Moderate Alcohol

According to the 2019 National Survey on Drug Use and Health (NSDUH), 85.6 percent of people aged 18 and older reported that they drank alcohol at some point in their lifetime. In 2019, 25.8 percent of people ages 18 and older reported that they engaged in binge drinking in the past month. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), which conducts the annual NSDUH, binge drinking is defined as consuming five or more alcoholic drinks for males or four or more alcoholic drinks for females at the same time, or within a couple of hours of each other. Binge drinkers who drink alcohol at twice the gender-specific thresholds as those who do not drink are 70 times more likely to have an alcohol related emergency department visit. If you choose to drink alcoholic beverages, you should do so sensibly and in moderation.

What is Moderate Drinking?

According to the 2020-2025 Dietary Guidelines for Americans, moderate drinking means up to one drink a day for women and up to two drinks a day for men. For most adults, this amount causes few, if any, problems.

Differences for Men & Women: Why are men allowed two drinks a day and women only one? Women become more impaired than men do after drinking the same amount of alcohol. There is a difference in men’s and women’s weight and size, as well as how their bodies process alcohol.

Alcohol is carried in the body’s fluids rather than in body fat. Women’s bodies contain less water than men’s bodies, which causes the same amount of alcohol to be more concentrated in the bloodstreams of women.

The enzyme that helps metabolize alcohol, Alcohol Dehydrogenase (ADH), is less active in women. In addition, medical problems from alcohol dependence (e.g., brain, heart, and liver damage) progress faster in women than in men.

When drinking alcohol, it is important to be aware of serving size.
Hannah Shifflette, ©2024 Clemson Extension

What is in a Serving of Alcohol?

Standard Serving Sizes: Most adults do not know that these standard servings of alcoholic beverages all contain the same amount of alcohol: 5 ounces of wine, 12 ounces of beer, or a mixed drink made with 1.5 ounces of 80-proof distilled spirits.

Distilled spirits, which are first fermented and then distilled, include whisky, vodka, rum, bourbon, gin, brandy, and liqueurs.

Calories: How many calories do you consume from alcoholic beverages? There is little leeway for consuming alcoholic beverages at most calorie levels because they are low in nutritional value and can be high in calories.

Alcohol has seven calories (energy) per gram, compared to four calories per gram of protein and carbohydrate, and nine calories per gram of fat. A drink made with one ounce of vodka (40% to 50% alcohol) contains about fourteen grams of alcohol and almost 100 calories. (7 calories per gram x 14 grams of alcohol = 98 calories in a drink containing one ounce of vodka)

What Counts as One Drink?

The total calories and alcohol content vary depending on the brand of the beverage. A beverage with higher alcohol content, including higher proof or a higher percentage of alcohol, contains more calories as well.

Adding mixers to an alcoholic beverage can contribute calories in addition to the calories from the alcohol itself. Mixers include soft drinks, tonic water, fruit juice or cream.

Health & Drinking Alcohol

Although early research has suggested that moderate alcohol use may reduce a person’s risk of developing cardiovascular disease, recent studies have shown that it is impossible to conclude whether the reduction in cardiovascular disease is due to moderate alcohol consumption or other contributing health factors. In fact, alcohol has been found to increase the risk of certain types of cancer, even at low levels of consumption (less than 1 drink in a day). Women who have one drink per day appear to have a slightly higher risk of breast cancer than women who do not drink.

There is no known benefit to drinking in younger adults. Drinking at levels higher than those suggested in the dietary guidelines significantly increases the risk of short-term harms, such as injuries, as well as the risk of long-term chronic health problems, such as some types of cancer.

The physical changes associated with aging can make older people feel “high” even after drinking only lesser amounts of alcohol. Alcohol can also make high blood pressure, ulcers, and other common medical conditions of the elderly more serious.

Alcoholic beverages are harmful when consumed in excess. Generally, anything more than moderate drinking can be harmful to your health. Heavy drinking alters one’s judgment and can lead to dependency or addiction to alcohol. It can cause many other medical problems and actually increase your risk for:

• Liver cirrhosis
• Inflammation of the pancreas
• Hypertension and stroke
• Damage to the heart and brain
• Cancers of the upper gastrointestinal tract
• Violence
• Motor vehicle accidents
• Other injuries
• Suicide
• Death

Heavy drinkers may be at risk of malnutrition if alcohol is substituted for nutritious foods. Excessive alcohol consumption makes it hard to get enough essential nutrients while staying within your daily calorie allotment and maintaining a healthy weight.

Who Should Avoid Alcohol?

Some people, or people in certain situations, should not drink at all. Alcoholic beverages should not be consumed by:

• People who are unable to restrict their alcohol intake. (e.g., recovering alcoholics)
• Women of childbearing age who may become pregnant
• Pregnant and lactating women.
• Children and adolescents
• Anyone taking certain over-the-counter or prescription medications that can interact with alcohol
• People with specific medical conditions
• Individuals engaging in activities that require attention, skill, or coordination, such as driving or operating machinery

People Taking Medications: The effects of alcohol are increased by medicines that depress the central nervous system, including:

• Sleeping pills
• Certain painkillers
• Antihistamines
• Antidepressants
• Anti-anxiety drugs

In addition, medicines for disorders such as diabetes, high blood pressure, and heart disease can interact harmfully with alcohol.

Pregnant Women & Women Who May Become Pregnant: Drinking during pregnancy is the leading cause of birth defects in the U.S. If the mother drinks alcohol, the baby can be born mentally retarded or with learning and behavioral problems that last a lifetime. Alcohol-related birth defects are 100% preventable simply by not drinking alcohol. Therefore, women who are pregnant or trying to get pregnant should not drink alcohol at all.

Exactly how much alcohol it takes to cause harmful effects on the baby is unknown. Even moderate drinking during pregnancy may cause the baby to have behavioral or developmental problems. Heavy drinking during pregnancy can produce intellectual disabilities, malformation, and numerous behavioral and psychosocial problems in the baby.

Allergy Sufferers: If you suffer from allergies, sulfites in wine may produce unwanted allergy symptoms by triggering histamine production.

Resources: If you have questions or concerns about the potential risks and benefits of drinking alcohol, talk to your doctor or healthcare provider.

Another excellent source of information on the effects of alcohol on your health is The National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIAAA).

Alcohol & Cooking

Wine, beer, and distilled spirits can add flavor, tenderness, and texture to the foods you prepare. Some of the alcohol burns off or evaporates during cooking. A flamed dish (flambé), for example, retains up to 75% of its alcohol content. On the other hand, only 35% of the alcohol remains in food that has been baked for 30 minutes. Usually, a longer cooking time reduces the alcohol content further.

The total amount of alcohol left depends on how long the dish was cooked, the preparation method used, and the amount of distilled spirits, wine, or beer used. Since most recipes do not contain much alcohol, the amount remaining should not pose any health concerns.

Regular table wine may be more flavorful than cooking wine, which is usually high in sodium.

Nonalcoholic Substitutions: If you want to omit alcohol in a recipe, always replace it with an equal amount of liquid, such as water, broth, apple, or white grape juice. Here are some quick, flavorful substitutions for a cup (8 oz.) of wine or spirits:

• ⅞ cup (7 oz.) chicken broth, vegetable broth or a fruit juice and ⅛ cup (1 oz.) lemon juice or vinegar
• An equal amount of nonalcoholic wine
• Water and flavored vinegar, such as raspberry or tarragon, to taste
• Water and similarly flavored extracts (essences) to taste

Drink Responsibly

One out of 13 U.S. adults, or almost fourteen million people, abuse alcohol or are alcoholics. Alcohol problems are highest among 18- to 29-year-olds and lowest among adults over 65 years old. Generally, more men than women have problems with alcohol.

The decision whether or not to drink is a personal choice, and abstention is an important option. If you choose to drink alcoholic beverages, follow these tips and drink responsibly:

• Satisfy your thirst with a nonalcoholic drink first. This should allow you to sip, not gulp, your alcoholic drinks.
• Never drink on an empty stomach. Food slows the absorption of alcohol.
• Set your drink limit ahead of time, preferably only one drink per day if you are female and two per day if you are male. The body can detoxify only about ½ ounce of alcohol per hour, or one standard size serving of beer, wine, or distilled spirits.
• Slow your drinking pace at parties. Put your drink down and socialize more.
• If you have more than one drink, enjoy a nonalcoholic drink in between to give your body time to process the alcohol.
• Drink “virgin” cocktails using nonalcoholic mixers without the liquor.
• When making mixed drinks, use a 1-ounce jigger rather than pouring distilled spirits directly from the bottle into the glass.
• Dilute drinks with water, ice, club soda, or juice and sip through a straw.
• If you are the host, do not feel that you must refresh your guests’ drinks.
• Order nonalcoholic beer, low-alcohol beer, or light wine.
• In addition to wine or beer, have a glass of water with your meal.
• Have bottled water or soft drinks on hand to ensure that you have a nonalcoholic option.

References:

1. Andréasson , S., Chikritzhs , T., Dangardt , F., Holder , H., Naimi , T., & Stockwell , T. (2014). Alcohol and Society. Stockholm: IOGT NTO & Swedish Society of Medicine.
2. Centers for Disease Control and Prevention. (2022, April 19). Facts about moderate drinking. Centers for Disease Control and Prevention. https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm
3. Chikritzhs, T., Fillmore, K., & Stockwell, T. (2009). A healthy dose of scepticism: Four good reasons to think again about protective effects of alcohol on coronary heart disease. Drug and Alcohol Review, 28(4), 441–444. https://doi.org/10.1111/j.1465-3362.2009.00052.x
4. Current dietary guidelines. Dietary Guidelines for Americans, 2020-2025 and Online Materials | Dietary Guidelines for Americans. (2020). https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials
5. Duke University. (n.d.). Gender Differences in Alcohol Metabolism. The Alcohol Pharmacology Education Partnership. https://sites.duke.edu/apep/module-1-gender-matters/content/content-gender-differences-in-alcohol-metabolism/
6. Naimi, T. S., Brown, D. W., Brewer, R. D., Giles, W. H., Mensah, G., Serdula, M. K., Mokdad, A. H., Hungerford, D. W., Lando, J., Naimi, S., & Stroup, D. F. (2005). Cardiovascular risk factors and confounders among nondrinking and moderate-drinking U.S. adults. American Journal of Preventive Medicine, 28(4), 369–373. https://doi.org/10.1016/j.amepre.2005.01.011
7. U.S. Department of Health and Human Services. (n.d.). Alcohol’s effects on health. National Institute on Alcohol Abuse and Alcoholism. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets

Originally published 05/23/2006.