Alcohol myths, Part II: Is alcohol good or bad for you? Is tequila the healthiest drink? What about red wine?

In my previous column, I discussed the truth about how alcohol is metabolized (no, it doesn’t “turn into sugar”) and how to fix a hangover (prevention is a reliable strategy, “cures” not so much).

Today’s column reviews some recent research about alcohol’s health benefits — or hazards. And for good measure, let’s discuss which alcoholic brew is the “best” for you.

Healthy or hazardous?

Should you should feel good or bad about drinking a glass of wine daily?  That’s the question that’s foremost in the mind of health policy experts, in light of conflicting research.

Many published studies show that heavy drinking leads to dire health issues, including increased risk for cirrhosis of the liver, cancer, cardiovascular disease, and car crashes (researchers have linked alcohol consumption to more than 60 diseases).

However, a 2017 study published in the Journal of American College of Cardiology found moderate drinking has a protective effect, while heavy or especially binge drinking (more than 5 drinks on a single occasion for men, or 4 for women) is harmful.

What IS “light to moderate” alcohol consumption?  Researchers define it as:

• For men, 14 or fewer drinks weekly
• For women, one a day, or less.
• One drink is one 5-oz. glass of wine, a 12-oz. regular beer, 8 oz. malt liquor, or 1 ½ oz. of distilled spirits.

While the accompanying editorial to this meta-analysis noted that women are advised to not exceed a low level of consumption due to an increased breast cancer risk, researchers advised, “for most older persons, the overall benefit of light drinking, especially the reduced [cardiovascular disease] risk, clearly outweigh possible cancer risk.”

So, is that the final word on alcohol and health? Not yet.

A recent review and systematic meta-analysis shows that, yes, light-to-moderate consumption is associated with a reduced risk of heart disease compared to non-drinking.

However, the authors report some serious design flaws in the 2016 meta-analysis that led to a healthful conclusion about including alcohol regularly.

They note that non-drinkers may have quit because of their history of alcoholism! They may not be drinking because of a pre-existing health issue.

And for those older people who drink regularly, they note that just because they’re healthy they are able to drink without negative consequences, compared to those with health problems and may be taking multiple medications (and therefore abstain).

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Calorie count for selected drinks.

As reported by Fortune.com, Tim Stockwell the director of the Centre for Addictions Research of BC and lead author of the review said, “maintain a healthy skepticism,” and “drink for pleasure, but don’t kid yourself that it’s making you healthier.”

If you don’t drink, don’t start for health reasons. Maintaining a healthy weight, staying active, not smoking, and managing stress are far more likely to make you healthy and keep you that way.

What’s the better brew?

If you do drink, is it better to drink wine, or beer, or distilled spirits?  Do any of them offer more health benefits compared to others? One thing for sure, certain beverages are really hard on the waistline, and some are especially hard on the liver.

By consensus, health experts say that one type of alcohol does not hold any health benefits over another. It’s the amount of alcohol that matters.

As noted in my Part I Alcohol Myths, alcohol is more quickly stored as fat than even excess calories from sugar (carbohydrate), or from protein, or even from fat itself. Fat has nine calories per gram, and protein and carbohydrate each have four calories per gram. Alcohol has seven calories per gram but, unlike foods, which require time for digestion, alcohol is quickly absorbed.

Wine may have some good-for-you compounds. As reported by MayoClinic.org, antioxidants called polyphenols may help protect the lining of the blood vessels in your heart. Many will be familiar with one of the most well known one, resveratrol, but is it the resveratrol in wine that makes it any better than, say, a Budweiser? There’s association, but not causation. Mayo notes that other foods are just as rich in resveratrol, including peanuts, blueberries and cranberries. And resveratrol supplements can pack a punch without the side effects of alcohol too.

How much you drink can undo all the “good” from light-moderate alcohol consumption. A glass of wine means very different things to different pourers. When assessing health benefits, “a glass” means a 5-oz. pour.

More calorie consciousness

Since it’s a known dis-inhibitor, drinking alcohol when trying to lose weight can be counter-indicated.

A 5-oz. glass of dry white wine or red wine has about 120-125 calories respectively, zero fat or cholesterol, a modicum of sodium, about a four grams of carbohydrate, no protein to speak of, but contains about 5% of your vitamin B6 for the day, plus some magnesium, iron, and a bit of calcium too.

A 12-oz. regular beer has 150 calories; a light beer about 110 calories; a dark beer about 160 calories, zero fat or cholesterol. The 12-oz regular has about 14 grams of carbohydrate, just a modicum of sodium and about a gram of protein.

Clear, distilled spirits like vodka, white rum, tequila blanca, or gin may seem like a “cleaner” drink, but they all contain much more ethanol per ounce.

A 1.5 oz. shot of a “clear” liquor like vodka, gin, or rum has about 96 calories; whiskey, scotch, or tequila has about 105 calories.

What does 80 proof mean?  In the U.S., proof is defined as twice the alcohol (ethanol) content by volume. For example, vodka with 40% alcohol is 80-proof.

A 100-proof whiskey contains 50% alcohol.

Congeners (and there are a large variety including tannins and methanol) are byproducts of fermentation in some alcohols. The greatest amounts of these toxins (named as such because they’re the most likely to cause hangovers) are found in red wine, dark beer, and dark liquors such as bourbon, brandy, and whisky.  White wine and clear liquors including rum, vodka and gin have fewer congeners. By the way, tequila does contain congeners too.

Cheap liquors contain more of the stuff that gives you a headache, so if you drink, make the investment in top shelf stuff.

Tequila tales

And have you heard that “real tequila” is a healthier drink? That it has some magic properties that allow you to imbibe without ever having a hangover? That it’s good for your bones?

Well, if it’s “top shelf” it may have fewer congeners. But the other claims? No.

One myth about hangovers began because of a research paper on mice presented at a meeting of the American Chemical Society. When fed agavins, obtained from the Blue Agave plant (real tequila is only made from the Blue Agave plant) mice experienced more stable blood sugars. Another paper by the same researcher found that agavins have a positive effect on bone density — when fed to mice.

But, in the process of fermentation, the agavins (like all carbohydrates including those from grains and potatoes) are converted into ethanol (alcohol) so by the time that brew is bottled these so-called health benefits disappear.

Can you conclude that clear liquors don’t cause hangovers? No, it depends how much you drink, and how fast you drink. That’s where the mixers can make the difference. The sweeter the mixer, the more likely you are to imbibe quickly. A shot of top-shelf tequila contains about 100 calories. A tequila sunrise? With orange juice and Grenadine syrup, about double that.

Mixologists are like artists with a plethora of high-calorie paints. For example, a seven-oz. piña colada – typically made with a sugary mix, has a choking 600 calories!

One frozen Daiquiri or Margarita can run you from 500-700 calories. Those popular chocolate Martinis? A mix of chocolate with vodka boosts calories significantly – up to 450.

Sugary mixers add calories; regular sodas, Coke, tonic, Sprite, all contain sugar. Stick to agua con gas con limón or drink your spirits neat – and drink despacio.

Sources

American Chemical Society. Tequila plant is possible sweetener for diabetics – helps reduce blood sugar, weight. https://www.acs.org/content/acs/en/pressroom/newsreleases/2014/march/tequila-plant-is-possible-sweetener-for-diabetics-helps-reduce-blood-sugar-weight.html

Fortune.com. Is Moderate Drinking Good for Your Health? The Science Is Confusing. http://fortune.com/2017/08/15/moderate-drinking-health/

Harvard Health Blog. The truth about tequila and your bones. https://www.health.harvard.edu/blog/truth-tequila-bones-201605259671

Journal of the American College of Cardiology. Relationship of Alcohol Consumption to All-Cause, Cardiovascular, and Cancer-Related Mortality in U.S. Adults. http://www.onlinejacc.org/content/70/8/913?_ga=2.206602389.740477694.1503926993-1274174174.1503926993&sso=1&sso_redirect_count=1&access_token=

Journal of Studies on Alcohol and Drugs. Do “Moderate” Drinkers Have Reduced Mortality Risk? A systematic review and meta-analysis of alcohol consumption and all-cause mortality. http://www.jsad.com/doi/10.15288/jsad.2016.77.185

WebMD.com. 12 Health Risks of Chronic Heavy Drinking. http://www.webmd.com/mental-health/addiction/features/12-health-risks-of-chronic-heavy-drinking#1