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You booze, you lose?

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Robin

Hi everyone –

The holiday season is in full swing, and I have events almost every night of the week leading up to the holiday break, and then again through New Year’s. Booze, as I’m sure you can relate, is everywhere. Despite recent news indicating that the share of Americans who choose to drink is declining and the general cultural norming of non-alcoholic alternatives—such as more restaurants reliably serving mocktails and low ABV options—from my vantage point, alcohol’s central place in our social lives hasn’t budged.

I’m often asked if any alcohol is okay, how often it’s okay to drink, what to drink if you’re going to drink, and how to supplement around alcohol use. So, I’ll attempt to answer these questions here.

For the record, I am not recommending consuming alcohol: The data on alcohol’s health impact is too clearly negative to recommend it. The potential benefits are too few and too hard to prove to outweigh the associated risks.

But I’m also a realist. Given that the majority of our tens of thousands of Parsley patients drink alcohol on some level, I want to help people make smarter, healthier choices that work for them—and for you too.

The Research

The hard truth is that the toxic effects of alcohol are well-established, and no amount of alcohol has been deemed “safe.” Alcohol is a known carcinogen, increasing the risk of breast, liver, GI, and most other cancers. It also increases dementia risk, damages the gut lining, disrupts a healthy microbiome, affects sleep quality, causes blood sugar imbalances, and suppresses the immune system. Even light or moderate alcohol use triggers depression and anxiety. Furthermore, as many as 30 million Americans have a clinically unsafe relationship with alcohol, leading to motor vehicle and firearm deaths, as well as other social and professional problems.

Most research on alcohol focuses on its known toxicity with moderate, heavy, or abusive intake. To date, research on the potential health benefits of low alcohol intake has mostly been observational, limited in their ability to factor out other health conditions, nutrition status, lifestyle, and genetics. Conducting higher-quality randomized control trials is challenging due to the known toxic effects of alcohol—it’s ethically problematic to encourage regular drinking.

A recent highly-covered study published in JAMA of over 300,000 people over 10 years attempted to reduce some observational trial noise using a research method called Mendelian randomization. This study found that even among light drinkers, every one drink per day increased the odds of high blood pressure by 30% and cardiovascular disease by 70%. The impact of more alcohol isn’t just linear—it’s exponential. For moderate drinkers, odds of high blood pressure and heart disease increased by 70% and 80%, respectively. For abusive drinkers, these odds skyrocketed by 160% and 470%, respectively. Conversely, reducing alcohol consumption exponentially improves heart health, contradicting the historically repeated notion that some alcohol is good for the heart.

So, What Do You Do Now?

How do you use this information to make decisions about what and how much to drink, if, like me, you recognize that alcohol is a toxin contributing to various health risks, but you do not suffer from alcohol addiction or alcohol abuse disorder, and you genuinely enjoy a glass of wine or a cocktail once in a while?

Step One: Assess your physical health status and risks

If you already suffer from health conditions like cancer, diabetes, heart disease, high blood pressure, or any other chronic condition, alcohol will exacerbate these issues. It’s advisable to avoid alcohol as much as possible. Additionally, consider your family history of cancer, heart disease, and stroke, as alcohol can interact with genetics to heighten these risks.

Step Two: Assess your mental health

Do you have depression, anxiety, or insomnia? Alcohol will worsen these conditions. For instance, the sleep impact I experience from even a glass of wine after 7 pm isn’t usually worth it for me.

Step Three: Assess your lifestyle and environmental exposure risks

Do you smoke? Follow a highly processed, high-sugar, low-nutrient-density diet? Are you sedentary or exposed to a highly polluted environment? These factors pose health risks, and combining them with alcohol increases the likelihood of diseases you’d want to avoid.

People are often surprised when I link these factors to alcohol, but the body can handle and recover from minor toxic injuries here and there, whether from sugar, air pollution, cleaning product chemicals, or ethanol. However, the chronic burden of these, along with others, leads to physiological overload, where our repair mechanisms struggle to keep up, resulting in disease.

From here, if you are generally healthy and none of the above factors significantly affect you, or if you simply don’t care about health advice and plan to drink socially, here’s what I recommend and practice for myself, as I do drink alcohol on a limited basis:

  • Limit: No more than two occasions/nights per week, and no more than two drinks per occasion.
  • Wine: Opt for natural wine (fully fermented, low to no residual sugar, lower ABV, mostly free from pesticides prevalent in conventional wine production). Our friends at Dry Farm Wines offer great options, and many stores now carry this type of wine. Reminder: most conventional wines contain sugar and pesticides, including many brands served at high-end restaurants and bars.
  • Cocktails: Stick with Mezcal, Vodka, or clear Tequila. Avoid rums, bourbons, whiskeys, and other darker alcohols due to the additional toxins in them. Mix with club soda, water, or have your cocktail neat. Steer clear of fruity or sugary cocktails, as the sugar content can cause inflammation.
  • Avoid beer if possible due to its carbs and gluten content. However, a dry, 0% residual sugar “keto” cider is an alternative.
  • Regularly supplement with methylated B-vitamins (I take 2 of Parsley’s Daily Dose Multi daily), Alpha Lipoic Acid, NAC (N-Acetyl Cysteine is a glutathione precursor, and glutathione is our cells’ most powerful antioxidant), and milk thistle to support detoxification and liver protection. These are basic, tried and true options for antioxidant support. Additionally, consider a high-quality probiotic due to alcohol’s impact on the microbiome or consume more fermented foods.
  • Pair drinking occasions with high-quality hydration support like Endura from Metagenics, which includes glutamine to help heal the gut lining.
  • Swap alcohol for one of the many excellent non-alcoholic beverages on the market, ensuring the one you choose isn’t overloaded with sugar. Personally, I enjoy Kin Euphorics and Amass non-alcoholic vodka.
  • Drink early and stop early. Allow your body time to metabolize alcohol before bedtime to achieve the lower resting heart rate and lower core body temperature required for deep sleep, which alcohol often interrupts.
  • Avoid ibuprofen during or soon after drinking, as it exacerbates the impact on your liver and gut lining, which have already experienced a toxic hit.

I hope this note equips you with the information and confidence to have a conversation about alcohol, both with yourself and with those you care about, in a positive and informed way. Wishing you a healthy, happy holiday season!

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