Alcohol - Why Not?

Alcohol - Why Not?

By Vicki Griffin, MS-Human Nutrition, MPA

Approximately two thirds of the American population consumes alcoholic beverages.1 Alcoholism affects about 15 million Americans,2 a staggering number even when comparing illegal drug and prescription drug abuse combined.

Alcoholic beverages are legal, socially accepted, and relatively inexpensive—but they are not harmless. Alcohol abuse costs this country an amazing $185 billion a year directly in lost workdays, drunken-driver accidents, and medical expenses—more than all illegal drug abuse combined.3 And that doesn’t include the indirect costs. According to Donna Shalala, former secretary of United States Health and Human Services: “Alcohol problems, both those of individuals and those that affect society at large, continue to impose a staggering burden on our nation. Domestic violence, child abuse, fires and other accidents, falls, rape, and other crimes against individuals such as robbery and assault—all are linked to alcohol misuse. Alcohol misuse also is implicated in diseases such as cancer, liver disease, and heart disease. Although often not aware of it, everyone shares a portion of this burden.”4

People like to think that when they drink alcohol they are gaining a great health benefit, whether they drink wine, beer, malt liquor, tequila, whisky, or some other liquor. Advertisers spend more than $1 billion a year to convince us that those who drink are healthier, friendlier, more cultured, better looking, sexier, and even more successful. Some clergy even get biblical about alcohol consumption:
Jesus, they say, drank wine. And they’re partially right. Jesus did drink wine, the “pure blood of the grape,” or fresh grape juice.5 It was no tailgate party at the wedding feast in Cana, where He turned hundreds of gallons of water into sweet, fresh juice.6 Such succulent beverages were highly prized among the ancients and had the blessing of God. “As the new wine is found in the cluster do not destroy it, for a blessing is in it.”7

Our word for wine always means a fermented beverage. But the Greek word for wine (oinos) can mean either fermented or unfermented juice. The Bible doesn’t contradict itself, and there is nothing biblical about a beverage that the Bible warns us not to even look at when it is active, or fermented.8 The Scriptures warn us that alcohol attacks the user with a vengeance and “at the last” has the death bite of a poisonous viper.9

Body and Brain Effects

So, what makes alcohol so insidiously harmful? For one thing, alcohol molecules are very small and are soluble in both fat and water. This enables them to easily permeate almost all parts of the body. As a result, alcohol attacks numerous body tissues, especially fatty tissues. Alcohol irritates the lining of the digestive tract, and increases the risk of oral and liver cancer, stomach ulcers, pancreatitis, and gastritis.10 And chronic alcohol consumption can cause extensive brain damage.

In light of these facts, it shouldn’t surprise anyone that alcohol is listed by the U.S. National Toxicology Program and the International Agency for Research on Cancer as a known human cancer-causing agent.11 Just one drink a day increases a woman’s risk of breast cancer by 9 percent, independent of other risk factors.12

At low doses alcohol acts to stimulate firing of nerve cells and lessen inhibition, but it is classified as a depressant because at moderate to high doses it actually depresses, or hinders, proper nerve cell operation.13 But Dutch researchers found that even one drink could cause reactions to slow, causing people to make more mistakes with less ability to perceive that they are making them.14

Like other addictive drugs, alcohol acts on numerous brain circuits, including the reward and compulsion centers of the brain, and produces tolerance and physical dependence. In addition to free radical damage, alcohol causes the actual death of brain cells, resulting in brain shrinkage. According to Kenneth Mukamal, an instructor at Harvard Medical School, every drink is associated with greater brain shrinkage, which itself is linked to dementia.15 He remarked: “It’s been clear that alcoholics have shrunken brains; it was a bit of a surprise that it wasn’t just alcoholics.”16

What about those “shrunken brains”? Is it possible for someone who quits drinking to recover lost motor and mental function lost through a long period of alcohol abuse? Thankfully, giving up alcohol can reverse much of the structural brain damage that occurs with chronic alcohol abuse.17 The brain’s frontal lobes, the centers for emotions and planning, are especially susceptible to alcohol damage. But after an average of two years abstinence, this part of the brain recovers some of its lost weight. According to one study author, “These results suggest reversal of structural abnormalities in some brain regions of abstinent alcoholics.”18

Abstaining alcoholics had a greater volume of white matter, the fibers connecting cells, in the frontal lobes. They also had less scarring of white matter in most areas of the brain, and a higher average volume of gray matter. Dr. Edith Sullivan, associate professor of psychiatry at Stanford University in California, commented on the study: “Taken together, these findings present hopeful data for recovering alcoholics and should provide encouragement for continued sobriety.”19

The Three Domains of Addiction

Why does a person continue addiction and abuse when disease, degradation, and discomfort increase with use, and quality of life is devastated?  To answer those questions, we must understand what happens in the brain when a person becomes addicted.

There are three domains associated with alcohol and drug addiction:20 First, genetics plays a role once a person has chosen to use an addictive drug.21 Second, the environment plays a role in vulnerability to addiction. Chronic pain, depression, violence, and abuse are settings where susceptibilities to risk-taking behavior are greater. But genetics and the environment are not causes of addiction, they are only associated with increased risk—an important distinction.

The third domain may be the major reason why alcoholics and drug abusers continue long after the pleasure is gone. Repeated exposure causes changes in brain function that affect behavior. Alcohol and drug abuse alter brain physiology at the molecular, biochemical, neurochemical, and structural level. This means that anyone with enough exposure to an addictive drug is a candidate for addiction. And the higher the used usually the longer it takes for the brain to recover—an important issue in relapse.

Brain changes can take place quickly and can be persistent.22 Alcohol abuse profoundly alters multiple brain systems, although often in subtly different ways. Important chemical messengers in the brain, such as cortisol, serotonin, endorphins, enkephalins, and dopamine are altered.23 Under normal circumstances, these messengers work together to balance such characteristics as drive, appetite, pleasure, depression, stress sensitivity, mental processing, aggression, pain, movement, and motivation.24 , 25

Alcohol and drug abuse affect several of these messengers, known as neurotransmitters, and how they interact with on another. The result is that alcohol and drug abuse effects may “cascade,” or create a domino effect, which then causes dysregulation or impairment of several neurotransmitter systems at once. When this happens, the brain can either overproduce or underproduce these important hormones, or just become nonfunctioning.

Of particular interest is dopamine, a chemical messenger linked pleasure, reward, motivation, and elation. Drugs of abuse increase the concentration of dopamine in the brain’s reward circuits, leading to feelings of euphoria or, in some cases, just preventing feelings of depression. But chronic use produces long-term changes, the most important change being the reduction of dopamine receptors. Receptors are the attachment sites on nerve cells that receive dopamine and allow it to enter into the cell. This reduction of receptors is the brain’s attempt to quiet down an overly noisy pleasure circuit with too much dopamine activity.

Having fewer receptors means dopamine is less available to the cells, so more of the drug is needed to produce the desired effect. As a result, experiences that used to bring pleasure, such as a good meal or a friendly chat, no longer ignite the same feelings of happiness. The result can be chronic depression, anxiety, and irritability. But abnormal dopamine activity is also associated with disruption of brain circuits involved with drive, repetitive behavior, and compulsion.26 Alcohols, drug abusers, the obese, and those suffering from other addictions are known to have fewer dopamine receptors in key areas of the brain.

Although addictive behavior is involved in the loss of dopamine receptors, it is also probable that some people have fewer receptors to begin with, putting them at greater risk for addictions. Gary27 is a prime example of this reality. He comes from a family with a strong history of alcoholism, gambling, and obesity. Early in his adult life Gary realized that he had addictive tendencies in his personality with a bent toward depression. After some dangerous brushes with alcohol and marijuana at age 19, Gary realized that he was well on his way to serious addiction. He made a conscious decision to develop a circle of friends who were involved in activities such as skiing, hiking, school, humanitarian activities, church, and work, and not involved with alcohol or marijuana.

Gary is now 50 and has led a fulfilled, happy, addiction-free life. When asked recently if he felt safe and free from his addictive tendencies, he answered without hesitation: “I don’t give myself the chance to find out.” Gary has developed a protective lifestyle as a hedge against his vulnerable tendencies, a vital key to staying free from addictions or avoiding relapse. He also carefully avoids situations that might weaken his resolve to remain committed to his chosen lifestyle. Many of these important lifestyle keys are covered in chapters 7-9.

The good news for recovering addicts is that addictions are learned behaviors that trigger genes to alter brain structure and function. Therefore, positive decisions and wholesome behaviors can also influence brain structure and function, so that dopamine receptors are replenished after a period of being drug free.

According to neuroscientist Jeffrey Schwartz, consciously adopting positive attitudes and choices results not only in “remarkable effects on mental and physical function—but also in the wholesale remodeling of neural networks.”28 Harvard neuroscientist John Ratey puts it this way: “Although the brain’s flexibility may decrease with age, it remains plastic throughout life, restructuring itself according to what it learns.”29

The French Paradox

It is clear that alcohol can damage brain tissue, even in socially acceptable amounts. But does alcohol really reduce heart attack risk? Some studies do indicate that light to moderate amounts of red wine consumption lower the risk of heart attack and fatal heart disease. However, the studies that question the extent of red wine’s benefits, or if the benefits outweigh the risk, seem to receive very little publicity.

One analysis of 42 published studies on the effects of alcohol on the heart came to this conclusion: “This analysis found that consumption of up to two drinks per day can promote changes in the levels of molecules that reduce the risk of heart disease while also increasing the level of certain molecules that promote heart disease.”30 In other words, there is no real benefit.

Alcohol acts as a mild blood thinner, thus possibly reducing the risk of strokes caused by clots. But lowering saturated animal fat intake and increasing fruit, whole grain, and vegetable intake do the same thing—and much more—without the risk of brain and organ damage, cancer, and addiction to alcohol. Articles on the so-called “French Paradox” have been widely published, which indicate that in France and other countries where saturated fat consumption and wine drinking is high, heart disease is lower than in countries such as Britain, where fat consumption is high and wine intake is low. But the conclusion that wine is the beneficial component of the French lifestyle has come under increasing fire.

British research has found no evidence that drinking red wine provides any protection against heart disease.31 Researchers found that death rates from ischemic heart disease in the French were linked to their low consumption of saturated fat in the past, and high consumption of more healthful fats for more than 30 years. In addition, some illnesses considered to be cardiovascular in Britain are not considered to be cardiovascular diseases in France, thus seriously skewing study results. There was no difference between wine and other forms of spirits on heart disease deaths according to this and other reports.32, 33

A 21-year study of nearly 6,000 Scottish drinking men showed that there was no clear relation between alcohol consumption and death from coronary heart disease, but there was double the risk of stroke when moderate drinkers were compared with non-drinkers.34 In addition, researchers concluded that drinking even small amounts had no increased health benefit.35 In fact, at levels commonly seen in social drinking, even levels deemed safe for driving, alcohol prompts a sharp increase in destructive free radical activity, linked to a wide array of chronic diseases, including liver and heart disease.36

Finally, according to Dr. Robert Superko, director of the Cholesterol, Genetics, and Heart Disease Institute in Berkeley, California, the cardiovascular benefits of alcohol have been greatly overstated. At a recent conference held by the American College of Cardiology, he stated the strong possibility that the studies favoring alcohol consumption for heart health are “quite biased.”37 “Add that insight to the considerable role alcohol plays in the alarming obesity epidemic in the United States,” Dr. Superko says, “and a highly unflattering picture of alcohol’s cardiovascular effects emerges. Indeed, alcohol avoidance, along with increased physical activity and the elimination of simple sugars from the diet, ought to be at the core of any strategy to reduce the obesity problems. Alcohol is very calorie dense. One glass of wine contains as many calories as a Snickers candy bar—about as many as are burned in a one-mile walk.”38

Grab Those Grapes!

For optimum heart health, you may want to grab the grapes or the grape juice instead of the wine bottle. In an animal model study, dark grape juice was “much more effective” than alcohol-containing wine in its ability to inhibit plaque buildup in the arteries, improve lipids, and raise blood levels of antioxidants that help fight heart disease.39

Plant compounds in grapes called polyphenols are thought to be the main source of benefit because they may dilate blood vessels, apart from the alcohol. In fact, wine without alcohol had the benefit of dilating vessels more quickly, while alcohol actually delayed the beneficial response, although it did occur.40

Here’s the latest word from the grapevine: The “pure blood of the grape,” the unfermented juice, with its “blessing” in the wholesome cluster is undoubtedly the safest, wisest, and most wholesome way to receive the health-promoting benefits of grapes.

1. T F Alcohol is the most widely used drug in the world.
2. T F Trying to escape life’s problems through drugs only adds to life’s problems.
3. T F Most people who have become dependent on drugs can easily stop using when they are ready.
4. T F Alcohol use does not affect the brain.
5. T F Alcohol abuse can alter the brain in multiple ways.
6. T F There is no hope for recover after addiction to alcohol.
7. T F Genetics cause addiction.

1 Pinel J. Biopsychology (Needham Heights, MA: Pearson Allyn & Bacon, 2000) p. 352.
2 Drug addictions: cellular and molecular endpoints. Kreek MA. Ann NY Acad Sci 2001 Jun:937:27-49.
3 Ibid.
4 U.S. Dept. of Health and Human Services report. Tenth special report to the U.S. Congress on Alcohol and Health, 2002. (quote from the first paragraph of the 492-page book)
5 Deuteronomy 32:14, KJV.
6 John 2:1-11.
7 Isaiah 65:8, NKJV.
8 Proverbs 23:31, KJV.
9 Ibid., verse 32.
10 Pinel J. Biopsychology (Needham Heights, MA: Pearson Allyn & Bacon, 2000) p. 352.
11 Alcohol: a recently identified risk factor for breast cancer. Aronson K. CMAJ 2004 Jan:168(9)1147-51.
12 Alcohol, tobacco and breast cancer—collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease. Hamajima N. Br J Cancer 2002 Nov:87(11)1234-45.
13 Ibid.
14 Alcohol consumption impairs detection of performance errors in the mediofrontal cortex. Ridderinhof KR, et al. Science 2002 Dec:298(5601)2209-11.
15 Alcohol consumption and subclinical findings on magnetic resonance imaging of the brain in older adults. Mukamal KJ, et al. Stroke 2001:32;1939-55.
16 Canadian Press, Sept 17, 2001.
17 Effects of abstinence on the brain: quantitative magnetic resonance imaging and magnetic resonance spectroscopic imaging in chronic alcohol abuse. O’Neill J, et al. Alcohol Clin Exp Res 2001 Nov:25(11)1673-82.
18 Reuters Health, Nov. 14, 2001.
19 Ibid.
20 Drug addictions: cellular and molecular endpoints. Kreek MA. Ann NY Acad Sci 2001 Jun:937:27-49.
21 Ibid.
22 Ibid.
23 Ibid.
24 Decreased striatal dopaminergic responsiveness in detoxified cocaine-dependent subjects. Volkow N, et al. Nature 1997 April:386:830-3.
25 Reward defiency syndrome: a biogenetic model for the diagnosis and treatment of impulsive, addictive, and compulsive behaviors. Blum K, et al. J Psychoactive Drugs 2000 Nov:32(Suppl i-iv)1-112.
26 Addiction, a disease of compulsion and drive: involvement of the obitofrontal cortex. Volkow N, Fowler J. Cereb Cortex 2000 Mar:10(3)318-25.
27 Not his real name.
28 Schwartz J. The Mind and the Brain (New York, NY: Harper Collins, 2002) p. 16.
29 Ratey J. User¹s Guide to the Brain (New York, NY: Vintage Books, 2002) pp. 34-5.
30 Alcohol’s effects on the risk for coronary heart disease. Mukamal KJ, Rimm EB. Alcohol Res Health 2001:25(4)255-61.
31 Why heart disease mortality is low in France: the time lag explanation. Law M, Wald N. BMJ 1999:318:1471-80.
32 Ibid.
33 Red wine, dealcoholized red wine, and especially grape juice, inhibit atherosclerosis in a hamster model. Vinson JA. Atherosclerosis 2001:156(1)67-72.
34 Alcohol consumption and mortality from all causes, coronary heart disease, and stroke: results from a prospective cohort study of Scottish men with 21 years of follow up. Hart CL, et al. BMJ 1999:318:1725-9.
35 Ibid., p. 1725.
36 Alcohol-induced generation of lipid peroxidation products in humans. Meagher EA, et al. J Clin Invest 1999:104(6)805-13.
37 Internal Medicine News 2003 Mar:36(6) Cardiovascular benefits of alcohol may be reflection of biased studies. International Medical News Group.
38 Ibid.
39 Red wine, dealcoholized red wine, and especially grape juice, inhibit atherosclerosis in a hamster model. Vinson JA, et al. Atherosclerosis 2001:156(1)67-72.
40 Benefits of red wine may not be due to alcohol content. Vinson JA, et al. Medical Tribune 1999:40(1)24.

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