A definite fault of mine is an inability to down tools. My life is too fast paced, and there’s always something on the go. I seem to cycle through periods of time getting increasingly busy, that are punctuated by much needed holidays. It is in these holidays that I reflect on how I need to change something to reduce the busyness of the periods at work, yet somehow, once back at work, the whole cycle seems to have a habit of just beginning again. Part of the issue may be that there is no-one to do any of my work whilst away, so like all doctors, coming back to work is a headache. The sheer volume of admin that builds up is frightening! That is for another day however, for the next week I am in the French countryside, in an airbnb, with no sound apart from the cicadas and my keys tapping on the keyboard. The kids have got their noses stuck in books, my wife is having a day-time snooze, and the only decision I need to make is which bottle of wine to open with dinner.
Alcohol and health, or ill-health, is a very complex subject, but whilst I ponder which claret will go best with by cote de beouf this evening, I’ll give you my summary thoughts. It’s probably a subject worth doing a deep dive on in future weeks, but for now, what’s the top line? Firstly, I don’t think there is any credible overall evidence that alcohol is healthy, but within that statement there are lots of caveats.
But let’s first consider the bad, then the good. We should take it as read that addiction problems are a major issue the world over, leading to untold mental and physical ills. Putting that aside, in ‘modest’ consumption, one of the biggest factors in my view is the empty calories that alcohol contains. A pint of 5% beer may have up to 222 kcal, and a 175 ml glass of 12% wine up to 158 kcal (and I can tell you my claret will be more than 12%!) This can soon add up, and there is no nutritional value. For people looking at losing weight, an honest assessment of alcohol calorie intake can therefore be of value. The detrimental effect on sleep I expect is something most of us have first hand experience. Even if you fall asleep ok, the quality of sleep is reduced, and with it the restorative effect of sleep itself.
On the face of it then, why would anyone drink alcohol? For me, there are a number of reasons, albeit none of them are related to improving my physical health! I love the taste of a good glass of wine with food, and I enjoy the social aspect of sharing a drink with friends and family. On that first point, I have definitely changed my behaviour in the last decade or two. Whereas at medical school, price and volume were arguably most students’ priorities, I now won’t drink unless it’s good quality. I don’t wish to sound snobby by saying that, but I recognise the negative health aspects, and don’t therefore want to waste that on poor quality alcohol! Give me a great glass of claret with my dinner and that’s a trade off I’m prepared to make!
I’ve mentioned red wine a few times, and that is definitely my tipple of choice. There are also some other potential upsides to that choice over other drink options. The skin of grapes (and those making red wine in particular) contains high levels of polyphenols. These useful chemicals enhance our gut microbiome, the diverse population of microbes living in our guts. The fermentation process further increases the polyphenol levels. Studies have shown that red wine drinkers had a healthier gut microbiome than non-drinkers (although non-drinkers fared better than drinkers of other alcohol). It also appears that a small glass of red wine with food reduces the risk of type 2 diabetes.
I’ll be absolutely honest though, I’m pretty sure I’ll have more than a small glass tonight! It was my 47th birthday the other day, but what with all the driving haven’t had a proper chance to celebrate yet. Salut, as the French would say!
In this week’s research video, I discuss a trial looking at the cumulative risk of cholesterol levels in young people. This interesting paper took people aged 18 – 40, and determined what their heart attack and stroke risk was over the next 20 years. It threw up a few interesting questions for me, as it’s not an area where there is a great amount of data, but definitely helped me think about how I might advise my patients in years to come.