Lighter drinkers decreased their consumption during the pandemic, while heavy drinkers hit the bottle harder, UK studies show. Photo / Christian Lue, Unsplash
Apologies if you are reading this with a glass of something restorative in one hand, but last week, two new studies suggested that the drinking patterns Britons fell into during the pandemic are now having a grave effect on the nation's health.
They make sobering reading. Research from the University of Sheffield presented a worst-case scenario involving nearly a million additional UK hospital admissions over the next 20 years. Meanwhile, the Institute of Alcohol Studies predicted 147,892 additional cases of alcohol-related diseases, ranging from liver cirrhosis to breast cancer, by 2035.
Lighter drinkers decreased their consumption during the pandemic. But, on average, heavy drinkers (those regularly drinking over the recommended 14 units a week) hit the bottle still harder, and deaths from alcohol have now reached record levels.
And those alarming figures aren't down to untamed teens staggering in the street. In recent decades, there's been a dramatic shift away from drinking in pubs towards doing it at home, and while young adults cut back on drinking, older groups have uncorked more bottles.
In the past, "the typical drinker at risk would have been an 18-year-old male, down the pub. Now, it's much more like a couple in their sixties, sharing a bottle of wine every night in front of the TV," says Colin Angus, the senior research fellow who led the University of Sheffield study.
"There was a big moral panic when it was the former, because it was so visible in town centres on a Friday night. But you don't see the older people drinking quietly at home, until they turn up in hospital with some chronic health consequences."
Sadie Boniface, head of research at the Institute of Alcohol Studies, which published the second of last week's studies, said: "The evidence that alcohol is harmful to health is crystal clear, but it still has a prominent place in British culture, media and society in general, and the majority of us drink.
"Myths, old wives' tales and junk science about alcohol feed a confirmation bias: we want to believe that things we already do – or enjoy – are not bad for us, or even that they might be good for us, when really they are not."
So, if that evening "stress-relieving" glass of wine (or three) is now a daily fixture, it might be time for some sober truths. Here three experts dismantle common myths about booze.
"This one drives me crazy," says Angus. Red wine contains a compound called resveratrol and "a load of sensible studies suggest resveratrol might have some beneficial health effects".
The hitch? Most of the studies are on mice or rats, which are administered such mammoth doses that – says Angus – humans would need to drink a swimming pool of red wine a day to get the equivalent dose: "So it's nonsense. Drink red wine if you like. But don't drink it because you think it's any better for you. It really isn't."
The rules are exactly the same for red wine as any other form of alcohol. To keep health risks low, the UK Chief Medical Officer's guidelines advise you drink under 14 units a week, spread across the week but with some booze-free nights.
"Alcohol has a lot of ways of potentially harming you," says Angus. "One is through acute consequences. You get drunk and make bad decisions: fall asleep with a cigarette butt in your hand; fall over and hit your head …"
If you have a high tolerance for alcohol, you face a lower risk of these acute outcomes. But they are only a relatively small part of your overall risk: "Drinking too much over a long period of time increases your risk of lots of chronic diseases including cardio-vascular disease and a range of cancers. Whether or not you have a tolerance for alcohol makes no difference to that. In fact, if you've got a high tolerance you probably got it through drinking a significant amount, so you're probably at increased chronic risk."
"Alcohol lowers your inhibition, so you probably do feel more gregarious and comfortable with a drink or two in you," says Boniface. "But it also impairs your judgment. So whether people experience you as better company is a different matter, especially if they aren't drinking. It may be that you feel you're better company, but you're just not as good a judge as you usually might be."
"I'm sorry, but alcohol is alcohol," says Boniface. The ethanol content is what counts from a health perspective, meaning there's little difference between a $50 bottle of fizz and a $5 can of beer.
"The size of a typical wine glass has grown over the last several decades," says Boniface. "And wine has also increased in strength. Decades ago, the typical ABV [alcohol by volume] was nine to 10 per cent. Now it's more like 12 to 13 per cent."
A 175ml glass – a medium size in a pub – of wine would contain 2.2 units, she says, meaning a daily tipple takes you over the weekly drinking guidelines (to 15.4 units). Plus: "When you drink at home, there's no guarantee you will pour 175ml. Especially if it isn't your first glass."
"Alcohol can relax us, let's not pretend otherwise," says Richard Piper, CEO of Alcohol Change UK, the charity that – among other things – runs the annual Dry January challenge. But, he continues: "One of the most interesting findings is that when people sit down in the pub with friends at the end of the day with a no-alcohol beer, the effect is almost identical. The mental trigger, the decision to unwind, is by far the biggest factor, as opposed to the alcohol itself."
Alcohol affects your brain activity, suppressing the release of glutamine (which typically boosts brain activity) and increasing the release of GABA (a neurotransmitter that blocks impulses between nerve cells in the brain and works to reduce brain activity), which is why we find it relaxing.
Unfortunately, your body will then try to correct the balance. Instead of returning to pre-drinking levels, there can be a rebound effect, resulting in low levels of GABA and increased glutamate that cause jittery feelings.
"Hangxiety [hangover-related anxiety] is a scientific fact, though it's not called that in the literature. It's not just worry about what you said last night, it's the clinical version of anxiety," says Piper. "And in the long term: "the link between alcohol and anxiety is proven. If you suffer from even mild anxiety, alcohol can massively exacerbate that." Even those of us who are generally unfazed can start to feel jittery with a hangover, he says.
Perhaps, says Piper, but: "the negative effects on your subsequent sleep far outweigh that. When we run Dry January, people tell us they're taking part because they want to take back control, lose weight or save money. At the end, we ask them how they benefited and everyone says: sleep!"
Alcohol's sedative effect can decrease the time you spend in the important, restorative, REM stage of sleep. Its diuretic effect can also lead to you waking in the night. It is also a muscle relaxant, so you could end up startling yourself awake with your own snoring.
It's your weekly consumption that matters, says Piper. "If you drink 14 units a week, every week, you stand a 1 per cent chance of dying from alcohol [-related causes]. If you go to 28 it doesn't just double, it rises to more like 3 or 4 per cent. Add another 14 (roughly, eight double gin and tonics), and make it 42 units, and your chances of dying from alcohol are really getting on for more like 10 per cent. You stand a pretty good chance of being one of those people who dies of cancer, strokes or heart disease. You're throwing the dice, regardless of whether that's spread over three or seven nights a week."
You worked hard for decades and the only prize you're after is a shared bottle of vino blanco in the garden of an evening. Where's the harm in that? Well, unfortunately older age groups have much higher rates of alcohol-related hospital admissions and deaths because, as Angus explains, drinking has a multiplying effect on your risk of chronic illness.
He gives the example of regularly drinking over 14 units a week, to an extent that you are increasing your risk of cancer by 5 per cent: "If your baseline risk for cancer is really tiny – because you're young and healthy – a 5 per cent increase still leaves you with a pretty small number. But older age groups are already at higher risk. Adding an additional 5 per cent to that risk suddenly creates a much bigger number."
• Track it. If you don't actually know what you're drinking, you can't cut back. The Try Dry app is the world's leading alcohol control app and is freely provided by the charity Alcohol Change UK.
• Be "mindful". Whatever you think about that buzzword, an excellent way to cut back is to make sure that every drink you have is for taste. Take it slowly and really savour it. In particular, watch out for drinking "mindlessly", moving quickly onto the next one, or just because it's a habit.
• Try alcohol-free drinks. There are now hundreds of great tasting alcohol-free beers, ciders, wines and spirits.
• Take a month off. A full month off alcohol is one of the most effective ways to start breaking a drinking habit, so you can reset. Once the month ends, you should be back in control and able to keep drinking down to low levels. The Try Dry app lets you select any month (or indeed, any length of time at all) as your personal goal.
- Tips from Richard Piper, CEO of Alcohol Change UK
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