2010-07-31 / Columnists

Alcohol Part I: The Subtle Spirit Should Be Used in Moderation

Maintaining Your Health on Mackinac
By Yvan Silva, M.D.

A lot of alcohol is served, especially in the summer months on Mackinac Island. Mackinac County ranks first, per capita, among the 83 counties in Michigan in state excise tax revenue on liquor, beer, and wine, averaging more than $42.69 per resident. This figure was reported about six years ago. More than 10,700 residents occupy this area of the Upper Peninsula; this also includes the Island with its 469 year-around population. The people in the county don't drink any more than other residents of the state. It’s the people who flock “up north” to summer homes, campsites, hotels, restaurants, casinos, and bars who help push these consumption figures up.

Derived from the Arabic, "al-kohl," meaning "subtle," alcohol is a pure carbohydrate that yields seven calories per gram when it’s oxidized. But the calories are "empty," meaning that there are no essential food factors and no energy storage. In fact, alcohol can weaken the very basic unit of the body - the cell. The romance with alcohol has been around for centuries. Some celebrate with it and drink on special occasions, while others drink enough to get drunk and still others get into trouble. In the short term, as Shakespeare put it, "It increases the desire, but inhibits the performance." And getting drunk can get you into trouble with the law. The overt effects of drinking have become unacceptable to society, and the legal aspects of drinking when driving automobiles or operating other vehicles or machinery have become very strictly defined and enforced on land and in the waters around us. The following facts should serve to debunk many commonly believed myths.

There is the same amount of alcohol in 1.5 ounces of 86- proof liquor, 12 ounces of beer, or five ounces of wine. Absorption occurs through the lining of the stomach and upper small intestine and alcohol then circulates in the blood stream until it is metabolized in the liver and is excreted through the kidneys and lungs. Depending on blood alcohol levels, and on tolerance to alcohol that ensues from chronic use, various bodily functions become impaired - physical and emotional. Effects depend on sex, body weight, how fast one drinks, how recently one has eaten, and on mood. Commonly, four drinks in one hour will raise the blood alcohol level in a 150-pound male above 0.08%. This will be slightly higher for a female of the same weight, because of gender differences in body composition. The rate of absorption is only slightly higher on an empty stomach. Caution is necessary when blood levels are .04% to .05%, driving and other tasks involving coordination and judgment are impaired at .051% to .099%, and most state laws decree levels at or above 0.08% or 0.10% as legally drunk. Breath analysis measures alcohol level/excretion through the lungs and closely reflects blood levels.

In most individuals between 150 pounds and 180 pounds, two drinks in one hour will put blood alcohol levels at .04% to .05%. Only time can decrease the levels, while the body deals with the effects. Cold showers, fresh air, black coffee, and physical exercise are of no use and play no role in clearing alcohol from the body. It has been well established that after alcohol intake has stopped, levels will only go down at the rate of 0.015% per hour. It is also well known that after reaching the legal limit of .08%, it takes only one drink per hour to maintain that level. And it will take six to eight hours for elimination of alcohol from the bloodstream. That is why drivers arrested for related offenses are required to spend several hours in detention prior to being released. Our society has refuted its tolerance to drinking; there are no more drunken jokes on television and in the movies. Comedians do not do drunken routines anymore. Drunkenness is not funny at all.

Prosecution has become immutably stringent. The penalties and fines seem harsh, but any counter-argument must contend with the sad realities of deaths and lifetime morbidities of victims of drunk driving and other tragedies involving alcohol.

Acute effects of alcohol on the body are early stimulation and euphoria, the feeling of a high or accentuated well being. Depending upon the amount ingested, physiologic effects progress to drowsiness, sleep, followed by a hangover and depression. The oft-exclaimed cure for the hangover, “the hair of the dog” in the form of another drink, does not ameliorate the symptoms - it just helps get you started drinking again, with the early effects of stimulation.

The latest debate in the health care discussion has centered on research that has allegedly shown that in light to moderate drinking, alcohol raises the HDL or good cholesterol level and thus might lower risks of heart attack. Some experts have postulated that red wine might reduce this risk better than other forms of alcoholic beverages. No clear advantages have been demonstrated for this so-called French Paradox - the lower than expected heart disease rates in French and Mediterranean countries where wine is commonly a part of the meal. In reality, a closer look at statistics on the health of people in France do not differ from other places very much. Other studies on alcohol consumption have been consistent over longer periods of observation. Heavy alcohol intake surely increases risk of death from liver damage, cancers of certain organs, heart failure, and stroke. And the definition remains difficult, at best, because of the wide variability of types of alcohol and patterns of drinking.

For now the guidelines on whether to drink to improve your health might best be listed as follows: If you do not drink at all, do not start. For light to moderate drinkers, the maximum benefit appears to be at the level of one drink to two per day. Heavy drinkers should reduce intake, and if that is not possible, they should stop.

One thing is sure: When you add up all the calories you take in, alcohol ranks high, at seven calories per gram, and the calories are empty. The best guide remains proper understanding of alcohol and its effects. There is very little room, if any, for its routine use in a sensible approach to good health with the obvious emphasis on good nutrition and a planned regimen of physical exercise.

Dr. Silva is a professor of surgery at Wayne State University and a resident of Woodbluff on Mackinac Island.

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