You may have heard that alcohol in moderation is beneficial for your heart – a suggestion based on number of studies that have shown a link between moderate drinking and a lowered risk for heart attack, heart and blood vessel diseases, stroke, type 2 diabetes, and gallstones.
But what does alcohol in moderation mean? And do these studies indicate alcohol should be included in a heart-healthy diet?
What does “drinking in moderation” mean?
Moderate drinking is defined as no more than one drink a day for women* and two drinks a day for men. A drink is considered the following:
- 12 ounces of regular beer
- 4 ounces to 5 ounces of wine
- 1.5 ounces of 80-proof distilled spirits
Moderation is different for men, women, and older adults. This is because alcohol’s effects depend on how the body absorbs and breaks down alcohol. Older adults break down alcohol more slowly than younger people. This means alcohol stays in their bodies longer. A person's height and weight also impact how alcohol is absorbed. The smaller and lighter you are, the more quickly alcohol is absorbed. People from some ethnic groups also have a harder time breaking down alcohol. Even small amounts can have a big effect on their bodies.
*Pregnant women should avoid all alcohol because it can lead to birth defects.
Potential health benefits and concerns of alcohol
The American Heart Association says moderate alcohol consumption can help protect against heart disease by raising HDL ("good") cholesterol and reducing plaque buildup in your arteries. Alcohol also has a mild blood thinning effect, which can keep platelets from clumping together to form blood clots.
But these potentially beneficial effects are largely dependent on your age.
For example, moderate drinking may lower the risk for heart disease among men older than 45 and women older than 55. But for younger people, moderate alcohol consumption provides little, if any, health benefit. And the risk of alcohol abuse increases when drinking starts at an early age.
In addition, excessive drinking can increase the following:
- triglyceride levels
- blood pressure
- your risk for abnormal heart rhythms, such as atrial fibrillation
- your risk for stroke
Newer studies question alcohol’s health benefits
Although numerous studies point to the benefits of moderate alcohol consumption, many of these studies have been purely observational, following participants who reported their alcohol consumption and allowed access to their health data over a set period of time. While the studies associate moderate alcohol consumption with reduced long-term development of several cardiac problems (such as hypertension, coronary artery disease, heart attack, and stroke), they merely show a correlation between heart health and alcohol – aka alcohol has not been proven to directly impact heart health.
Additionally, two recent studies question the direct benefits of alcohol on heart health, raising the suggestion that people who consume low to moderate amounts of alcohol tend to engage in other behaviors that improve cardiac risk factors, such as exercise, a lower body mass, tobacco abstinence, and a healthier diet.
“In other words, both studies have suggested that drinking alcohol does not increase cardiovascular health beyond that of the other observed behavioral patterns,” explains cardiologist James Fox, MD, FACC, of Munson Healthcare’s Traverse Heart & Vascular.
The verdict of alcohol and heart health
Alcohol may have some health benefits, specifically for men over age 45 and women over age 55. But it may lead to excessive drinking and other diseases. Because there's no sure way to know who may struggle with alcohol, the American Heart Association (AHA) and other experts don't advise drinking alcohol to gain possible health benefits.
“I would certainly not suggest that people start alcohol intake specifically for cardioprotective benefits,” says Dr. Fox. “However, I don’t think that it has been established that low to moderate alcohol intake is explicitly harmful.”
If you do choose to drink alcohol, it’s important to know how it may impact you, both in the intermediate and long-term. This varies among individuals based on a number of factors.
Know how you react to alcohol
People respond differently to alcohol for several reasons, like weight, gender, and heredity. The amount of alcohol you drink, when you drink it, and any history of problem drinking can also affect your reaction to alcohol.
When you drink alcohol, it passes from the stomach and small intestine into the blood, where it’s carried to your organs. Alcohol can be dissolved in water, so it enters your organs in proportion to the amount of water they hold. The more water available in the organs to soak up the alcohol, the less alcohol remains in your bloodstream.
Your liver does most of the work of breaking down alcohol so it won't damage other organs. But, the liver can break down only a certain amount of alcohol per hour, regardless of the amount you drink. A very small percentage of alcohol escapes this process and is eliminated unchanged in your breath, sweat, and urine. Until all the alcohol in your body has been broken down, it stays in the brain and other tissues of the body and continues to cause effects.
Other factors that impact alcohol’s influence on your body
Gender
In general, women and older men have less water in their organs than younger men. Therefore, less alcohol enters their organs and more alcohol stays in their bloodstream. Younger women make less of the stomach enzyme that breaks down alcohol in the stomach. This means more alcohol is available to be soaked up into the blood. As a result, a young woman will have a higher blood alcohol level than a man of the same age who drinks the same amount of alcohol.
Heredity
Heredity may play a role in how alcohol and your body act together. Moderate drinkers who have genes that cause a slower breakdown of alcohol are at much lower risk for heart and blood vessel disease than moderate drinkers who have genes that cause rapid breakdown of alcohol.
Food Intake
Alcohol is broken down more slowly when it's soaked up. The process of soaking up alcohol is slowed when you drink alcohol during or right after a meal. The slower soaking up process lets the liver break down alcohol at a rate that keeps more of it from reaching other organs.
Medications and Disease
Because the liver breaks down alcohol, people with liver disease are more sensitive to drinking. Certain medicines may cause harmful reactions if you drink while taking them. Alcohol affects the breakdown of a wide variety of medicines by increasing the activity of some and decreasing the activity of others. Most notably, heavy alcohol consumption when taking acetaminophen can lead to liver damage.
Also, for people with a history of alcoholism, the danger of drinking is far greater than the possible heart and blood vessel benefits.
Know Your Heart
Are you curious or concerned about your heart health? Start with our Heart Health Assessment to know your risk for developing heart disease, which can begin at a young age.
Help is Available
If you or a loved one is struggling with alcohol or other substances, you are not alone. Certified Peer Recovery Coaches are available through Munson Healthcare. Our Peer Recovery Coaches have personally battled addiction and offer a unique type of support, resources, and tools to help you or a loved one reach or maintain recovery. Call 231-935-6716 to connect with a coach in northern Michigan.
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