alcohol | U.S. Preventive Medicine, Inc. (USPM)

We know nutrition and exercise are ways to improve our health, but it’s also important to discuss alcohol consumption and the impact of excessive alcohol use on our health. Drinking excessively is harmful, but it can be controlled and prevented. According to the Centers for Disease Control and Prevention (CDC), excessive alcohol use leads to about 88,000 deaths in the U.S. each year and shortens the life of those who die by almost 30 years.¹

What’s considered a ‘drink’?

12 ounces of beer (5% alcohol by volume)
8 ounces of malt liquor (7% alcohol by volume)
5 ounces of wine (12% alcohol by volume)
1.5 ounces of distilled spirits such as vodka, whiskey, gin, etc. (40% alcohol by volume)

Do you know the signs of excessive alcohol use?

Binge drinking is the most common, costly, and deadly pattern of excessive alcohol use in the U.S. The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as a pattern of drinking that brings a person’s blood alcohol concentration (BAC) to 0.08 grams percent or above. This typically happens when men consume 5 or more drinks or women consume 4 or more drinks in about 2 hours. Most people who binge drink are not alcohol dependent.²

Source: CDC¹

Who binge drinks?

One in six U.S. adults binge drinks about four times a month, consuming about eight drinks per binge.
Binge drinking is most common among younger adults aged 18–34 years old.
The prevalence of binge drinking among men is twice the prevalence among women.²

The Cost of Excessive Alcohol Use

Excessive drinking cost the American economy $249 billion in 2010:

Workplace productivity: $179 billion (72%)
Healthcare: $28 billion (11%)
Criminal Justice: $25 billion (10%)
Collisions: $13 billion (5%)³

Binge drinkers account for most of the cost at $191 billion (77% of the total cost). For more details, visit the CDC.

Short-Term Health Risks

Excessive alcohol use has immediate effects that increase the risk of many harmful health conditions. These are most often the result of binge drinking and include the following:

Injuries, such as motor vehicle crashes, falls, drownings, and burns.
Violence, including homicide, suicide, sexual assault, and intimate partner violence.
Alcohol poisoning, a medical emergency that results from high blood alcohol levels.
Risky sexual behaviors, including unprotected sex or sex with multiple partners. These behaviors can result in unintended pregnancy or sexually transmitted diseases, including HIV.
Miscarriage and stillbirth or fetal alcohol spectrum disorders (FASDs) among pregnant women.⁴

Long-Term Health Risks

Over time, excessive alcohol use can lead to the development of chronic diseases and other serious problems including:

High blood pressure, heart disease, stroke, liver disease, and digestive problems.
Cancer of the breast, mouth, throat, esophagus, liver, and colon.
Learning and memory problems, including dementia and poor school performance.
Mental health problems, including depression and anxiety.
Social problems, including lost productivity, family problems, and unemployment.
Alcohol dependence, or alcoholism.⁴

By not drinking too much, you can reduce the risk of these short- and long-term health risks.

Life-Threatening Signs of Alcohol Poisoning Include:

Inability to wake up
Vomiting
Slow breathing (fewer than 8 breaths per minute)
Irregular breathing (10 seconds or more between breaths)
Seizures
Hypothermia (low body temperature), bluish skin color, paleness⁵

Alcohol Poisoning Deaths

According to the CDC, most people who die of alcohol poisoning are non-Hispanic whites (68%). Additionally, 76% of deaths are men and 24% are women. Alcohol poisoning deaths vary by state and are most common among middle aged adults.⁵

Image Source: CDC⁵

What is Moderate Drinking?

The Dietary Guidelines for Americans defines moderate drinking as up to 1 drink per day for women and up to 2 drinks per day for men. In addition, the Dietary Guidelines do not recommend that individuals who do not drink alcohol start drinking for any reason.

However, there are some people who should not drink any alcohol, including those who are:

Younger than age 21.
Pregnant or may be pregnant.
Driving, planning to drive, or participating in other activities requiring skill, coordination, and alertness.
Taking certain prescription or over-the-counter medications that can interact with alcohol.
Suffering from certain medical conditions.
Recovering from alcoholism or are unable to control the amount they drink.

By adhering to the Dietary Guidelines, you can reduce the risk of harm to yourself or others.

Alcohol Use Disorders

Alcohol use disorder is when your drinking causes serious problems in your life, yet you keep drinking. You may also need more and more alcohol to feel drunk. Stopping suddenly may cause withdrawal symptoms.

You may have an alcohol use disorder if you:

Have little or no control over the amount you drink, when you drink, or how often you drink.
Tried to limit or stop your drinking but found you could not.
Had withdrawal symptoms when you tried to stop drinking. (These symptoms include tremors, anxiety, irritability, racing heart, nausea, sweating, trouble sleeping, and seizures.)
Have put yourself in a dangerous situation (such as driving, swimming, and unsafe sex) on one or more occasions while drinking.
Have become tolerant to the effects of drinking and require more alcohol to become intoxicated.
Have continued to drink despite having memory blackouts after drinking or having frequent hangovers that cause you to miss work and other normal activities.
Have continued to drink despite having a medical condition that you know is worsened by alcohol consumption.
Have continued to drink despite knowing it is causing problems at home, school, or work.
Start your drinking early in the day.⁶

Screening Tests

There are many screening tests that doctors use to check for alcohol use disorders. Some of these tests you can take on your own. The CAGE test is an acronym for the following questions. It asks:

Have you ever felt you should CUT (C) down on your drinking?
Have people ANNOYED (A) you by criticizing your drinking?
Have you ever felt bad or GUILTY (G) about your drinking?
Have you ever had a drink first thing in the morning, to steady your nerves, or to get rid of a hangover (use of alcohol as an EYE-OPENER [E] in the morning)?
If you responded “yes” to at least two of these questions, you may be at risk for alcoholism.⁶

Screening in the Doctor’s Office

Primary care doctors should screen adults for alcohol misuse, according to guidelines from the U.S Preventive Services Task Force (USPSTF). Health care providers can give people identified at risk brief behavioral counseling interventions to help them address their drinking.

Medications for Alcohol Use Disorders

Oral naltrexone (ReVia, generic) and acamprosate (Campral, generic) are effective medications for treating alcohol use disorders, according to a 2014 study in the Journal of the American Medical Association.

Alcoholism Resources

The following organizations are good resources for information on alcoholism:

Alcoholics Anonymous – www.aa.org
Al-Anon/Alateen – www.al-anon.org/home
National Institute on Alcohol Abuse and Alcoholism – www.niaaa.nih.gov/alcohol-health
Substance Abuse and Mental Health Services Administration – www.samhsa.gov

References

Did you know that 96% of all Medicare spending is spent on chronic conditions that have lifestyle health risk factors?¹You have more control over your health than you realize!

Lower Your Risk

Here are a few tips to help lower your risk of most cancers and chronic conditions. Practice these habits to build lasting changes for your health and wellbeing journey.

1. Know Your Numbers

Excess body fat has been shown to increase the risk of the following cancers: colorectal, esophageal, kidney, breast (in postmenopausal women), uterine, stomach, liver, gall bladder, pancreas, ovarian thyroid, meningioma and multiple myeloma. Also, there have been suggested links to prostate cancer, breast cancer in men and non-Hodgkin lymphoma with excess weight.²

Extra fat around your belly may increase health risks more so than having extra fat around your hips and thighs. Getting to and staying at a healthy weight can help lower health risks, including cancers.

A BMI (body mass index) of 18.5 to 24.9 and a waist circumference of less than 40” for men and less than 35” for women will help lower your health risks. Calculate your BMI on the CDC website.

2. Eat Healthy and Exercise

Achieving and maintaining a healthy weight requires both physical activity and a healthy eating plan. Any extra physical activity and healthier food choices can make a difference in improving overall health! Always check with your physician first to confirm that a new exercise or activity will be safe for you.

Avoid packaged, processed and fast foods. If it comes in a package, look for whole food options. Examples include steel cut oats instead of packaged quick oats or homemade soup and salad for lunch. Eliminate the boxed macaroni and cheese and roast a variety of vegetables in the oven instead. For dessert try making a recipe from scratch rather than from a box or better yet choose fresh fruit instead of packaged treats.

3. Sleep Well

Insufficient sleep is linked to an increased risk for Type 2 diabetes and obesity. The light emitted from electronic devices tends to wake up the brain and decrease melatonin production. Our bodies have a great capacity to continually heal and repair cellular damage and most of this occurs at night while we are sleeping.

Turn off all electronics 15 minutes earlier each night. Try reading a book rather than watching TV. Practice meditation, prayer, deep breathing or gentle stretching or yoga to help reduce stress and increase relaxation. Go to bed at the same time each night and rise at the same time each morning, aiming for a minimum of 7 hours of sleep each night.

4. Cut Down or Reduce Alcohol

Alcohol affects every organ in the body. The risk of cancers, along with other health problems can increase with the amount of alcohol consumed. Along with disrupting sleep, alcohol can result in weight gain, elevate blood glucose and increase triglyceride levels in the body. For most women, no more than one drink per day and for most men, no more than two drinks per day is recommended.³

Rather than meeting a friend for a drink, skip the alcohol and go for a walk together. If you typically have two glasses of wine with dinner, have only one. If you decide to have more than one alcoholic beverage at a sitting, sip on a full glass of water in between. Instead of alcohol, choose unflavored sparkling/seltzer water, add fresh berries or fruit slices and serve it in your favorite crystal or stem ware. And if alcohol helps you to unwind before bed, try replacing it with gentle stretching or yoga, listen to relaxing music, and enjoy a soothing cup of decaf chai tea.

5. Avoid Tobacco

Lung cancer is the leading cause of cancer death, and cigarette smoking causes almost all cases. “Compared to nonsmokers, current smokers are about 25 times more likely to die from lung cancer. Smoking causes about 80% to 90% of lung cancer deaths. Smoking also causes cancer of the mouth and throat, esophagus, stomach, colon, rectum, liver, pancreas, voicebox (larynx), trachea, bronchus, kidney and renal pelvis, urinary bladder, and cervix, and causes acute myeloid leukemia.”⁴

Visit smokefree.gov to learn how you can quit smoking.

6. Eliminate or Reduce Chemicals

Pesticides, industrial pollutants, cleaning supplies, cosmetics, and medications all contain chemical substances that can increase our risk of cancers and other health problems. The synthetic chemicals within these products can disrupt the normal functioning of our endocrine system resulting in reproductive and immune problems, obesity and increased inflammation throughout the body. Try to minimize or eliminate chemical products in your environment.

The “Dirty Dozen” & “Clean 15”

Use the Dirty Dozen and the Clean 15 produce lists when shopping for fruits and vegetables.

Check the labels on your cosmetics, shampoos, and lotions for parabens, a chemical preservative commonly used in personal care products, that mimics the hormone estrogen and can result in a much stronger effect and more aggressive growth of some cancer cells.
Check out EWG’s Skin Deep website or download the app to find safer options for your favorite products.
Switch out plastic food storage containers for glass. And stop microwaving food in plastic. Pickle and spaghetti sauce jars work great for food storage, without any additional cost.
Break a sweat! Sweating through exercise or sitting in a dry sauna are great ways to remove toxins from the body. Always check with your physician first to confirm that a new exercise or activity is safe for you try.