Your Definitive Healthy Alcohol Guide: What to Drink, How Much, and How It Affects Your Health

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If you’re health-conscious—but still love a glass of wine with dinner, a beer or two on the weekend, or a nice long happy hour with coworkers—you’ve probably wondered how drinking affects your overall health.

In functional medicine, there is no “one-size-fits-all” when it comes to food. And the same goes for alcohol consumption. Some people can handle a higher alcohol consumption while others would be better off avoiding it altogether. But for the most part, alcohol can be enjoyed in moderation.

If you are curious how alcohol affects your health, how much alcohol is too much, or just looking to understand what types of alcohol are the healthiest, look no further. Here’s your complete guide on alcohol and your health.

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Is alcohol bad for your health?

We all know that chronic heavy alcohol use and alcohol use disorders are bad for our health. When alcohol intake becomes severe, it can lead to an increased risk for liver disease, cancer, diabetes, neurological complications, bone damage, and many more inflammation-related conditions, according to the Mayo Clinic. (1)

But what about moderate drinking or a drink every now and again? Moderate alcohol consumption is typically defined as up to one drink per day for women and two drinks a day for men.

The research on alcohol intake is very mixed. Some studies show that even very small amounts of alcohol can increase your risk for certain illnesses. For example, a study published by the American Institute for Cancer Research showed that just one drink a day could increase a person’s risk for breast cancer. Another study even found that moderate alcohol consumption to be a contributing factor in more than 60 different (2) chronic health conditions!

Meanwhile, other studies—like this one published (3) in 2015—say that mild or moderate amounts of certain types of alcohol could actually be beneficial to your health. In fact, a more recent 2020 study (4) found that low to moderate amounts of alcohol can be protective against cardiovascular disease. 

However, some researchers believe that the harmful effects of alcohol outweigh any of these potential benefits. These mixed results just show us that the question of whether or not alcohol is “healthy” can greatly vary from person to person. 

How does alcohol affect your brain?

Researchers are beginning to examine the link between regular alcohol consumption and brain health. While more studies are needed, some fascinating research has come out correlating moderate drinking with early onset dementia.

This could be due to alcohol’s relationship with neurogenesis - your brain’s ability to grow new, healthy cells. Studies have shown (5) that increased alcohol use inhibits the growth of new cells in areas of the brain like the hippocampus which is responsible for learning and memory thus contributing to memory problems and dementia. The good news though is that neurogenesis can be restored by reducing alcohol intake.

Even if you aren’t a heavy drinker, another study (6) published in the British Medical Journal, showed that even moderate amounts of alcohol can affect your memory. 

This doesn’t even include the devastating psychological hold it can have on those struggling with alcohol addiction. 

How does alcohol affect inflammation?

Inflammation is often the main underlying factor in most chronic diseases. In fact, it’s such a big deal that it’s the topic of my book, The Inflammation Spectrum, and a frequent topic of conversation during my patient consultations.

When it comes to inflammation and alcohol, the research is also a bit mixed. For example, a study (7) published in the journal Alcohol & Alcoholism showed that levels of the inflammatory C-reactive protein were higher in people who consumed alcohol. Other studies have shown that alcohol increases levels (8) of the endotoxin lipopolysaccharide (LPS) in the gut, which is known for inducing inflammation. Finally, people who drink can also develop leaky gut, which can drive widespread inflammation in the body and brain. (9)

On the flip side, certain types of alcohol—mainly red wine—have actually displayed anti-inflammatory properties due to its high concentration of polyphenols (10) such as resveratrol. Doctors often tell their patients that moderate alcohol consumption is A-okay. As Karen Costenbader, M.D., MPH, a rheumatologist at Brigham and Women’s Hospital in Boston told the arthritis foundation: “Moderate alcohol consumption…reduces biomarkers of inflammation, including c-reactive protein, interleukin-6, and TNF-alpha receptor 2.”

Additionally, due to the anti-inflammatory properties of these beverages, moderate alcohol consumption has been shown to positively affect (11) overall immune health whereas high alcohol consumption actually suppresses the immune system.

Confusing, isn’t it? The question is, how much is too much?

How much alcohol is bad for you?

If you do consume alcohol, portions matter. According to the National Institute on Alcohol Abuse and Alcoholism, a standard drink is defined as the following: (12)

  • 12 ounces (355 milliliters) of regular beer
  • 8 to 9 ounces (237 to 266 milliliters) of malt liquor
  • 5 ounces (148 milliliters) of unfortified wine
  • 1.5 ounces (44 milliliters) of 80-proof hard liquor

In my practice, I recommend that my patients treat alcohol like sugar. In other words, it’s a treat—which is meant to be consumed only occasionally and in true moderation. The way I see it, there’s no doubt that alcohol can be inflammatory, mostly due to the burden that it puts on your GI tract and liver, which houses your body’s detoxification system. Not to mention, alcohol can affect your blood sugar, cause poor sleep, and lead you to indulge in processed and sugar-filled foods; foods that no-doubt contribute to inflammation.

I feel that limiting alcohol intake as much as possible is the safest approach. I often see patients who do everything “right” but still have issues with their gut, mood, anxiety levels, and inflammation levels. Oftentimes, eliminating those few drinks on the weekend or glass of wine at night is the answer.

If you think alcohol might be contributing to chronic inflammation in your body, try going alcohol-free for one month, replacing your favorite drinks with mocktails and adaptogenic elixirs. A study (13) from the University of Sussex showed that people who participated in “Dry January” reported improvements in their health and their relationship with booze. More specifically:

  • 71% slept better;
  • 67% had more energy;
  • 58% lost weight;
  • 57% had better concentration;
  • 54% had better skin.

Who knows, cutting down on the booze could end up benefiting your health in more ways than one.

What are the healthiest types of alcohol?

If you do choose to indulge in a drink, the type of alcohol you consume matters just as much as the amount you are drinking.

When choosing a drink, I always encourage my patients to go for the least inherently inflammatory beverage based on its ingredients and how it was produced. Not all alcohol is created equal even if it's labeled “all-natural” or “organic”. For example, some things like gluten are always going to be inflammatory for my patients regardless of where it’s sourced.

These are my top choices for your next drink.

1. Red wine

Red wine is packed with beneficial antioxidants like resveratrol, which can help improve heart health and even lower inflammatory markers like CRP. That said, it should always be consumed in moderation. 

However, certain alcohols like red wine can also contain mycotoxins - toxic byproducts of mold that can contribute to a variety of health problems. I recommend opting for organic, sulfate-free brands from Europe as they usually follow stricter guidelines and testing requirements for mold so you can take full advantage of its properties.

If you want to further increase your intake of antioxidants, you can take resveratrol supplements or focus on eating antioxidant-rich foods like berries, leafy greens, and citrus fruits.

Expert tip: I personally love Dry Farm Wines because they are organic, sulfate-free, paleo, and keto due to their low sugar content.

2. Tequila

If (Taco) Tuesday is your favorite day of the week, you’ll be happy to know that this clean liquor made is a surprisingly healthy choice. Just make sure that you’re buying a product that is 100 percent agave, as some brands use grains in addition to agave, which can make the tequila more inflammatory.

Expert tip: Make sure to drink tequila on the rocks or with soda and a splash of line instead of mixing it with sugar-filled pre-made margarita mixes. If you do need a little sweetness, a little bit of pure maple syrup is a great complementary option.

3. Hard Cider

If you’re craving something sweet and refreshing, hard cider is a delicious and naturally gluten-free choice. Cider is made from apples but it still contains quite a bit of sugar, so always consume it in moderation. You also want to double check the label to make sure they didn’t add any barley or other gluten-containing ingredients for added flavor.

Expert tip: Look for dry cider as this variety will still be a little sweet but will be lower in overall sugar content.

4. Champagne

If your go-to drink is a glass of bubbly, I have great news. Due to the fermentation process, champagne actually has some probiotic properties, which means it might help promote a healthy balance of good bacteria in your gut microbiome. If you’ve got something to celebrate, champagne is a great choice.

Expert tip: Level up your glass of champagne with some pomegranate seeds or berries for added antioxidants!

5. Rum

Rum is also grain-free, which means it’s less inflammatory than other choices. That said, it’s distilled using molasses and sugarcane so it’s got a higher sugar content than some of my other top picks.

Expert tip: Stay away from spiced or flavored rums because these can have gluten-containing ingredients or other unhealthy additives.

6. Gin

Gin is unique in that it’s distilled using botanicals like coriander, juniper, and cinnamon, which actually have antibacterial properties as well as blood sugar stabilizing and antimicrobial properties. Gin is also made using grains like wheat and barley but some experts argue that the gluten protein is broken down during the distillation process and so, depending on your level of sensitivity to gluten and grains, you may be able to tolerate it.

Expert tip: If you do have an issue with gluten, you can find gin brands made with potatoes to avoid any trace of gluten whatsoever.

7. Vodka

Speaking of potatoes, vodka is another good choice if you’re looking to avoid grains. Just be sure to check the label before making your purchase and avoid flavored options with added sugar.

Expert tip: While potato vodka is a great choice for those avoiding gluten, you might want to skip this choice if you have a sensitivity to nightshades.

8. Whiskey

Most whiskeys are made from gluten-containing grains like wheat and barley, but there are also brands that use corn. Whiskey isn’t my first choice, but if it’s one of your favorites I’d recommend testing out some gluten-free options.

Expert tip: If whiskey and coke is your drink of choice, try swapping out Coke for a can of Cola flavored Zevia instead.

How do you make healthier alcohol choices?

Now that we’ve established the healthiest types of alcohol, let’s take it a step further. Most mixed drinks are made with additional ingredients that are filled with sugar and other ingredients that are less than optimal for your health. Therefore, it’s important to choose your mixers wisely. 

You can start by simply saying no to soda or other pre-mixed syrups since they are loaded with sugar and can impact your gut health and perpetuate inflammation. Instead, stick to flavored seltzer like La Croix, Spindrift, or even Zevia, which is made with stevia instead of soda.

If you want to take things to the next level, using kombucha as a mixer will give you the added benefit of probiotics and the antioxidant power of tea. You can also incorporate herbs into your cocktails. You can muddle in or make homemade syrups out of lavender, ginger, or cilantro, which can not just make your drink taste a lot more interesting but they can bring additional health benefits like anxiety and stress, (14) easing digestive distress and inflammation, (15) and enhancing detoxification. (16)

Cocktails are also a fun opportunity to play around with plant-based herbal medicines, like adaptogens, which have taken the wellness world by storm. Adaptogens are a group of natural ingredients with an amazing ability to restore balance in the body and since they are most commonly found in powdered form, you can easily mix these into your drinks. (To learn more about adaptogens, check out my expert guide.)

Save this article for the next time you throw a dinner party, attend office happy hour, enjoy a drink at home. Your health will thank you!

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe. 

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References:

  1. Alcohol Use Disorder Mayo Clinic 2018. https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243
  2. Iranpour, Abedin, and Nouzar Nakhaee. “A Review of Alcohol-Related Harms: A Recent Update.” Addiction & health vol. 11,2 (2019): 129-137. doi:10.22122/ahj.v11i2.225
  3. Fehér, János et al. “A bor kultúrtörténetex, a borterápia elméleti háttere” [Cultural history of wine, the theoretical background of wine therapy]. Orvosi hetilap vol. 146,52 (2005): 2635-9.
  4. Chiva-Blanch, Gemma, and Lina Badimon. “Benefits and Risks of Moderate Alcohol Consumption on Cardiovascular Disease: Current Findings and Controversies.” Nutrients vol. 12,1 108. 30 Dec. 2019, doi:10.3390/nu12010108
  5. Nixon, Kimberly, and Fulton T Crews. “Binge ethanol exposure decreases neurogenesis in adult rat hippocampus.” Journal of neurochemistry vol. 83,5 (2002): 1087-93. doi:10.1046/j.1471-4159.2002.01214.x
  6. Topiwala A, Allan C L, Valkanova V, Zsoldos E, Filippini N, Sexton C et al. Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study BMJ 2017; 357 :j2353 doi:10.1136/bmj.j2353
  7. Oliveira, Andreia, Fernando Rodriguez-Artalejo, and Carla Lopes. “Alcohol Intake and Systemic Markers of Inflammation-Shape of the Association according to Sex and Body Mass Index.” Alcohol and Alcoholism (Oxford, Oxfordshire) 45, no. 2 (April 2010): 119-25. https://doi.org/10.1093/alcalc/agp092.
  8. Bala, Shashi et al. “Acute binge drinking increases serum endotoxin and bacterial DNA levels in healthy individuals.” PloS one vol. 9,5 e96864. 14 May. 2014, doi:10.1371/journal.pone.0096864

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BY DR. WILL COLE

Evidence-based reviewed article

Dr. Will Cole, IFMCP, DNM, DC, leading functional medicine expert, consults people around the world via webcam and locally in Pittsburgh. He received his doctorate from Southern California University of Health Sciences and post doctorate education and training in functional medicine and clinical nutrition. He specializes in clinically researching underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Dr. Cole was named one of the top 50 functional medicine and integrative doctors in the nation and is the best selling author of Ketotarian and The Inflammation Spectrum.