Sachin Arora, 55, a New Delhi-based entrepreneur, loves his single malt. Every evening after work he unwinds with a warm bath and two small pegs of his favourite whisky. Over the years, he has come out a winner by reversing the initial stages of heart disease, failing eyesight and a propensity to gain weight with regular check-ups, a good diet and exercise. Alcohol is just something he enjoys and he hardly considers it a vice.
Shashank Malhotra*, 35, a banker, had his first drink at 14. While he didn’t enjoy that first brush with alcohol, it didn’t stop the habit from slowly taking over his life. In the last five years or so he has found he can easily finish a 750ml or 1-litre bottle of vodka on his own in a single sitting. Now, even though he desperately wants to kick the habit, he cannot because he finds it impossible to sleep without having a few drinks daily.
Unlike cigarettes, which have no positive effects on the body, alcohol can be good or bad depending on how much of it you indulge in. In February, the World Health Organization (WHO) estimated that alcohol kills 2.5 million people every year. On the other hand, researchers from the University of Rome in November found that heart bypass patients who had two drinks (of any type) a day following surgery subsequently needed fewer heart procedures than those who remained teetotallers, pointing to the beneficial effects of moderate consumption.
Good and bad: The more one drinks above the safe limit, the more harmful alcohol is likely to be.
Our panel of experts—Jay Kirtani, consultant, internal medicine, Max Healthcare, New Delhi; Mumbai-based nutritionist Suman Aggarwal; and the Forum of Alcoholics Anonymous**, Mumbai—help us understand how alcohol can be good, bad or ugly.
When: Not more than two-three units of alcohol a day for women and three-four units for men, with at least two-three alcohol-free days each week. One unit is considered to be 8ml of alcohol, or equivalent to half a pint of standard strength beer, cider or lager, a pub measure of spirit (25ml), half a standard glass (175ml) of wine, a pub measure of sherry, vermouth or liqueur, says Dr Kirtani.
Why: Moderate alcohol intake may reduce the risk of developing heart disease or dying of a heart attack, possibly reduce the risk of strokes, particularly ischemic strokes, minimize the risk of developing gallstones, and possibly reduce the risk of diabetes. Even so, the evidence of the possible health benefits of alcohol isn’t certain, and alcohol may not benefit everyone who drinks.
Red wine in particular contains resveratrol, an anti-fungal compound found in grape skin, which increases HDL (good cholesterol) and inhibits LDL (bad cholesterol). But if you are prone to migraine or acidity, avoid wine. Beer is considered better because it has lesser quantity of alcohol and is not as dehydrating as spirits.
However, do keep in mind that moderate alcohol use may be beneficial only in older adults (over 40 years). In younger adults, some evidence shows that even moderate alcohol use may cause more harm than good. In addition, women who drink alcohol regularly must take supplemental folate to help reduce the risk of breast cancer associated with regular alcohol intake.
When: In general, the more one drinks above the safe limits, the more harmful alcohol is likely to be. And binge drinking can be harmful even though the weekly total may not seem too high.
Why: There are certain signs that reflect alcohol abuse. These include increased lipid profile, triglycerides and uric acid. Physiologically, frequent headaches, an inability to concentrate, fatigue and sluggishness all indicate that alcohol use may be going out of hand.
What makes it worse is mixing drinks. This produces more adverse reactions because different types of alcohol contain different amounts of compounds called congeners produced during the fermentation of alcohol. Drinks that contain high quantities of congeners may increase hangover symptoms. Clear beverages such as vodka, gin and white wine contain less congeners than darker drinks such as brandy, whisky, rum and red wine. Mixing these congeners may increase stomach irritation.
In general, excessive consumption of alcohol—roughly equivalent to a six-pack of beer or a litre of wine daily—for a significant length of time can lead to alcohol-induced liver disease (ALD) in men. Women are much more susceptible to the toxicity of alcohol than men. The specific length of time it takes for ALD to develop is not known with any precision because so many different factors play a role in its development.
Similarly, the amount of time that it takes for cirrhosis to develop is not known. However, experts suggest that an average person will develop cirrhosis if he continues drinking the above-mentioned amounts of alcohol daily for five years.
When: A man consumes more than eight units of alcohol and a woman consumes over six units in one sitting. Consistently drinking four or more units a day (men), or three or more units a day (women) amounts to alcoholism.
Why: There are two major warning signs of alcoholism. The first is tolerance, which means that over a period of time a person needs increased quantities of alcohol to feel the same effects. The second major sign is withdrawal. When one drinks heavily, the body gets used to the alcohol and experiences withdrawal symptoms if it’s not consumed. These include anxiety or jumpiness, shakiness or trembling, sweating, nausea and vomiting, insomnia, depression, irritability, fatigue, loss of appetite and headaches. In severe cases, withdrawal from alcohol can also involve hallucinations, confusion, seizures, fever, and agitation.
According to the Forum of Alcoholics Anonymous, an alcoholic usually starts off as a moderate drinker. He may or may not become a continuous hard drinker, but at some stage he begins to lose all control of his liquor consumption. Once alcohol enters his system, something happens, both in the physical and mental sense, which makes it virtually impossible for him to stop. These high levels of alcohol consumption are directly related to an increased risk of developing heart disease, chronic pancreatitis, alcoholic liver disease, and cancer. Damage to the central nervous system and peripheral nervous system can occur from sustained alcohol consumption.
Long-term use of alcohol in excessive quantities is capable of damaging nearly every organ and system in the body. If you think your alcohol consumption is going out of hand and you find it impossible to stop reaching for a refill, it’s prudent to take professional help. First, admit that there is a problem since denial is the biggest hurdle in treating alcoholism. Second, ask for help, even though you may feel awkward about it.
Prevent the downfall
A lot of people believe they can overcome alcoholism on their own. However, the reality is that alcohol consumes a person and controls their life, not the other way around. Depending on the level of addiction, one may need to undergo alcohol detox before quitting drinking. Withdrawal symptoms can be very dangerous for those who are severely addicted and can include anything from hallucinations to seizures. For this reason, it is best if detox is done in a supervised setting for one’s own safety.
The next vital step to cure alcoholism is to treat the emotional side of the condition. There are many different treatment centres and methods for doing this. While it’s ideal to drink in moderation (only on weekends and special occasions), if you find yourself drinking in excess of two-three units every day, contact a health professional to help wean you off the tipple.
Drinking for dummies
Jay Kirtani and Suman Aggarwal give some pointers on how to indulge healthily on the assumption that you are drinking within limits:
• Never drink on an empty stomach; while drinking, snack on nuts and non-fried foods.
• Alternate your hard drinks with a fresh lime soda (salted) or a fruit juice or any non-alcoholic drink or a glass of water to avoid getting dehydrated.
• Make mixed drinks with diet sodas. This can take off about 100 calories per drink which, depending on how much you have, can add up to quite a lot by the end of the night.
• Light beer has fewer calories than the regular kind but can cause you to drink more since you won’t feel full. If you drink light beer to save on the amount of calories, keep track of how much you’re actually drinking because it may be a lot more than you think.
The liver requires certain nutrients for detox. In addition, increasing the flow of bile is an important part of detox because bile carries stored fat-soluble toxins away from the liver to be excreted in the stool. Signs of poor bile flow include constipation, flatulence, dry skin and hair, indigestion after consuming fatty foods and small, hard stools. Here’s what you can do if you need a detox:
• Apples, carrot, beet, grapefruit, bitter gourd, whole grains, broccoli, cauliflower, cabbage and lettuce all help detoxify the liver.
• Milk thistle herb (available as a supplement) has many positive effects on the liver. It is an antioxidant, assists in liver cell regeneration, and is used after adverse effects from excess alcohol or fat consumption.
• Protein is required by the liver for detox. Beans, nuts, seeds, quinoa or protein powder are good sources.
• Water-soluble vitamin C is an antioxidant that supports detox. Pop one when you feel you have overindulged.
* Name changed
** If you think you have an alcohol problem, log on to www.aagsoindia.org, the Alcoholics nonymous, India, website
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