The truth about women and alcohol

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Twenty years ago, women drank on average five and a half units per week. Its now closer to eight units.

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London - Gone are the days when women might sip a sweet sherry at Christmas but leave the serious drinking to the menfolk. Twenty years ago, women drank on average five and a half units per week. It’s now closer to eight units, with a rising number, nearly a fifth of women, drinking more than the recommended maximum of 14 units a week.

We all know drinking to excess is bad for our health, and is linked to a range of serious health problems, from cancer to high blood pressure and liver disease.

But there have also been reports that moderate amounts may have health benefits for some people. For example, it may help to boost “good” HDL cholesterol and reduce levels of “bad” LDL cholesterol, helping to protect against heart disease and stroke.

Last week, Danish researchers overturned the shibboleth that drinking during pregnancy will harm your baby. They said that moderate amounts - one drink a day - were fine. So exactly how much alcohol is too much for women? Does it matter how old you are? Can alcohol be good for your health? And can you drink while you are breastfeeding?

We asked the experts to separate the facts from the fiction, so women can enjoy one of life’s great pleasures without the angst...

YES, WOMEN DO GET SQUIFFY FASTER THAN MEN

Ladettes may think otherwise, but the fact is, alcohol does have a faster effect on women.

This has been shown by multiple studies in which women and men have been given the same amount of alcohol and then asked to perform tests such as co-ordination and verbal reasoning. Even if a woman and a man are the same size and weight, the woman would still feel intoxicated sooner. This has nothing to do with hormones, but the fact that women’s bodies contain a lower proportion of water, so there is less fluid to dilute any circulating alcohol in the blood.

“Another factor is that women’s liver cells have less of an enzyme which breaks down alcohol, known as alcohol dehydrogenase, so it stays in circulation longer, having a greater effect,” says Professor Sir Ian Gilmore, specialist adviser on alcohol to the Royal College of Physicians.

So do women feel the effects of alcohol differently? There’s no scientific evidence to suggest this, but, women are more at risk of blackouts and may be more susceptible to milder forms of memory impairment, even when they have drunk the same amount as men.

DOES THIS MEAN THEIR HANGOVERS ARE WORSE?

Alcohol, which is a toxin, is more concentrated in women’s blood. This is why they’re more than twice as likely as men to suffer the morning-after queasiness, stomach ache, raging thirst and headache after having more than five alcoholic drinks, as a Danish study published earlier this year found.

“A morning-after headache is caused by the dehydrating effect of alcohol when the brain membrane shrinks,” says Katherine Brown, at the Institute of Alcohol Studies. Sickness is caused by alcohol’s corrosive effect on the stomach lining.

ARE SOME TYPES OF ALCOHOL HEALTHY?

Women’s favourite tipple depends very much on their age. Like Bridget Jones, women between 45 and 64 are dedicated wine drinkers, with wine accounting for 70 percent of their weekly consumption in 2010.

For younger women (aged 16 to 24), spirits are the most popular, followed by wine, according to the NHS. Older women prefer fortified wines such as sherry.

“Different drinks contain different volumes of alcohol, so some will make you tipsy faster than others,” says Katherine Brown. “There is some evidence that the bubbles in champagne may help the alcohol to take effect more quickly.”

However, no drink is ‘better’ for you than another.

“It’s the alcohol content that matters, full stop,” says Sir Ian. “There is no evidence that what you drink makes any difference to the health consequences.”

And if you choose red wine because “at least it’s healthy”, this theory is difficult to substantiate. That’s because it’s hard to separate the health benefits of diet and lifestyle that tend to go with wine drinking.

“What is clear, however, is that it’s only after the age of 50 (when blood vessel disease is showing) that small amounts of alcohol with meals have a health benefit,” says Sir Ian.

WILL A DAILY TIPPLE CAUSE CANCER?

When it comes to breast cancer, there are no safe limits for women drinkers, according to findings earlier this year that suggested alcohol is responsible for one in five cases of breast cancer in Scotland. Even one unit of alcohol a day increases a woman’s risk by 10 percent.

Carolyn Rogers, a clinical nurse specialist at the charity Breast Cancer Care, says there’s an “established link” and the risk rises the more you drink. “One theory is it could be affecting levels of the hormone oestrogen within the body, which is known to fuel some types of breast cancer cells.”

Would swapping to a less alcoholic drink, say from spirits to wine, help? Only if you are already drinking more than the recommended weekly number of units.

But alcohol is not one of the three main risk factors for breast cancer (these are age, gender and a significant family history of the disease).

“If you cut down your alcohol intake, it doesn’t mean that you won’t get breast cancer, but it will reduce the risk,” says Carolyn Rogers.

Does that mean you should cut it out altogether? Professor Michael Baum, a leading oncologist who specialises in breast cancer treatment, says no. “Alcohol in excess increases the risk of breast cancer in all risk groups, but I would never frighten women into abstaining, but merely to drink sensibly - no more than seven units a week.”

There are no other female-specific cancers linked to drinking alcohol (however, as with men, alcohol puts women at greater risk of bowel, liver, mouth and neck cancers).

Drinking more than the recommended limit of two units a day also raises women’s risk of conditions such as cardiovascular disease, type 2 diabetes and pancreatitis.

Heavy drinkers of both sexes can suffer alcohol-related depression, possibly because alcohol reduces the amount of “feelgood” hormones such as dopamine circulating in the brain.

But women drinkers are more at risk of depression and alcoholic brain disease than men drinking the same levels of alcohol, because of the higher concentration in their bodies.

Alcoholic women also experience more brain shrinkage, associated with dementia, than men.

ISN’T ALCOHOL GOOD FOR MY HEART?

The good news is there is some evidence drinking in moderation may help boost your health. The French love of red wine with a meal has been pinpointed as the possible explanation for the French paradox, where that nationality have lower levels of heart disease despite a diet rich in saturated fat.

However, it seems the colour of the wine is probably irrelevant - it’s the alcohol itself that counts. And the heart benefit applies only to middle-aged men and post-menopausal women.

“There are a few studies which suggest that older women could gain a protective effect for heart disease if they drink alcohol in light amounts - one drink a day or every other day,” says Sir Ian. “But this does not mean teetotallers should take up drinking to get the benefit.”

There’s also a suggestion alcohol may protect against type 2 diabetes. Women in middle age who eat large amounts of refined carbohydrates such as white bread and pasta can help reduce their risk of this if they drink alcohol in moderation.

A study at the Harvard School of Public Health found it cut the risk by nearly a third compared with women with similar diets who didn’t drink alcohol at all. It could be because alcohol reduces blood sugar levels.

Perhaps not surprisingly, the Government has decided not to include any possible health benefits in its standard low-risk drinking guidelines.

“The health benefits are not concrete and some are quite hotly debated,” says Katherine Brown of the Institute of Alcohol Studies.

BINGE-DRINKING IS HARDER ON WOMEN

Statistics suggest 13 percent of females aged 16-24 drink more than six units on at least one day a week - double the rate of 15 years ago.

There has been a slight fall in recent years, but doctors are seeing young women in their 20s with serious liver disease that used to appear only in middle-aged heavy drinkers.

You may not even realise that you regularly binge-drink, as Andrew Langford, the chief executive of the British Liver Trust, explains: “Sharing a bottle of wine over dinner is technically a binge-drinking session.”

Female deaths due to alcohol-related liver disease are increasing each year; since 2005, there has been a 10 percent rise. On average, nearly 30 women a week are dying from alcohol-related liver disease - compared with 75 for men. If a woman and man drank exactly the same amount of alcohol, over exactly the same amount of time, exceeding guidelines, the woman would be more likely to develop liver damage, says Andrew Langford.

The number of women given on-the-spot fines for being drunk and disorderly rose by 30 percent between 2005 and 2007, from 6,098 to 7,930. (For men, the figures increased by 20 percent, from 34,078 to 41,132.)

ALCOHOL MAKES WOMEN APPLE-SHAPED

Recent studies suggest that regularly drinking alcohol to excess may make women gain extra weight around the abdomen, which is associated with a greater risk of heart disease and diabetes.

A 2009 study at University College London found that female binge-drinkers (who drank more than a bottle of wine at a sitting) gained around four extra inches to the waist over a three-year period, compared with two inches gained by men who drank similar amounts.

Lead researcher Professor Martin Bobak said it was unclear why sporadic heavy drinking should increase abdominal fat, especially in women, but it may be part of an unhealthy lifestyle.

Some research also suggested that stress was to blame. Stress causes the body to produce elevated levels of the hormone cortisol, which triggers fat to be deposited around the waistline.

BAN TOOTHBRUSHING AFTER DRINKING

“Drinking alcohol can cause long-term problems,” says Dr Mervyn Druian, director of the London Centre for Cosmetic Dentistry, who counts former Prime Minister Gordon Brown among his clients.

“It’s not just alcohol which contains sugar, but mixers: fizzy drinks, with or without sugar, contain acids which can damage the enamel of the teeth.”

White wine is generally more acidic than red, and dry white wine is more acidic than sweet, according to Dr Druian.

There is no reason why women should be more affected than men, but they may be more prone to habits which exacerbate the problem, such as brushing teeth directly after drinking.

“This is particularly damaging because the acid has softened the enamel. I see this a lot in women who want to hide the fact that they have been drinking.

“It is best to drink wine or alcoholic drinks with food, so the chewing action can stimulate the production of saliva, which restores a neutral pH balance in the mouth,” he adds.

I NEED A DRINK, I’M MENOPAUSAL

While it may take your mind off things, drinking alcohol could make your symptoms worse, according to consultant gynaecologist Mike Bowen. “Alcohol is a vasodilator, meaning it causes blood vessels in the skin to dilate. If you are suffering from hot flushes already, due to fluctuating levels of hormones, this is just going to amplify the unpleasant effect.”

Long-term consumption of alcohol may affect bone density, which declines markedly after the menopause. This is because alcohol can interfere with the movement of calcium between the bloodstream and the bones.

However, women going through the menopause do not have to stop drinking altogether because around 30 percent of women do not suffer significant symptoms, and there may be heart-protecting benefits.

SHOULD PREGNANT WOMEN ABSTAIN?

The Department of Health advises that women who are trying to conceive and those up to 12 weeks pregnant should not drink at all. But this advice has been called into question by a Danish study suggesting that moderate drinking - around one unit a day - will not cause harm to an unborn baby.

This is also the first time a study has suggested that occasional binge-drinking won’t cause harm.

“However, this does not mean women can use this as an excuse to indulge in more than the recommended amount in the UK,” says Patrick O’Brien, a consultant obstetrician at University College Hospital in London.

Indeed, just to add to the confusion, data soon to be published from a US study of 1,600 children shows that “difficultness” in under-fives is greater in children born to mothers who were drinking even those small amounts, when their behaviour is compared with siblings who were born at times when their mother was drinking less.

The official view remains that if a woman is trying to conceive or falls pregnant, she should abstain from alcohol.

“However, if she would like to have a drink, current evidence shows that one or two units, once or twice a week, is acceptable after 12 weeks of pregnancy,” says Dr O’Brien. He recommends women who are breastfeeding abstain altogether, or if they choose to drink, have only one or two units no more than once or twice a week.

“We know alcohol can pass into breast milk and affect the infant. It seems sensible to limit that exposure,” he adds.

P.S. IT’S INCLUDED IN YOUR FLUID INTAKE

You don’t need to sip endless bottled water to get the two litres of fluid you need each day. In fact, almost every fluid you imbibe - including coffee, wine and beer - will add to your fluid intake.

The difference is that alcoholic drinks also have a diuretic effect, so you will lose some of the volume through extra urine.

Spirits are not included, however, because they cause you to lose more volume than they add, so there is a net loss.

“Everyone knows you should be taking in around two litres of liquids a day,” says Catherine Collins, chief dietician at St George’s Hospital, London.

“But despite what the bottled water companies tell us, that can be almost any fluid. So you can include soup, tea, coffee, and even beer as part of your intake.” - Daily Mail

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