When we say about someone that they “drink a lot” it is out of concern for that person’s health, but what do we really mean by “a lot”? While some people have a couple of beers or glasses of wine daily, others may be drinking alcohol only on the weekend, but in large quantities, what is called in English “binge drinking”. What are the health effects of these behaviors?
Drink daily or drink on the weekend?
The answer, as is often the case, is that it depends on several factors, such as the total amount of alcohol ingested, the frequency of consumption and the individual’s susceptibility to the effects of alcohol. According to the Survey on Alcohol and Drugs in Spain (EDADES) 202276.5% of the population aged 15 to 64 had consumed alcohol in the last year, with a higher prevalence in men (77.5%) than in women (75.5%).
The same study indicates that 9.6% of the population in Spain consumes alcohol daily, again being more common among men (13.3%) than among women (5.9%). Furthermore, 15.4% of those surveyed have practiced intensive alcohol consumption in one go in the last 30 days. This behavior also has a greater impact on the group of younger consumers, between 20 and 24 years old. Among students aged 14 to 18, consumption grows from 36.5% at age 14 to 73.8% at age 18, and at these ages is when the pattern of weekend binge drinking tends to be established. .
During the Covid-19 pandemic, changes in alcohol consumption patterns were observed. According to a report from the Ministry of Health in 2021alcohol consumption decreased in both sexes during confinement, with a more notable reduction among young people between 15 and 34 years old, which would indicate that at these ages alcohol has a high social component.
A study from this same year by researchers from the Carlos III Health Institute (ISCIII) in Madrid analyzed the different patterns of alcohol consumption and their impact on mortality. Occasional consumption or low and infrequent amounts of alcohol did not significantly increase mortality. However, never-drinkers, former drinkers, individuals with regular drinking of two drinks a day or more, and those who drank heavily on a weekly basis experienced an increased risk of mortality.
The myths of moderate daily consumption
Scientific studies have been published for many years in which moderate daily alcohol consumption, often defined as one or two drinks a day for men and one drink for women, has been linked to certain health benefits, particularly in relationship with cardiovascular diseases. One of the most recent, published in 2019 by researchers from the Sant Pau Hospital in Barcelona and the Carlos III Health Institute in Madrid speaks of a hormetic relationship between alcohol consumption and cardiovascular risk. This means that high consumption is harmful, but moderate consumption presents better results than zero consumption.
A WHO statement released last year challenges the myth of moderate alcohol consumption as harmless or even beneficial, stating that ‘there is no safe level of alcohol consumption.
However, a WHO statement published last year challenges this idea, stating that “there is no safe level of alcohol consumption.” The data on which this warning is based comes from a 2021 study that estimated that the number of cancer cases attributable to moderate alcohol consumption (one or two drinks a day) in the EU in 2017 was responsible for 23,300 new cases of cancer.
The main author of the ISCII study, epidemiologist Iñaki Galán, from the National Center of Epidemiology, insists that the risk is always there, even in moderate quantities, despite messages that years ago insisted that moderate consumption could have benefits. : “It is a message that comes from the industry and has even reached healthcare professionals, especially cardiologists. But the problem is that it is being used as a reference to teetotalers, who probably do not drink because they were already sick,” he explains.
Other analyzes such as the one published in The Lancet in 2022 as part of the Global Burden of Disease study have proven that the supposed benefits of that glass of wine a day could be limited to adults over 40 years of age, and no such benefits were found at younger ages.
Regular consumption, although moderate, can also cause tolerance to alcohol, which increases the risk of dependence. Furthermore, alcohol affects the liver even in small doses, and can trigger liver fat accumulation according to a 2020 review and, over time, cellular damage that could lead to cirrhosis.
Regular consumption, although moderate, can also cause tolerance to alcohol, which increases the risk of dependence. In addition, alcohol affects the liver even in small doses
As Dr. Galán explains, “the effect has a J-shaped curve, as you consume a little more you have a much greater risk of general mortality. Cardiovascular pathology is going to increase in this way, but in the seven types of cancer associated with alcohol consumption the increase is more linear,” he clarifies. “The amount of cancer attributable to moderate consumption is much lower than that of excessive consumption, but because so many people are exposed to moderate consumption, the burden of disease ends up being tremendously large.”
The occasional drunkenness
Occasional excessive consumption or “binge drinking” It is defined as the intake of more than five drinks for men or four for women in a short period of time. This form of consumption, more common among young people, is also associated with acute and long-term health risks.
In the short term, excessive consumption can lead to severe alcohol poisoning, unconsciousness, accidents, and risky behavior such as driving under the influence. A 2017 RACC study It confirms that drivers involved in fatal accidents with a positive alcohol test are concentrated in the age groups between 25 and 44 years. “Above all, it is associated with the effects of external causes, that is, the probability of having an accident, a fall, being involved in fights…”, corroborates Dr. Galán.
The amount of cancer attributable to moderate consumption is much lower than that of excessive consumption, but because so many people are exposed to moderate consumption, the burden of disease ends up being tremendously large.
Iñaki Galan
— National Epidemiology Center
But, in addition, binge drinking can cause damage to all tissues, even in young and healthy people. The damage caused by drunkenness was recorded by a study from the University of Louisiana. In the long term, recurrent binge drinking increases the risk of brain damage, liver disease, hypertension, and alcohol dependence. “Alcohol consumption causes liver pain because it is responsible for eliminating that alcohol, and then there is also the neurological risk, especially in young populations under 20 years of age, where the brain is still developing”, warns Dr. Galán.
Is it worse to drink a little every day or a lot on the weekend?
In reality, both consumption patterns have negative consequences for health, which manifest themselves in different ways. Moderate daily consumption may seem less bad due to the absence of spikes in blood alcohol concentration, but the cumulative damage over years to the liver, cardiovascular system and cancer risk cannot be underestimated.
People don’t know what moderate consumption is, and they think it’s having five drinks.
Iñaki Galan
— National Epidemiology Center
“We are not Taliban,” explains the gallant doctor. “The best health advice is not to drink. Now, if you drink, it is better to drink very low amounts. People really don’t know what moderate consumption is, and they think it’s having five drinks. With one or two glasses of wine or beer, or half a mixed drink, throughout a meal, in a much slower way over time, and also socializing, you are not exempt from risk, but the risk increases a little.
However, you have to be careful, since the curve from there is exponential. “Above these quantities the risk increases very intensely, and more so as we introduce more quantities of alcohol,” concludes Dr. Galán.
*Darío Pescador is editor and director of the Quo magazine and author of the book your best self Posted by Oberon.
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