Wellness

Can You Have Alcohol in a Healthy Diet?

1/4/2023

Many of my clients ask me if there is a role for alcohol in their lives. I smile as I write this, considering that I grew up with a vineyard in my backyard in Italy. To a European, an alcoholic beverage is just another aspect of conviviality as we sit down to an evening (or lunchtime) meal together with family or friends.

Many of my clients ask me if there is a role for alcohol in their lives. I smile as I write this, considering that I grew up with a vineyard in my backyard in Italy. To a European, an alcoholic beverage is just another aspect of conviviality as we sit down to an evening (or lunchtime) meal together with family or friends.  

“L’aperitif, c’est la priere du soir des Francais”-Paul Morand, writer

(“The aperitif is the evening prayer of the French”)

Italy, France, and so many other countries and cultures around the world have evolved with the long-standing tradition of fermented beverages, so why do we, as a society, feel confused about alcohol’s place in our daily lives?

Well, simply put, it is a question of quality and quantity.  

In my practice, I suggest always putting quality first. A tomato picked early and shipped from the southern hemisphere in a refrigerated container cannot hold a candle to a ripe, fresh, earth-scented tomato picked at the height of summer. The quality of alcohol also matters. In the case of wine, grapes grown organically and biodynamically have a much higher polyphenol content which is expressed in the flavor of the wine. The wines are also less manipulated with external ingredients that create a more “processed” beverage.

As I try to educate in my practice, we want to consider everything in moderation. Whether we discuss chocolate cake or a fresh kale salad, too much of anything is just not healthy. When it comes to excess, most alcohol consuming adults can tell you a story or two about one too many glasses of wine or beer.  

We all know that too much of any good thing is bad, but do we really understand why?

Let me break it down for you biochemically. What I mean is, we must understand how our body breaks down alcohol, a process known as “biological oxidation of alcohols,” to understand the more nuanced impact of alcohol on our body.

Ethanol is the main alcohol found in our favorite beers, wines, and spirits. There are many different alcohols with different chemical structures, but for the sake of simplicity, we will focus on ethanol. Through a series of chemical conversions, ethanol is metabolized or broken down to be eliminated from the body because it is highly toxic. But that does not mean that a favorite drink needs to be eliminated altogether. In fact, moderate consumption of alcohol such as red wine, may even have some health benefits (Golan, Gepner & Shai, 2019).

But here is where my client’s original question about alcohol is important: Our body identifies food as macronutrients. For example, your body cannot tell the difference between a piece of fruit and a piece of candy, it just recognizes the ingested bolus as a form of sugar. It is important to understand that there is an order by which these “macronutrients” get broken down, known as “substrate hierarchy.” Carbohydrates are generally metabolized first, followed by proteins and then fats. There are many different organs involved in the digestive process, including the liver.  

When we drink alcohol, the liver, which is what makes and stores blood glucose once you consume carbohydrates, is sidetracked to take over the removal of the toxic alcohol. This means that the foods you ingested at the same time are left to get used later since they cannot be broken down for energy at the same time. In other words, when you drink alcohol, you cannot also burn your food for energy, so it mostly gets stored as fat for future use. This can explain the pesky weight that creeps up on us, despite counting food calories and watching what we eat. Alcohol itself has about 7 calories per gram, the caveat here is that while we tend to feel full after a certain amount of food, we don’t often get fullness signals when we have had an equivalent amount to drink. Furthermore, alcohol lowers our inhibitions and increases our hunger, a tricky combination to say the least.

Another point to note is that for those of you wearing a continuous glucose monitor (CGM), you might see your blood sugar drop, even quite dramatically, when consuming an alcoholic beverage. Again, the liver is quickly removing toxins from your body, and your blood sugar levels reflect this physiologic manifestation. That is why for my diabetic clients and those trying to control their blood sugar, alcohol can be a little risky, causing glucose levels to either plummet or rise depending on the type of diet (Emanuele, Swade & Emanuele, 1998).  

Of course, I would be remiss to not mention that any alcohol in excess can also interfere with medications, increase blood pressure, stimulate hunger, damage internal organs such as the liver and pancreas, and impair sleep.

The takeaway? If you are not suffering from any medical conditions that warrant abstinence from alcohol, an occasional glass can absolutely be enjoyed. I do recommend always staying away from sugar-laden cocktails and instead opting for biodynamic dry wines and organic spirits where there is quality control. To avoid any surprise weight gain, cap your intake to 1 drink per night, as is the general recommended guideline for women.

Research

Emanuele, N. V., Swade, T. F., & Emanuele, M. A. (1998). Consequences of alcohol use in diabetics. Alcohol health and research world, 22(3), 211.

Golan, R., Gepner, Y., & Shai, I. (2019). Wine and health–new evidence. European journal of clinical nutrition, 72(1), 55-59.