Last month was Sober October. I didn’t know until recently that Americans now have 2 months dedicated to promoting an alcohol-free lifestyle. Both Sober October and Dry January, sandwich the months of November and December when alcohol intakes are at their highest. 

While I’ve never been a big drinker (as in a binge drinker), I do enjoy a glass of wine on the weekends and even a few days a week. In my mind, I justify drinking (wine, specifically) due to its high antioxidant content and its purported health benefits. 

Plus, the Dietary Guidelines say women are allowed 1 drink per day. One drink being the equivalent to 12 fluid ounces of regular beer, 5 fluid ounces of wine, or 1.5 fluid ounces of 80-proof distilled spirits. 

But I’m beginning to wonder, if this is solid advice given the physical and mental health issues so many of us face?

An almost 2 year long pandemic has brought with it a variety of emotions including: anxiety, frustration, anger, and sadness. Combine this with increased rates of depression and isolation, and call me crazy but routinely adding alcohol (both a toxin and depressant) to the mix, doesn’t seem like the best idea. 

Am I right?

I’m playing devil’s advocate here. Because truth be told, I love nothing more than the ritual of pouring a glass of wine after work and sipping it while I cook dinner. 

But I’m beginning to question whether this ritual is serving me anymore.

In my twenties, I could easily drink a glass or two of wine every night and not feel it the next day, but I can’t say the same now that I’ve reached my mid-thirties. After a night of drinking (even one glass), I find I don’t sleep as well which can put me on the path for a not-so-great day. 

I’m very protective over how much sleep I get every night. Several years ago I experienced debilitating insomnia and I never, ever want to experience that again. Therefore, I’m vigilant about my sleep hygiene and hyper aware of how it impacts my sleep and how I feel the following morning.

I have also given more thought about alcohol’s role in health because I coach others on how to improve their health with good nutrition and lifestyle changes. 

And because I want to practice what I preach, which is ‘everything in moderation’ I feel like I owe it to myself and my clients the ability to articulate whether ‘everything in moderation’ also applies to alcohol. 

Let’s first discuss alcohol's role in mental health. Because our physical health is directly linked to our mental health. First, let’s state the obvious: alcohol is a mood-altering drug. While one drink can ignite feelings of relaxation and happiness; it’s positive effects are short-lived. 

When you drink, alcohol lowers your inhibitions. That said, if you are naturally a more impulsive person by nature - your impulsivity will be magnified while under the influence.

The main problems with this from a health perspective if that we become less risk adverse and and therefore more likely to do stupid things because our judgement has been clouded. Alcohol also impacts the region of our brain that controls emotions. Typically, whatever emotions we are feeling in the moment will be magnified. 

And because alcohol depletes neurotransmitters in the brain, in particular serotonin (a feel good chemical) - both anxiety and depression is worsened with alcohol intake. 

Those with pre-existing depression and anxiety are also more likely to use alcohol as a coping mechanism and develop dependence. According to the National Institutes of Health, about half of individuals who develop alcohol, drug, or medication dependence experience co-occurring mental disorders including anxiety, depression, ADHD, bi-polar disorder, personality disorder, among other (1)

Heightened impulsivity due to alcohol consumption can also cause us to not just drink more but eat more, too. If you drink alcohol, you likely have felt alcohol’s appetite enhancing effects at one point or another. This is due to both reduced inhibitions and physiological changes that happen when we drink alcohol.

First, when we drink alcohol our body prioritizes removing the toxins. In turn, energy from food can’t be processed as well causing our blood sugar to drop. This drop in blood sugar is responsible for feeling a bit more light-headed or what some people call ‘tipsy.’

In addition, there are neurochemical changes that happen. Alcohol has been proposed to support an overall increase in food intake due to two different pathways: (1) alcohol binds to type-A gamma-aminobutyric acid (GABAA) receptor--stimulating the release of opioids and (2) alcohol decreases serotonin and leptin production, both hunger suppressants.

We also have to remember that alcohol is typically consumed not as a substitute to food but in addition to a regular eating pattern. One meta-analysis reviewing 12 studies, showed that those who drank alcohol consumed an average of 80 more calories from food than those who consumed non-alcoholic beverages.

Despite this acute increase in food intake, research shows those who drink moderately don’t have a higher body mass index (BMI) than those who abstain. It may be that those who drink compensate for their increased calorie intake by actually eating fewer calories at subsequent meals. 

It could also be that those who consume alcohol benefit from its high thermic effect. The thermic effect of food (TEF) refers to the amount of energy it takes to digest and metabolize a substance. Alcohol has a higher TEF than any macronutrient which means we ‘net’ fewer calories from alcohol than we do other sources of energy (protein, carbohydrates, and fat). 

Other factors that influence weight status include the type of alcohol consumed and the frequency of consumption. For example, drinking wine has been shown to be more protective against weight gain than drinking beer and spirits. Some speculate this is due to wine’s resveratrol content. Others speculate that it could also be that those who habitually drink wine have healthier dietary patterns than those who drink beer or spirits. 

Also, those who drink heavily or binge-drink as defined as having greater than 2 to 3  drinks per day are more likely to have a higher body weight than those who drink a low to moderate amount of alcohol. 

Alcohol has also a profound impact on sleep quality. While initially alcohol has a relaxing and sedative effect helping you to doze off, alcohol disturbs both the quality and duration of rapid-eye movement sleep (REM). REM is believed to be the most restorative cycle of sleep characterized by memory consolidation and dreaming. Poor sleep quality often leads to sleepiness the following day which can diminish productivity and healthy behaviors.

Research shows that  both lack of sleep/poor sleep quality compromises eating choices and energy expenditure. In a study surveying 1.1 million people, sleep duration and frequency of insomnia was linked to an increasing BMI in those who habitually slept less than 7-8 hours per night.

Shorter sleep times are also associated with increased circulating ghrelin (an appetite-stimulating hormone) and decreased leptin (an appetite-suppressing hormone). Sleep deprivation has also been shown to increase food cravings for high fat sugary foods. 

Research suggests that the reward center of the brain is also more prominently lit up after sleep deprivation; this may explain your drive for eating foods that elicit a higher reward (hello, Taco Bell).

A poor night’s sleep due to excessive alcohol consumption can also hinder physical activity. When we feel tired we are much less likely to engage in both physical activity and non-exercise activity thermogenesis (NEAT). Physical activity and NEAT make up between 15-30% of total energy expenditure per day. Consequently, alcohol can spell double trouble in that it not only can increase your calorie intake, but also reduce the number of calories you burn the following day.

Boozing prior to exercise is not a very common occurrence. Nonetheless, it should be noted that alcohol can certainly interfere with exercise performance. Alcohol acts as a depressant to the central nervous system; this can impair motor skills, coordination, reaction time, and balance. I’d advise not riding your bike down a busy street after drinking! 

If you drink after working out, alcohol can impede recovery, as well. Recovery after exercise usually requires three things: restoring hydration, replenishing glycogen stores (that is, carbohydrates stored in the liver and muscle), and repairing and/or synthesizing new muscle tissue. All of these processes can be hampered by alcohol consumption post-exercise. 

To prevent alcohol from interfering with recovery, it’s important to drink plenty of liquids before you begin imbibing especially if you are working out in a hot environment. Also ensure you eat a source of carbohydrate and protein to help with muscle synthesis and glycogen replenishment.

So far I have given you multiple reasons to be cautious about your alcohol intake. But are there any upsides to drinking in moderation? 

Improved Heart Health with Drinking

Well, a large body of research (over 100 prospective studies) show there is an inverse relationship between light and moderate drinking and heart disease.

The main reason why alcohol seems to be protective against cardiovascular disease is because it raises good cholesterol, known as HDL. HDL is the form of cholesterol that essentially “cleans-up” harmful cholesterol (LDL) in the body. Alcohol consumption is also associated with fewer blood clots occurring in the arteries of the heart, neck, and brain which reduces your risk for stroke.

Reduced Risk of Type II Diabetes

Alcohol may provide protection against type II diabetes because of its role in reducing blood sugar and insulin. Chronically elevated levels of blood sugar/insulin is believed to contribute to insulin resistance. 

Data from the Health Professionals Follow-up Study which includes over 38,000 middle-aged men - looked at alcohol consumption patterns over a 4 year period. While 75% of the men remained relatively stable in their alcohol consumption, another portion of the men increased their intake from light to moderate levels; this increase was tied to a 25% reduction in risk of developing type 2 diabetes.

Protection Against Alzheimer's Disease

Lastly, alcohol consumption is tied to a reduced risk of Alzheimers. A study published in the Journal of Neuropsychiatric Disease & Treatment looked at alcohol consumption of over a million people and determined that moderate consumption was linked to a decreased risk of Alzheimers, whereas heavy drinking increases one’s risk of developing Alzheimers by 300 percent! 

The same study found that drinking wine over other alcoholic beverages provided more benefits. Red wine in particular contains several antioxidants including anthocyanins, catechins, and resveratrol Antioxidants like resveratrol play a role in neutralizing free radicals which essentially are damaged cells in the body; resveratrol also crosses the blood-brain barrier, therefore, can positively affect brain cells and nerve cells. 

While the exact reason for why alcohol appears to be protective against Alzheimers is debated, some reason, it has to do with the social aspect of alcohol. Drinking is a more common occurrence in social situations. And we also know that having an active social life may ward off Alzheimer's disease. That said, the benefits of alcohol are likely enriched in the company of friends and family!

Clearly, the benefits of alcohol are only as good as the dose! Light to moderate drinking is protective against cardiovascular disease but anything beyond moderate amounts is counter-productive. Also, it should be noted that heavy users of alcohol experience greater rates of liver disease, mental health issues, and  cancer especially mouth, esophageal, colon, and breast cancers. It is also advised that if you currently don't drink, starting for health reasons alone.

Studies differ on habitual drinking patterns but the National Institute on Alcohol Abuse & Alcoholism uses the following guidelines:

• Light to Moderate Drinking: Up to 1 drink per day for women and up to 2 drinks per day for men. This is also aligned with the Dietary Guidelines for Americans.
• Binge Drinking: Consuming 5 or more drinks (male), or 4 or more drinks (female) in 2 hours or less or the same day regardless of time.
• Heavy Drinking: For men, consuming more than 4 drinks on any day or more than 14 drinks per week. For women, consuming more than 3 drinks on any day or more than 7 drinks per week.

One’s current health status and genetics should also be factored into whether you drink or not. Those who struggle with mental health issues whether it be depression or anxiety should practice caution with drinking. If you have a family history of addiction you should also be vigilant about monitoring your drinking habits or avoid it altogether.

And while there's not enough research to say that alcohol consumption necessarily derail's one's weight-loss efforts, those who struggle with impulsivity or don't have good eating habits to begin with, may find it more difficult to lose weight if consuming alcohol regularly.

Ultimately, each of us has to decide whether drinking enhances or detracts from our life experiences and our goals.

Personally, I don't plan on eliminating my Pinot Noir anytime soon. But I do plan on tapering back my intake. While in my twenties I could handle drinking on a daily basis . Now that in my thirties, I can't say the same. I also have realized that I care more about how my 'future' self then the self who wants instant gratification and frankly has a hard time limiting myself to a 5 ounce pour.

While I'll still be imbibing - I plan on doing less of it for not only my sleeps sake but the desire to start off more mornings feel fresh, and ready to take-on a new day.