The Festive Season & Alcohol Consumption

Article by Catherine Merry

Christmas is just around the corner, and during the festive season it is often common to indulge in more alcohol than usual. Although this is enjoyable and can be a great way to connect with loved ones, it is important to be mindful of our alcohol consumption and its effects it can have on our health. Reducing your alcohol intake is a great way to improve your overall health, increase energy levels and save money (1). This blog aims to educate about the health effects of alcohol and offers some advice on how to reduce your alcohol intake. Please be informed that the given advice is not appropriate for those who are alcohol dependent, who will need professional help and advice from their GP or other appropriate services. 

How much should we be drinking?

In the UK, it is recommended that both men and women drink no more than 14 units of alcohol a week, and that these units are spread over at least 3 days or more (2). 1 unit of alcohol represents 10ml of pure alcohol within a drink (the amount of alcohol the average person can process in an hour), and the number of units within a drink will be subjective to the size and strength of the drink (2). Alcohol by volume (ABV) refers to the amount of pure alcohol in a drink as a percentage. 14 units of alcohol is equivalent to about 4 large 12% ABV (250) glasses of wine, or 6 pints of 4% ABV alcohol beer (3). Drinking alcohol on a regular basis and over the recommended 14 units a week can be detrimental to both our physical and mental health. There is no level of drinking that is considered ‘safe’ or free of risk, however the recommended 14 units a week spread across 3 days or more is considered ‘low risk’ drinking, meaning the health risks that come with it are minimal (1).  

How does alcohol effect our health?

It is well known within society that excessive alcohol consumption is associated with adverse health effects. The pattern of how an individual drinks such as volume of alcohol consumption or heavy irregular drinking sessions are both associated with increased burden of disease (4). In England, over 10 million people drink alcohol at levels higher than the recommended low risk 14 units spread over a week (18). Harmful use of alcohol contributes to 5.1% of the global burden of disease and can also result in social and economic consequences (4).

Although there is some truth in the fact that low to moderate alcohol consumption can have protective effects on heart health, research has indicated that a healthy diet and regular exercise is far more effective at protecting the heart, and that the other health risks of consuming low to moderate alcohol outweighs the benefits (5).

Regular alcohol consumption is related to several major disease and injury conditions worldwide (6). Too name a few, on a global level alcohol consumption is related to 37% cases of oesophageal cancer, 30% of liver cancer, 23% of epilepsy disorders, 4% of ischemic heart disease, 18% of haemorrhagic stroke, 25% of road traffic accidents and 15% of self-inflicted harm (6). Alcohol consumption is also associated with an increased risk of breast cancer in women, those women who do drink alcohol regularly can reduce their risk of breast cancer by reducing the amount of alcohol they drink (7). In the UK, liver disease is one of the leading causes of death, and alcohol is related to one third of cases of liver disease (8). These are obviously some very shocking statistics, and it is hard to determine how alcohol will affect someone on an individual level, however, drinking within the recommended guidelines of 14 units spread over a week will reduce your risk of alcohol related major disease. 

What effect does alcohol have on our brain & mental health?

Alcohol has many effects on the brain, but one of these is its effect on neurotransmitters. Neurotransmitters help send messages along neurones in the brain, which are responsible for many actions and processes such as sleeping, swallowing, walking, talking, and storing memories (9). Two neurotransmitters that are very important for the brain that are heavily influenced by alcohol are gamma-aminobutyric acid (GABA) and glutamine. GABA and glutamine are considered the ‘on and off’ switch of the brain, glutamine makes the brain more active, whereas GABA has the opposite effect (9). These two neurotransmitters work in harmony together to ensure there is balance, for example, too much glutamine can increase feelings of stress and anxiety, so GABA is released to inhibit these feelings (9,10). When we drink alcohol, the calming GABA system is turned on, leaving us feeling relaxed and enjoying the pleasant feelings that comes with alcohol (10,11). However, if we drink too much, other parts of the brain are switched off, for example parts which control our judgement, hence the phrase ‘losing inhibitions’ if we get drunk. This can explain why even though we may fully plan on having just a couple of drinks, we inevitably end up drinking far more than we intended!

Alcohol consumption is associated with an increased risk of depression and anxiety. Many people may use alcohol to relieve symptoms of depression or anxiety, but this relief is only short lived. In terms of anxiety, although in the short-term alcohol may relieve symptoms of anxiety, as described earlier via neurotransmitters in the brain, it can eventually leave you feeling more anxious than when you first started drinking (12). Alcohol is also a depressant, although it is difficult to differentiate between cause and effect, heavy drinking on a regular basis is associated with increased feelings of depression (14). Studies have shown that reducing the amount you drink can improve symptoms of anxiety, depression, and improve quality of sleep (13). 

How can I drink mindfully over the festive period?

Now that we have covered some of the effects alcohol can have on our health, the brain, and mental health, let’s consider how we can reduce our alcohol intake by improving the relationship we have with alcohol. 

‘Mindful drinking’ has become a popular phrase over the last few years, and it refers to drinking alcohol in a way that we are aware of how much and why we drink. Being aware of how much we drink on a typical drinking session can bring awareness to our habits and behaviour around drinking, and hopefully reduce the amount of alcohol we drink (15). Considering why we drink alcohol is also very helpful, perhaps it’s to unwind after a long day at work, or to feel more relaxed in a busy social setting. Being aware of our ‘why’ can point us in the right direction of opting for healthier coping mechanisms, further reducing our alcohol consumption (15).

At Christmas time alcohol is often heavily embedded in our surroundings, there are lots of social events in the calendar where drinks are flowing, but you can reduce your alcohol intake through some of the following tips (16)-

  • Set a budget – only bring a certain amount of money so you don’t over drink

  • Order lower strength drinks

  • Order smaller drinks

  • Try alcohol free drinks

  • Drink plenty of water in between alcoholic beverages

  • Let friends and family know you are cutting down

  • Plan events not centred around drinking

  • Plan alcohol free days

  • Don’t buy rounds – drink at your own pace 

Summary and tips:

There are numerous benefits of reducing your alcohol intake and we hope this will encourage you to consider reducing the amount you drink. To summarise, some of the key benefits of reducing your alcohol consumption includes (17) –

  • Improved mood

  • Better sleep

  • More energy

  • Better skin

  • Improved immunity 

  • Reduce risk of non-communicable disease (NCD) such as hypertension, stroke, and cancer

  • Better weight management

  • Saves money

This blog was written by Catherine Merry; she is currently in her third year of university at the University of Brighton where she studies Nutrition, specialising in Public Health. Catherine is enthusiastic about promoting a healthy balanced lifestyle and achieving this through good nutrition where pleasure and enjoyment can still come from food. She is keen to carry on her studies once she has completed her undergraduate degree and do a masters in Public Health.

References:

(1) (2022) NHS choices. NHS. Available at: https://www.nhs.uk/better-health/drink-less/ (Accessed: November 18, 2022). 

(2) UK low risk drinking guidelines (2022) Drinkaware. Available at: https://www.drinkaware.co.uk/facts/alcoholic-drinks-and-units/low-risk-drinking-guidelines (Accessed: November 18, 2022). 

(3) (2022) NHS choices. NHS. Available at: https://www.nhs.uk/live-well/alcohol-advice/calculating-alcohol-units/ (Accessed: November 18, 2022). 

(4) Alcohol (2022) World Health Organization. World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/alcohol (Accessed: November 18, 2022). 

(5) Jackson, R. and Beaglehole, R., (1993). The relationship between alcohol and coronary heart disease: is there a protective effect? Current opinion in Lipidology, 4(1), pp.21-26.

(6) Room, R., Babor, T. and Rehm, J. (2005). Alcohol and public health. The lancet, 365(9458), pp.519-530. 

(7) Smith-Warner, S.A., Spiegelman, D., Yaun, S.S., Van Den Brandt, P.A., Folsom, A.R., Goldbohm, R.A., Graham, S., Holmberg, L., Howe, G.R., Marshall, J.R. and Miller, A.B., (1998. Alcohol and breast cancer in women: a pooled analysis of cohort studies. Jama, 279(7), pp.535-540.

(8) Office for Health Improvement and Disparities (OHID) (2020) Local Alcohol Profiles for England - mortality due to alcohol, Local Alcohol Profiles for England - Mortality due to alcohol - OHID. Available at: https://fingertips.phe.org.uk/profile/local-alcohol-profiles/supporting-information/mortality2 (Accessed: November 18, 2022). 

(9) Professor David Nutt (2020). Drink? The new science of alcohol and health. Hachette Go.

(10) Ramadan, S., Lin, A. and Stanwell, P., (2013). Glutamate and glutamine: a review of in vivo MRS in the human brain. NMR in Biomedicine, 26(12), pp.1630-1646. 

(11) Tsai, G.E., Ragan, P., Chang, R., Chen, S., Linnoila, V.M.I. and Coyle, J.T. (1998). Increased glutamatergic neurotransmission and oxidative stress after alcohol withdrawal. American Journal of Psychiatry, 155(6), pp.726-732.

(12) Alcohol and Mental Health (2022) Drinkaware. Available at: https://www.drinkaware.co.uk/facts/health-effects-of-alcohol/mental-health/alcohol-and-mental-health (Accessed: November 18, 2022). 

(13) Boden, J.M. and Fergusson, D.M., (2011). Alcohol and depression. Addiction, 106(5), pp.906-914 

(14) Alcohol and mental health - fact sheet (no date) Alcohol Change UK. Available at: https://alcoholchange.org.uk/alcohol-facts/fact-sheets/alcohol-and-mental-health (Accessed: November 18, 2022).

(15) Ostafin, B.D., Bauer, C. and Myxter, P., 2012. Mindfulness decouples the relation between automatic alcohol motivation and heavy drinking. Journal of Social and Clinical Psychology, 31(7), p.729

(16) (2022) NHS choices. NHS. Available at: https://www.nhs.uk/live-well/alcohol-advice/tips-on-cutting-down-alcohol/ (Accessed: November 18, 2022). 

(17) Reasons for cutting down on alcohol (2020) Drinkaware. Available at: https://www.drinkaware.co.uk/advice/how-to-reduce-your-drinking/reasons-for-cutting-down-on-alcohol#benefitsofcuttingdownonalcohol (Accessed: November 18, 2022). 

(18) Alcohol: Applying all our health (2022) GOV.UK. Available at: https://www.gov.uk/government/publications/alcohol-applying-all-our-health/alcohol-applying-all-our-health (Accessed: November 21, 2022). 

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