By Linda Illingworth, RDN
US Dietary Guidelines
Every five years the USDA reviews our nation’s dietary trends and current research on health and nutrition. The 2020-2025 Dietary Guidelines are in progress and the Advisory Committee has included new advice on the consumption of alcohol for men.
Past dietary guidance has recommended alcohol consumption not exceed 2 drinks per day for men and 1 drink per day for women, and has been generally stated as 10-14 drinks/week for men and 7 drinks per week for women. The new guideline for men is a significant departure from this. The Dietary Guideline Advisory Committee states that consuming the current limit of two drinks per day is associated with a “modest but meaningful increase” in death rates due to all causes, compared with just one drink per day. Many factors contribute to the mortality rate associated with alcohol. The lowest risk of all cause mortality from alcohol consumption is 1-1.5 drinks/day for men and 0.5 drinks/day for women. Since it is impractical to recommend a fraction of a drink per day, the committee recommends women limit alcohol to ‘1 drink per day but not every day’. If you don’t currently drink, there is no evidence indicating it will improve your health to start drinking. However, if you do consume alcohol, there is ample evidence that limiting your intake is best for your health.
The science behind the new guidance.
Emerging evidence suggests the magnitude of risk associated with drinking smaller amounts of alcohol may have been underestimated in the past. Men are more likely to drink than women and experience more alcohol-related health issues and accidents compared to women. Greater understanding of the association of alcohol consumption with at least 7 types of cancers, and that cancer mortality is now equal to that of cardiovascular disease, the #1 killer of Americans. Alcohol is also one of the more challenging food components we consume. We hear that alcohol can be good for us and increase our longevity like the centenarians living in Blue Zones. Yet, alcoholic beverages still remain a toxin at their core despite the vitamins and antioxidants they might contain.
Current Recommendations
The dietary guidelines for alcohol consumption recommend that alcohol should not contribute more than 10% of your total calories each day. Not only does this curtail a host of medical problems, it helps prevent alcohol from replacing nutrient dense foods that would provide vitamins, minerals, antioxidants, fiber and other macro nutrients. Most of the calories contained in alcohol are in the form of ethanol and residual carbohydrate that did not ferment. Since the body cannot store ethanol this makes alcohol the first fuel burned by the body to meet energy needs. Any calories consumed in excess will be burned later, putting them at greater risk for being stored as fat.
What makes alcohol so tricky nutritionally is not as obvious as the calories. Alcohol is a behavioral dis-inhibitor. Disinhibition is a lack of restraint and shows up as impulsivity and poor risk assessment. It affects our cognitive and perceptual skills, as well as motor, instinctual, and emotional skills. This means that alcohol can influence your decisions when choosing a meal, whether to have dessert, another glass of wine or both. This impairment is easier to understand in the context of a party or bar where people are speaking louder and laughing more freely over the course of a drink or two.
Alcohol is also an appetite stimulant. Cocktail hours are sometimes available at assisted living facilities to help stimulate waning appetites and lift spirits. Restaurants increase profits by taking your beverage order before asking about your main meal. Combining impaired decision making and appetite stimulation is a green light for overindulging. If you struggle at meal times with over-eating, or wonder why you can’t stick to a healthy food choice, it could be due to an increased appetite and lack of restraint caused by alcohol consumption.
Learning to better manage imbibing can have a big impact on your health. Alcohol affects not only your weight but can ramp up your cholesterol and blood sugar as well. And by no means are we suggesting you begin drinking. If you don’t currently drink, there is no evidence that adding alcohol will improve your health. For those with addictions, abstinence is paramount to a healthy life.
Tips for reducing alcohol consumption.
Dining out:
Order a non-alcoholic beverage FIRST! Wait to order alcohol when your soup or salad arrives. If you are only having an entrée, ask that your alcoholic beverage be served with your meal or order your beverage when your entree arrives.
Define drinking days:
Limit alcohol consumption to a few days a week. Avoid daily drinking to give your liver time to recoup and make less cholesterol. Daily drinking can create insulin resistance and permanently raise blood sugar. Enjoy your beer, wine, or cocktail then toss the bottle or put the glass out of sight. The smell and sight can leave you wanting more.
Replace alcohol with kombucha.
Kombucha contains 1/2 as many calories and should only contain trace amounts of alcohol, if any.
Alternate alcoholic beverages with water, sparkling water or iced tea.
This helps curtail the dehydrating effects of alcohol and replaces alcohol with calorie free alternatives.
BYOAFB—Bring your own alcohol-free beverage to gatherings.
Take kombucha, sparkling waters, or flavored tea to parties and have them on hand for guests when hosting. You’ll be more likely to have one too.
Sticking to the new guidelines.
If you currently toss back more than one drink a day, it’s best to make a plan. Some simple structure around eating and drinking can make a big difference in feeling satisfied versus feeling deprived. Even your attitude can play a role. Think of cutting back or eliminating alcohol as adding other aspects to your life rather than taking away from it. If you find it too difficult to cut back, that can be a sign you need to talk to someone about it. We are always here for you to discuss any aspect of your health including alcohol consumption. Give us a call and we can help with reassurance, referral to recovery specialists, and therapists.For more information on alcohol and nutrition, you can find the entire draft of the Scientific Report of the 2020 Dietary Guidelines Advisory Committee here. You can jump to Chapter 11 which addresses alcohol exclusively.
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