Alcohol: Health Advice
How much should I drink?
Doctors and scientists agree that there is no completely safe lower limit when it comes to
alcohol. Drinking alcohol will always carry some risk to health. However, by drinking sensibly,
the risks to health are very low and there could even be some benefits!
Sensible drinking means not getting drunk. Being drunk means that the liver is overloaded
and can’t deal with the alcohol in the bloodstream quickly enough to stop it affecting the rest of
the body. At the same time as it’s making us feel happy, lightheaded and talkative, it’s also
damaging cells, particularly the liver.
Units
The alcohol content of a drink is indicated in Units. A unit is 10 mls or 8 grams of pure alcohol.
You can calculate the number of units in a drink by multiplying the amount in millilitres by the
strength (Alcohol by volume – ABV) and dividing the result by 1000.
As a quick guide, there is a unit for every percentage point of ABV in a litre. e.g. a litre of
typical whisky at 37.5 ABV will contain 37.5 units.
Current medical evidence shows that men should not regularly drink more than three to four
units in a day and women not more than two to three. Regularly means drinking every day or
most days of the week. Drinking more than this amount consistently can risk damaging your
health with the risks increasing the longer you continue and the more you drink.
The limits are lower for women because women’s bodies have a higher fat to water ratio than
men, making them less able to dilute alcohol in the body. Women tend to get drunk faster,
feel the effects longer and run a greater risk of damage to health.
Your personal body weight and size also affects your susceptibility to alcohol. If you are
smaller than average, the effects of the same amount of alcohol will be greater. Other
considerations:
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The recommended unit totals are for drinking spread through the week, not all
consumed on one or two nights.
Your body needs time to recover from drinking alcohol and would benefit from two to
three alcohol free days per week.
Drinking impairs your driving skills; just one drink affects your judgement. If you are
driving – don’t drink any alcohol.
Drinking alcohol can affect your ability to operate machinery or equipment and can
increase the likelihood of an accident
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If you are responsible for the care of others, or need to make important decisions,
drinking alcohol can be harmful in these situations
Certain medications do not mix with alcohol, always read the instructions on the bottle
or in the leaflet.
As well as the link with accidents, alcohol can impair judgement and lead to people
having unsafe sex risking pregnancy and sexually transmitted diseases
A healthy adult body can break down 10 mls of alcohol in 60 minutes. So, if you drink 10 mls
of alcohol, after one hour, there shouldn’t be any left in your bloodstream. The liver breaks
down most of the alcohol, though a small amount of it is excreted through the skin, breath and
urine.
As a guide, some common types of drinks are listed here with their alcohol content;
Beer, lager and cider at 2%
4%
5%
6%
Beer, lager and cider at 9%
-
Gin, rum, vodka and whisky
Tequila, Sambucca
Bottle
(330ml)
Can
(440ml)
Pint
(588ml)
Litre
0.7 units
0.9 units
1.1 units
2 units
Bottle
(330ml)
Can
(440ml)
Pint
(588ml)
Litre
1.3 units
1.7 units
2 units
1.8 units
2.2 units
2.6 units
2.3 units
2.8 units
3.4 units
4 units
5 units
6 units
Bottle
(330ml)
Can
(440ml)
Pint
(588ml)
Litre
3 units
4 units
5.1 units
9 units
Bottle
(275 ml)
-
-
-
1.4 units
-
-
-
Small
Measure
(25 ml)
Large
measure
(35 ml)
1 unit
1.4 units
Small
double
measure
(50ml)
1.9 – 2
units
Large
double
measure
(70ml)
2.7 – 2.8
units
Small
measure
(25ml)
Large
measure
(35 ml)
1 unit
1.3 units
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Standard
measure
(50ml)
0.9 – 1
unit
Sherry and port
10%
11%
12%
13%
14%
Small
glass
(125ml)
Standard
Glass
(175ml)
Large
Glass
(250ml)
Bottle
(750ml)
1.25 units
1.4 units
1.5 units
1.6 units
1.75 units
1.75 units
1.9 units
2.1 units
2.3 units
2.5 units
2.5 units
2.8 units
3 units
3.3 units
3.5 units
7.5 units
8.3 units
9 units
9.8 units
10.5 units
Facts
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There are around 10 million people drinking above the recommended drinking limits
Between 15000 and 20000 premature deaths in England and Wales each year are
associated with alcohol misuse
Alcohol can be fattening. If you were to add fur gin and tonics to your daily diet, you
could put on four pounds over four weeks
Children learn behaviour largely from their parents so how you drink may affect their
future drinking habits.
What exactly are the effects of alcohol on the body?
The Immediate effects
It is important to remember that alcohol is a depressant and it is also an irritant.
Alcohol depresses the activity of the parts of the brain responsible for inhibitions and
coordination.
This means that after drinking, judgement and mobility are impaired, the effects increasing
with each drink consumed.
Alcohol is an irritant which makes the stomach over produce the natural acid to the point that it
can overwhelm the normal protective layer and begin to dissolve the stomach lining itself.
These effects are felt as indigestion the morning after. When the lining is inflamed, this gives
rise to gastritis; when one spot only is dissolved more deeply, this becomes a stomach ulcer;
both can have dangerous, long term complications.
Alcohol is rich in calories, these are utilised as a source of energy for the body as the calories
from alcohol cannot be stored. However, at the same time, while the energy from the alcohol
is being burned off, calories from carbohydrates and fats are not being used and are stored in
the body as fat.
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How does the body get rid of alcohol?
The liver is the organ of the body responsible for detoxifying poisons. Alcohol is burnt up
slowly in the liver; it takes approximately one hour to burn off one unit of alcohol.
For drivers, this is an important consideration.
For example, if you have seven pints of strong lager, in an evening drinking session, you may
still be over the limit for driving late in the afternoon of the following day. Some alcohol may
remain in the body twenty four hours later. Any further drinks after this session will add their
units to those yet to be processed.
The stages of intoxication:
Stage one
After on eor two drinks, (1-3 units) we become more talkative and our heart rate speeds up a
little, giving us an ‘up’ feeling. This is the effect that people refer to when they say that alcohol
makes them more sociable. The ‘ warm feeling’ or flushes, is caused by alcohol in the
bloodstream making small blood vessels near surface of the skin expand allowing more blood
to flow closer to the surface and lowering the blood pressure at the same time.
Stage two
After a couple more drinks (4 – 6 units), we feel light headed and our coordination and
reaction times are impaired. Our ability to make decisions is also slowed down. All of these
effects are caused by the alcohol acting on nerve cells around the body and making them
work ore slowly. At this stage, driving is illegal and operating machinery shouldn’t be
considered.
Stage three
Another few drinks (7 – 9 units) and most people will be showing definite outward signs of the
effects of alcohol. Reaction times are much slower, vision becomes blurry and speech is
slurred. Drinking more than eight units in one session seriously overloads the liver, however,
taking care of ourselves in the days to come, means that it should repair itself – however, the
effects of drinking 7 – 9 units will manifest itself as a severe hangover in the morning.
Stage four
Drinking more than ten units has most people staggering about the place. Accidents are
commonplace – as are fights. This amount of alcohol will be affecting cells all over the body.
In an effort to get rid of the poison, the body tries to pass the alcohol out mixed with water as
urine. This is why alcohol makes us go to the loo a lot and causes the dehydration which
gives us the hangover symptoms the next day. Alcohol also attacks the gut giving us
heartburn, stomach upsets, sickness and diarrhoea.
Stage five
Drinking more than 30 units (that’s about twelve pints of strong lager or cider) is enough to
knock most people out. From there it’s a short step to heart failure and respiratory failure.
Even when people are already unconscious, alcohol in the stomach can continue to be
absorbed and can reach lethal levels. People can also be sick and suffocate on their own
vomit. For these reasons, someone who is very drunk should never be left alone.
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What about alcohol tolerance?
You may be thinking – ‘but I can drink more than ten units and be okay’
People who regularly drink to excess develop a tolerance to alcohol. This nmeans that more
alcohol can be consumed than normal without the person seeming to suffer the typical effects
as outlined above.
Unfortunately, a tolerance does not protect the body from harm. Having a high tolerance to
alcohol can indicate that a person drinks too much and the more we drink the more damage is
caused.
What about binge drinking?
‘Binge drinking’ means different things to different people. For most it means serious
drunkenness, fighting and aggression, throwing up and behaving badly in public.
However, the medical definition of binge drinking is usually reckoned to be drinking more than
eight units if you are a man and more than five units if you are a woman.
Looking at the chart above, for a woman, drinking three large glasses of 10% ABV wine would
be regarded as binge drinking.
The importance of alcohol free days
Alcohol causes changes to the cells in the liver. Over time, these changes build up into liver
disease and even liver cancer. By not drinking every day, the liver gets a chance to repair
itself so there is no lasting damage.
Everyone who drinks alcohol should have 2 - 3 days without alcohol every week.
If you drink over the sensible limit on any occasion, you should avoid alcohol for at least 48
hours.
Long term effects of alcohol on the body
What you drink makes no difference to the health effects of alcohol. Alcohol affects all kinds
of cells in the body, causing changes in some and stopping others from working properly. As
with most poisons, the more you take, the worse the effects are.
Please refer to the section on ‘common drinks’ to find out the alcohol content.
Is there a safe limit?
All of the ‘experts’ seem to be in agreement that there is no safe limit as even small amounts
of alcohol carries some risk to health. However, its broadly accepted tha the risk are low if
you drink sensibly.
Liver health and alcohol
Our livers make a special substance that breaks down alcohol and burns it as fuel. However,
alcohol exhausts the livers ability to do this and too much too often can damage the liver
permanently.
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The liver carries out many important functions and it is impossible to live without this organ. It
stores glycogen, breaking it down into glucose that is then released inot the bloodstream
providing energy.
It also processes fats and proteins from digested food, produces essential clotting substances,
removes poisons and toxins from the body and produces bile that passes into the gut and
helps with the digestion of fats.
Alcohol related cirrhosis usually develops after ten or more years of heavy drinking and affects
about 10% of heavy drinkers. Some people are more susceptible to liver cell damage than
others and the reasons for this are unknown.
Liver damage (cirrhosis) progresses slowly and gradually causes a decline in the liver function.
There may not be symptoms in the early stages, but as the condition of the liver deteriorates,
serious problems develop, for example, the liver will fail to control infection and blood clotting
and prevent bile from passing into the
large intestine.
As the healthy liver tissue is destroyed, and scar tissue builds up, the liver will lose its ability to
function properly.
Symptoms may include:
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Tiredness and weakness
Loss of appetite, feeling sick and vomiting
A build up of fluid in the bloodstream, legs (oedema) and abdomen (ascites)
Weight loss
A tendency to bruise and bleed easily
Jaundice (due to a build up of bilirubin)
Itchiness due to a build up of toxins
Personality and behaviour changes can occur due to the toxins in the blood stream
affecting the brain. You may become confused, forgetful and have difficulty
concentrating. Severe changes can lead to a loss of consciousness, coma and death.
As the cirrhosis develops the scar tissue restricts blood flow through the liver. The pressure in
the vein that normally transports blood from the gut to the liver will increase, leading to
hypertension. This can cause the veins in the lining of the oesophagus and stomach to swell.
These swellings (varices) often bleed into the gut, leading to vomiting blood and also passing
blood in faeces.
Apart from liver cirrhosis, what other long term health effects are there?
Cancer
After smoking, drinking alcohol is the second biggest risk factor for cancers of the mouth and
throat. Drinking and smoking together carries the highest risk. People who develop alcohol
related cirrhosis can also develop liver cancer.
Mental health problems
There is a link between drinking too much alcohol and mental health problems. Heavy use
can cause anxiety and depression and also can affect memory, leading to longer term
problems.
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Heart Disease
In men over forty and women past the menopause, small amounts of alcohol may reduce the
risk of heart disease, however with the increased risk of hypertension and weight gain, some
risks of heart disease remain the same.
Stroke
Drinking more than the sensible limits dramatically increases the risk of having a stroke.
A 20 year study of 6000 Scottish men found that those who drank more than five units a day
were twice as likely to die from a stroke compared to non drinkers.
Strokes are caused either by blood clots obstructing the cerebral circulation or by blood
vessels rupturing and leaking into the brain. A very heavy session (more than 8 units for men
and 5 for women) causes dehydration and makes the blood thicker and more likely to form
clots, both in the brain and elsewhere. Prolonged heavy use of alcohol also raises blood
pressure and can be another cause of stroke.
Changes in physical appearance
Due to the calorie content of alcoholic drinks, weight gain among people who drink to excess
is common.
Alcohol affects the circulation by expanding blood vessels and this can cuase thread veins,
often on the face and purple, bulbous ‘ drinkers nose’
Heavy drinkers may not be eating properly and too much alcohol prevents the body absorbing
the nutrients it needs. This can lead to poor skin and brittle hair and nails.
Prolonged heavy drinking makes men’s breasts get bigger.
Diabetes
Due to the likelihood of weight gain, as with many overweight people, regular heavy drinkers
can go on to develop diabetes. This can be because of the weight gain but can also be
related to chronic pancreatitis.
Sexual health problems
Too much alcohol can shrink genitals and affect fertility. Alcohol should be avoided by women
planning to conceive and who are pregnant.
Being drunk can loosen inhibitions and affect judgement, heightening the risk of pregnancy
and sexually transmitted diseases.
It can also make it more liable that you will have unwanted sex.
Drinking alcohol lowers sperm counts in men and makes it more difficult for woment to get
pregnant. Even young women who drink heavily can find tha ttheri periods stop altogether.
Pancreatitis
Long term heavy drinkers can develop this painful, and sometimes life threatening, condition.
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The pancreas makes insulin and other substances to properly digest food. If left untreated,
pancreatitis causes malnutrition and can lead to diabetes. In the UK, approximately 500
people per year die of alcohol related pancreatitis.
Memory problems
Not only can people fail to remember what happened after a sustained drinking session,
persistent heavy drinkers can develop chronic problems with memory loss. A type of
dementia called Wernicke-Korsakoff’s syndrome is caused by a vitamin B1 deficiency, which
is in turn brought on by alcohol abuse over a long period.
Top tips for healthier drinking
Stick to the limits
The best way to stay healthy is not to drink more than the recommended daily limit and to
have at least two alcohol free days every week.
Change your drink
If you normally drink pints, cut down to halves. If you drink doubles, ask for singles. If you
drink strong lagers or beers, choose brands with lower alcohol content. If you drink wine, opt
for a smaller measure, or add water or soda.
Eat before you drink
Just as eating before you drink can help limit how quickly alcohol gets into your bloodstream.
If you are going out for the night, eat a decent meal before you go.
Eat while you drink
It’s a good idea to have some food while you drink. The affects of alcohol can be softened by
food. However, avoid salty foods which may make you thirstier.
Time your drinks
You may find that you tens to gulp your drinks down – set yourself time limits for each drink or
make sure you have a gap in between drinks.
Use soft drink spacers
Alternate between alcoholic and soft drinks. You can then spin out your alcohol quota for
longer. It will also stop you getting dehydrated and lessen the chance of having a hangover in
the morning.
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Avoid drinking in rounds
Drinking in rounds can mean that everyone ends up drinking more than they want to. If you
do drink in rounds, order a soft drink from time to time.
Delay your first drink
If you have your first drink later in the day, you may find that you drink less overall. So, if you
normally have your first drink at lunchtime, wait until the evening. If you start in the evening,
go out later.
Don’t drink every day
The human liver is an incredible and vital organ. It deals with all sorts of poisons and can also
repair itself. Drinking alcohol causes changes in some of the liver cells and kills off others.
The liver needs time to recover after processing alcohol, so it is essential to have at least two
alcohol free days every week.
Mix your drinks
Dilute your spirit measures with more mixer and you can make each one last longer and drink
less across the night.
Keep a drinking diary
It can sometimes be difficult to keep track of exactly how much you are drinking over the last
week, particularly if some of the measures are confusing.
Keep a daily diary for a period of several weeks detailing what you drank and where. Be
honest! It will help you to get a better picture of how much you are drinking and help you to
decide what you need to do if you are regularly drinking above the sensible limit.
If you are concerned about the level of your drinking, listed below are some sources of
help:
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Your Local GP who will be able to advise you on local services and offer support and
advice
Drinkline – Offering help and information for people concerned about their drinking
0800 917 8282
Alcoholics Anonymous
www.alcoholics-anonymous.org.uk
Tel: 0845 769 7555
Addaction – a government initiative set up to help people with drink or drug problems
www.addaction.org.uk
Samaritans – charity supporting people in crisis
www.samaritans.org.uk
Tel: 08457 90 90 90
www.downyourdrink.org.uk
an interactive web site
www.alcoholconcern.org.uk
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Drinking Diary
Each day, you should record on this sheet where, what, why and with whom you drank. In the
small boxes, write in the number of units consumed in the session. You can copy this page
and monitor your drinking over a period of weeks.
Week Beginning:
AM / PM/
Evening
Where and with whom / alone
Type of drink
No. of
units
Mon
Tues
Weds
Thurs
Fri
Sat
Sun
Total Units
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