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Moderate, Heavy and Binge Drinking

Moderate Drinking

According to the Dietary Guidelines for Americans, 2010, moderate drinking is [1-p.31]:

  • For men: 2 drinks per day or 14 drinks per week
  • For women and adults after 65: 1 drink per day or 7 drinks per week

Possible Health Benefits of Moderate Drinking

  • Reduced risk of coronary heart disease, heart attack and heart failure due to increased blood levels of HDL and decreased levels of LDL cholesterol and triglycerides, and decreased blood coagulation and thus clot formation [1-p.31; 3,4]. Drinking up to two drinks per day does not affect the blood pressure [4]. It is still not clear if consuming red wine is more protective to the heart than consuming other alcohol beverages [1].
  • Reduced risk of the hardening of the arteries (atherosclerosis) in the limbs, but only in non-smokers [1,2]. Alcohol dilates arteries, but not enough to significantly increase the blood flow through the already narrowed atherosclerotic arteries in the limbs [5].
  • Reduced risk of obesity [6]diabetes type 2 [1,2] chronic atrophic gastritis caused by H. pylori (in individuals who drink less than four drinks per week) [7]gallstones [1,2]ischemic stroke (caused by a clogged brain artery) [1,2]osteoporosis in women after menopause [8]cognitive decline in old people and death [1]
  • Reduced risk of kidney cancer, lymphoma and thyroid cancer [9]. Long-term wine drinking may somewhat protect against esophageal, stomach and colorectal cancer [10]. The protective effect of polyphenols quercetin, rutin and resveratrol in wine is uncertain, though.
  • The sensitivity for the beneficial effects of moderated alcohol drinking is partly genetically determined [2].

Possible Harms of Moderate Drinking

  • Increased risk of breast cancer [1]. According to one estimation, each gram of alcohol per day increases the risk of breast cancer by 1%, possibly due to increased estrogen levels [1]. Taking 400-600 mg of folate per day might reduce the risk of breast cancer in moderately drinking women [1,2].
  • Progression to heavy drinking, especially in the persons with family history of alcoholism [1]
  • Increased risk of nerve damage (peripheral neuropathy) in diabetics [11]
  • Increase of the blood triglyceride levels in those who already have hypertriglyceridemia [12]
  • Increased risk of reactivation of the inflammatory bowel disease (Crohn’s disease, ulcerative colitis) [12,13]

Heavy or High-Risk Drinking

Heavy or high risk drinking means [1]:

  • For men: 5 drinks or more at a single occasion or 15 drinks or more per week
  • For women and adults after 65: 4 drinks or more at a single occasion or eight drinks or more per week. Women and adults after 65 tend to have less body water than men before 65, so they may achieve certain blood alcohol concentrations after fewer drinks than men before 65.

Binge Drinking

According to the National Institute on Alcohol Abuse and Alcoholism in the U.S., binge drinking is drinking that brings the blood alcohol concentration (BAC) to 0.08% (g/100 ml blood) or above [14], which may result, for example, from 3 drinks in an hour by a 140 lbs (65 kg) woman or 4 drinks in an hour by a 160 lbs (73 kg) man [15].

Dangers of Binge Drinking

  • Increased risk of irregular heart rhythm (arrhythmia) [16]. Heart rhythm disturbances after the weekend drinking are known as “holiday heart syndrome” [1].
  • Sudden increase of blood pressure [17]
  • Chest pain (in individuals with heart-related chest pain) due to a coronary artery spasm several hours after consumption (often in the morning) [21]
  • Increased risk of sudden cardiac death [18]
  • Hypoglycemia or alcoholic ketoacidosis, especially in individuals who have not eaten for few days, or in diabetics taking insulin or glucose-lowering drugs [11,19]
  • Adolescent who engage in binge drinking are at increased risk to become alcoholics [20].
  • Binge alcohol drinking inhibits the synthesis of proteins and may thus reduce the muscle-growing (anabolic) effect of protein intake and exercise [16].
  1. Dietary Guidelines for Americans, 2010
  2. Alcohol: Balancing Risks and Benefits  Harvard T.H. Chan
  3. Hein HO et al, 1997, Alcohol consumption, S-LDL-cholesterol and risk of ischemic heart disease. 6-year follow-up in The Copenhagen Male Study  PubMed
  4. Spaak J et al, 2008, Dose-related effects of red wine and alcohol on hemodynamics, sympathetic nerve activity, and arterial diameter  PubMed
  5. Gillespie JA, 1967, Vasodilator Properties of Alcohol  PubMed Central
  6. Arif AA et al, 2005, Patterns of alcohol drinking and its association with obesity: data from the third national health and nutrition examination survey, 1988–1994  PubMed Central
  7. Gao GL, 2009, Alcohol consumption and chronic atrophic gastritis: population-based study among 9,444 older adults from Germany  PubMed
  8. Sampson HW, 1998, Alcohol’s Harmful Effects on Bone  National Institute on Alcohol Abuse and Alcoholism
  9. Lee JE et al, 2007, Alcohol intake and renal cell cancer in a pooled analysis of 12 prospective studies  PubMed
  10. Stockley CS, 2003, Recent research about alcohol and colorectal cancer  Aim-digest.com
  11. Emanuele NV, 1998, Consequences of Alcohol Use in Diabetes  National Institute on Alcohol Abuse and Alcoholism
  12. Ginsberg H et al, Moderate Ethanol Ingestion and Plasma Triglyceride Levels: A Study in Normal and Hypertriglyceridemic Persons  Annals of Internal Medicine
  13. Swanson GR et al, 2011, Is moderate red wine consumption safe in inactive inflammatory bowel disease?  PubMed
  14. NIAAA Newsletter, December, 2004  National Institute on Alcohol Abuse and Alcoholism
  15. 2003, Alcohol Problems in Intimate Relationships: Identification and Intervention  National Institute on Alcohol Abuse and Alcoholism
  16. Budzikowski AS, Holiday Heart Syndrome  Emedicine
  17. High blood pressure (hypertension)  Mayo Clinic
  18. Panos RJ et al, 1988, Sudden death associated with alcohol consumption  PubMed
  19. Alcohol ketoacidosis  Emedicine
  20. Crabbe JC et al, 2011, Preclinical studies of alcohol binge drinking  PubMed
  21. Matsuguchi T et al, 1984, Provocation of variant angina by alcohol ingestion  PubMed

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