I was invited to luncheon symposium on communicating alcohol guidelines to consumers while in Washington, DC for my annual food and nutrition conference. The lunch was sponsored by the Distilled Spirits Council* and after the event I reached out to Senior Vice-President of the council and former Division Director at the National Institute on Alcohol Abuse and Alcoholism, Dr. Samir Zakhari, to answer the questions asked by adults over the age of 50.
First, let’s be clear that the Dietary Guidelines for Americans include alcohol and say that if you drink alcohol “it should be consumed in moderation and only by adults of legal drinking age.” So, you are all of legal drinking age, but what does moderation mean? For women, it is up to one drink per day, and for men, up to two drinks per day. Sounds simple but check out the visual of what one drink looks like. And, just as I reminded college students in my teaching days, moderation does not mean saving it all for Friday night. Drinking more than four or five drinks in a couple of hours defines binge drinking, not moderation.
Here are the questions I asked of Dr. Zakhari and his responses may surprise you.
I hear some older adults say they don’t tolerate alcohol as well as they did when they were younger. Are there changes to how we metabolize alcohol as we age?
Yes, aging adults metabolize and eliminate alcohol at a slower rate than younger adults, which leads to higher blood alcohol levels and affects the brain at lower levels of intake. Add to that many older adults take medications that may interact negatively with alcohol. This may result in exaggeration or interference of therapeutic effect of some medications and/or exacerbation of adverse effects of others (e.g., aspirin, Tylenol). Another example is Ranitidine (Zantac) which is used to treat ulcers in the stomach and small intestines. It increases blood alcohol to levels known to impair motor skills needed for driving. Older adults who drink alcohol and who take medications should consult with their doctor or pharmacist to assess their risks and get advice about safe use of alcohol and medications.
Can you explain why moderate drinking is defined as 1 drink/day for women, but 2 drinks a day for men?
Alcohol’s effects are due to blood alcohol concentration (BAC) which is determined by the volume of total body water (TBW) and the amount of alcohol mixed with it. On average, women tend to be smaller than men, with lower body weight and higher proportion of fat to lean body mass. This generally results in a lower TBW in women, and hence a given dose based on per pound of body weight will result in a higher BAC in women than in men. Thus, the lower definition of moderate drinking for women.
Many people think red wine is a “healthy” alcohol choice…can you explain why they think that and what the facts are about alcohol and disease/mortality reduction?
In the early 1990s, a 60-Minutes program segment with the catchphrase “The French Paradox” referred to the notion that despite eating cheese, pastries, and other rich fatty food the French people have relatively low rates of heart disease. Thus, the red wine health halo was born and the day after the story aired red wine sales increased 40%.
A theory has since developed that the potential health benefits of wine is due to a substance called resveratrol. However, resveratrol is quickly eliminated from the intestine and one needs to drink large amounts of wine to attain any appreciable amounts of resveratrol.
However, later research showed that the potential health benefits (e.g., decrease in risk of heart disease or type 2 diabetes) due to moderate drinking of alcoholic beverages (wine, beer, and spirits) is due to alcohol content, not the resveratrol in red wine.
A bottle of beer (12 oz, 5% alcohol), a glass of wine (5 oz, 12% alcohol), or a shot of spirits (1.5 oz, 40% alcohol) contain the same amount of alcohol (0.6 oz, or 14 grams). It is also important to know that beer and wine alcohol content is increasing; some craft beers have up to 6.5% alcohol and the average alcohol of wine is around 13.5%, so it is increasing, too.
I’ve seen supplements of “red wine extract with resveratrol” claiming to do everything from preventing heart disease to life extension. Some older adults who choose not to drink are tempted to take resveratrol supplements; what is your take on it?
Resveratrol is a type of natural phenol that is present in the skin of grapes. After absorption from the intestine its bioavailability is quickly decreased due to extremely rapid metabolism in the liver and excretion in urine. Although it is sold as a dietary supplement, there is no good evidence that consuming resveratrol affects life expectancy or human health.
Many older adults experience “weight creep.” Could alcohol calories contribute to weight gain?
The human body can use energy from proteins and carbs (each produce four calories per gram), fat (one gram has nine calories), and alcohol (one gram provides seven calories). Calories produced from alcohol are termed “empty” calories and most of it is dissipated as heat. Moderate drinking may not contribute much to increased body weight; in fact, some studies show no increase in body weight in women after moderate drinking, but chronic heavy alcohol consumption may result in increased weight. And, we should also consider that many mixes with distilled spirits can be high in calories and that we often snack with our alcoholic beverages. Calories from alcoholic beverages are produced not only from alcohol but also from carbs (approximately 2 grams/glass of wine; 12 grams/bottle of beer, and zero grams from spirits not mixed with calorie containing additives).
As the holiday season is upon us, many hangover cures will be circulating. What causes the symptoms of a hangover and is there really any cure?
Hangover is mainly due to dehydration and sleep interruption due to excessive drinking. Some also say it is due to the presence of “congeners” – chemicals produced in dark drinks but not in distilled spirits. The best cure for hangover is people who choose to drink should drink moderately, with plenty of water and try to sleep longer. Remedies claimed to treat hangover are largely ineffective.
Thanks to Dr. Zakhari for taking time to answer your questions. For more information check out Drink in Moderation from the Distilled Spirits Council and Rethinking Drinking from the National Institute on Alcohol Abuse and Alcoholism.
*I was not asked or compensated to write this post.
For more information on alcohol and many other topics of interest to those of us over 50, check out Food & Fitness After 50, available at Amazon and other book sellers.