Alcohol and Its Effects on...Everything

With many recommendations suggesting moderation in alcohol intake, and some even suggesting that a routine glass of wine or alcoholic drink each day is good for reducing heart disease risk, it is difficult to know what to do. Alcohol can damage the body's immunity and the way the body metabolizes nutrients. Drinking and smoking often go hand in hand (and, many times, with other risk factors, such as reduced physical activity), so it is important to take a look at some of the research on alcohol in chronic disease and HIV infection. Alcohol changes the ability of the body to defend itself against infection. For instance, drinking can change the body's immune response with cytokines (the little proteins that activate the process), changes in nutritional status that cause immune suppression, and increases in cell damage, as seen in oxidative stress. People who drink heavily and routinely may be at a higher risk for becoming HIV-positive because of changes in the gastrointestinal tract and the body's immunity. Once a person is HIV-infected, alcohol consumption can continue to cause damage and may accelerate the disease process. Researchers at the University of Miami School of Medicine looked at a group of 220 HIV-infected men with past history of alcohol or drug abuse. The heavy drinkers (this was defined by the researchers as alcohol consumption daily or three to four times per week) had lower CD4-cell counts and were less likely to successfully lower viral loads with their antiretroviral medications than nondrinkers. Less directly, alcohol affects nutritional well-being, which can in turn affect immune function. Alcohol, by causing some damage, can change how well a person can absorb nutrients in their intestines. Alcohol provides a fairly significant level of calories, and people who drink heavily tend to eat less of the nutrients they need, especially protein and micronutrients (vitamins and minerals). Alcohol can change the way the body metabolizes, stores, and gets rid of nutrients through the bowels and kidneys. People who drink heavily are at high risk for malnutrition and infections because of alcohol-induced immune suppression. Beyond immunity problems, we know that alcohol increases risk and exacerbates the effects of other chronic diseases. Heart disease, insulin resistance, and diabetes can be worsened with too much alcohol consumption. Pancreatitis and liver disease are more common in people who routinely drink. Other notable problems include an increase in risk for hypertension and stroke, cancer, dental disease, and osteoporosis. And, as was already mentioned, heavy drinking can add some heavy-duty calories and thus contribute to obesity and all of its related risks. Smaller amounts of alcohol intake have been suggested to be protective against heart disease, diabetes, and even loss of mental function. Light to moderate alcohol intake was associated with better levels of 'good' cholesterol and less insulin resistance (an effect that disappears when overweight). Researchers have suggested that the relationship between alcohol intake and disease risk is 'J'-shaped: That is, people who do not drink at all may have a slightly higher risk than those who drink lightly or moderately (10 to 12 grams per day for women and 20 to 24 grams per day for men), while those who drink heavily are at highest risk for chronic disease. The differences between nondrinkers and light to moderate drinkers may not be as significant to consider as the higher risk for heavier drinkers. Also, heavy drinkers with higher weights were at significantly more risk than heavy drinkers with lower weights. If you don't drink, the benefits are not so great to suggest starting now. If you drink lightly to moderately and don't have complications (liver disease, pancreatitis, low CD4-cell count), then you may be OK with it. However, if you tend to binge or drink heavily, you may want to rethink the damage-versus-benefit ratio of depressing immune function. Take a look at the table to see how much alcohol is contained in typical drinks. ALCHOHOL CONTENT IN SOME COMMON DRINKS Drink // Alcohol Content Beer (12 ounces) contains 12'14 grams of alcohol Light beer (12 ounces) contains 10'12 grams of alcohol Wine, red or white (3.5 ounces) contains 10 grams of alcohol Wine cooler (12 ounces) contains 12'13 grams of alcohol Gin, rum, vodka shot (1.5 ounces) contains 14'18 grams of alcohol Bloody Mary (5 ounces) contains 14 grams of alcohol Daiquiri (2 ounces) contains 20 grams of alcohol Gin and tonic (7.5 ounces) contains 16 grams of alcohol Martini (2.5 ounces) contains 22'23 grams of alcohol Pi'a colada (4.5 ounces) contains 20 grams of alcohol SOURCE: Jean A.T. Pennington, Bowes & Church's Food Values of Portions Commonly Used Fields-Gardner is the director of services for The Cutting Edge, an HIV nutrition company in the Chicago area. She has written a book on HIV medications and a guide to nutritional management of HIV for clinicians.