Alcohol: The Good and the Bad

by Mark Sisson
Mark’s Daily Apple

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What do we make of alcohol? In sufficient amounts, it’s a poison. It’s incredibly addictive. It destroys entire communities. It tears families apart and compels otherwise reasonable, upstanding individuals to commit terribly senseless acts. On the other hand, it’s a powerful social lubricant. The good stuff tastes great and can enhance the healthfulness of certain foods while inhibiting the unhealthfulness of others. It’s fun, it’s pleasurable, and it brings real (if chemically enhanced) joy to people. Moreover, we have a long and storied history with alcohol; it’s been an integral part of human culture and society for thousands, if not tens of thousands, of years.

So, what’s the deal? Is it good, or is it bad? Is it poison, or is it a gift? Let’s take a look at both sides of the story, which, as is often the case, isn’t exactly black and white:

First, the downsides.

It’s toxic.

Our ability to break alcohol down into less toxic metabolites didn’t arise because of our tendency to seek out fermented fruits. Over the course of an average day, the average human digestive system produces about three grams of ethanol just from the gut flora fermenting the gut’s contents. If we didn’t have the ability to metabolize and detoxify ethanol, those three grams would add up real quick and represent a huge toxin load on our bodies. After alcohol is consumed, a number of enzymatic reactions ensue. In the liver, an enzyme called alcohol dehydrogenase converts the ethanol to acetaldehyde, an incredibly toxic compound that’s been implicated in causing many hangover symptoms. An enzyme called acetaldehyde dehydrogenase converts the acetaldehyde into acetic acid, or vinegar (which is harmless unless you’re a cucumber). From there, you’re good to go. Sounds simple enough, right? Just let the enzymes do their thing. As long as you make those enzymes, the alcohol will be safely and effectively metabolized into table vinegar which can then be extracted to form a delicious salad dressing (that last part isn’t true).

Unfortunately, not everyone produces the same amount and quality of detoxifying enzymes. Many people of East Asian descent possess a dominant mutation in the gene that codes for aldehyde dehydrogenase, making it less effective. While they’re less likely to be alcoholics, folks with the mutation (characterized by a “flushing” upon ingestion) are at an elevated risk of liver damage and esophageal cancer.

It can give you fatty liver (and worse).

Around these parts, we usually talk about non-alcoholic fatty liver, a disease associated with sugar and fat intake coupled with inadequate choline to support the liver’s function. But notice that we have to qualify it with “non-alcoholic.” That’s because the most-studied type of fatty liver is alcoholic fatty liver. The mechanisms behind alcoholic fatty liver are myriad and multifaceted, but it ultimately comes down to the fact that you’re bathing your liver in a known toxin. Liver alcohol metabolism increases the NADH/NAD+ ratio, thereby promoting the creation of liver fat cells and a reduction in fatty acid oxidation; the result is added fat in the liver and impaired fat burning. Acetaldehyde, especially if it lingers for too long, also induces inflammation in the liver, which can ultimately progress to full cirrhosis and liver failure.

It can be carcinogenic.

Excessive alcohol intake is an established epidemiological risk factor for several cancers, including stomach, liver, and colon cancer (to name just a few; more than a dozen cancers are linked to alcohol abuse). In the stomach and liver, alcohol dehydrogenase converts ethanol into acetaldehyde, which is inflammatory and toxic. Alcohol that makes it through the stomach into the small intestine is also oxidized into acetaldehyde, this time by gut flora. While the liver produces the necessary enzymes to break down acetaldehyde into acetic acid, our gut microbes aren’t so well equipped and the acetaldehyde is allowed to linger longer.

It’s addictive.

While I’d argue that being addicted to anything will have a negative effect on your life, if not your physical health, being addicted to alcohol is particularly harmful because of how toxic it is – especially the more you drink. To get an idea of just how addictive it is, check out the results of this study: alcohol is less addictive than nicotine, crystal meth, and crack, but more addictive than heroin, intranasal amphetamine, cocaine, and caffeine. One’s susceptibility to alcohol addiction is often hereditary, too, meaning some people will be far more likely to become addicted than others.

It disrupts sleep.

A nightcap is a misnomer. Sure, it’ll help you fall asleep, but your sleep won’t be any better. In fact, as plenty of people reminded me in the comment section of last week’s post on sleep, alcohol is a serious disrupter of sleep quality. It increases the incidence of sleep disruptions, and it perturbs the healthy sleep cycles.

It affects judgment and perception.

Even though alcohol destroys a person’s ability to safely maneuver a motor vehicle, one in three car accidents that result in death involve drunk drivers. Everyone knows that you shouldn’t drive drunk, but why does it keep happening? A recent study even showed that just a single drink caused subjects to find “intentionality” in other people’s actions (PDF). Subjects who got the alcohol were less likely to view simple actions as accidental, rather than intentional. Thus, when you’re under the influence of alcohol, you’re more likely to take personal offense at the guy bumping into your shoulder, the lady stepping on your shoe, or the person “staring” at you from across the bar. Because, after all, they “meant” to do it, right? The title of the study sums it up quite nicely: “‘There’s No Such Thing as an Accident,’ Especially When People are Drunk.”

It promotes bad eating.

Everyone who’s ever gotten at least a buzz from a glass or two of wine or a mixed drink has felt the often irresistible urge to snack, to order something salty, crunchy, and sweet from the menu, to beg the driver to swing by the greasiest nastiest fast food drive-thru. This is a well-documented phenomenon. Alcohol affects both active overeating and passive overeating. Active overeating describes the conscious decision to “get some grub.” Passive overeating describes the amount you eat once the food is in front of you. Both are enhanced by alcohol. This wouldn’t be such a bad thing if you’re drinking at a Primal meet-up, where you’re surrounded by relatively healthy food, but that’s not where most drinking occurs.

It gives hangovers.

What’s worse than a bad hangover? I’m unaware of anything, at least on a physical scale. Sure, you can mitigate the damage, but the fact that a hangover even exists tells us that whatever we’re ingesting that gave us the hangover is bad for us (in the amount we ingested, at least).

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November 23, 2012

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