Part 2: Alcohol and Health Series – Am I a heavy drinker?
People often say to us – “Just tell me how much I’m allowed to drink and I’ll do it” but unfortunately, like any health related question it is not that simple. In Part 1 of our Alcohol & Health series we started looking at how alcohol affects our health but in this, Part 2, we will dig a bit deeper on how much is too much when it comes to alcohol and provide you with expert recommendations on the “safe” level of consumption for adult drinkers.
What is heavy drinking?
The more alcohol you drink, the greater the risk to your health and wellbeing. To protect your long-term health, experts recommend that over your lifetime, on average:
- Men should have 2 days alcohol free days per week and a maximum of 15 standard drinks per week. So, this equates to 3 standard drinks a day for 5 days of the week and 2 days off
- Females should have 2 days alcohol free days per week and a maximum of 10 standard drinks per week. This equates to 2 standard drinks a day for 5 days, 2 days off.
Anything more than this would be considered heavy drinking so when you read about those “heavy drinkers” in the Ministry of Health stats – it is actually referring to lots of people just like you and I.
Some of you might be patting yourselves on the back for having more than 2 alcohol free days a week which is great – well done BUT if you go out on Saturday and have a dozen beers (approx. 16 std drinks), a few bourbons (approx. 3 std drinks) and a couple of shots (approx. 2 std drinks) you will be considered a heavy drinker as this is well over the 15 standard drinks per week recommendation for men. You can work out what your average night would equate to by getting to know your standards here . This standard drink calculator might help too.
If you want to drink smarter and protect your health while you’re socializing the best thing you can do is to think about your – SIZE, PACE, SPACE
- SIZE: Get to know the size of the drinks you are having and stop kidding yourself, it was just one wine, when you have ½ a bottle in your glass.
- PACE: Know your limit and build a plan around this. Think about what a good pace is for you to stay in the happy, relaxed space all night. Eating well before, during and after drinking will also help, so sip slower and enjoy the conversation!
- SPACE: Space your drinks out to last the distance in style. Maybe that is having a glass of water each hour, choosing drinks with a lower alcohol content, having a meal, playing a game of pool or hitting the dance floor without a drink in your hand.
You definitely don’t need to drink to have a good time but if you do choose to drink, it is important to remember that alcohol affects each of us in different ways. While our gender, age, size, ethnicity, fitness level, body chemistry and intake of food don’t change the job the liver does processing the alcohol (remember it can only ever process 1 std drink/10g of pure alcohol per hour ), they can impact how the body reacts to alcohol and how we feel the effects. Here are some examples of why and how:
Sex:
- Women tend to break down alcohol more slowly than men – this is due to a number of factors such as their smaller builds and the fact they have less of the enzyme that breaks down alcohol. Therefore the same amount of alcohol leads to a higher BAC in women than in men.
- Hormone levels also affect the body’s ability to process alcohol, and women may experience higher BAC’s drinking their regular amount of alcohol right before menstruation.
- Men also typically have a higher proportion of lean tissue (muscle mass). Muscles have a high water content so alcohol can go through muscles where as it can’t mix with fat. Put simply, this means there are more places for the alcohol to go in a man’s body.
Age:
- As you get older you have less of the ADH enzyme which helps break down the alcohol.
- Adolescents are also more sensitive to alcohol.
- Read more about alcohol and age here
Medication:
- Your overall health can have a huge impact on the way you feel the effects of alcohol. People with certain health conditions can be at increased risk if they consume alcohol. It is also important to be aware of how alcohol interacts with any medications you are on.
Mental Health:
- People who have, or are prone to, mental health conditions may have worse symptoms after drinking. Depression, anxiety and anger can also cause changes in the enzymes in your stomach and therefore impact how your body processes alcohol.
Body Fat/Weight:
- As per the comments made earlier in the sex section, the key here is muscle mass.
- Muscles have a high-water content and therefore the alcohol can go through them.
- Alcohol and fat however don’t mix (much like water and fat when you soak your roasting dish on a Sunday night) so if you are carrying more fat than you used to, the alcohol will have fewer places to go and therefore centres around the vital organs more and you will feel the effects of the alcohol more acutely.
- Put simply, the more muscle mass/ lean tissue you have, the better when it comes to helping reduce the effects of the alcohol while it is waiting to be processed.
Functional Tolerance
- This is what is commonly described as “piss fit” – functional tolerance is a decrease in the body’s sensitivity to alcohol’s effects so when you have been drinking lots and/or more often, your body seems to handle the booze better than normal but actually your liver is just living in a state of heightened awareness.
- This is fine on occasion but long term it can result in physical dependence and alcohol-related organ damage – the liver eventually burns out!
That’s why we highly recommend that you don’t compare yourself to others when it comes to drinking – always make the decisions that are right for you on that particular occasion!
Alcohol impairs your judgment and impaired judgment leads to compromised decision making so planning how you are going to drink before you start is a great way to help protect your health and keep your drinking in check. Maybe you could start by asking yourself these questions:
- How much can I drink and still feel like myself?
- How much can I drink and retain my good judgement?
- What happens for you on either side of drunkenness?
- What responsibilities do you have?
- Who else should you be thinking of when you make your drinking choices?
- What do you need to do to the day after drinking?
If you’re not making good decisions, you’re (a) more likely to put yourself in harm’s way and (b) your drinking is more likely start to impact other areas of your life (work, relationships, sleep, finances etc) and that is when drinking becomes a problem. That is why experts suggest that 1 standard drink per hour is a great rule of thumb for helping to keep your safe and sociable whilst also ensuring you remember the occasion for all the right reasons!
The other major watch out for regular and prolonged heavy drinking is the negative health impacts which we covered off on Part 1 of this series – see here. It can sometimes be quite hard to get your head around all this when you are younger and seemingly more invincible, but they are not things you only need to start worrying about when you turn 60. The impacts can be cumulative over the course of your lifetime so knowing what they are will help you make good decisions now, to protect your long-term health.
To understand more about the health impacts of alcohol check out our “My Body” module here and make sure you consult your health professional if you have specific questions or concerns you want answered.
Where to seek help
If you’re worried about your drinking, or someone else’s, have a chat with your doctor, or to the friendly folk at your nearest Alcohol and Drug and Information Centre. You can also learn more at cheers.org.nz
It might all seem like a lot to take in but if you plan ahead and remember your simple SIZE, PACE, SPACE mantra when you are in the moment you will be well placed to make smarter drinking choices now and in the future.
Drink safe, stay sociable