in blood sugar are desirable, elevated insulin levels are undesirable for many reasons (see my Carbohydrate page)
  4. There is mounting evidence and a slowly growing consensus that the most powerful dietary risk factors for heart disease are refined and high glycemic index carbohydrates, not a lack of alcohol intake. Therefore, it is much safer, much wiser, and likely much more effective to reduce dangerous refined carbohydrates in your diet than to add a toxic liquid to your diet that may or may not reduce your risk.

Resveratrol—the red wine antioxidant

There’s been a lot of buzz about resveratrol, a polyphenol antioxidant found in grape skins. Since red wine is made with grape skins and white wine is not, red wine has been (wrongly) elevated to the status of a health food. There is no reason to believe that red wine or even resveratrol itself is good for you, much as we would love to think it’s true. Numerous studies, most of them done in animals and test tubes, suggest that resveratrol might be beneficial as an anti-aging and anticancer drug. However, there is, as of yet, no convincing evidence in human trials to support its benefits.

What is resveratrol?

Resveratrol is a chemical that certain plants (like grapevines) produce under stress to protect themselves against enemies, such as fungi, worms, and insects. Resveratrol can kill a fungus in 30 minutes by destroying the membranes of its endoplasmic reticulum, nucleus, and mitochondria. These structures are critical to the life of all cells, so fungi cannot live without them. As with all “healthy antioxidants” produced by plants, I can’t help but wonder what damage they might be able to do to our own vital cellular components (see: my Vegetables page).


Is red wine special?

Studies find no difference in heart disease rates between people who drink red wine and people who drink other types of alcoholic beverages, which do not contain resveratrol, so red wine is not special. If there is a connection between alcohol and reduced heart attack incidence, it has to do with the alcohol itself, not the resveratrol.


How much resveratrol is in red wine?

The average glass of red wine contains a maximum of 1 mg of resveratrol. Many of the studies that make resveratrol sound promising are done in laboratory animals, using concentrations of resveratrol that are impossible to get from drinking red wine. For example, one important mouse study published in the journal Nature (Baur 2006) used doses between 5-22 mg/kg body weight. A 150 lb (68 kg) human being would have to drink between 340 and 1500 glasses of red wine to obtain that much resveratrol.


Is resveratrol safe?

In brief trials, humans can tolerate up to about 1 gram (1000 mg) of resveratrol extract per day without getting sick. When researchers at the pharmaceutical company GlaxoSmithKline tested high-dose resveratrol in people with a form of cancer called multiple myeloma, they decided to end the trial early because it was associated with an increased risk of kidney failure, and caused nausea, vomiting, and diarrhea.


How is resveratrol handled by the body?

Even if resveratrol were a miracle antioxidant, it probably wouldn’t matter, because our bodies transform it into other compounds within less than 30 minutes of entering our bloodstream.

Most importantly, alcohol is a proven pro-oxidant, and is toxic to humans. It doesn’t make sense to drink red wine, which is a toxic pro-oxidant, known to damage cells throughout the body, in order to (maybe) get (a little bit of) anti-oxidant benefit from resveratrol to (perhaps) reduce your risk of one single health problem—heart attacks.

If you believe in the potential power of resveratrol, despite the lack of evidence for benefits to human health, best to find a source that does not contain alcohol.

BOTTOM LINE ABOUT ALCOHOL:

There are no studies proving that alcohol is beneficial to human health.

The risks of drinking alcohol FAR outweigh any potential benefits.

If you are not a problem drinker, and do not have any significant medical reasons why you shouldn’t drink, and you enjoy drinking alcohol from time to time, that’s one thing. That’s a personal decision and you can weigh the risks and benefits for yourself.

However, if you are drinking alcohol because you believe that it has medicinal benefits and that it’s good for your heart, I wouldn’t recommend it. I would recommend paying attention to the overall quality of your diet and reducing the amount of high glycemic and refined carbohydrates you eat instead.

  • Des

    Dr. Ede, what do you think about wood aged spirits such as whiskey? These unflavoured beverages have virtually 0 carbs. Does that matter when it comes to blood sugar, or does all alcohol raise blood glucose all the same?

  • http://diagnosisdiet.com/ Dr. Ede

    Alcohol (unsweetened 0 carb spirits) has a very complicated effect on blood sugar and insulin levels, typically lowering blood sugar, probably by raising insulin levels. Sweet alcoholic drinks can raise blood sugar, however.

  • Des

    Hi Dr. Ede, do you think alcohol will exacerbate my brothers SIBO or is a drink here and there ok?

  • http://diagnosisdiet.com/ Dr. Ede

    I don’t know; most bacteria are killed in the presence of significant concentrations of alcohol, but there are some bacteria which can use alcohol as a food source. However, alcohol is absorbed long before it can reach the colon, which is where the bacteria are.

    • Des

      Thank you, this is informative.

    • Melchior Meijer

      Hi Georgia,

      Slightly off topic, but there are also bacteria in the small intestine and they may be
      of monumental importance. Are you aware of the work of Dr Ian Spreadbury? If
      you haven’t read his paper yet, I’m quite confident you will be intrigued by it.

      “Comparison with ancestral diets suggests dense acellular carbohydrates
      promote an inflammatory microbiota, and may be the primary dietary cause of
      leptin resistance and obesity”

      If his elegant theory holds water – which I think – it would tie together all our
      observations. Dr Spreadbury is paleo himself (it cured his beginning liver
      pathology) and he’s actively trying to convince colleague’s that the paleo diet
      ‘is the best intervention we have’. Here’s the link to his paper:

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3402009/

  • MM

    Hi Georgia and Des,

    I comment under my initials this time, because I share some personal info and I wnat to be able to say ‘It wasn’t me!’ ;-) .

    I promised to report the changes I’ve experienced since quitting my daily glass of red wine, about two weeks ago. It’s just an n=1, I am not completely sure if I can attribute them to the ‘intervention’, but I find them remarkable none the less. I am aware that it could all be a plecebo effect. So here I go. It might help that I am male, build in 1963, without (known) health problems and not on medication. Paleo since approximately 2004, though I have been enjoying one glass of red wine on an almost daily basis for ages.

    1 The biggest and most important effect is the almost complete disappearance of a long standing, nagging problem that I have self diagnosed as either costochondritis, ‘myofascial triggerpoints’ or some minor upper spine problem. It manifests as a sharp, ‘inflamed’ pain behind the schoulderblades and on the breast bone, often radiating into the arms and causing palpable, painful knots in the arm muscles. At times this pain feels constricting and given my morbid medical interest you can imagine what I have been fearing. Heart problems have been ruled out though (as far as they can be ruled out), and scince I run, swim and bike quite vigorously on an almost daily basis, I accepted the ‘muscoluskelettal nature’ of the complaint. Swimming and weigt lifting tends to make it worse. Two days after quitting the wine habit, I noticed a ‘lack of pain’. At the moment it is all but gone. Will it last? I do hope so!

    2 While exercising I’m sometimes more aware of my heart action than I like. Could feel my heart beating in my spine. This pounding sensation (aneurysm alert for hypochondriacs!) has disappeared. My heart beat feels more steady. I also perform better. Got muscle aches again, because I pushed harder.

    3 Tendency towards contracting ‘athlete’s foot’ in the swimming pool seems to have gone.

    4 Paleo got me rid of nocturia, but sometimes I was bothered with what I can only describe as a ‘prostate cold’ in the morning. At the first visit to the bathroom there sometimes was impaired urine flow. I did not like this, because I could only explain it as a sign of BPH (terrible!), although flow was always fully restored during the second urination (which I found puzzling). Now, always unrestricted flow, also early in the morning.

    5 I have never been a loud snorer, but I did make some bedroom noise. My wife would poke me at least once every night. Which annoyed me, not only for her, but because snoring is in my eyes a sure sign of less than perfect metabolic health. She has not poked me one time since I stopped the wine. I assume I sleep completely noise free.

    6 Fresher breath, even when I sometimes fail to brush properly ;-) .

    7 I seem to feel calmer.

    I drank for social reasons, but also because I was under the impression that some wine is healthy. It might be healthy for a big part of the population, but I suspect that even one glass a day might be slightly toxic for me. Do I react to accumulating levels of acetaldehyde? Is it not the alcohol iteself but the amines in red wine? Who knows. I agree with Georgia that no disease is a manifestation of alcohol insufficiency. I happily continue this ‘experiment’.

    I still drink coffee. Coffee is one big conundrum to me. It massively raises cortsiol, yet seems to protect against diabetes. Do the effects of chlorogenic acid override all the negative effects? Im looking forward to Georgia’s coffee (and chocolate) piece(s). I think I know where it is heading… I’m prepared to kill those darlings too :-) .

    • Des

      Thank you for this insightful response!

      • MM

        Sorry for the typo’s. Placebo. Musculoskeletal. I forgot two things. My dreams are much more vivid and I seem to tolerate my cold showers more easily.

    • http://diagnosisdiet.com/ Dr. Ede

      MM, you are a courageous soul! Not only have you dared to abstain from a beloved ritual, but you have bravely shared your very personal experience here so that others may benefit from it. I find the details very interesting indeed. Clearly some ingredient or metabolite of alcohol was acting as a neuromuscular irritant, but it is so difficult to know which one, how, or why. In any case, I’m so glad you are feeling better, and here’s hoping your wife does not find any new reasons to poke you:)

  • http://diagnosisdiet.com/ Dr. Ede

    Melchior, this is fascinating! I love the idea of conceptualizing “refined” carbohydrates as “acellular.” That is brilliant. I can’t wait to read the paper–should have time on the airplane to Utah tomorrow. Thank you so much for making me aware of this work. I am already making a connection in my mind between bacteria and mitochondria (they have a lot in common…)

    • Melchior Meijer

      Hi Georgia,

      I’m glad you like the concept. If you are as blown away by this paper as I was when I first read it, I strongly disencourage you to read it on the airplane. Just kidding. For me this publication was the event of 2012. Ian Spreadbury has been invited to talk in Norway in April. Although not exactly next door, it’s much nearer than Canada for me (about a two hour flight) and I’m pondering with the idea to attend.

      Yes, the connection between bacteria and mitochondria is fascinating. Most obese people have impaired mitochondrial function and a relative inability to oxidize fat. My impression is that correcting the microbiota in the small intestine (by not feeding them dense, acellular carbohydrates) results in host-microbe crosstalk that restores mitochondrial function.

      Happy mitochondria, happy us ;-) .

      Have a great time in Utah! I’m so jealous (in a positive way).

  • http://diagnosisdiet.com/ Dr. Ede

    Hi NS
    First of all I apologize for the delay in displaying your comment; I was at a conference with poor internet access yesterday.

    I appreciate the comment am curious to know if you have references to support the statement that alcohol is not necessarily a toxin; I would be interested in reading more about that. I’m asking because: just because something has been around a long time doesn’t necessarily mean it’s not toxic. Do you know of any sources that can help us understand if there is a threshold effect, as you are suggesting?

    • NS

      According to Dr. Eric Westman there are no modern laboratory studies. He mentioned to me that “normal” alcohol consumption is defined by the culture and cuisine of a given society. He was’t going to tell me what was normal. Basically he said in so many words: we don’t really know.

      There are hints given in the literature on the microbiome and humans relationship to yeasts. In fact some are asserting that humans and yeasts co-evolved. Also the anthropological literature. Fermentation is an ancient food preservation practice that has been rediscovered in the US. The current fermentation community is a good place to go to find information on humans’ historic relationship to fermented beverages and foods.

      Many things that have been around for a long time can become toxic when ingested in too great a concentration or volume. Water poisoning for example. I agree though that not all traditional practices are necessarily safe (to whit: the African community that ate the brains of their dead as funerary practice. They developed Jakob-Kreutzfeld disease.) But this might be an example of a traditional practice that is toxic in smaller concentrations, and usually natural selection brings such cultural practices to an end. And one must take a critical eye to any traditional practice, but we must take care not to have our preconceived notions distorting our analysis (which is always a risk when looking back at history).

  • Erik Berggren

    Do you drink alcohol?

    • http://diagnosisdiet.com/ Dr. Ede

      Hi Erik
      I almost never drink alcohol, and when I do I only drink very small amounts. This is partly because alcohol doesn’t appeal to me, and partly because I don’t tolerate it well–it interrupts my sleep and the next day I feel blue and have trouble with concentration, motivation, and energy. I also have some idiosyncratic reactions to alcohol, such as racing heart and migraines, which may have to do with the biogenic amines which are generated in fermentation process (see my blog post about histamine intolerance for more information).

Last Modified: Mar 12, 2013 at 12:01pm