The Times, 20th February: How alcohol affects your face, weight – and brain

New guidelines on alcohol intake introduced by the UK’s chief medical officer say there is no such thing as a healthy level of drinking and that we should all be cutting down on booze. According to the lastest recommendations, men as well as women should consume no more than 14 units a week — equivalent to six pints of beer or seven glasses of wine —and pregnant women should not drink at all.

After smoking and obesity, alcohol is the biggest lifestyle risk factor for disease and death in the UK, yet many of us drink far more than we should. The charity Alcohol Concern estimates that 7.5 million people are unaware of the damage their drinking could be causing and says that more than 9 million people in England alone are thought to exceed the suggested daily limits for safe drinking. So what are the risks for men and women who consume alcohol to excess?

Men

Brain One of the largest studies into the long-term effects of alcohol consumption a couple of years ago suggested that chronic heavy drinking is linked to a significant cognitive decline in men but not in women, who, for reasons that aren’t clear, seem to be protected against some of the toxic effect. Researchers from University College London (UCL), reporting in the Journal of Neurology, found that middle-aged men (average age 56) who drank 36 grams, the equivalent of at least two shots or pints of booze a day for a decade, experienced greater memory loss and slowing of brain function compared with “occasional” or “moderate” drinkers.

Female participants were classified as “heavy drinkers” if they consumed about one shot a day but didn’t show nearly the level of cognitive decline as the men, possibly because of the protective effect of the hormone oestrogen. “Our study focused on middle-aged participants and suggests that heavy drinking is associated with faster decline in all areas of cognitive function in men,” says Dr Severine Sabia, an epidemiologist at UCL.

Heart Moderate amounts of alcohol have been shown to protect against heart disease for some people but long-term heavy drinking and binge-drinking episodes can raise the risk of a heart attack sharply in men and women. A review of alcohol consumption by the World Health Organisation showed that, at 35.5 per cent, men in the UK were more likely than women to have had a binge-drinking episode in the previous month.

Last year researchers at the Harvard School of Public Health in Boston, Massachusetts, found binge drinking raised the risk of a heart attack by more than 70 per cent and that the dangers are greatest within the first hour of heavy drinking. Spirits such as vodka, whisky and gin posed the greatest threat, with beer and wine considered less risky possibly because of the blood vessel-relaxing polyphenols they contain. The study also found that people most at risk were those who drink little or nothing during the week but overdo it at the weekend. “Even if you haven’t drunk alcohol Monday to Friday, that doesn’t mean you can have a week’s worth on Saturday,” says Victoria Taylor, a senior dietician for the British Heart Foundation (BHF).

Binge drinking is defined as eight units of alcohol in one sitting for men, which is three pints of 5 per cent alcohol beer or three and a half standard glasses (175ml each) of 13 per cent alcohol wine. A YouGov survey commissioned by the BHF revealed that one in 20 men thought that binge drinking for them would be a minimum of ten pints of beer or more.

Sperm count As few as five alcoholic drinks a week could reduce the quality of a man’s sperm, according to a study in the journal BMJ Open. Danish researchers examined 1,200 male recruits aged 18 to 28, asking them about their diet and drinking habits and getting them to provide sperm and blood samples. Results showed that drinking alcohol in the week before the samples were taken was associated with distinct changes in reproductive hormone levels, and the more alcohol consumed, the weaker the quality of the men’s sperm.

The effects were evident in those who drank five or more units or just over two pints of beer a week but most pronounced in men who drank 25 units or more. “Young men should be advised to avoid habitual alcohol intake,” the researchers wrote.

Waistline It’s not just the calories in alcohol — substantial in themselves — but the lax approach to diet when drinking that spells bad news for the male middle. Two years ago a study by the US National Institute on Alcohol Abuse and Alcoholism showed that men consume an extra 433 calories (equivalent to a McDonald’s double cheeseburger) on the days when they drink a moderate amount of alcohol, with only about 61 per cent of the increase accounted for by alcohol.

Men also reported in the same survey eating higher amounts of fats and meat but less fruit and milk on the days they were drinking. “Poorer food choices on drinking days have public-health implications,” says Rosalind Breslow, an epidemiologist and lead author of the study.

Stomach A single episode of binge drinking can result in bacteria leaking from the gut and increased levels of toxins in the blood. These bacterial toxins, called endotoxins, could trigger the body to produce immune cells involved in fever, inflammation and tissue destruction, says Gyongyi Szabo, professor of medicine at the University of Massachusetts Medical School who leads the research in this area. “We found that a single alcohol binge can elicit an immune response, potentially impacting the health of an otherwise healthy individual,” says Szabo. “Our observations suggest that an alcohol binge is more dangerous than previously thought.”

Previous studies have also shown how chronic alcohol consumption also causes greater gut permeability and the release of potentially harmful products such as bacteria and toxins that can travel through the intestinal wall to other parts of the body. Risk of stomach cancer is also higher in men who drink heavily.

Muscles Men who think they are offsetting the effects of booze by hitting the gym are mistaken. In fact, too much alcohol may undo the hard work they put in to working out. Researchers in New Zealand published a study that found significant delays in muscle recovery when the men drank even a “moderate” amount of alcohol after working out.

An Australian study revealed that alcohol can also interfere with muscle growth. In the trial, men were put through three vigorous workouts, including weights, hard cycling and high-intensity sprints. After two of the sessions they were given what the scientists deemed “optimal” post-exercise nutrition in the form of high protein and carb-rich meals. After the third trial they were given only alcohol and carbohydrate. Results showed that drinking 1.5g/kg of alcohol after exercise suppresses the signals that would normally tell the muscles to adapt and grow stronger.

“Chronic heavy alcohol consumption also impairs healing and recovery from sports injuries,” says Hannah Sheridan, a nutritionist at the University of Birmingham’s High Performance Centre.

Prostate According to Prostate Cancer UK, there is not enough direct evidence to link a heavy alcohol intake to this disease in men. However, the charity states that “we do know that drinking too much alcohol can make you put on weight, and being overweight increases your risk of advanced or aggressive prostate cancer”.

Some studies suggest that heavy drinking, especially when it’s beer, increases the risk of getting highly aggressive prostate cancer. Findings from the Fred Hutchinson Cancer Research Center in Seattle suggest that heavy drinking reduces the cancer-preventing effect of finasteride, a drug prescribed to prevent prostate cancer.

Women

Weight “While women can store nutrients, protein, carbohydrates and fat in their bodies, for nutritional reasons the body has no use for alcohol and therefore stores the excess calories it provides as fat,” says Professor Paul Wallace, the chief medical adviser to the alcohol education charity Drinkaware. “It’s healthier to cut back on alcohol rather than food for weight loss,” Wallace says. “Calories from alcohol are ‘empty calories’; they have no nutritional value.”

Statistics produced by the charity show how two ciders are equal to an overall calorie intake of 648, about 32 per cent of a woman’s recommended daily allowance of 2,000 calories. Add four beers and a double gin and tonic, and it amounts to 1,284 calories, the equivalent of four burgers, and would require a 128-minute run (nine to ten miles for most people) to work it off.

The trainer Matt Roberts says that increased alcohol consumption is often the cause of weight gain in women. “Most alcoholic drinks and mixers contain high amounts of sugar, which are then stored away in the body as fat. It also disturbs your sleep and dehydrates you, so as you cut down you will find that the quality of your exercise improves.”

Fertility Official advice from the Department of Health is that women trying for a baby should avoid alcohol. “There is a link between drinking and fertility, although exactly how alcohol makes women less fertile isn’t understood clearly,” says Anthony Rutherford, a consultant in reproductive medicine and chairman of the British Fertility Society. “Many studies have shown that even drinking lightly can have an effect.”

One Danish paper showed drinking between one and five drinks a week reduced the chances of conceiving, and ten drinks or more decreases the likelihood of conception even further. Some fertility clinics recommend that women cease drinking three months before they start IVF treatment. In research on couples for whom three cycles of IVF had failed it was reported how those who abstained from alcohol had a 90 per cent chance of achieving a successful pregnancy within three years. Even one to two glasses a week reduced their success rates to 66 per cent.