Table of Contents
Alcohol consumption is drinking beer, wine, or distilled spirits such as gin, whiskey, or vodka, that contains ethyl alcohol.
(Illustration by GGS Information Services/Thomson Gale.)
In earlier times, when subsistence agriculture was the norm, alcoholic beverages, usually beer or mead (fermented honey and water), provided a substantial percentage of calories in the diet. Today people drink alcohol to relax and socialize, to get high, or because they are physically addicted to it.
Ethyl alcohol, or ethanol, is produced by yeast fermentation of the natural sugars in plants, such as grapes (wine), hops (beer), sugar cane (rum), agave (tequila), or rice (saki). The process of fermenting plants to produce alcohol is at least 10,000 years old and appears to have developed independently in many cultures
Alcohol affects almost every system of the body. Research suggests that when alcohol is consumed in moderation, there are some health benefits and some health risks. Heavy use of alcohol has no health benefits and many health risks. The federal Dietary Guidelines for Americans 2005. define moderate alcohol consumption as one drink per day for women and two drinks per day for men. This difference by gender is because women tend to be smaller than men, and their bodies contain a lower percentage of water, so an equivalent amount of alcohol in a woman’s bloodstream will be more concentrated than in a man’s. A “drink” according to these guidelines contains about 14 grams of alcohol and is defined as:
- 12 fluid ounces of regular beer
- 5 fluid ounces of wine
- 1.5 fluid ounces of 80 proof distilled spirits
Using this definition, one regular beer contains about 145 calories. One glass of red wine has 105 calories, and white wine has about 100 calories. One shot of distilled spirits has about 95 calories plus any calories in the mixer used mixed drinks.
Benefits of moderate alcohol consumption
Good evidence based on more than 100 studies shows that moderate alcohol consumption can help prevent heart attack, sudden cardiac death, peripheral vascular disease, and stroke caused by blood clots (ischemic stroke). The risk of these diseases is reduced between 25% and 40% in both men and women. The reduction is seen in both people who have no apparent heart disease and those who are at high risk of heart disease because they have type 2 diabetes, high blood pressure (hypertension), angina (chest pain), or have already had one heart attack. Researchers suggest that this protective effect occurs because alcohol increases the amount of HDL or “good” cholesterol and also affects various proteins in ways that make blood clotting less likely.
In two other large studies, people who were moderate drinkers also were less likely to develop type 2 diabetes and gallstones. Gallstones are hard masses of cholesterol and calcium that form in the gallbladder. Finally, moderate drinking serves a social purpose that can provide psychological benefits.
Risks of moderate alcohol consumption
Moderate alcohol consumption also carries with it some risks. In women, even moderate drinking is associated with a modest increase in the risk of developing breast cancer. However, researchers suggest that taking at least 600 mg of folic acid daily will counteract this increased risk.
Even moderate alcohol consumption by a pregnant woman can damage the developing fetus. Alcohol consumption can also alter sleep patterns and interact with many medications (see Interactions below). However, by far the greatest risk of moderate
drinking is that for some people it will lead to heavy alcohol consumption, alcohol abuse, and alcohol dependency. Twin and family studies indicated that there is an inherited tendency for some individuals to develop alcohol abuse disorders.
Risks of heavy alcohol consumption
Heavy alcohol consumption is defined for men as consuming 15 or more alcoholic drinks per week and for women as consuming 8 or more drinks per week. Between moderate and heavy alcohol consumption is a gray area of potentially problem drinking that includes binge drinking.
Binge drinking is heavy alcohol consumption that occurs intermittently. Bingeing for men means consuming 5 or more drinks in a period of about twohours. For women, it is consuming 4 or more drinks in the same time period. About 60% of men ages 18–25 binge drink.
Heavy alcohol consumption leads to two alcohol abuse disorders that are recognized in the Diagnostic and Statistical Manual for Mental Disorders Fourth Edition (DSM-IV-TR) published by the American Psychiatric Association. More men abuse alcohol than women, and these men begin drinking at an earlier age than women.
Alcohol dependence is diagnosed when one or more of the following occur within a 12-month period.
- Repeated alcohol use causes failure to fulfill obligations at work, home, or school.
- The individual repeatedly performs hazardous activities such as driving or operating machinery while under the influence of alcohol.
- Alcohol use causes legal problems.
- Alcohol use continues despite problems it causes in relationships.
- These symptoms do not rise to the level of alcohol dependence.
Alcohol abuse, or alcoholism, is diagnosed when three or more of the following occur within a 12- month period
- Tolerance to the effects of alcohol develops.
- Stopping drinking causes, or would cause, physical symptoms of withdrawal.
- More alcohol is regularly drunk than is intended.
- Efforts to reduce alcohol consumption are unsuccessful.
- Getting alcohol, drinking, and recovering from drinking alcohol consumes a great deal of time.
- Work, social, and recreational activities are replaced by drinking or recovering from drinking.
- Alcohol use continues despite its causing obvious physical and/or psychological problems.
On any given day, about 7% of Americans, or more than 17 million people, are alcohol dependent or have alcoholism. Costs related to alcohol disorders are estimated to be more than $185 billion annually. Alcohol disorders are related to increased rates of motor vehicle deaths, homicides, suicides, and domestic violence. About 34% of Americans never drink alcohol.
Some people who should never drink alcohol. These include:
- children and adolescents under age 21
- women who are pregnant, breastfeeding, or who could become pregnant
- people who cannot control their drinking and keep it at the level of moderate consumption
- people who plan to drive, fly a plane, operate dangerous equipment, act as a lifeguard, or perform any activity that requires quick reactions, good judgment, and coordination
- people who are unable to control their aggression when they drink
- people taking certain medications (see below)
- people with liver or kidney damage
- people who are recovering from alcoholism
Alcohol is a central nervous system depressant. More than 150 drugs interact with alcohol. Some of these interactions can be fatal, especially those that involve narcotic drugs that also depress the central nervous system. Categories of drugs that interact with alcohol include:
- narcotic drugs
- sleeping pills
- anti-anxiety medications
The best-known treatment for alcohol abuse disorders is the 12-step program of Alcoholics Anonymous. This program uses social support, rewards, and mentoring to change behavior. For it to succeed, the person with alcoholism must want to recover and must be willing to work at achieving sobriety. Relapses are common. Families of alcoholics may be helped by Al-Non and teens by Alateen, whether or not their family member with alcoholism participates in Alcoholics Anonymous.
The United States Food and Drug Administration (FDA) approved three medications for the treatment of alcoholism. Disulfiram (Antabuse) makes the individual feel ill after drinking alcohol. Naltrexone (Depade, ReVia) act on the brain to reduce the craving for alcohol, and acamprosate (Canpral) reduces withdrawal symptoms. These medications are more effective with some people than others.
Complications of moderate and heavy alcohol abuse are listed above. In addition to physical complications, alcohol consumption can take an emotional and psychological toll on relationships and families, especially on children who have a parent with alcoholism.
Alcohol consumption by adolescents substantially increases their risk of being in both fatal and nonfatal motor vehicle accidents. It also increases the chance of participating in risky sexual behavior, failing or dropping out of school, committing suicide, and being a homicide victim. Children who begin to drink before age 15 are four times more likely to develop alcoholism than people who begin drinking at age 21.
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Tish Davidson, A.M.