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Alcohol: 16 Reasons to Rethink Your Drink

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A recent study suggested a trend toward reduced fertility with high alcohol consumption, defined as more than 14 drinks per week, but the results were not statistically significant.[1] Other studies support this finding, while others disagree. Apart from fertility, excessive alcohol use is associated with high-risk sexual behaviors and STD transmission,[2] date rape, and sexual assault.[3] Of course, alcohol consumption during pregnancy is a bad idea, being a cause of miscarriage,[4] fetal alcohol syndrome, alcohol-related neurodevelopmental disorder (ARND), and alcohol-related birth defects.[5]

So, drinking and pregnancy do not mix. I’m sure that’s not the most astonishing news you’ve heard today.

Beyond fertility issues, alcohol intake has been linked to worse outcomes in numerous conditions, as follows:

  1. Cancer. Excess alcohol consumption may increase the risk of the following cancers:[6] [7]
    • Colorectal cancer – 10–20% increased risk with usual consumption of 50g daily, or 3–4 standard-sized drinks daily.
    • Breast cancer – For each 2/3 of a drink consumed daily (10g alcohol), risk increases by 7–10%.
    • Cancer of the oral cavity, pharynx, larynx – Less than 2 drinks daily = 86% increased risk. 3–4 drinks daily = 311% increased risk.
    • Esophageal cancer Less than 2 drinks = 39% increased risk, 3–4 drinks daily = 93% increased risk..
    • Liver cancer Less than 2 drinks daily – 19% increased risk, 3–4 drinks daily = 40% increased risk.
    • Stomach cancer Less certain relationship. May be related to alcohol.
    • Pancreatic cancer – Less certain relationship. May be related to alcohol.
    • Lung cancer – Less certain relationship. May be related to alcohol.
  2. Stress urinary incontinence (a sneeze or cough causes leakage of urine): 2.4 times more common among women who consume alcohol.[8]
  3. Depression – Alcohol consumption is associated with depression and has biochemical effects that explain how it causes and exacerbates depression.
  4. Hemorrhagic stroke (a type of stroke where a blood vessel breaks open) – More than four drinks a day are associated with over 200% increased risk.[7]
  5. Pneumonia – Two drinks a day increase risk by 13%. More drinks lead to higher risk.[7]
  6. High blood pressure – Just two drinks a day is linked to a 25% increased risk in men. More is linked to higher risks.[7]
  7. Heart rhythm problems – More than two drinks daily are linked to about a 15% increased risk of conduction problems.[7]
  8. Pancreatitis – High alcohol consumption strikingly increases the risk of pancreatitis.
  9. Liver cirrhosis – High alcohol consumption increases the risk of liver cirrhosis and failure.
  10. Addiction – 7% of American adults have an alcohol use disorder, which includes alcohol abuse and alcohol dependence.[9]
  11. Insomnia – 35–70% of people who chronically drink alcohol have insomnia, a much higher rate than the general population.[10]
  12. Heartburn – Alcohol can hamper the function of the sphincter barrier between the esophagus and stomach, leading to acid reflux and heartburn.[11]
  13. Leaky gut – Alcohol can disrupt the barrier function of the intestine, allowing large molecules that normally couldn’t be absorbed into your body.[11]
  14. Disrupted nutrition – High levels of alcohol consumption inhibit the absorption of various nutrients.[11]
  15. Psoriasis Alcohol may be a trigger for psoriasis exacerbations.[7]
  16. Obesity – Alcohol contains lots of calories, and people may not compensate for those calories by eating less food. Alcohol may even stimulate appetite. That said, observational data does not link alcohol intake with weight gain.[12]

Many of these problems are common issues that people struggle with daily, ranging from annoyances to life-threatening diagnoses. In addition to these issues, excessive alcohol use helps to cause a whole collection of serious injuries, including drunk driving accidents, falls, violent injuries, or drowning. 31% of traffic fatalities involve alcohol.[13] In all, it is estimated that more than 140,000 people die from alcohol-related causes annually in the US.[14]

What about the benefits of alcohol we’ve all heard about? There is evidence that light or moderate drinking is significantly associated with a reduced risk of heart disease, ischemic stroke (the kind caused by a clot in the blood vessel), and diabetes.[7] However, these associations should be balanced against the negative effects listed above.

And while I’ve listed a large, impressive list of health problems, many of these dangers are related to excessive alcohol use. But some are not. For example, there is no clear threshold below which alcohol consumption seems to be okay for certain cancers, and even one drink can affect heartburn or sleep.
All doctors have seen plenty of tragedy caused by alcohol and treat many chronic issues like heartburn, obesity, and high blood pressure that may be related to alcohol. People commonly ask me about beverage choices, particularly alcohol. After reviewing some of the evidence, I suggest, if they don’t have a health problem listed here, that an occasional social outing with a drink or two is fine, but folks who find themselves drinking almost every day may be at high risk for promoting one of the problems above. High-risk drinking is considered to be more than one drink daily for women (or seven drinks weekly) and more than two drinks daily for men (or fourteen drinks weekly). If, for whatever reason, someone is getting anywhere close to those levels of consumption, I strongly suggest they rethink their alcohol consumption.

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References

  1. Mikkelsen EM, Riis AH, Wise LA, et al. Alcohol consumption and fecundability: prospective Danish cohort study. Bmj 2016;354:i4262.
  2. Wechsler H, Davenport A, Dowdall G, Moeykens B, Castillo S. Health and behavioral consequences of binge drinking in college. A national survey of students at 140 campuses. JAMA 1994;272:1672-7.
  3. Hingson RW, Zha W, Weitzman ER. Magnitude of and trends in alcohol-related mortality and morbidity among U.S. college students ages 18-24, 1998-2005. J Stud Alcohol Drugs Suppl 2009:12-20.
  4. Kesmodel U, Wisborg K, Olsen SF, Henriksen TB, Secher NJ. Moderate alcohol intake in pregnancy and the risk of spontaneous abortion. Alcohol Alcohol 2002;37:87-92.
  5. American Academy of Pediatrics. Committee on Substance Abuse and Committee on Children With Disabilities. Fetal alcohol syndrome and alcohol-related neurodevelopmental disorders. Pediatrics 2000;106:358-61.
  6. Cao Y, Giovannucci EL. Alcohol as a Risk Factor for Cancer. Semin Oncol Nurs 2016;32:325-31.
  7. Rehm J, Baliunas D, Borges GL, et al. The relation between different dimensions of alcohol consumption and burden of disease: an overview. Addiction 2010;105:817-43.
  8. Amaral MO, Coutinho EC, Nelas PA, Chaves CM, Duarte JC. Risk factors associated with urinary incontinence in Portugal and the quality of life of affected women. Int J Gynaecol Obstet 2015;131:82-6.
  9. National Institute of Alcohol Abuse and Alcoholism. https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics
  10. Angarita GA, Emadi N, Hodges S, Morgan PT. Sleep abnormalities associated with alcohol, cannabis, cocaine, and opiate use: a comprehensive review. Addict Sci Clin Pract 2016;11:9.
  11. Bode C, Bode JC. Alcohol’s role in gastrointestinal tract disorders. Alcohol Health Res World 1997;21:76-83.
  12. Traversy G, Chaput JP. Alcohol Consumption and Obesity: An Update. Curr Obes Rep 2015;4:122-30.
  13. National Center for Statistics and Analysis. (2015, November). 2014 Crash Data Key Findings (Traffic Safety Facts Crash Stats. Report No. DOT HS 812 219). Washington, DC: National Highway Traffic Safety Administration. Available at: http://www-nrd.nhtsa.dot.gov/Pubs/812219.pdf
  14. CDC. http://www.cdc.gov/chronicdisease/resources/publications/aag/alcohol.htm

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