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Alcohol: Myths, Metabolism, Diet, and Health Benefits

by Max Wettstein, Copyright 2012 **Not medical advice**

Once again this topic has to be very limited in scope as one could write pages and pages about alcohol and its physiological effects.  Here I’m only going to discuss how alcohol is absorbed and metabolized, and used for energy in the body, (and why it does not make you fat!)  I’m going to dispel a few myths or common misbelieves, mostly pertaining to diet and weight loss, and our health.  I have no intention to discuss the many adverse effects on one’s motor skills from an aviation aspect or otherwise, or get into BAC levels or any kind of legal or ethical discussion.  As pilots who have all been flying for many years and made it this far, I have no doubts we’re all comfortable and responsible when it comes to estimating our BAC and knowing when consuming alcohol is not appropriate or permitted, and when it is not safe to operate a vehicle!  I don’t want to bore you with such repetitiveness or present you with yet even more information bashing alcohol.  In fact much to the contrary, this article will cast a positive light on including moderate amounts of alcohol in your diet.  But this isn’t a result of me just presenting information from selective sources that you want to hear.  This is based on a broad review of many studies and resources, with no spin on my part.     

    Myth: Alcohol makes you fatter.  Excess calories make you fatter, period.  Alcohol has 7 calories per gram and can be used as an energy source by the body just like carbs, protein, and fat can, (4, 4, and 9 calories per gram respectively).  The only catch is that the body must burn the alcohol calories first, before it can move on to the other food you’ve eaten.  However, don’t forget to consider your mixer, or how dark your beer is, as this will add carbs/sugars and additional calories to your alcoholic beverage.  When you order that Margarita or Bloody Mary, you’re drinking a lot more than just alcohol.

** Some of the calories accounted for in this chart for beer and wine are from the additional carbs/sugars they contain.  This is a standard serving, but most of us usually drink more per serving.  Darker beers and micro-brews are higher in calories, from both higher alcohol and carb content.  Dry wine will have as little as 2 grams of sugar per serving**  

    Myth: Alcohol is really a form of sugar/digests into sugar/the body treats alcohol like sugar.  Negative, negative, and negative.  Alcohol is not sugar, nor a form of sugar, and does not digest/break down into sugar.  Alcohol is alcohol!  Therefore alcohol does not raise insulin levels.  Simply described, once consumed alcohol absorbs through the stomach lining and small-intestine directly into your blood stream as alcohol – it does not digest at all.  If food is consumed while drinking alcohol, its absorption rate will be slowed.  Also remember, if your mixer contains sugar or other carbs, then an insulin release will occur.  More on this later, but once in the blood stream alcohol is oxidized, (metabolized), by the liver into an energy source known as acetic acid for the body.

    Myth:  If you drink a lot of beer you will grow a beer belly.  Again, false.  There appears to be no correlation between beer consumption, or any type of alcohol for that matter, and a bulging belly.  A ‘beer belly’ develops from a combination of excess calories, inactivity, and having a genetic predisposition to store fat around your midsection.  Recent studies suggest chronic elevated levels of the hormone Cortisol may also contribute to belly fat.

    Myth:  Alcohol consumption sabotages diet and weight-loss efforts.   Alcohol in itself plays a neutral role in dieting.  There are two things physiologically that matter when considering alcohol while dieting: The additional calories, and the fact that when you consume alcohol with food, your body will metabolize the alcohol for energy first.  Studies of dieters who drink alcohol have shown that those who replace some of their normal carbohydrate intake with the caloric equivalent of alcohol gained no additional weight, and some even lost more weight.  However you must consider that while alcohol is an energy source for the body, it is void of nutrients, has a mild diuretic effect, (dehydrating), and the oxidation byproduct, acetaldehyde, can interfere with the activation of vitamins.  Also, a little alcohol can boost appetite, and psychologically it can loosen inhibitions and discipline causing dieters to give in to temptation and possible junk food binges.  Lastly, don’t forget to consider your mixer, which could be loaded with sugar!

    Myth:  Alcohol is a toxic drug that is harmful to your health.  This will always be subject to controversy because alcohol is a drug and is toxic when abused, particularly to the liver which is the sole organ that provides the enzymes to oxidize alcohol.  However, such a generalization is incorrect because in moderate amounts, alcohol is becoming widely recognized as beneficial to heart health and preventing heart disease, red wine in particular.  The key is moderation, meaning 1 drink per day for women and 1 to 2 drinks per day for men.  Any more then this and the benefits are negated and the potential for harm exists.  Numerous clinical studies now back up this heart health claim, long known by some cultures as seen in Mediterranean fare, so you can do your own research to verify.  What is not widely known and is beginning to show promise is that alcohol may also protect against adult-onset/type-II diabetes.   

    Myth:  Mixing different types of alcohol makes you sick or will cause hangover.  Simply not true.  The body and more specifically the liver, treats the alcohol content the same in all beverages.  It is primarily the toxic byproduct acetaldehyde and dehydration that cause hangover effects if alcohol is abused.  Sulfites found in wine may adversely affect some people, while few others may not produce the liver enzymes necessary to oxidize alcohol.

    Myth:  Alcohol enhances libido.  We certainly wish this one were true.  While a few drinks will loosen one’s inhibitions and ease stress, more than this and testosterone levels will rapidly decline, while estrogen/estradiol levels increase.  Testosterone is the one and only hormone in both men and women that drives libido.

    More on the health benefits of alcohol in moderation: Alcohol is a double-edged sword to be sure.  For those who abuse the risks far outweigh any benefits, and we’re all familiar with the negatives.  But for those of us who care about our health and can drink in moderation, the heart-disease protection associated with a glass a day is just about equal to what the latest generation of cholesterol-lowering drugs offers, lowering risk of heart disease by about 32% when compared to those who abstain.  Specifically, alcohol does this by boosting levels of HDL, (good), cholesterol, which keeps the bad LDL cholesterol in check.  Several studies suggest that alcoholic beverages may even protect against certain forms of cancer.  All these benefits are associated with any type of alcoholic beverage, but the grapes used to make red wine contain even more anti-oxidant benefits in the form of phyto-chemicals called Polyphenols and Flavonoids, which are believed to protect the lining of arteries from damage.  Incidentally, wine drinkers are less likely to be alcoholics than beer or liquor drinkers, and are less likely to be overweight.  This is mostly because wine is typically consumed with meals and it’s usually sipped slowly.  Alcohol also contains a micronutrient called Resveratrol that helps prevent blood clots that might otherwise block blood supply to cardiac muscles, the cause of most heart attacks, and keep blood vessels healthier by combating hardening plaque.  Lastly, several small clinical trials have shown that moderate alcohol consumption improves insulin sensitivity, meaning your cells uptake glucose for energy more efficiently and require less insulin.  This by definition lowers risk of type-II diabetes.  Exercise has this same effect, to a much larger degree.  Again, always keep in mind that all of these health benefits are completely negated as soon as you drink more than one drink a day for a woman and two drinks a day for a man.

    Alcohol metabolism, (oxidation): Once we drink alcohol it is absorbed easily through the stomach lining and the small intestine.  Alcohol then enters the blood stream where it cannot be stored in our bodies and eventually makes its way to the liver where the oxidation process starts, to get rid of it and convert into an energy source.  In general after the consumption of one standard drink, a person’s blood alcohol concentration, (BAC), will peak within 30 to 45 minutes.  Consuming food, especially fat, along with alcohol will slow absorption rate.  Alcohol is metabolized more slowly than it is absorbed.  Approximately 90% of the alcohol we drink is oxidized by the liver while the other 10% is excreted through our lungs and in our urine unaltered, (which is why BAC can be measured through breath.)  Only the liver possesses the enzyme required to metabolize alcohol, known as dehydrogenase, (ADH), enzyme.  How much of this ADH enzyme we make in our liver is primarily genetically determined, but an average healthy liver will completely metabolize 1 standard drink in 2 hours, (BAC equal to zero).  Gender, age, lean-body mass, and health all affect BAC levels, but not so much oxidation rate.  Also if one is taking other drugs, this will place an additional load on the liver.  The liver first converts alcohol, (by ADH enzyme), to acetaldehyde, which plays the central role in toxicity once the liver reaches its saturation point and some of the acetaldehyde escapes into the blood stream before oxidation is complete.  Acetaldehyde exerts its toxic effects by inhibiting the mitochondria reactions and functions in cells, (and along with dehydration is the main cause of hangover).  However as long as alcohol is consumed at a moderate pace and quantity, a normal, healthy liver easily keeps up and further oxidizes the acetaldehyde into acetic acid a common energy source for cells.  CO2 and water is the final byproduct when oxidation is complete.  Over time a moderate drinker will produce more ADH enzyme in their liver, causing them to oxidize alcohol more efficiently and build up an increase in tolerance.   

 Sources:  Too many too list here!    

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