How alcohol affects your health, why you should consider joining in Dry January – and why a month without drink is not enough

A team from Oxford University in the UK found in a June 2023 study that more Chinese men are drinking alcohol.

Those who reported having alcohol in the past 12 months rose from 59 per cent to 85 per cent between 1990 and 2017. And this percentage is predicted to grow.

Dr Iona Millwood – who took part in the Oxford study – said researchers wanted to learn more about genetics and alcohol tolerance.

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“Chinese and other East Asian populations have genetic variants that strongly affect alcohol tolerance,” she said. People with these variants, about a third of Chinese populations, cannot metabolise alcohol effectively, and that causes facial flushing and nausea after drinking.

The Oxford study found that among Chinese men, alcohol was associated with 61 diseases, including conditions not typically linked to alcohol, such as cataracts and gout.

The risks are worse for women. Hong Kong general practitioner Dr Wong Sze-Man notes that women have fewer enzymes to metabolise alcohol, and more fatty tissue, leading to a higher and more persistent blood-alcohol concentration.

Alcohol consumption has been linked to a higher risk of developing seven different cancer types, including breast cancer. Having just one drink a day increases a woman’s lifetime risk of developing this cancer by 9 per cent.

Wong describes alcohol’s journey through the body. “From the first sip, alcohol affects your system. And from the warm sensation on your skin to the hangover of the next morning, its effects are multiple.”

From the mouth it travels through the digestive system quickly and is rapidly absorbed. Blood alcohol levels peak in under an hour. “Once the trip is over, alcohol reaches the liver where it is metabolised,” she says.

Alcohol has many effects on the body, and can affect the liver, brain, and other organs in different ways, not all of which are fully understood.

Here we look at some of those effects:

1. The brain

The short-term effects of alcohol on the brain – such as lowered inhibition – are often the reason people drink in the first place.

This lowered inhibition comes from gamma-aminobutyric acid, or Gaba, the most common inhibitory neurotransmitter in your central nervous system. Alcohol targets Gaba receptors and mimics its effects, helping to relax the mind and body.

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As you keep drinking, the hormone dopamine kicks in, making you feel happier and more energetic. But as its effect starts to wear off, you want more. This can lead to drinking to excess, and inevitably, a hangover.

The long-term effects from a regular drinking habit may be far worse, as it has been linked to depression, strokes and more. Even light drinking damages the hippocampus, leading to a poorer ability to make or retain memories.

2. Weight

If you want to lose weight for a New Year resolution, you might want to consider giving Dry January a go. Alcohol has a sneaky number of hidden calories: a large glass of red wine has around 160 calories, while a Long Island Iced Tea (the innocent sounding “tea” hiding the fact it contains gin, vodka, tequila, rum and triple sec) has a whopping 780 calories.

Not only does alcohol have a lot of calories, it also plays havoc with your hormones.

You may have noticed a pattern between drinking too much and the urge to stuff your face full of greasy takeaway food. Alcohol switches the brain into starvation mode, increasing hunger and appetite.

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3. The heart

The long-term effects of alcohol consumption on the heart are many.

Alcohol increases hormones that cause arteries to tighten and constrict, changing how hard the heart needs to work to pump blood around the body.

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It also affects receptors in blood vessels near the heart that help maintain blood pressure, and can even increase stress hormones like cortisol which boost heart rate.

4. The liver

The liver can regrow to a normal size even after up to 90 per cent of it has been removed. Yet it can only tolerate so much alcohol. On average, it can break down around one small glass of wine or a pint of beer an hour.

When more than that is consumed, the excess alcohol circulates in your bloodstream, affecting your brain, heart and other tissues. Blood pressure may fall, and newly alcohol-infused blood is pumped to the lungs, where some of your intake is exhaled – which is what a breathalyser test measures.

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Short-term alcohol overconsumption puts pressure on the liver, but also spreads the negative effects throughout the body.

5. The skin

Flushing – that redness in the face and neck that shows you had a night of hard drinking – might be embarrassing. But too many of those nights may lead to permanent facial redness, including a red nose.

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No level of alcohol consumption is healthy

Many of us might have whispered “a small glass of red wine is good for us!” while clutching said small glass. Experts, backed by studies, are challenging this, and the idea that moderate drinking has any health benefit.

Millwood is one. Some studies suggest moderate drinkers show an apparently lower risk of death compared with non-drinkers, particularly death from coronary heart disease, but “our research has shown that this apparently protective effect of moderate drinking (one or two drinks a day on average) is unlikely to be causal”, she says.

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In other words, researchers aren’t sure if those healthy effects come from the alcohol – or from other good lifestyle choices that moderate drinkers make.

In January 2022, the World Heart Federation stated that any amount of alcohol is bad for your heart.

“The evidence is clear: any level of alcohol consumption can lead to loss of healthy life,” the group said. “To date, no reliable correlation has been found between moderate alcohol consumption and a lower risk of heart disease.”

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In January 2023, the World Health Organization said unequivocally, there is no safe amount of alcohol you can drink.

“It doesn’t matter how much you drink – the risk to the drinker’s health starts from the first drop of any alcoholic beverage,” said Dr Carina Ferreira-Borges, a WHO adviser for alcohol and illicit drugs for Europe.

“The only thing that we can say for sure is that the more you drink, the more harmful it is – or, in other words, the less you drink, the safer it is.”

Perhaps in January 2024 we’ll listen – and pay heed all year.