Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
20 Nov

Alcohol: The Good and the Bad

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).

But what about the positives?

It improves endothelial function (with a catch).

Impaired release of nitric oxide from the endothelial cells is strongly associated with cardiovascular disease. Ethanol actually increases the production of nitric oxide, which dilates blood vessels, regulates blood pressure, induces vascular smooth muscle relaxation, and basically improves endothelial function. If you want good cardiovascular health, you want good endothelial function. However, it’s important to note that large doses of ethanol seem to decrease endothelial function, so caution is obviously warranted.

It can reduce stress.

A lot of people use a glass of wine or beer to “wind down” after a hard day. This sounds bad on the surface – “you’re relying on alcohol to stay sane!” – but really, if you have to choose between stewing in your stress hormones all day and night and having a drink or two to settle yourself down, I think the drink can be a better option for some people – particularly if the stress is going to impair your sleep and affect your relationships. You’ll want to identify and deal with the original source of the stress, of course, but some people may find a net benefit from having that drink.

It promotes socializing.

Humans are social animals, and we are happiest and healthiest when we have friends, loved ones, and spend quality time with them. Social isolation is a consistent and strong risk factor for increased mortality and morbidity (meaning it’s linked with earlier death and worse health in the days up until that death). You shouldn’t base your socialization entirely on drinking alcohol, but it can certainly be a powerful enhancer of your social life, and if you’re having a couple of glasses of wine as you host dinner parties, hang out with friends, enjoy a candlelit dinner with your significant other, or throw a BBQ with your social circle, it will likely have a net positive effect on your health. Of course, this isn’t to say that alcohol is any way needed to have a good time in a social setting.

It can reduce post-prandial blood sugar and lipid peroxidation (when taken with a meal).

Just like it says above, drinking alcohol (like wine, for example) with food can reduce postprandial blood glucose and the susceptibility of blood lipids to peroxidation (PDF).

It can lower iron absorption if you’ve got iron overload.

Although the conventional push is to increase the intake of iron from foods (especially via fortified grains), some people don’t actually need the added iron. If you have hemochromatosis, a genetic condition that probably arose in Europeans as a survival response to the bubonic plague, you are a hyper-absorber of dietary iron. Luckily, ethanol seems to inhibit the absorption of heme iron, the kind you find in red meat. Red wine is also effective at reducing non-heme iron absorption, an effect most likely due to the polyphenols present. That said, the entirely non-alcoholic black tea also inhibits iron absorption and has even been shown to reduce the frequency of blood-draws required in patients with iron overload. Coffee works, too.

If you’re going to drink:

Have it with food.

When you eat a meal, and your stomach is “full,” the pyloric sphincter – which controls the passage of food and drink from the stomach into the small intestine – closes up until your stomach can break down its contents. Any alcohol added to a full stomach will also spend more time being broken down by the relevant enzymes. If you drink on an empty stomach, the pyloric sphincter is wide open, and a greater proportion of alcohol will make it to the small intestine for immediate absorption. Plus, as I mentioned earlier, drinking alcohol with food can reduce postprandial blood glucose and the susceptibility of blood lipids to peroxidation (PDF). Keeping your drinking around meals will let you take advantage of these benefits.

Focus on alcoholic drinks with greater fluid content.

Shots of plastic bottle vodka (or even the best vodka) are concentrated sources of ethanol, and as long as we’ve been nibbling on fermented fruits and brewing up Paleolithic moonshine from mushrooms and honey, consuming concentrated, distilled ethanol in the form of rum, gin, whiskey, vodka, and other hard liquors is a relatively recent practice. Some accounts suggest that the Chinese were distilling rice liquor in 800 BC, while others say it wasn’t until the 12th century AD that distillation became commonplace across the “known” world. At any rate, one could certainly argue that alcohol with a low fluid content is an evolutionarily novel food item. Less fluid means less “stuff” in your stomach, which means a more open and allowing pyloric sphincter, which means faster absorption through the small intestine. More fluid means more “stuff” in your stomach and a more restrictive pyloric sphincter and slower absorption. You could even make like the ancient Greeks and water down your wine, which some people seem to think actually improves the wine.

Choose your drinking companions wisely.

Even among voles, peer pressure-induced binge drinking is a reality. If that super cool vole with the sweet facial hair is double fisting acorn shells filled with dandelion wine, you’ll be subconsciously drawn to do the same. If your group of friends gets absolutely obliterated every time you go out with them, you’re more likely to join in on the “fun.”

Drink moderate amounts.

All the research suggesting health benefits to drinking revolves around “moderate drinking,” which is one, two, or three drinks a day. They’re not talking about pounding shots, or drinking Long Island iced teas, or doing Jello shots (although the gelatin might help matters). They’re talking about a glass or two of something.

Have everything else in line.

If you want to drink and remain healthy, you should strive to eat healthy, exercise well, reduce stress, walk a lot, experience nature, hang out with friends and loved ones, get sun when available, avoid nighttime light exposure as much as possible, and every other lifestyle prescription I recommend. In short, alcohol can augment (or at least fail to impact either way) an already healthy lifestyle, but it probably won’t make a bad situation better.

Full disclosure: I drink. My drink of choice is red wine, and I might do a glass or two most nights, but I never get drunk. Heck, I don’t even really get “buzzed.” I’d never recommend that people take up drinking or continue drinking, but I also don’t see it as a great evil in and of itself. The dose and frequency make the poison; it’s just that depending on a number of factors, the dose that makes alcohol a poison might be lower or higher for you than for me. If your sleep is affected or you are the least bit “off” the next day, you probably surpassed your ability to effectively process it and you should factor that in to your choice and approach to drinking again. And remember, alcoholism is a serious issue for some people and I am in no way suggesting there is any “workaround” or excuse herein for someone with those issues, or that drinking, even in moderation, is necessary or optimal for healthy living.

Okay, that’s about it for me. Let’s open it up to you guys, now. I want to hear your thoughts on alcohol, especially whether it’s had a positive, negative, or neutral effect on your life and the life of those you care about. I want to hear how you’ve integrated alcohol into your otherwise healthy lifestyle (or not). Thanks for reading!

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. I am interested in what you said about “flushing.” When I drink even one glass of wine (and it gets worse if I drink more than that) my cheeks get hot and I feel like I am blushing. Is that what you are referring to and does that mean I am at higher risk?


    Emma wrote on November 20th, 2012
    • Yes, that is what he is talking about.

      Wayne wrote on November 20th, 2012
    • Emma,
      I started getting a similar reaction at the end of college. At first it was after more drinks than I should’ve had, but it progressed to where I would get flushed, with red splotches from my chest up to my head after just a few drinks. Did some reading in a few medical journals, and believe I found that an increase in taurine can upregulate the production of acetaldehyde dehygrodenase. From almost the day I started a taurine supplement, the effects are non-existant now. I’m not a medical professional though, so take it for what you will.

      Randy wrote on November 20th, 2012
    • I get a terrible flush from wine. Feels like my skin is getting pricked while it’s burning. I am very sensitive to sulphites though. I can have agave tequila with no problem though. BTW, I don’t drink very often anymore and don’t miss it at all. I find food and drink to be mostly habitual.

      Janet wrote on November 20th, 2012
    • All alcoholic beverages cause dilation of the capillaries, which causes flushing. It’s why people are fooled into thinking alcohol will warm them up on a cold night, when in fact it will cool you down because more of your blood is exposed to a larger surface area.

      Red wine is also high in histamines, which can cause this flushing reaction in people who are sensitive to it. If you only experience flushing when you drink red wine, you could switch to something else and see how it goes.

      Mark A wrote on November 20th, 2012
      • That would explain why my nose acts up when I drink red wine. Actually it happens whenever I drink. It didn’t used to when I was younger but now all it takes is one drink and instant clogged nose.

        Jim wrote on November 21st, 2012
        • Me too, I feel like someone fill my head with a complete pillow when I drink. Sinus full blocked…

          Harry wrote on November 21st, 2012
    • Be aware also that the gene that codes for alcohol metabolism is also deficient in people of Finno-Ugric descent/genome. I.e., it’s not just “Asians.” Though arguably many boreal/arctic Finno-Ugric people have steppe ancestors (to whom we also owe our magnificent almond-shaped eyes). 😀

      This is one reason that alcoholism is so bad in Finland and Russia: people with genetic alcohol dehydrogenase (enzyme) deficiency can drink much more alcohol before “feeling it.” We may flush, but even a five-foot-three Finn like myself can drink just about anybody under the table. In fact I used that to my advantage as a cub reporter in my 20s, and to get myself out of dates that were shaping up to be icky.

      I never understood why I was “that way” till learning about this enzymatic pathway. Some of us Finns can quite literally drink ourselves to death, and only feel the woozy relaxation that others apparently feel after a drink or two when we have had seriously toxic amounts of alcohol. This is why I rely on sauna, dietary fat, winter sports, snuggling, and Sibelius for my endorphin rushes.

      jussi wrote on November 28th, 2012
      • Mmmmmm, sauna, fat, snuggling, and Sibelius. Sounds wonderful. I’ll try to package that here in the southern US.

        C Liston wrote on November 20th, 2013
      • Celts must also be like Finno-Ugric peoples! Takes a lot (or it used to, lol!) to put me “under the table”…. except in my case it involved drinking lots of army blokes under the table- who didn’t believe a girl could do it…. the things we do when we think we are bulletproof :)

        Sarah wrote on November 20th, 2013
  2. I am in the 20th day of a 21 day challenge to give up alcohol completely. This experience has given me some great perspective on drinking. I didn’t realize how much I was drinking until I stopped. I was probably going to two happy hours a week, drinking wine with a steak once a week and having a bottle with a lady friend on the weekend. That is 4 times a week which is more often then I need and led to poor food decisions the night of drinking as well as the next day I would crave junk food. I have been pleasantly surprised of how accepting people were of my choice not to drink even at happy hours and night out at the bar. It also saved me a lot of money, many bar tenders wouldn’t even charge me for a soda water with lime. Once my challenge ends I will go back to drinking but I will be doing it less often and I will try to limit my drinking to one or two glasses per occasion.

    Wayne wrote on November 20th, 2012
    • Right one Wayne.

      I too have been surprised how accepting friends have been since I stopped drinking.

      I was worried about the peer pressure, awkward social situations, etc. Most of my social groups are heavy drinkers, but even hanging with them in bars, while I don’t drink has been fun.

      I might go back to having a glass of wine now and then, but for now, I like what I’m doing.

      PS. A Jack In the Box about a half mile from my house was my downfall on many a drunken night.

      Lars T. wrote on November 20th, 2012
    • I was thinking of doing this same 21 day challenge as I do drink along the same lines as you did before starting. I’m down to about 8 or 9 percent body fat and want to make that final jump into the 5 or 6 percent range. I feel like alcohol is what is separating me at this point. Have you noticed any fat loss or other effects in your 21 days?

      Patrick wrote on November 20th, 2012
      • I’m just at the end of a paleo 60 challenge and gave up alcohol as part of that. I’ve noticed I’ve dropped almost 2 dress sizes esp around my waist, lost 6lbs, and have improved fitness at Crossfit, improved sleep, improved skin texture. Not missed it at all these last few weeks – although it was hard at first. You’ve got nothing to lose and everything to gain – give it a go!

        Jules H wrote on November 21st, 2012
      • I did lose a few pounds.

        Wayne Atwell wrote on November 25th, 2012
  3. Plastic bottle vodak is a clean source of alcohol though Everclear is probably better.

    rob wrote on November 20th, 2012
  4. Drinking gives me an instant intense headache which I am all to prone to so it really makes the decision not to drink for me.

    Groktimus Primal wrote on November 20th, 2012
    • I too get a terrible migraine the next day if I have any alcohol other than good vodka (Grey Goose or Belvedere). A few months ago I thought I’d make the switch to a more Paleo choice, Patron. Boy was that a mistake. The subsequent two day migraine taught me not to stray from my safe choice.

      Hilary wrote on November 23rd, 2012
      • However, I only drink a few times a year on social occasions and do have between 3-5 drinks each time. It feels good to cut loose every once in a while.

        I am much more likely to go out for a long walk or take an Ativan than I am to have a drink. I wonder if occasional benzodiazepene use is worse than an occasional few glasses of alcohol. Any thoughts?

        Hilary wrote on November 24th, 2012
        • Certain alcoholic drinks give me terrible headaches the next day, too. Still haven’t figured it out, but a lot of times it’s cheap wine.

          Kathleen wrote on November 20th, 2013
        • Try one of the vodkas out there made from potatoes, sweet potatoes or grapes.

          Paul wrote on May 8th, 2014
        • I believe that occasional benzo use is safer. And I’ve taken benzos before so I’m not just speculating. Especially if not used regularly. I, too, noticed the difference from drinking Grey Goose as opposed to cheaper vodkas! However I’ve tried to eliminate alcohol completely as I really think, on the whole, it’s more detrimental than beneficial.

          Beth wrote on May 20th, 2014
  5. The toxicity of alcohol may actually belong on both sides of the ledger. Because of its toxicity, alcohol activates heat shock transcription factors, upregulating the production of heat shock proteins, which help to repair and/or clear away misfolded proteins.

    Brandon Berg wrote on November 20th, 2012
    • Because of this, and because of a family history of neurological illness, I’ve been trying to drink more wine, but I just don’t like it. I may be the only person in the world whose drinking problem consists of not drinking enough.

      Brandon Berg wrote on November 20th, 2012
      • I’d be real careful about extrapolating from molecular biology to organismal biology! What happens in a multi-well dish in the lab does not necessarily translate to the human neurological system…

        Chica wrote on November 20th, 2012
      • Could you give us a few brands you chose and what about them you hated (too sweet, too bitter, etc.)? I have tried MANY, though I do lean toward the lesser expensive variety. Might be able to suggest one to you.

        Claudette wrote on November 30th, 2012
    • Try sauna instead!

      jussi wrote on November 28th, 2012
  6. I hate drinking anything and everything. Makes me feel like total crap no matter what kind it is or how much I consume.

    Liz wrote on November 20th, 2012
  7. I love both of these shimilar posts and wanted to be sure Wayne was here early again

    Tom B-D wrote on November 20th, 2012
    • : )

      Madama Butterfry wrote on November 20th, 2012
  8. I recently quit drinking. It affected me several ways, but sleep was one of them.

    I would have trouble sleeping up to a full 24 hours after drinking. If I drank a lot on a Saturday, I slept horribly on Sunday night, affecting my Monday.
    I hated drinking on worknights, so I rarely went out. Now that I don’t drink, I go out more often.

    Lars T. wrote on November 20th, 2012
    • Im with you I sleep awful if I drink (which is pretty rare)….If im drunk oh lord were talking three day hangovers. Cutting it out really does helps you gauge how much it affects you!

      luke depron wrote on November 20th, 2012
  9. I’ve never been much of a drinker. I mean I’ve had my nights of getting pretty damn drunk now and again but they have been very few and far between. These days I pretty much never drink unless I’m out of town and then only if can find a good cider. Cider is really the only alcoholic drink I actually LIKE.

    I’ve found that I can quite comfortably hang out at a bar or party with friends and just drink water or a soda or iced tea and have just as much fun (or more!) then if I was drinking. And as a bonus that means at the end of the night I can insist on driving my more indulgent friends home so they don’t end up in my ambulance (I’m a paramedic, part of the reason I never drink when I’m home!).

    That said, I don’t seem to be particularly sensitive to alcohol and generally don’t have too much in the way of symptoms from drinking it. Unless I drink Budweiser or coors beer. 😛 Then I get a headache about halfway through the first can.

    Noctiluca wrote on November 20th, 2012
  10. You mentioned that alcohol is implicated in one of three car accidents resulting in death. Alcohol is also the most violence-causing drug, merely from its use. According to government statistics 49% of all murders and attempted murders are caused by people who were drinking before committing their crime. That figure goes up to over 60% in large metropolitan areas.

    As to the ancient Greeks, anyone who didn’t water his wine was considered an alcoholic. Biblical wine of the Hebrews was supposed to be 1 part wine and 3 parts water. But I imagine the ancients had sweeter wines and so adding water wouldn’t hurt. And the Hebrew priests were prohibited from using “strong drink” in a blessing. Since they didn’t have distilled spirits, strong drink could only refer to undiluted wine.

    D. M. Mitchell wrote on November 20th, 2012
    • What a crock. Alchohol does not cause violence, being a violent person causes violences. That statistic is stupid.
      100% of all crime is committed by people who were breathing at the time. Does that equate to oxygen causes crime? Of course not. I am weary of people being excused or their culpability being diminished due to other factors. “Oh, the alchohol made me do it.” Really? alchohol is inanimate, how exactlydoes an inanimate thing MAKE you do anything? You did it because you’re a jerkoff with poor self control. Alchohol does not even cause drunkenness. You drinking it does. Whatever you do after is your fault.

      Bourke wrote on November 20th, 2012
      • Alcohol lowers inhibitions. If one is a violent, confrontational person by nature, they will become much more so with alcohol in their system (this describes my Ex to a tee). I know of several easy-going, nice people who become “happy drunks”…not violent at all. So, I agree with you: “Alcohol does not cause violence, being a violent person causes violence.”

        Sue wrote on November 20th, 2012
        • “Alcohol does not cause violence, being a violent person causes violence.”

          to which I would add:

          “…especially when they add alcohol” :)

          Ashley wrote on November 20th, 2012
      • The libertarians are out. Must be a full moon.

        Steve wrote on November 22nd, 2012
        • Actually, if the Libertarians are out, that generally means the sun is shining brightly!

          Joey wrote on November 23rd, 2012
        • Bravo Joey, BRAVO!!!! 😀

          Kenny wrote on November 24th, 2012
        • I was not aware that the ability to distinguish between causation and correlation corresponded solely with political beliefs. I thought it was a fundamental precept of experimental research and Popperian logic.

          jussi wrote on November 28th, 2012
  11. I used to drink about 2 glasses of wine per night (sometimes more, rarely less) and I quit completely two months ago. I’ve noticed positive changes in my cycle which indicate to me that the alcohol was having a serious effect on my hormones. I cut it out to try and have a baby but regardless of what happens, this experiment has convinced me that alcohol is more poisonous than I knew, and I won’t go back to drinking at that level again.

    Katherine wrote on November 20th, 2012
  12. Before going primal sometimes when I drank red wine it would cause me to experience what felt like a “closing” in my throat (some kind of swelling i assumed). After going primal 10 months ago I’ve never experienced that since and drink red wine nearly every night for dinner.

    Chance Bunger wrote on November 20th, 2012
  13. Thanks, Mark! Great summary as always. I’ll continue my practice of having a small glass of red wine about four times a week, with dinner.

    I would add that IF is very important in giving the liver recovery time, and that choline (e.g. from egg yolks) is great for liver health. I often fast until noon, then have eggs.

    Harry Mossman wrote on November 20th, 2012
  14. I regularly drink a glas of red wine, but I have at least 2 days a week without it. Every day seems a bit much to me, especially since it is addictive.

    Tanja wrote on November 20th, 2012
  15. Up until 2months ago, I was drinking a bottle of red wine every day to help me unwind from the stress of life, including being in a very high pressure sales position. In the process, I gained 40 or 50 pounds. Then I retired. My doctor told me my cholesterol levels were “trending” higher, and wanted to put me on a statin drug. Instead, I declined and quit the booze altogether. The liquor store still calls my name when I drive by. I miss it.

    Ezestreets wrote on November 20th, 2012
  16. I just wanted to say that this is one of the most well-balanced analyses of alcohol consumption I’ve ever read. I’m a recovered alcoholic, so alcohol is not an issue in my diet (or my life!). One of the (many) experiences I had that made me aware of my problem was a day when I hadn’t had a drink for months, and I read an article about the health benefits of drinking a single glass of red wine with dinner as well as eating a little dark chocolate–it was a very superficial blurb in one of those mainstream fitness magazines, and the hook was something like “A little vice might actually be nice”–or something like that. So…on the way home that day, I bought a good bottle of wine and two Dove dark chocolate bars. By the time I got home–20 minutes by subway–I had already eaten BOTH chocolate bars (did I mention I’m also a compulsive eater?), and by the time I went to bed, I had polished off the entire bottle of red wine, gone back to the corner wine store, purchased two more, had a beer on the walk back home, a beer in the elevator, and finished one and a half of the two extra bottles of wine. If one GLASS is healthy, just think how healthy it was for me to have two and a half bottles! I was the absolute picture of physical fitness! Anyway, alcohol is a long-gone part of my life, and the Primal Blueprint has proven to be a God-send when it comes to eating. It is simply the most logical approach to food I’ve ever encountered–eat the way we were meant to eat. Thanks Mark!

    Bob wrote on November 20th, 2012
    • Wow Bob quite the story man, glad to hear you no longer battle alcohol congrats that’s a tough hurdle to overcome. As a personal trainer I always recommend to my clients to cut alcohol out for 30 days just to see what kind of affect of hold it has on them. Alot of people don’t realize how much of a pull it has on them. The more is better analogy is where its easy to get in trouble

      luke depron wrote on November 20th, 2012
      • Thanks, Luke. That is a great approach you’re taking with your clients. Whether or not they have a problem, it can’t hurt, and they will definitely learn something about their relationship with alcohol–good or bad. It’s a no-lose policy.

        Bob wrote on November 20th, 2012
    • Bob your comment made me laugh so hard, in a good way. Because I understand. Mark labeled a section “Drink Moderate Amounts” and I immediately thought, “Moderation? What’s that” lol. To me it’s either all or nothing, so today (one day at a time) it’s nothing. And it feels SO good :]

      Rachel M wrote on November 20th, 2012
  17. I’m on the fourth week of an elimination diet — alcohol (red wine for me most nights) is not on the list. I’ve been using a glucometer to check my reactions to food for about a year now. Before starting the diet, my morning glucose was rarely below 100 (tho not over 110) — now it’s running around 90 every morning. I have read that alcohol can increase blood glucose — and that certainly seems to be the case for my X of 1. Though it could be the dairy I’ve cut out…, we’ll see. I didn’t do much dairy, but had a glass or two of wine most nights.

    Diane wrote on November 20th, 2012
  18. Good well-balanced article! I drink 2 glasses of red wine every night. But I also run, life weights, eat 100% primal, sleep well and get lots of play time. For me, wine is a pure pleasure and I balance it with everything else.

    mars wrote on November 20th, 2012
    • Your experience is very similar to mine. I typically drink 1 to 2 glasses of red wine each night and may have some dark chocolate as well. Otherwise 90% primal plus yoga, some mid level heart rate running, lift weights and sprint. Feel amazing, body fat at 10%. The wine and chocolates are pure pleasure and luckily don’t seem to have a negative effect.

      John wrote on November 20th, 2012
  19. There’s an interesting elephant in the primal room that’s been as far as I can tell ignored completely by the paleo world:

    When will there be an article on Cannabis? Surely it’s at *least* as primal as alcohol if not more so and it has many of the benefits of alcohol without the downsides.

    There are supposed to be no “sacred cows” here are there?

    JohnC wrote on November 20th, 2012
    • I quit smoking pot almost 2 years ago, and while I doubt the consumption of cannabis itself would be all that contrary to a paleo lifestyle, I can comfortably say I will never willfully ingest any smoke ever again—I would potentially be open to eating it in a sugar/grain free vehicle at some point, however…

      Graham wrote on November 20th, 2012
      • Anyone know where Animarchy is? Surely there are so many kick-off points for a mind-bendingly wayward tale from this post…

        Madama Butterfry wrote on November 20th, 2012
        • LOL, I was having similar thoughts!

          Cheralyn wrote on November 22nd, 2012
  20. “…acetaldehyde, an incredibly toxic compound that’s been implicated in causing many hangover symptoms.”

    Many things have been “implicated” wrt hangovers, but I know of one that gets overlooked. Consistently.

    I had “hangovers” for years, especially on Saturday and Sunday mornings. Strangely enough, I DID NOT DRINK ALCOHOL. (I did get drunk once, when I turned 21, and it was such an awful experience that I can’t understand why anybody would deliberately do it a second time.)

    I had a severe case of Obstructive Sleep Apnea (currently treated, and much less severe due to substantial weight loss).

    Sleep apnea can be caused by ingestion of even moderate amounts alcohol, even in people who do not normally suffer from the disorder. One of the more obvious symptoms is irregular snoring, but that is not always present.

    Sleep apnea will give you EXTREME headaches, especially if you try to sleep an extra hour or two (e.g., Saturday and Sunday mornings), because the last sleep cycle tends to be the deepest (at least if you have OSA).

    Howard wrote on November 20th, 2012
    • Whoa. Really? That could be the explanation for my Saturday morning headaches! Back when I was SAD-ly pre-Primal, I’d get these horrible day-long headthrobbers on Saturdays, and could never figure it out! At the same time, I was having lots of apneatic sleep (which is what got me started Primal), But I had no idea they were linked! Since two years of 95/5 Primal living, thirty pounds of fat loss, and fifteen pounds of muscle gain, my apnea has all but disappeared, and I haven’t had one of those headaches in well over a year. Thanks for the info, Howard. Wow! I’m still shaking my head, here. Never would have made that connection on my own.

      Erok wrote on November 20th, 2012
  21. I have heard that drinking also can cause depression. I drink a lot less than I used to and feel happier and healthier because of it.

    Diane wrote on November 20th, 2012
  22. George wrote on November 20th, 2012
  23. I drink wine with dinner nearly every night (6 nights out of 7). I lived in Europe for a long time; there, wine is considered a normal part of the evening meal. I probably have 2 or 3 glasses. I make sure to eat saturated fat with my meal (it protects the liver somewhat from the effects of alcohol), and otherwise I eat & live 100% primal. (And I’m a slender, fit, 40ish mother of three.)

    Primal Donna wrote on November 20th, 2012
    • “Eat some lard before you go to drink.” – that is what I used to hear from my grandmother. Could she be aware of the intestinal mucasa damage induced by alcohol and the protective effect saturated fat can have? She died healthy at the age of 98.

      Martin @ Leaky gut research wrote on January 3rd, 2013
  24. I work at a craft brewery and I used to have my free beer after every shift. Since going primal a year ago, even smelling alcohol is revolting and makes me gag. Wonder why? On the plus side, in the event that I need to drink for a social occasion, I make it through half a drink and I’m done for the night. Much cheaper than when I could pound several shots and a few beers and just barely feel buzzed!

    Cherice wrote on November 20th, 2012
  25. For most people alcohol is more of a social thing than a physical one. We drink because other people around us are drinking and, presumably, having a great time. It loosens us up and relaxes the inhibitions; wallflowers become instant social butterflies. Sometimes too much so, as in, “OMG, did I really do that last night?”

    Booze and I don’t mix well. I’m a cheap drunk because I usually get sick after a drink and a half of anything. Then I’m in the loo throwing up. Call me a killjoy, but that’s not my idea of a good time. White wine gives me a stuffy nose, and red wine gives me a headache AND a stuffy nose. Once in a while I’ll sip a G&T, but it’s gotten to be too sweet-tasting since I’ve gone paleo and eliminated sweets from my diet.

    Because of these things I rarely drink anything alcoholic and can’t say I miss it. I much prefer a glass of tea on the rocks or just water with a slice or two of lemon. Then I can sit and chuckle as I watch the OTHER people losing their inhibitions.

    Shary wrote on November 20th, 2012
    • I am with you on that entirely, Shary! I rarely drink, anymore, after I discovered how negatively it was affecting my sleep and health…and, I was a pretty conservative drinker before, with the very rare binge. I don’t like the drunken feeling or the subsequent hangover. I’m also quite the lightweight. One glass of wine and I’m toast!
      Yes, it is much more fun to sit back with my glass of Perrier water (w/twist of lime) and watch everyone else…Haha!!

      Sue wrote on November 20th, 2012
  26. One of the MANY benefits I’ve noticed since going primal about 6 weeks ago is that I no longer crave alcohol. I used to feel the need to always have several drinks when out with friends, and now I’m perfectly content with none, or just one. I think it stems in part from the fact that I feel so good on this diet, that I no longer like the loss of focus and clarity brought on by drinking large amounts. I also don’t tend to have anxiety like before, and therefore no need to use alcohol to calm myself.

    Smileyprimal wrote on November 20th, 2012
  27. “Is it poison, or is it a gift?”

    “Gift” is the German word for “poison.” Ach…

    cavedog wrote on November 20th, 2012
    • :) You’re right.. heeheee

      Emina wrote on November 25th, 2012
  28. This is SO timely and a really good analysis! I do think that the main thing is that everyone reacts differently so it’s really important to figure yourself out.
    I have often felt like i drink too much but it’s never really THAT much (maybe 2-3 glasses of red wine max/night). Fact though is I live alone and sometimes, after 2 glasses, my judgement does get impaired and i am more likely to get that last glass or more dark chocolate etc. What i have noticed though (like last night) I poured a small 3rd glass, but then ended up pouring it back in the bottle! That’s a new one. Not sure if it’s because i am newly primal (3 weeks) or what but an interesting turn.
    My goal now is 3 nights booze free and come Jan 1 i’ll do a 30d no booze challenge. I really want to get over this thing in my head that keeps telling me to ease up…

    Mel wrote on November 20th, 2012
  29. Since being primal, I’ve found that I am more susceptible to alocohol effects. This is also true for my girlfriend. Any thoughts on this?

    Dan wrote on November 20th, 2012
    • I think this is the same for me, I get terrific hangovers now! But maybe I just think they are worse because I am drinking less often? I don’t know…

      Sarah wrote on November 20th, 2012
    • I’m just the opposite. I’ve found that since I stopped eating grains and sugar, if I do overindulge in alcohol, I don’t feel as bad the next day. I might wake up with some slight dizziness, but none of the all-day “Irish flu.” Some eggs and berries for breakfast and I feel pretty good.

      Mark A wrote on November 20th, 2012
    • Drinking alcohol I feel nauseous more quickly when eating primal (low-carb). If I want to drink more, eating a banana and potato chips before/while drinking seems to fix the problem.

      Boston wrote on November 20th, 2012
  30. I’ve never had an alcoholic drink. I never saw the point in the first place.

    Nathan wrote on November 20th, 2012
  31. I have a glass of red almost every night. Occasionally two :o, but any more than that gives me a headache so its easy to limit it.(no white, too much sugar and not enough of the good resveratrol)

    Maybe its just me, but a small glass ( again, of red)helps curb my appetite and keeps me from wanting to eat sugar/snacks, etc….anyone else feel this way?

    jan wrote on November 20th, 2012
    • Alcohol definitely curbs my appetite. Even in pre primal days.

      Kate wrote on November 20th, 2012
  32. The gift to me is my total non tolerance of alcohol. I think it has kept me out of trouble. If I just have a few sips, my arms go numb, the top of my head feels dizzy and I feel like I am going to fall over. I did drink a full glass of wine once and then up-chucked an expensive dinner.

    As a consequence I have never been drunk. I have noticed my non drinking makes some people uncomfortable. I try not to make a big deal out of it but sometimes they keep pushing. I have never been much for going along with the crowd so it doesn’t bother me other that I don’t like to make the host of a party uncomfortable.

    I am now an old person and what I want to know is, where is all the money I have not spent on alcohol?

    Sharon wrote on November 20th, 2012
    • Ask your kids where the money is! :)

      Mark Cruden wrote on November 20th, 2012
  33. Years ago my husband worked with the chemical solvent Trichloroethylene. Within a few weeks of starting that job he began to experience fire red flushing of his cheeks neck shoulders and splotches across his forhead and back anytime he would drink more than one or two beer. We were young and nieve then and thought it was crazy but he made for an interesting conversation piece at the parties we went to. It got to the point where one beer would do this. The job only lasted 4 or 5 months and later we learned the previous man who held that job for many years of his life had died of liver cancer. Once away from that chemical the flushing reaction to beer stopped completly… until several years later when sucrolose became the new sugarfree sweetner. We switched all our sugar-free stuff to sucrolose containing products and within a few weeks my husband began having the same flushing reactions to beer. This continued a little while until we associated the two. We stoppped using sucrolose sweetened products and the flushing stopped. Both chemicals are chlorocarbons.. I have no idea and maybe there are several other chlorcarbons we come into contact with all the time but I’d say these two did something to his liver enzymes during those times when he had a higher exosure to them!

    shelley wrote on November 20th, 2012
  34. I’ve always diluted wine with water. I think it makes it taste better. People get on my case about this, but apparently I’m not the only one: the NY Times article confirms it.

    shannon wrote on November 20th, 2012
    • Whaaat !!! (initial knee jerk reaction)
      You know what: this is a very good idea, I will do this from now on (actually I just did it to my remaining half cup of red wine)

      WildGrok wrote on November 20th, 2012
    • How much are you diluting? Does it taste the same?

      I love wine but really need to cut down as it seems to be sabotaging my weight loss.

      Grace wrote on November 21st, 2012
  35. Mark, I have noticed myself that the effects of alcohol are so much more pronouned now. Not just sensitivity to it while drinking, but also the augmented hang overs the next day or two after drinking only a moderate amount (ie 2 glasses). I used to be an inconsistent drinker but when i did, it was often 4+ glasses a night. Whereas since the primal transition, my alcohol toerance has gone to almost zero regardless of whether its wine or spirits. I’ve noticed other readers making the same observation on previous posts you have logged on alcohol. It would be great if you could write a post to address why this might be the case and the possible physiological reasons underpinning it? Thanks!

    Elaine wrote on November 20th, 2012
  36. I use the financial software app, “Mint”, which is tied to my credit card. Every Saturday Mint sends an email that contains a pie chart infographic mapped to your spending. Many-a-emails the pie chart looked like pacman. The majority area being alcohol and bars. Good times.

    Paleo Bon Rurgundy wrote on November 20th, 2012
    • Ditto..

      I would get many “Over Budget” alerts from Mint.

      “You’re $350.05 over budget for Alcohol & Bars” -That was from last year.


      Lars T. wrote on November 20th, 2012
    • What – you use a credit card? I assumed you would be on the gold standard!

      Mark A wrote on November 20th, 2012
      • I would if I could. There are visa debit cards linked to gold. Euro Pacific Capital International offers one. The catch is only non US residences can use it. Bitcoin is catching on. I think word press now accepts bitcoin.

        Paleo Bon Rurgundy wrote on November 20th, 2012
  37. I actually find that I cope with day-to-day stress better when I don’t drink. If I go a little overboard, I feel very anxious the next day and have some trouble dealing with (what should be) seamingly minor issues. Could be that alcohol really disrupts my sleep. I do enjoy wine but I stick to the occasional drink amongst good company and to accompany a great steak. That’s when it’s most enjoyable. I will try the dilution thing. As a side-note, it’s estimated that 25% of drivers in Ontario on a weekend evening have at least some alcohol in their system. Very scary considering that as of July 30th, there had been 202 road deaths in Ontario.

    Mark Cruden wrote on November 20th, 2012
  38. Bourbon, either neat over over a big ass ice cube. I’ll have one after work, whilst sitting on the couch with my shoes off. I enjoy it thoroughly. Now I could post links to the health benefits of Bourbon, and I think Mark himself has even mentioned them in prior posts on spirits, but whom am I kidding? I don’t drink it because of its health benefits. I drink it because I enjoy the taste, and how I feel afterwards.

    Brian wrote on November 20th, 2012
  39. I phased out the beers after my primal conversion, it was not unusual for me on a weekend on the beach to have a 6 pack. Now the few times I have beers it is never more than two in a day (and only on the weekend). I may have an average of 2, 3 cups of wine a week with food.

    But … almost daily I have one or two shots of whiskey (or brandy or gin) when having a good time at night banging my keyboard. It just feels right and my music sounds much better :-)

    wildgrok wrote on November 20th, 2012
  40. One trick I’ve started using is to cook a huge primal roast (or something big) on Fridays. That way, when I come home after a night of drinking I’m sure not to punctuate my night with munchies because my meal is already cooked and waiting for me.

    Patrick wrote on November 20th, 2012

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