How to drink less

Source: The Swiss Association for Nutrition (SAN)
May 12, 2000 (Reviewed: December 8, 2002)

Introduction

A popular drink, but...
Alcohol has a tradition in our society dating back thousands of years: as a "social lubricant" at informal occasions, as a crowning supplement to culinary creations or as "world champion thirst-quencher" (as the advertisement for a beer recently put it). In Switzerland, for instance, the average consumption is about 9 litres of pure alcohol per year per head of the population. When one considers that an adult consumes a total of about 850 litres of liquid a year with their solid food and in the form of drinks, 9 litres of alcohol at first sight would seem quite low. But bear in mind that this quantity of pure alcohol corresponds to about 180-200 litres of beer or 80-90 litres of wine! So alcoholic beverages are flowing in substantial quantities.

About 80% of adults consume alcohol, usually in moderation and without any problems. But a relatively small group (7-10%) drinks about half of all the alcoholic beverages consumed; these people thus display problematical drinking behaviour.

There are clear sociocultural differences in drinking habits. For instance, in Switzerland people in the French-speaking and Italian-speaking parts drink on average more alcohol than those in the German-speaking part, with wine more popular among these groups than beer.

If the critical limit for alcohol consumption is put at 80 g pure alcohol per day, about 5% of the population of Switzerland can be described as heavy drinkers. Many of these people either have problems or cause them as a result of their alcohol consumption. Several new developments also give cause for concern; for instance, the proportion of women among consumers of alcohol is on the increase. As a result, the proportion of children being born with alcohol-induced damage is also rising. In adolescents there is a growing fashion for so-called alcopops - ready-mixed soft drinks containing alcohol - and drinking by adolescents is a problem in many countries today.

Damage to health
Alcohol supplies nearly twice as much energy per gram as carbohydrates and protein. Anyone who consumes excessive amounts of alcohol is thus getting his or her calories in "liquid form", and often eats an unbalanced diet as a result. Consequently, the body doesn't get enough essential nutrients. Alcohol also slows the burning of fat in the body, so anyone who has weight problems should either not drink at all or only a little.

There is no organ or cell system in the human body that cannot be damaged by alcohol, either directly or indirectly. In medicine, the treatment of alcohol-related diseases is a part of daily practice. Acute consequences of drinking are alcohol poisoning and alcohol-related accidents, which are a common occurrence. With chronic damage, the level of alcohol intake is of particular importance; heavy consumption significantly increases the risk for various forms of cancer (especially of the mouth, larynx and throat, as well as breast cancer in women) and disorders of the pancreas, fatty liver or cirrhosis of the liver.

It is not only the medical consequences of excessive alcohol consumption that can be a burden, but also the psychosocial consequences; acute drinking often leads to a loss of self-restraint, aggression and acts of violence. Chronic drinking is almost always a cause of serious social and economic problems (family tension, loss of friends, debt, unemployment). Many cases also have psychological problems that may range from depression to a decline in intellectual ability, delirium tremens or suicide.

Health benefit of alcohol?
Recently there has been evidence to suggest that moderate consumption of alcohol has a positive influence on the development of atherosclerotic changes, and can thus help to protect against heart attack (myocardial infarction). This preventive effect is primarily seen in men aged over 40 or in women aged over 50. However, this by no means suggests that those who do not drink alcohol should start drinking it now for health reasons! The associations are complex - in women, for example, the risk of dying from cirrhosis of the liver, cancer of the breast or bowel, or stroke, is markedly increased with the consumption of more than 3 alcoholic drinks a day.

Recommendations

How much is too much?
For the reasons mentioned above, it is not easy to give clear guidelines as to who would be best advised to abstain from alcohol and in what situations, or who should drink how much. Some people develop alcohol problems more readily than others. People also react differently to alcohol in different phases of their lives. Women overall are more sensitive to alcohol than men. If a woman and a man with identical bodyweight drink too much alcohol, negative effects occur sooner in the woman. The following recommendations from experts are not intended as a guide to drinking, but as threshold limits:

• 2 standard glasses of alcoholic drinks per day are safe
• > In informal settings, 4 standard glasses may also be enjoyed once in a while
• Women would do better to consume somewhat less
• For health reasons, it is advisable every so often to have an alcohol-free day

A standard glass is taken to mean the quantity of alcohol that is normally served per glass in a pub or restaurant. A standard glass contains about 8 g of pure alcohol; examples:

• 1 standard glass = 3 dl normal-strength beer or cider
• 1 standard glass = 1 dl wine
• 1 standard glass = 1 aperitif (0.4 dl of sherry, vermouth, etc.)
• 1 standard glass = 1 spirit (0.2 dl of whisky, gin, brandy, vodka, etc.)

Note: at home, many people are considerably more generous with alcohol. For instance, they tend to drink the equivalent of several standard glasses in one large glass.

The following people should abstain completely from alcohol:

• Children
• Pregnant and breastfeeding women
• People who have been advised for medical reasons not to consume alcohol
• People suffering from mental problems or diseases
• People who are under-weight
• People who are seriously overweight
• Most people taking medication (check with your physician)

There are also many everyday situations in which it is advisable to abstain from alcohol, because of the risks to oneself or others:

• Before or during the driving of motor vehicles or operation of machinery
• Before or during sporting activities, such as football, riding, sailing, skiing, diving, mountaineering, cycling, etc.
• Before and during work (for many professional groups there is an explicit ban on alcohol during work)

Tips for coping with alcohol

In everyday life

• Alcoholic drinks are poor thirst quenchers - to quench your thirst, there are many more effective beverages (mineral water, cold herbal tea, diluted fruit juices etc.)
• Preferably drink a beverage with a low alcohol content rather than a "good stiff" drink. Alcohol-free alternatives to beer and cider have an excellent quality of flavour.
• Always eat something when you drink. This not only slows the rate at which the alcohol enters the circulation, but also reduces the quantity consumed. The salted nuts, crisps and crackers etc. that are often provided with alcohol only increase the thirst and supply the body with unnecessary fat.
• Reduce your consumption of alcohol if you have weight problems. In particular, avoid alcoholic drinks after the evening meal.

On social occasions

• Decide beforehand how many standard glasses you want to drink at an informal social occasion, and stick to this.
• Do not join in when rounds of drinks are being bought or, if you do, order alcohol-free drinks or coffee.
• At gatherings where alcohol starts to flow freely, drink alcohol-free beverages every so often, such as fruit juice, milk, lemonade and water. Always order mineral water with wine.
• Put down your glass between each sip. In this way, you will drink more slowly.
• If you have the feeling that you are probably drinking more than you would like, leave the gathering for short time and get some fresh air.
• Don't let yourself be forced by anyone to drink, even at celebrations and parties. Say when enough is enough - good friends will respect a "no, thank-you".
• The ability to hold one's drink is not a virtue and does not win any medals! Men can prove their virility (or women their emancipation) in other ways than in drinking competitions.

Related Books
Beyond the Influence : Understanding and Defeating Alcoholism

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