Pouring on the pounds………Should alcoholic drinks carry health warnings?

As far as I’m concerned, yes!

How much should we be drinking?

Current Government ‘lower risk guidelines’ for drinking alcohol state men should have no more than 3-4 units a day and women no more than 2-3 units a day. Consistently drinking more than this is linked with a progressive increase in risk to our health.  Specific recommendations have been set for pregnant women or those planning pregnancy, who should drink no more than 1–2 units of alcohol once or twice a week and should avoid heavy drinking sessions.

But what does this really mean in terms of an actual drink(s)? There is no single or simple answer because drinks vary in strength and volume. One unit = 10 ml of pure alcohol. It takes the average adult around 1 hour (for the liver) to process and eliminate this from the body.  Alcohol content is also expressed as a percentage of the whole drink, or alcohol by volume (ABV). Drinks typically range from 3.5%-40%, a lager for example of 5%ABV contains 5% pure alcohol.

 Source: the Daily Mail (2011)

The Calorific value of alcohol

When having an alcoholic drink, more than likely we have no idea what the drink is providing  in terms of our energy, or Calorie intake.  In fact much of the population completely discount the Calories they are getting from alcohol. I am not sure why this is; is it because it’s a drink rather than food, so we think it’s ‘free’? Whatever the reason we need to be aware that alcohol is in fact almost as calorific as fat! At 7 Calories per gram, alcohol makes it very easy for us to exceed our daily Calorie requirement.  The 10ml of alcohol in each unit provides 56kcal but other ingredients in the drinks, like sugar, cream and fruit juice add more calories. No wonder it’s making us fatter!

Current advice says alcohol should contribute no more than 5% of our Calorie intake. This equates to 100 Cal for women and 125 Cal for men, which is not a lot! Studies in the UK however have shown that alcohol actually accounts for nearly 10% of our calorie intake amongst adults who drink (that’s 200 Cal for women and 250 Cal for men). As we shall see in a moment though, it is very tricky to get a clear picture of exactly how much we are drinking.

Here is a list of typical drinks with their unit and calorific values (To do this I used the Drink Aware Unit and Calorie Counter):

Picture1

Another way to look at alcohol is the equivalent food we would be eating with each drink. For example,

  • 1 x 125ml glass sparking wine = 1 chocolate digestive
  • 1 large glass (250ml) red wine = 1 slice of cake
  • 1 pint beer = 1 large slice of pizza
  • 2 alcopops = 1 burger

On a night out I would never dream of eating 2 slices of cake and a biscuit after my meal (well perhaps if it had been a day from hell!) Particularly if you are drinking in a group and the tendency is you drink one after another, after another, you lose track of what you are having. It is easy for calories from alcohol to add up quickly and unnoticed. Pub measures have increased in size (a single can be 25 or 35ml, so doubles can be 50 or 70ml!) and there is often the temptation to ‘go large’ as it’s better value for money. Also be aware that alcohol is an appetite stimulant causing us to overeating at mealtimes and snack late at night.

Now if someone was to say “have a piece of cake”, then offer you another and another, I imagine you would (eventually) turn it down, especially if you are ‘watching your weight’. Visualising the food equivalents can be very effective to help you moderate your intake and is even a good deterrent.

Now I like a drink as much as the next person, especially at the weekend but the fact is, much of the UK population are drinking too much.  If we want to know exactly how much we are drinking however, we have a slight problem. Well, quite a big one really. We don’t exactly know how much people are drinking  because we have a tendency to under-report alcohol consumption. The reasons for this include us drinking more at home which is more difficult to record and when we do drink at home, we seem to adopt the ‘continental free-pour approach’ and therefore drink more than we intended as we are unaware of the volumes and strength of the drinks we have.

Do you know what  a unit looks like? You can buy a Unit measure cup to help you moderate your drinking at home.

Drinkaware have also developed (just launched today!) a free iphone app to help you keep track of your units and Calories which sounds brilliant. Just a shame I have an android phone, otherwise I would be downloading it, although the android version is coming early 2015. Details can be found here.

Surely alcohol isn’t that bad?

Well no, providing you drink sensibly, responsibly and within the lower risk guidelines.

As we have seen, alcoholic drinks contain a considerable number of calories. These Calories come from the sugar that is converted into alcohol. This conversion does not cause the Calories to magically evaporate away, it increases the Calories from 4 Cal / gram found in sugar to 7 Cal / gram found in alcohol.

Apart from alcohol, there is really nothing else in an alcoholic drink that provides anything useful. This is why we refer to alcohol as ’empty calories’. Now I admit that there is a little bit of protein in most drinks and beer and wine contain small amounts of some vitamins and minerals.  These are not in sufficient quantities however to justify having a drink for nutritional purpose, no matter what is being claimed!

Source: Daily Mail (2011)

How much are we really drinking?

University College London made an effort last year to calculate how much we underestimate how much we drink. In 2012, they suggested 75% of men and 80% of women were drinking above the daily limit! The study also showed that when under-reporting is taken in to account, ~50% of men and women could be classed as ‘binge drinkers’ (defined by the Department of Health as consuming more than eight units of alcohol in a single session for men, and more than six units for women). Now even if these figure are ‘a little out’ due to the nature of the problem (and getting accurate data), it is not hard to see that many of us are drinking too much.

Often the term ‘alcohol misuse’ is used when discussing our consumption or the impact of drinking in excess. I think we detach ourselves from the word ‘misuse’ but in fact this is the norm for many of us. One of the problems we have in our society is that we are all becoming reclusive drinkers.   Driven by tight budgets and the high cost of alcohol in pubs and restaurants, we take advantage of the bargain barrels offered in our supermarkets. We drink more than we ever used to at home: off-license sales continue to increase as on-license sales decline. We often drink as a reward; that we’ve made it to the end of the week, because its Wednesday, because it’s Sunday; a last chance to drown out sorrows before going back to work again.  Oh its pay-day, let’s have a drink, I’m stressed out; I need a drink….and so on. The public need to be made more aware of the impact alcohol can have when we think we drink ‘normally’.

Why do we drink when we are stressed?

We live high pressured lives with a 24 -7 attitude.

Workers in the UK currently work the longest hours in Europe, take the shortest lunch breaks and enjoy the fewest public holidays. Childcare is expensive and difficult to find, care for older people is of inconsistent quality and financial support during family-related leave is lower than in some other parts of Europe. (Trades Union Congress, 2014)

We need to think about effective de-stressing; finding an alternative to ‘I need a drink!’ As much as we think having a drink will help us relax (it’s depressant action slows down the body), it is really avoidance ‘therapy’. In the long term, alcohol will not solve the cause of your stress, it will only contribute to feelings of anxiety and depression and ultimately make stress harder to deal with. There a a huge pool of evidence that says those who drink more heavily are more likely to suffer mental health problems.

Why are we so worried about how much people are drinking?

Excessive alcohol consumption is a major cause of preventable premature death, accounting for 1.4% of all deaths registered in England and Wales in 2012 (ONS, 2014) This latest ONS (Office for National Statistics) report also revealed the over 65’s drink more regularly than the under 40’s (sherry being the favourite tipple) whilst 16-24 yr olds are the heaviest drinkers. 1 person is killed every hour by alcohol yet according to the Government’s reducing harmful drinking, 83% of people who regularly drink above the guidelines don’t think their drinking is putting their long-term health at risk. Is this being in denial or just being naive?

Alcoholic liver disease was responsible for the majority (63%) of alcohol-related deaths in 2012 and whilst the public may be aware of the link between alcohol and liver disease, we seem much less informed about the many other health risks such as increased risks of developing cancers, diabetes, high blood pressure, heart disease and stroke; diseases that we associate with (sugary and fatty) food rather than drink. As liver disease is what we call a ‘silent’ disease, most people are actually completely unaware they may be damaging their liver through alcohol. The liver is a hugely capable organ; it can tolerate a considerable amount of work, partly because it has the ability to regenerate, given an opportunity. There is a limit however – by the time someone shows symptoms that their liver is struggling, around 2/3 of it will have been damaged. This is a long way down the road to severe liver damage before anyone knows about it. The public need to be made more aware of the variety of health problems caused by exceeding the safe drinking guidelines.

So what is to be done?

Basically a lot more needs to be done if we are to reduce the impact that excessive alcohol consumption is having on our society. The All-Party Parliamentary Group on Alcohol Misuse have submitted a manifesto asking political parties to commit to 10 recommendations to minimise alcohol-related harm in the UK: I am picking on just 3 of the 10 (click on the link above to read the manifesto and see all 10) but agree there needs to be a ‘blanket approach’ to this problem.

1. Make reducing alcohol harms the responsibility of a single government minister with clear accountability

2. Introduce a minimum unit price for alcoholic drinks

7. Include a health warning on all alcohol labels and deliver a government-funded national public awareness campaign on alcohol-related health issues

Starting with no.1 and no.2, I will be honest to say I am not confident. David Cameron scrapped the plan to introduce a minimum price for alcohol last year claiming there was not enough evidence that the policy would reduce excessive drinking.  The problem is the government receives significant revenue from alcohol sales so it would not be in their best interests to curb consumption?

Moving on to no.7, this is the one that I am personally most interested in and also the one that I think will really help, if it happens. Currently the only information provided on most bottles or cans of drink is the volume strength (ABV) and unit content. New food and drink legislation will come into force in December of this year but alcohol is exempt from this i.e. the calories will not need to be declared. This is a massive missed opportunity. Why have they refused consumers their right to know what is in their drinks? European institutions must address this loophole and ensure alcoholic drinks carry this information so we know how many calories as well as units we are drinking.  This is very much about helping the public make informed choices.

Health warnings are a familiar and prominent feature on cigarette packets and yet the UK seem to be lagging behind other countries that have adopted stronger approaches. The WHO say pictures “significantly enhance the effectiveness” of warning labels but we have yet to make this step. Perhaps because there is also a pool of evidence that says negative messaging is unhelpful. Does the ‘shock factor’ have the right impact? Is it enough to change our habits? Why do we always think ‘it’ will never happen to us?

I would be really interested to know what you think about labels on drinks.

Would something like this help? (Source NY Huffington Post)

Or this? (Source: Faculty of Public Health)

 

 

 

 

Finally should we be looking to lower our drinking guidelines (as well as the drink-drive limit) to encourage the UK population to drink less? An interesting study was published in the BMJ (2012) that suggested “the optimum consumption for drinkers is about half a unit a day, which would avert or delay between 2544 to 6590 deaths per year”.

To end on a positive note, here are 10 tips on how to drink sensibly 🙂

  1. Don’t drink on an empty stomach (food slows down the absorption of alcohol so you are less likely to feel so intoxicated so quickly)
  2. Set yourself a limit before you go out and tell your friends you are ‘trying to be good’ so they can support you.
  3. Alternate an alcoholic drink with a soft drink or water (this will stop you getting too dehydrated and feeling rough the morning after) and if having a meal, have a glass or jug of water with any alcoholic drinks.
  4. Dilute alcoholic drinks with a soft drink – add soda or lemonade to wine to make a weaker ‘long’ drink.
  5. Go for smaller measures – small glass of wine instead of a large, half instead of a whole pint (often you are not asked what size).
  6. Try not to get caught up in big rounds when you might be persuaded to drink much more, more quickly. Also finish your drink before someone ‘tops it up’ for you – this way you can keep a more accurate measure of what you are drinking.
  7. Avoid binge drinking – just because you don’t drink in the week, it doesn’t mean you can ‘save it all up’ for a blowout at the weekend – lots of alcohol stresses your liver
  8. Find an alternative to alcohol to help you de-stress: try a different distraction like exercise, chatting on the phone, reading, cooking or having a bath.
  9. You should avoid alcohol for 48 hrs after a large amount to drink; everybody should aim for 2 drink-free days a week
  10. Don’t drink alcohol when you are thirsty  – it will make you drink more and drink too quickly. Quench your thirst with water first (and avoid salty snacks like peanuts, crisps and pretzels as they will make you more thirsty).

Confessions of a binge drinker

On the 24th April, my favourite newspaper the Daily Mail reported that binge drinking leads to over eating. I am currently having flashbacks from the week just gone; of enjoyable evenings in the bar, sipping on a few drinks each night, combined with some nice conversation and getting rather stressed with getting my son to sleep……………….and now I am thinking hmmm…………. I wonder how much I did drink on holiday? How many units was in that Mojito?

Mango_mojito

Now I don’t class myself as a big drinker, in fact I only tend to have a glass or two of wine or something on a Friday and Saturday night.  Me + early get ups + nursery run + work does not go with a drink. I am a sensible person and responsible drinker. I am certainly not a binge drinker (I am frowning as I write this) – I lecture my students about the effects of drinking in excess and what harm it can do. The penny has just dropped.  I am in denial………….Hang on a minute, back to the Daily Mail……………………

The research was commissioned by Slimming World (not exactly sure why? I am wondering what would be in it for them – probably some new low-calorie alcohol range or post-booze snack range they are developing perhaps?) The research itself was carried out by YouGov who, as it turns out collect public opinion data so this is not exactly real research, it’s a survey that can show trends of peoples eating and drinking habits.

But these are their ‘findings’ ………………

50% of the people who said drinking impacted their food choices had also cancelled physical activities the day after drinking more than 9.3 units, equivalent to slightly less than four pints of beer.

Pug_lying_in_bed_with_its_head_on_the_pillow

They had opted for bed, TV and using social media to stave off the hangover – along with another extra 2,051 calories, on top of their usual diet, the next day.

On the night, they had consumed about 2,829 calories extra in food and 1,476 extra calories in drink, the survey said.

And the following day, the drinkers ate on average 2,051 extra calories.

SONY DSC

Alcohol loosened self-control and people who had consumed more alcohol tended to eat at a greater rate and for longer.

Alcohol makes the food even more rewarding. It tastes good and feels even better than it would do normally.

So fair enough, but is this jumping the gun a bit…………….shouldn’t we be more aware of the Calories in alcoholic drinks in the first place? And this brings me to my confession…………..

I drank every night on holiday – this is what I had (from what I remember – it’s not THAT bad!):

Sunday:

  • 3 glasses of wine
  • 6.9 units, 477 Calories, equivalent to 1.6 burgers or 80 mins running needed to burn it off

Monday

  • 1 and 1/2 pints lager and lime
  • 1 shot Jagermeister
  • 5.2 units, 445 Calories, 1.5 burgers or 44 mins running

Tuesday

  • 1 pint cider and blackcurrant
  • 1 shot Jagermeister
  • 2 shots Sambuca
  • 5.6 units, 399 Calories, 1.4 burgers, 40 mins running

Wednesday

  • 2 mojitos
  • 1 Jagermeister
  • 3 units, 183 Calories, o.6 burgers, 18 mins running

Thursday

  • 1 and 1/2 pints lager and lime
  • 1 Jagermeister
  • 5.2 units, 445 Calories, 1.5 burgers, 44 mins running

Total = 25.9 units, 1949 Calories, 6.6 burgers, 3.85 hrs running needed to burn it all off again :-0

Then there’s the snacks we all dipped into……………….3 tubs of Sahara nuts (probably around 300 Calories a tub)  and a packet of crisps (~170 Calories)  OMG this looks so bad!

Beer

I would never dream of eating nearly 7 burgers but actually visualising the food equivalents is very effective, even a good deterrent.

This information (units etc) came from the Drink Aware unit calculator – just enter what drinks you had and it calculates the units and Calories for you.  It’s certainly an eye opener – try it!

Now lets just establish what we mean by a binge drink.  

A binge is defined as consuming more than double your daily alcohol allowance in 1 sitting.

So what is my daily allowance?

  • 2-3 units a day for women
  • 3-4 units a day for men

So a binge for me is more than 6 units a day…………………phew I’m not that bad after all I only binged once!! But really, this is not good.  I am surprised by the total Calories more than anything and then by the mixture of stuff I had.  Luckily I didn’t have a pina colada (something like 550 Calories in that bad boy) My list looks like I’m 40 going on 22! Thank God I don’t drink like this all the time.  Mind you, I couldn’t even if I wanted to, I just can’t do it any more.  The days of late nights and hangovers are long gone.  If I do let my hair down completely, it takes me at least 3-4 days to recover. It’s just not worth it! I can see why it piles on the pounds too.  Having said that, with a (nearly) 2 yr old, I don’t remember what a lie-in feels like, or how you could ever lie on the sofa watching TV all day or get left alone to eat a decent cooked breakfast all in one go. So thanks to my son I have no need to do that 3hr run tomorrow to burn it all off again 🙂  Even the thought of that is exhausting!

One of the problems we have in our society is that we are all becoming reclusive drinkers.  Holiday drinking aside, we now consume more drink in our homes than ever before.  Driven by the high cost of alcohol in pubs and restaurants, we take advantage of the bargain barrels offered in our supermarkets. And one of the problems with this is that we completely lose track of how much we are drinking.  We often drink as a reward; that we’ve made it to the end of the week, because its Wednesday; the peek of the week, because it’s Sunday; last chance to drown out sorrows before going back to work again.  Oh its pay day, lets have a drink, I’m stressed out; I need a drink….and so on.

So what can we learn from this?

How to drink sensibly

  1. Don’t drink on an empty stomach (food slows down the absorption of alcohol so you are less likely to feel so intoxicated so quickly)
  2. Alternate an alcoholic drink with a soft drink or water (this will stop you getting too dehydrated and feeling rough the morning after)
  3. Dilute alcoholic drinks with a soft drink – add soda or lemonade to wine to make a weaker ‘long’ drink for example
  4. Try not to get caught up in big rounds when you might be persuaded to drink much more, more quickly.
  5. Avoid binge drinking – just because you don’t drink in the week, it doesn’t mean you can ‘save it all up’ for a blowout at the weekend – lots of alcohol stresses your liver
  6. You should avoid alcohol for 48hrs after a large amount to drink.
  7. Everybody should aim for 2 drink-free days a week

Drinking myths

  1. Women can handle their drink just as well as men. Err no. Men tend to have more body water so can dilute the alcohol more than women.  Men also tend to have a higher metabolic rate so may not reach the same alcohol ‘high’ as women (although this is not true for my husband!
  2. A Guinness a day is ‘good for you.’ No to this one too.  It was promoted as a ‘healthy’ drink but Guinness were asked to remove this slogan.  The iron content of stout is not enough to justify drinking it.  Essentially alcohol just provides empty Calories – there are no essential nutrient in any alcoholic drink.
  3. Mixing your drinks makes you more drunk. Nope it’s about how many units you have had. Alcohol is alcohol as far as our body is concerned and the liver knows no better if its dealing with wine or cider. Mixing your drinks will most likely make you sick due to the concoction in your stomach that upsets it.
  4. Beer before liquor, never been sicker; liquor before beer, you’re in the clear. Nope again  – as with the previous myth
  5. Being sick, having  a cold shower or cup of coffee will all make you sober up. No – these will all probably ‘wake you up’ and counteract the sedative effect alcohol can have. They will not remove the alcohol that’s already in your blood stream.
  6. The more you drink the more tolerance you develop so you can safely drink more.  This is a definite no no. The more you drink the more damage you do to your body full stop.
  7. Alcohol is a stimulant. Initially alcohol may stimulate you; making you feel more energetic and more confident but as it builds up in the blood stream it depresses your nervous system.  It is this effect that slows your speech and reactions and ultimately can mean you fall asleep or lose consciousness.
  8. Oh and apparently alcohol does not make sex better.  I’ll leave that one for you to think about (but must add that drinking too much reduces both male and female fertility).

So its Saturday night and I might be having a night off but you enjoy your drink if you are having one 🙂

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