WHAT IT MEANS TO DRINK IN MODERATION

A few months ago, a new study was released in the British medical journal The Lancet that reported that when it comes to alcohol, no amount of drinking can improve our health. Previously the thought had been that drinking alcohol, in moderation, of course, resulted in some health benefits, especially for heart disease, and reduced the risk of stroke and diabetes. The study suggests that these potential benefits are outweighed by an increased risk of cancer and other health related-harms that alcohol poses to oneself and others.

So, after decades of being told that “moderate” drinking was not just safe for us, but actually “healthy,” the findings in this new study bring these notions into question. But there’s no need to throw out those good bottles of wine that you’ve been saving for a special occasion quite yet. However, with the holidays approaching fast, it is time to redefine what drinking in moderation means.

The National Institutes of Health (NIH) and National Institute of Alcohol Abuse and Alcoholism (NIAAA) have created some guidelines to help us by “Rethinking Drinking.” It defines a standard drink as equaled to 14 grams of ethanol which can be found in 5 ounces of wine, 12 ounces of beer or 1.5 ounces of 80 proof spirits. So how many drinks can you have?

For people with no known liver problems, this means that on any single day:

• No more than 4 drinks for men

• No more than 3 drinks for women

If you’re counting your drinks throughout the week:

• No more than 14 drinks for men

• No more than 7 drinks for women

The amount is lower for women as they have less volume for the alcohol to be distributed because they tend to weigh less than men and have less body water per pound compared to men. Women are also at a greater risk of liver damage from drinking alcohol than men. Furthermore, it is still unclear if there is any safe amount of alcohol to drink if you already have an underlying liver disease, so you may be especially at risk of alcoholic liver injury if:

• You have already been diagnosed with a liver disease such as iron overload or hepatitis B or C.

• You are obese.

• You have genetic factors that could determine the likelihood of liver injury after heavy drinking.

• You have a family history of alcoholism.

And because liver disease is often silent, people may not know that they have an underlying liver disease such as Hepatitis C Virus (HCV) even though they may be drinking moderately. With this in mind, there is a New York State law that requires health care providers to offer one-time testing for all those born between 1945-1965. If one is found to have HCV, there are many well-tolerated, oral, and highly effective one-time treatments that can eliminate the virus and cure the disease.

Alcohol consumption is common in the United Sates with 86% of all people greater than 18 years of age reporting having tried alcohol at some point in their lives. Furthermore, 56 percent of adult Americans say they drank alcohol in the last month, according to the National Institute on Alcohol Abuse and Alcoholism. This holiday season, the “The Big Apple” may be the city that never sleeps, but let’s also try to make it the city that drinks mindfully.

Dr. Amon Asgharpour is an Assistant Professor in the Department of Medicine, The Division of Liver Diseases at Mount Sinai.