Alcohol: How much is too much?

In my previous company, we used to discuss a lot of nutrition-related issues during the lunch-time. One of them was alcohol. Some of us justified social drinking, saying moderate consumption is not harmful at all and some, including meJ, discouraged its consumption saying that it has too many negative impacts on health. But we never reached any consensus.


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Just a few days ago, when a friend of mine asked me about the safe level of ethanol consumption, I started off by saying, “there is no optimal amount of ethanol!". Then I remembered our never-ending debate during the lunch-time and realized that this one-line answer will not be sufficient. So, here is my answer…
 

Definitely, there is no safe limit for consuming alcohol. Alcohol, as a beverage, has no nutritional advantage. It provides just empty calories (7 kcal/g) contributing to obesity. Excessive drinking suppresses appetite and interferes with absorption and metabolism of nutrients, leading to various nutritional-deficiency diseases. It has many adverse effects on health. It affects various organ systems like brain, heart, liver and stomach; it leads to cancer and affects the immune system as well. Adverse effects of excessive alcohol consumption are well known and everybody, including those who drink it, admits it.

But the curious part is about moderate or low alcohol consumption. What happens if a person drinks in low or moderate amounts? I liked the answer given by National Health and Medical Research Council of Australian government. It says ‘There is no level of drinking alcohol that can be guaranteed to be completely ’safe’ or ‘no risk’. Rather guidelines set out advice on the level of drinking alcohol that will enable healthy adults to keep their risk of alcohol-related accidents, injuries, diseases and death low both in the short and long term.’ The problem with alcohol is its addictive nature. About 10 to 15% of alcohol users develop alcohol dependence and become alcoholics.

So, Indian guidelines are very simple. ‘Avoid Alcohol. Those who drink should limit its intake.’ Maybe, it is thought that allowing a certain amount may act as an indirect way of promoting alcohol consumption. Unfortunately, it does not solve our problem. Many corporate meetings, business deals or parties are not complete without alcohol. Just saying ‘Avoid alcohol’ doesn’t stop people from drinking it. Hence, though it is not advisable to have it, those who still drink should at least know where to stop.

Unlike India, many other countries, where alcohol is a part of their culture, have defined moderate drinking or low risk drinking guidelines. So when we don’t have the definite guidelines, we go to WHO (World Health Organization) to seek help. WHO has given low-risk responsible drinking guidelines as follows. (Remember, these are low-risk guidelines.)

1.       Women should not drink more than two drinks a day on average.

2.       For men, not more than three drinks a day on average.

3.       Try not to exceed four drinks on any one occasion.

4.      Don’t drink alcohol in some situations, such as when driving, if pregnant or in certain work situations.

5.       Abstain from drinking at least once a week.

Men or women who consistently drink more than these recommended levels may increase the risk to their health.

There is no consensus, internationally, on a single standard drink size. It varies from 8 g to 14 g of pure ethanol. So to be on safer side, we can assume a standard drink size of 8g. Another reason for considering a lower level of ethanol is our genetics. Indian may have low tolerance towards alcohol consumption. INTERHEART study (A Global Case-Control Study of Risk Factors for Acute Myocardial Infarction, carried out in 52 countries) demonstrated that alcohol consumption (>1 drink per week) has no beneficial effect in the South Asian population and may actually have a harmful effect in Asian Indians in terms of heart disease risk. This was not the case with other populations. The result might be due to difference in pattern of drinking or type of drinking. It was not investigated further in the study.

Some studies show beneficial effect on heart from moderate alcohol consumption in certain populations. Unfortunately, we are not one of them. However, yet no public health guidelines support alcohol consumption on those bases.

The strengths of different types of alcoholic beverage vary significantly; beer contains 2-5% and wine 8-10% of alcohol; while brandy, rum and whisky contain much higher concentrations (30-40%). Check alcohol content before you consume.

So, to summarize, avoid alcohol. Those who do not drink please don’t start; it’s really not good for health. It is not advisable to drink alcohol. Those who drink should drink responsibly by following low-risk guidelines given by WHO.

No more than 24 g/day of ethanol on average for men, no more than 16 g/day for women and no more than 32g of ethanol on any single occasion. Binge drinking is equally harmful. Don't drink at least once a week.

Something you should know about tea!

For most of us, it is difficult to start the day without a steaming cup of tea. As our nutri-poll suggested, more than 60 % of voters think of tea as a healthy beverage, and why not? When consumed in moderation, tea may prove as a healthy beverage. Tea, especially green tea, is a very good source of antioxidants; however, the amount of antioxidants depends upon the type of tea and preparation method. The highest concentration of flavonoids is found in brewed hot tea, less in instant preparations and still lower amounts in iced and ready-to-drink tea. Drinking tea may help in reducing the risk of heart disease and certain forms of cancer. Though, not conclusive, but limited research shows beneficial impact of tea on bone density, cognitive function and dental caries. So, let’s make our tea consumption healthier by following certain tips!

1.      Green is better than black!

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Tea is a good source of polyphenolic compounds commonly known as catechins. These compounds are strong antioxidants, which are responsible for many health benefits including reducing the risk of heart disease and cancer.

Green tea is manufactured by drying fresh tea leaves. A typical cup of green tea beverage contains 30–42% catechins. Whereas production of black tea involves crushing tea leaves, which destroys some amount of catechins. Hence brewed black tea has only 3-10 % of catechins. Thus drinking green tea is a healthier option than drinking black tea.
 

2.      Drinking tea one hour before and after meals is not advisable.

Tannin present in tea is known to interfere in absorption of iron from vegetarian sources. Research has shown that black tea can reduce the absorption of iron by 79%-94% when consumed with vegetarian meal. Iron deficiency, i.e. anemia, is a very prevalent problem in India. Thus it is better to avoid drinking tea along with food that is rich in iron, or at least for one hour before and after meals, to ensure optimum iron absorption.
 

3.      Drinking more than 3 cups of tea in a day... Not good!

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A cup (150ml) of tea contains 30 to 65 mg of caffeine. When consumed in lower doses (i.e. 20-200 mg), caffeine makes you energetic, alert and gives a feeling of positivity. That is the exact reason we crave for a cup of strong tea on a dull day. However, if more than 200 mg of caffeine is consumed in a day, it may produce certain negative effects such as nervousness and anxiety. Thus, prefer decaffeinated tea if available in your grocery store.
 

       4.      Watch the sugar content!

Excessive tea consumption can contribute significant amount of calories. Generally we tend to drink tea with addition of milk and sugar. Addition of sugar can add significant calories to our diet. Drinking 5 cups of tea in a day can easily finish your daily sugar quota. However, you can have tea without adding sugar or along with non-nutritive sweeteners.
 

5.      Tea is better without milk!

Though not confirmed, it is observed that tea polyphenols bind with milk protein and hence, may interfere with protein absorption. Milk fat may affect the antioxidant properties of the tea. Also the addition of milk dilutes flavonoid content of tea per serving. It is better to have tea without addition of milk.