Monday, January 10, 2011

Alcohol is Anti-Inflammatory, but …

I was trying to be good as I celebrated a friend’s birthday last night.  Didn’t touch the French bread, didn’t succumb to the pasta, and steadfastly resisted the cake, but everybody knows that dry red wines are healthy … and I was feeling very healthy as they began to pour the second bottle.

The truth is that alcohol is anti-inflammatory and the relationship between alcohol consumption and the tendency to have an elevated C-reactive protein number (a measure of inflammation) is a mildly U-shaped curve.  Those that abstain completely from alcohol tend to have a higher CRP than those who drink lightly or moderately.  It is only when one drinks excessive quantities of alcohol that CRP begins to rise.  This anti-inflammatory effect is believed to be the reason that light to moderate alcohol consumption has been shown statistically to be somewhat cardio-protective.  So, drink up, right?

Hate to spoil the party, folks, but there is another side to alcohol.  Alcohol is a hepatotoxin that messes with our livers.  Like fructose, ethyl alcohol raises triglycerides, contributes to fatty liver, worsens insulin resistance, and promotes obesity in a dose dependant fashion.  There is probably some threshold below which the liver can safely detoxify it, but for people who are overweight or suffer diabetes or some other metabolic disorder, this threshold may be very low.  As fructose and alcohol have an additive effect, the amount of alcohol one can safely consume is diminished by the consumption of sweet foods which contain fructose.

So, what is the optimal amount of alcohol to consume?  It takes very little alcohol to get the anti-inflammatory effect.  Three to four fluid ounces (90-120 mL) of dry wine or a shot of distilled spirits is probably all it takes.  Most people can probably safely detoxify this much alcohol without hurting their livers.  Anything beyond this will not significantly improve inflammation but will have the aforementioned ill effects on your liver and your metabolism.

I love fine wines and really hate to be a killjoy, but I believe that the health recommendation should be to drink lightly, that is, one small serving of alcohol per day.  What most of us think of as moderate drinking may be too much for somebody with a metabolic disorder like obesity or diabetes.

In my own case, I try to limit my combined daily consumption of fructose and alcohol to less than 20 grams a day.  A four ounce glass of wine has about  15 grams of alcohol, a medium apple has about 9 grams of fructose, a 12 oz. can of Coke has 22 grams of fructose, and a piece of birthday cake has about 12 grams of fructose.  I get about 6 grams a day of fructose from the vegetables I eat.  So, if I have a glass of wine, it has to be a small one to meet my goal and I cannot eat any fruit or sweets.

I am not as disciplined as this blog might suggest.  On some occasions, I choose hedonistic pleasures over health, but let’s at least be honest about how much drinking is healthy.