Alcohol health risks- The “French paradox”, “the wine”, and “in moderation”

We all know that alcohol is a bad and toxic substance for us and that alcohol health risks are real. But somehow we all believe that one glass of wine is not all that bad and actually is good and somehow health-promoting because of all of its antioxidants from the grapes. A pregnant woman will avoid drinking alcohol because of fetal development but usually, people are just not aware that alcohol does much more than killing our brain cells. It is a genotoxic, cancerous, pro-inflammatory mutagen.

The developing fetus and adolescent brain are primarily vulnerable to the toxic effects of alcohol and this is the reason why it is absolutely forbidden in pregnancy. If the mother drinks during pregnancy that will have an adverse effect on fetal development. The most severe condition in this spectrum of diseases is known as fetal alcohol syndrome (FAS).

Alcohol is something as known as a teratogen, and that means that it prevents the cells from developing by blocking maternal and fetal enzymes.

“Alcohol can act as a teratogen through numerous methods including reactive oxygen species (generated as byproducts of CYP2E1), decreased endogenous antioxidant levels, mitochondrial damage, lipid peroxidation, disrupted neuronal cell-cell adhesion, placental vasoconstriction, and inhibition of cofactors required for fetal growth and development.”

(Gupta et al., 2016)

In healthy adults, alcohol restricts to some extent the production of vasopressin (ADH) (Harper et al., 2018). It is a hormone produced in the hypothalamus and is secreted from the posterior pituitary gland. Dehydration after alcohol consumption is a consequence of this restriction. This might be a reason for the hangover to a smaller extent. Hangover just by itself is not dehydration. You might try to prevent a hangover the morning after by consuming large amounts of fluid during binge drinking but that would not completely prevent the restriction of vasopressin and dehydration.

“Also, markers of dehydration (e.g., vasopressin) were not significantly related to hangover severity. Analyses showed that concentrations of various hormones, electrolytes, free fatty acids, triglycerides, lactate, ketone bodies, cortisol, and glucose were not significantly correlated with reported alcohol hangover severity. Some studies report a significant correlation between blood acetaldehyde concentration and hangover severity, but most convincing is the significant relationship between immune factors and hangover severity. The latter is supported by studies showing that hangover severity may be reduced by inhibitors of prostaglandin synthesis. Several factors do not cause alcohol hangovers but can aggravate their severity. These include sleep deprivation, smoking, congeners, health status, genetics, and individual differences.”

(Penning et al., 2010)

People who regularly drink more than one standard drink per day are at higher risk of long-term health conditions. Even if you do not feel the effect of the drink, you did yourself harm. And that is not all. Alcohol consumption releases excess GABA and dopamine. If too much of these neurotransmitters get released situation can change dramatically from feeling nice and relaxed to increased heart rate, shortness of breath, increased levels of both aggression and depression, high blood pressure, delusions, hallucinations, night terrors, spasms, and so on (Liang et al., 2014).

Excess drinking causes the liver to accumulate fat, which can lead to fatty liver disease especially if you are already obese.

“Alcoholic liver disease (ALD) is the most prevalent type of chronic liver disease worldwide. ALD can progress from alcoholic fatty liver (AFL) to alcoholic steatohepatitis (ASH), which is characterized by hepatic inflammation. Chronic ASH can eventually lead to fibrosis and cirrhosis and in some cases hepatocellular cancer (HCC). In addition, severe ASH (with or without cirrhosis) can lead to alcoholic hepatitis, which is an acute clinical presentation of ALD that is associated with liver failure and high mortality. Most individuals consuming >40 g of alcohol per day develop AFL; however, only a subset of individuals will develop more advanced disease.”

(Seitz et al., 2018)

All of these alcohol health risks are well known but what is not so known is that even just one drink a day may increase the person’s risk for breast cancer by 4% because alcohol has a pro-estrogenic influence on the cells. Cancers that are responsive to hormones will also have a positive response to substances that influence hormones like for instance breast cancer. The increase in the order of 4% is done just by one small alcoholic drink per day (Shield et al., 2016).

If you drink three or more drinks a day, then your breast cancer risk goes up by, imagine this 40-50 percent.

Around 5 percent of all breast cancers in the US are attributed just to alcohol consumption and around 1 to 2 percent to light drinks alone. Combine this with the pro-estrogenic effects of POPs and plastic and all other xenoestrogens.

Besides breast cancer, 3.6% of other types of cancers are caused directly by chronic alcohol drinking, and these include the liver, the colorectum, and of the upper digestive tract (Bagnardi et al., 2013).

The International Agency for Research on Cancer (IARC) official UN body under the WHO considers ethanol a carcinogen to humans (Group 1). Besides ethanol, alcoholic beverages are multicomponent mixtures that can be containing several different carcinogenic compounds, such as acetaldehyde, aflatoxins, and ethyl carbamate. Ethanol is considered the most important carcinogen in alcoholic beverages, but there are other carcinogenic compounds as well.

The biological mechanisms by which alcohol intake increases the risk of cancer are not fully understood, but the primary mechanisms are likely to include a genotoxic effect of acetaldehyde, the induction of cytochrome P450 2E1 and associated oxidative stress, increased estrogen concentration, a role as a solvent for tobacco carcinogens, changes in folate metabolism, and changes in DNA repair.

For cancers of the digestive tract, especially those of the upper digestive tract, acetaldehyde (a derivate from alcohol that creates itself almost instantly when you sip on an alcoholic beverage) has been highlighted as a likely and important causal pathway. That metabolite is so toxic it is terrible.

For colorectal cancer, in addition to the genotoxic effect of acetaldehyde, there may be the involvement of folate: alcohol may act through folate metabolism or synergistically with low folate intake. Bacteria in our mouths oxidase ethanol into acetaldehyde almost instantaneously. Even a single sip is enough to cause high concentrations of acetaldehyde even without drinking, there is still an effect for example if you use alcoholic mouthwash. In this study (Linderborg et al., 2011) they found that holding a single sip of a strong alcoholic beverage for 5 seconds in the mouth and then spitting it out formed carcinogenic concentrations of acetaldehyde in the oral cavity instantly and the exposure continued for at least 10 min. So even washing your mouth with it is cancer-promoting.

There is also more to booze than just cancer. Alcohol rises lipids in the blood and also blood pressure. That will increase the risk of raised cholesterol, hypertension, stroke, and heart attack. It causes cardiomyopathy, and myocarditis and it also causes arrhythmia.

However, wait red wine has long been considered the elixir of heart health. We can all remember the scam named French Paradox.

French paradox was a love affair for everyone. In 1980 some French scientists tried to explain the correlation between high fat intake, especially saturated one from lots of meat and dairy products with lower heart attack rates in France especially when compared with one in Britain for example. It was statistical proof that cholesterol and all of meat and eggs and cheese do not cause heart disease and even if they do we can just add some nice red wine after the meal and what more do you want. Red wine is some kind of superfood. However, correlation is not causation, and one factor that had been ignored was, and I will write it again was, the past tense, that the French diet was generally healthier than other nations at the time. They had been eating four times more vegetables than counterpart countries and it was a form of a semi-Mediterranean diet. However, it turned out to be no paradox at all. It turned out that French physicians underreport heart disease on death certificates as much as 20% according to WHO. If we correct that statistical error, then no benefit of wine. The only good thing in wine is the phytochemicals from grapes so if you want these, the better option will be just regular grape juice and the even better option will be to eat fresh grapes.

Some other studies support alcohol health risks correlated with heart disease connection. Low levels of alcohol consumption can raise levels of high-density lipoprotein (good cholesterol), and HDL. So they had the idea that moderate drinking protects against cardiovascular disease by raising HDL, which would make sense biologically if you already have razed levels of cholesterol. They need this kind of study to calm people down from time to time. Alternatively, we will stop eating animal products if we fear cholesterol. Also, some small amounts of alcohol consumption like a glass of wine a day had been found to have beneficial changes in factors that influence blood clotting, and that will mean fewer chances for thrombosis of any sort like blood clots in the brain, block arteries in the heart and so on. Blood clots are the most common kind of stroke. Booze is what chemists call amphiphilic. It interacts favorably with both polar and non-polar molecules same as any other amphiphilic substance like soaps and detergents. So if you add rubbing alcohol to grease, the alcohol starts mixing with it. It blends in by going in between the long fatty chains. It does the same thing in the bloodstream. 

References:

1. Gupta, K. K., Gupta, V. K., & Shirasaka, T. (2016). An Update on Fetal Alcohol Syndrome-Pathogenesis, Risks, and Treatment. Alcoholism, clinical and experimental research, 40(8), 1594–1602. https://doi.org/10.1111/acer.13135
2. Caputo, C., Wood, E., & Jabbour, L. (2016). Impact of fetal alcohol exposure on body systems: A systematic review. Birth defects research. Part C, Embryo today : reviews, 108(2), 174–180. https://doi.org/10.1002/bdrc.21129
3. Harper, K. M., Knapp, D. J., Criswell, H. E., & Breese, G. R. (2018). Vasopressin and alcohol: a multifaceted relationship. Psychopharmacology, 235(12), 3363–3379. https://doi.org/10.1007/s00213-018-5099-x
4. Penning, R., van Nuland, M., Fliervoet, L. A., Olivier, B., & Verster, J. C. (2010). The pathology of alcohol hangover. Current drug abuse reviews, 3(2), 68–75. https://doi.org/10.2174/1874473711003020068
5. Liang, J., & Olsen, R. W. (2014). Alcohol use disorders and current pharmacological therapies: the role of GABA(A) receptors. Acta pharmacologica Sinica, 35(8), 981–993. https://doi.org/10.1038/aps.2014.50
6. Seitz, H. K., Bataller, R., Cortez-Pinto, H., Gao, B., Gual, A., Lackner, C., Mathurin, P., Mueller, S., Szabo, G., & Tsukamoto, H. (2018). Alcoholic liver disease. Nature reviews. Disease primers, 4(1), 16. https://doi.org/10.1038/s41572-018-0014-7
7. Shield, K. D., Soerjomataram, I., & Rehm, J. (2016). Alcohol Use and Breast Cancer: A Critical Review. Alcoholism, clinical and experimental research, 40(6), 1166–1181. https://doi.org/10.1111/acer.13071
8. Bagnardi, V., Rota, M., Botteri, E., Tramacere, I., Islami, F., Fedirko, V., Scotti, L., Jenab, M., Turati, F., Pasquali, E., Pelucchi, C., Bellocco, R., Negri, E., Corrao, G., Rehm, J., Boffetta, P., & La Vecchia, C. (2013). Light alcohol drinking and cancer: a meta-analysis. Annals of oncology : official journal of the European Society for Medical Oncology, 24(2), 301–308. https://doi.org/10.1093/annonc/mds337
9. Linderborg, K., Salaspuro, M., & Väkeväinen, S. (2011). A single sip of a strong alcoholic beverage causes exposure to carcinogenic concentrations of acetaldehyde in the oral cavity. Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association, 49(9), 2103–2106. https://doi.org/10.1016/j.fct.2011.05.024
10. Criqui, M. H., & Ringel, B. L. (1994). Does diet or alcohol explain the French paradox?. Lancet (London, England), 344(8939-8940), 1719–1723. https://doi.org/10.1016/s0140-6736(94)92883-5
11. Law, M., & Wald, N. (1999). Why heart disease mortality is low in France: the time lag explanation. BMJ (Clinical research ed.), 318(7196), 1471–1476. https://doi.org/10.1136/bmj.318.7196.1471
12. Ferrières J. (2004). The French paradox: lessons for other countries. Heart (British Cardiac Society), 90(1), 107–111. https://doi.org/10.1136/heart.90.1.107

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