Updated: Nov 20
When I was in my residency program at Kaiser Permanente in Vallejo, California, every week I sat in rounds where all the disciplines would discuss the patient caseload. One day, I sat in rounds with an amazing physician, who was the quintessential California hippie woman. She had long gray hair, wore the same clothes she had donned for years, and led her team in meditation at the beginning of their meetings. She was probably around her early 70's and there were rumors that she still surfed and played sound bowls for her patients. She had no chip on her shoulder, which can be rare in the medical community. So, this one time in rounds, Dr. California Hippie started talking about a specific patient and mentioned their age. Someone corrected her, saying the patient was actually younger than that. She replied, "Alcohol really ages people." I thought, is that true? I never forgot that comment on that day, 11 years ago. Fast forward to now and I can definitively say I agree. Patients whom consume alcohol regularly are generally aged beyond their chronological years. The quality of their movements tend to be more rigid, they are more stiff, and they often mention multiple joints that are painful because of their diagnosed arthritis. Is this just coincidence?
There is a ton of research out there about how alcohol consumption affects every system in our body and therefore impacts our general health. Our society has been bamboozled by the alcohol industry into thinking that a daily glass of red wine is good for your heart. This statement has never been supported by the research (5). There is also the opinion that there's nothing like a good nightcap to help you sleep but the research has shown the exact opposite (8). Alcohol has plenty of risks with minimal, if any, benefits.
Alcohol has shown to increase risk of cancer (6). In one study, researchers discussed how society is globally unaware of the link between alcohol consumption and the increased risk of breast cancer (7). Most of us are well aware, however, of how alcohol taxes our liver. The risk of liver cirrhosis (scarring of the liver) is significantly higher for women that consume one glass daily whereas for men, the risk increases with more than one glass a day.(4) With our liver performing SO many functions for our bodies, this is alarming!
One interesting fact, that you may not be aware of, is alcohol has as a negative impact on our bones and cartilage. This is where that stiffness and rigidity I started noticing years ago really makes sense. Increased alcohol consumption is associated with increased risk for osteoarthritis. In one study (1), researchers observed that individuals that drank more than roughly 3 glasses of alcohol per day had significantly increased risk of osteoarthritis in the knee. This research article also discussed how in animal studies, alcohol has shown to increase inflammatory factors that affect cartilage. They specifically mentioned these changes in shoulder and knee joints. Another study (2) found that in mice, binge alcohol exposure delayed fracture healing, demonstrated decreased bone mineral density (osteopenia and osteoperotisis!), and decreased strength. No wonder why professional, semi-professional, and college athletes are asked not to partake in drinking during the competitive season. Researchers noted that systemic oxidative stress caused by alcohol could be one of the culprits of all these skeletal changes. This means that multiple systems in our body are insulted by alcohol and so we get delayed or impaired tissue healing and repairing. The understanding of osteoarthritis is expanding beyond the idea of "wear and tear" on the body. Now we are starting to understand that it is also a result of chronic inflammation in our systems. Alcohol is one of the fuels to the inflammation fire.
Let's take this oxidative stress a little further. Oxidative stress has also been shown to decrease the quality of the microbiome in our gut (9). This means other systems that rely on our gut health are compromised, including our immune system. Since the majority of our serotonin is made in our gut (see previous blog post), wouldn't it make sense that we may have feelings of depression and/or anxiety with increased alcohol use? Top that with poor sleep that occurs with drinking and we have one cranky person.
How do we know what amount of boozy beverages is deemed safe to consume? Scientists have yet to determine what is the tipping point of alcohol intake where we start to see an increase in disease states. Research on this is difficult because it can only be studied in retrospect and there are always other factors at play including genetics, comorbidities, medications, age, and sex. The general recommendation is to consume minimally, if at all. To keep us in check at home, we have a guideline that we don't drink alcohol on weekdays. However, I still believe it is important to treat yourself to a special drink! I like to think of it as my reward for the day. There are all sorts of creative ideas for special beverages, including kombucha, shrubs, mocktails, tonic or sparkling water, and tea.
I really appreciate how Dr. Peter Attia, MD talks about alcohol in his podcast and in his book, Outlive (10). He advises that if you choose to still consume, save it for the really special occasions. Thinking about our lives in the long run, wouldn't it be preferable to live with the least amount of disease possible so that we aren't spending our later years truly suffering? The name of the game is keeping inflammation in our bodies low and decreasing alcohol intake is one of our many defenses.
8. "Why We Sleep" by Matthew Walker