
Sober October has just passed and some of my clients took the opportunity to experiment with their drinking habits. For those who are unfamiliar: sober October is pretty much the same thing as dry january: a fancy way of saying no to booze for a whole month, sometimes for charity. Maybe you struggled or maybe you found it actually wasn’t that much of a big deal as you anticipated, especially with lockdown making going out pretty much impossible. Lockdown won’t last forever and bars will eventually open again so finding a sensible way to consume alcohol will be useful to anyone with a social life.
What happens when we drink alcohol?
Alcohol is the fourth, often overlooked macronutrient aside from the better known carbohydrates, protein and fat and provides 7 calories per gram (for comparison protein and carbs 4, fats 9). A standard serving of any alcoholic drink contains about 10 grams of pure alcohol with slight differences between countries.
When you drink alcohol it is absorbed in the stomach and small intestine mostly. From there it passes through the liver and into the blood. Every time it passes through the liver some of the alcohol is broken down by 2 main enzymes Alcohol Dehydrogenase (ADH) and Aldehyde Dehydrogenase (ALDH). The rate at which this happens can vary a lot depending on genetics, body size, gender, time of day (yes really), and how much of a seasoned drinker you are (Zakhari). If you drink faster than your liver can keep up, the alcohol builds up and you will get drunk.
Why some people hold their liquor better than others
There are several reasons why some people and species even can hold their liquor better than others and these are mainly due to differences in the efficiency of those 2 enzymes. Humans are one of 3 species (together with gorillas and chimpanzees) able to digest alcohol efficiently because our ADH is about 40 times more efficient than most other primates (Carrigan, 2015).
There is some variation depending on ethnicity as well. Many Asian populations have a less efficient version of the enzyme ALDH which makes them more prone to some unpleasant side effects like nausea, red flush of the face and headaches which must also discourage alcohol use. If you’re sick after one beer, it makes the whole experience much less enjoyable.
The efficiency also changes as we age. Men tend to have a slightly more efficient version of ADH than women (Frezza, 1990), but the opposite is found in later life: older women hold their liquor better than older men (Parlesak et al, 2002). Susceptibility to alcohol abuse also seems to have a genetic basis. Some people experience a higher reward from alcohol consumption and therefore more likely to develop unhealthy drinking habits (Morozova 2014).
Effects on the body and brain
Alcohol is first broken down to acetaldehyde and then to acetate before it can get broken down to water and CO2. These first 2 compounds are toxic. Unlike many other things we eat, alcohol can freely enter any cells and therefore has the potential to damage any tissue. These compounds are free radicals, (you know, the stuff you try to control with antioxidants) and can increase the risk of cancer.
Because the body cannot store alcohol it prioritises breaking it down interrupting normal metabolism. Alcohol consumption alters metabolism of cells, particularly liver cells to store fatty acids rather than to burn them. Not great if you are looking to lose fat. It’s not all bad news, alcohol also stimulates the production of proteins like serotonin which make you feel good.
Alcohol also affects the brain and these effects are widespread. Anyone who’s ever stayed until closing time at the average nightclub might be able to confirm consequences go from slurred speaking, slow reaction times, disorientation and loss of memory to aggressive behaviour. People respond differently to alcohol, it sedates and agitates mostly.
Frequent and long term use of alcohol can damage a developing brain (read: anyone up to 25 years old). Alcohol changes the way the brain develops and not in a good way causing poorer memory, learning and impulsive behaviour (Lees, et al. 2020) just to name a few.
Why alcohol isn’t great for fat loss
Alcoholic drinks do not need to mention calories or macros on the label as they don’t have to comply with the same legislation as everything else we eat. Weird but true, in the EU drinks that contain more than 1.2% alcohol (which is pretty much any alcoholic drink) do not have tell what’s in it. This is slowly changing but no solid measures are in place yet and there’s not a bar in the world who will voluntarily put calorie counts on their menu.
That has probably contributed to the idea that liquid calories don’t count. Do you have any idea how many calories are in the average glass of wine or beer? Nah, didn’t think you did so I made you an overview of some very popular drinks.

So you can see how an evening drinking can substantially increase your calorie intake. And if you like mixers or cocktails, these are often made with sugary sodas adding to the empty calories. A week of dieting can easily be undone on a big night out.
But that’s not the only problem. Liquid calories do not satiate. It is much easier to drink 2000 calories than it is to eat them. Liquids pass through our stomach relatively quickly compared to solid food. Unfortunately, this doesn’t mean that we do not eat, because alcohol makes us hungry too. And not for the chicken, rice and broccoli you prepared last night.
Alcohol also numbs the part of your brain responsible for rational decision making. This is why you get reckless and less concerned with your health and fitness goals when you’re 2 beers down in 30 mins on an empty stomach and all of a sudden that kebab with fries seems like a great idea. Getting drunk switches off our rational brain and any willpower to stick to your diet. Until you wake up the next morning and regret your choices.
Chances are the sabotage continues even then. Hungover people are much less likely to get up and go gym or prep their meals for the week. On top of that again no one craves broccoli after a night of heavy drinking.
But my family will disown me if I don’t go to this wedding and I’ll need to join on the toast..
Sometimes you need to fold your diet around your life and not the other way around. For those times I’ve put together some tips and insights from my own competition prep a few years ago. If you have a serious fat loss goal I’d always recommend to not drink at all because as quoted above, I can resist anything except temptation. Total abstinence is sometimes easier than moderation. These tips do not guarantee you won’t get overexcited and it’s up to you if you are happy to take that risk. The overall trick is not to overdo it. Here’s how:
–          Be mindful of how much you are having, anticipate what else you are having on the day and ensure it fits your macros. Decide beforehand how much you’re going to have and STICK TO IT. It helps to share this with the people you are with. Good friends will keep you on track and call you out if you’re considering having more. It’s important to realise that something is not going to taste any better by having more of it. You really do not need to finish the whole bottle. Besides, sharing is caring. Make some friends and share the booze.
–          Choose a drink that you really enjoy regardless of calories. This may sound a bit controversial as some alcoholic drinks are more diet friendly than others. Yes straight vodka on the rocks may be a relatively “skinny” choice of drink. However, few people truly enjoy the taste. Trying to quench a craving with something less than the crave is wasting calories in my opinion. It will only leave you craving more, hating your diet and feeling deprived and sorry for yourself because “you can’t have anything nice ever again”. It’s better to have one glass of something you really like so you feel satisfied and it’s easier to then get back on track the next day.Â
–        For fat loss you need to be in a caloric deficit. To ensure you are still in a deficit you can also increase your expenditure. If you know you’re having an event in the evening, you may want to go for an extra run to increase your calorie allowance. Be mindful not to overcompensate here though. A 5K run burns at most 400 calories. It is not an excuse to go all out but can help control the damage.
–Â Â Â Â Â Â Â Â A simple way to cut calories to increase your allowance for a dinner for example is to skip a meal on the day. The easiest meal to skip is breakfast. Especially on the weekend, you may want to sleep a little longer and postpone lunch until you are really hungry. Ensure to have something nutritious and protein rich.
–         Always order a small glass. This is especially useful in a busy pub. If you need to wait 15 mins in a busy pub for every glass you’ll drink less and also because a small glass is relatively more expensive so you can buy less booze with the same amount of money.Â
–Â Â Â Â Â Â Â Â Â Ensure to have a healthy meal/snack ready when you come home so even if you get a little too excited, there is no reason to top it up with a pizza on the way home. My urge not to want to waste food and money has been stronger than my boozy brain several times.
–Â Â Â Â Â Â Â Â Â Drink water in between. It helps slowing down the rate at which you finish your drink and ensures you’re less likely to get too excited and lose control.
–         Say no. Sometimes it really isn’t such a bad thing not to drink even on social occasions. I think going out and not drinking is a skill but definitely worth acquiring and it really isn’t as bad as you think it is.Â
I hope these tips are of use, and can help some of you feeling a bit more in control in social occasions. However, if you are revising these tips every weekend it’s also worth asking yourself where your priorities lay.Â
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But what about healthy antioxidants in red wine?
Yes, there are some studies indicating that there’s a potential health benefit of drinking the occasional glass of red wine due to its polyphenol content, resveratrol in particular, which is an antioxidant. It also has some anticancer potential. However, to drink wine to lower your risk of heart disease is silly. There’s nothing in wine that you cannot get from eating a healthy, varied diet, even resveratrol is found in other foods like berries, chocolate and, how would you guess, red grapes.Â
Have a glass of wine because you enjoy the taste, it goes well with your meal and the company you are having this with has something to celebrate. That is in my humble opinion the health benefit of drinking alcohol somewhat supported by science.Â
Some studies indicate light to moderate alcohol consumption (read the odd glass here and there) lead to reduced incidence of heart disease by calming the stress response (Jones et al, 2013). A drink chills you out, makes good memories and increases your joy in life. Remember, the poison is the dose. This is the case with most things nutrition and alcohol is no exception. Small amounts can be handled by the liver fine. It’s what it’s made to do. To reduce your risk of heart disease, make sure this isn’t a daily occurence, that your diet is on point most of the time and that you move around enough.Â
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Resources
Carrigan, M. A., Uryasev, O., Frye, C. B., Eckman, B. L., Myers, C. R., Hurley, T. D., & Benner, S. A. (2015). Hominids adapted to metabolize ethanol long before human-directed fermentation. Proceedings of the National Academy of Sciences, 112(2), 458-463.
Frezza, M., di Padova, C., Pozzato, G., Terpin, M., Baraona, E., & Lieber, C. S. (1990). High blood alcohol levels in women: the role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism. New England Journal of Medicine, 322(2), 95-99.
Jones, A., McMillan, M. R., Jones, R. W., Kowalik, G. T., Steeden, J. A., Pruessner, J. C., … & Muthurangu, V. (2013). Habitual alcohol consumption is associated with lower cardiovascular stress responses–a novel explanation for the known cardiovascular benefits of alcohol?. Stress, 16(4), 369-376.
Lees, B., Meredith, L. R., Kirkland, A. E., Bryant, B. E., & Squeglia, L. M. (2020). Effect of alcohol use on the adolescent brain and behavior. Pharmacology Biochemistry and Behavior, 172906.
Morozova, T. V., Mackay, T. F., & Anholt, R. R. (2014). Genetics and genomics of alcohol sensitivity. Molecular Genetics and Genomics, 289(3), 253-269.
Parlesak, A., Billinger, M. H. U., Bode, C., & Bode, J. C. (2002). Gastric alcohol dehydrogenase activity in man: influence of gender, age, alcohol consumption and smoking in a Caucasian population. Alcohol and Alcoholism, 37(4), 388-393.
Zakhari, S. (2006). Overview: how is alcohol metabolized by the body?. Alcohol Research & Health, 29(4), 245.