The alcohol conundrum: Is it safe at even low levels of consumption?

Excessive alcohol consumption has long been recognized as an illness that contributes to societal problems like drunken driving and domestic violence, along with a host of physical ailments that are potentially fatal.

Right up until the 21st century, though, there was consensus that moderate alcohol intake did little harm, and might even have had some health benefits. Red wine, in particular, was found to contain antioxidants like resveratrol that may lower blood pressure and polyphenols, which may improve blood flow to the heart.

That was then, and this is now.

Increasingly, research is finding that the risks of even moderate alcohol intake outweigh its benefits. Alcohol consumption is a risk factor for several types of cancer, including breast, colorectal and oral cavity cancers. According to the National Cancer Institute (NCI), moderate drinkers have a 1.23-fold higher risk of alcohol-related cancers.

The World Health Organization (WHO) says that there is no safe level of alcohol consumption, and that even relatively low levels can increase the risk of breast cancer.

And a large British study released just this month found “light” drinking (about an ounce of spirits a day for men and half an ounce for women) was associated with an increase in cancer deaths among older participants. The risk was greater for those who had existing health problems or who lived in low-income areas.

Just as cigarettes were once thought to be healthful and are now known to be dangerous, alcohol is on a trajectory to becoming another health pariah. Dr. Victoria Amesbury, an internist in Deerfield who has been practicing for 36 years, would be OK with that.

“One of the amazing things I run into all the time is well-educated women who drink,” she says. “There are studies that indicate even two drinks a week is toxic, and that it is now thought there is a definite connection between alcohol and breast cancer.

“But when I tell a patient to stop drinking, they say all their friends drink and they don't want to be an outcast.”

There’s the rub. Alcohol is so ingrained in our society that it’s hard to imagine life without it. Around the time America was founded, alcohol was actually thought to warm the body and aid digestion. It was used to treat colds and fevers and even given as a sedative during childbirth. During the mid-19th century, alcohol was the main painkiller used in surgery.

Look back at movies from the ’30s and ’40s (I’m thinking particularly of “The Thin Man” series) in which cocktails took center stage, consumed by glamorous people. How could we not fall in love with booze?

Should we all quit drinking cold turkey, particularly women? That’s not likely to happen. Just as everyone hasn’t been persuaded to give up cigarettes, not everyone will be persuaded to stop drinking alcohol, no matter what the research says.

I think the question becomes, “How do you mitigate your risk factors if you choose to continue drinking?”

For her patients who continue to drink, Dr. Amesbury recommends abstaining for three or four consecutive days each week, and then consume only light amounts the other days, no more than five ounces of wine. If you want more to drink, mix the wine with club soda or another mixer.

Another tactic is to take a monthlong “vacation” from drinking a couple of times a year, say a “dry January” and a “dry July.” In those 31 days, research has found, moderate-heavy drinkers can see improvements in insulin resistance, blood pressure, body weight and cancer-related growth factors. It also allows liver cells to recover from alcohol’s toxicity.

Only drinking alcohol during meals, drinking slowly, alternating alcoholic and nonalcoholic beverages (particularly water!) are other measures you can take to mitigate some of the risks associated with alcohol.

There is also the growing trend of “mocktails,” which can mimic favorite alcoholic drinks in flavor without the buzz. Think about mocktail mimosas, Moscow mules or sangria.

There was a time when a nonsmoker was considered weird, and now smokers are relegated to designated areas, or smoking is banned entirely. Maybe a time will come when not drinking is considered the cool thing to do. Until then, do what you can to lower your risk factors.

• Teri (Dreher) Frykenberg is a board-certified patient advocate. A critical care registered nurse for 30+ years, she is founder of NShore Patient Advocates (www.NorthShoreRN.com). Her book, “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” is available on Amazon. She is offering a free phone consultation to Daily Herald readers; email her at teri@northshorern.com.