Alcohol and your health – is it time to rethink the drink?

3 THINGS TO KNOW

1. Largest-ever study confirms no safe level of drinking alcohol.
2. Alcohol is more harmful for women than men, and increases the risk of breast and other cancers, heart disease and early death.
3. Women can enjoy improved health and wellbeing by reducing alcohol intake.

During Australia's penal era, more alcohol was consumed per person than at any other time in history. Rum was even used as currency. Today things are different. The Australian Bureau of Statistics says that Australians are drinking at the lowest level in 50 years, amounting to around 2.6 standard drinks per person per day.

Yet the recent headlines about alcohol have been … well … rather sobering. The largest ever study to assess alcohol and disease has concluded that there is no safe level of drinking alcohol. This news is especially worrying for women, given that alcohol is more toxic to women than men, and takes longer to process. This is due to the smaller percentage of water in a woman's body, and because the protein that breaks down alcohol is produced in smaller quantities in smaller livers.

The study, published in the international medical journal The Lancet, showed that three million deaths globally were due to alcohol use in 2016. The findings mirror other studies which link alcohol with premature death, heart disease, and cancer, particularly breast cancer. In Australia alone, more than 5500 lives are lost every year due to alcohol use.

Jean Hailes endocrinologist Dr Sonia Davison says there is a lot of debate about what is 'safe' alcohol use and the study reinforces the overall message "that zero alcohol intake is safest".

Attitudes to alcohol

The 2018 Jean Hailes women's health survey, which surveyed more than 15,200 women across Australia about their health, revealed that 9.5% of women drink alcohol every day. Of this, 13.7% of women aged over 50 reported drinking alcohol daily, compared to 2.2% of women aged 18-35.

A 2018 poll by the Foundation for Alcohol Research and Education found 45% of Australian drinkers consume alcohol to get drunk, and – not surprisingly – that 73% of people believe that excess drinking is a problem in Australia.

Current guidelines on alcohol consumption

Dr Davison believes that despite the potential harm, it's not realistic to advise women to stop drinking entirely. Instead, she says "we should educate about responsible alcohol consumption – drinking within the recommended limits."

Guidelines and standard drinks vary around the world. A standard drink in Australia is defined as 10g of alcohol. This equates to a 100mL glass of wine. However, many restaurants and pubs will pour at least 150mL in a regular serve, making it more difficult to keep track.

In the UK, a standard drink is 8g of alcohol. The UK's guidelines are now set at six glasses per week, while the recommended limits in Italy, Portugal, and Spain are about 50% higher.

The 2009 Australian Alcohol Guidelines are currently under review by the Australian Government's National Health and Medical Research Council (NHMRC) and due for release in 2020.

The current guidelines advise:

• drinking no more than two standard drinks on any day
• drinking no more than four standard drinks on a single occasion
• no drinking for women who are pregnant, planning a pregnancy, or breastfeeding
• no drinking for the under 15 age group.

Cancer risk

Alcoholic beverages are a group 1 carcinogen, meaning they're as dangerous as smoking. Alcohol causes seven different types of cancer – mouth, throat, oesophageal, liver, stomach, bowel and female breast.

Cancer Council Victoria's Alcohol Legal Policy Adviser Sarah Jackson says that most Australians are unaware that alcohol causes cancer. "Cancer Council Victoria recommends that to minimise the risk, people should avoid alcohol altogether," she says. "But if people do choose to drink, then limit to within the guidelines," she says.

Breast cancer and alcohol

While drinking alcohol doesn't automatically mean you will get breast cancer, research shows that the more you drink, the greater your risk. Women who drink one standard glass of alcohol each day have a 7% greater risk of breast cancer when compared to women who don't drink. Alcohol use is believed to cause 6% of breast cancer cases each year in Australia. Although the exact link is not fully understood, it is known that:

• alcohol increases the levels of the hormone oestrogen. High levels of oestrogen can cause a cancer cell to multiply out of control
• alcohol is broken down by the body into a substance called acetaldehyde, which can cause changes in our DNA. This can cause cancerous cells to grow.

How to reduce home drinking

"Drinking is woven into the fabric of society in Australia," says Jean Hailes psychologist Gillian Needleman.

"Home drinking, in particular, is both a common occurrence and a challenging habit to change – especially if it is the 'circuit breaker' or daily ritual used to transition from work to relaxation mode," she says. "If you would like to curb your drinking, however, you should feel confident you can make it happen."

Getting started

Anyone concerned about their drinking can talk to their local GP or other health professional for support. Ms Needleman also asks her clients to consider the following when planning for change.

• Self-reflection – assess why you're drinking in the first place – this helps to identify the 'cause'.
• Goal setting – set an overall goal and then segment in to smaller, measurable targets.
• Plan – substitute drinking with another activity, eg, walking, yoga, reading. Identify which days of the week you find it more difficult to abstain and think of an alternative activity.
• Set new rituals – at home, don't sit in the same chair that you would normally drink in. Add cucumber and lemon to soda water. Make it interesting/tasty.
• Monitor self-talk – combat negative self-talk with some positive thoughts or affirmations.
• Respect the process of change – if you don't meet your targets one week, acknowledge it, and then put it behind you. Look ahead to what you can do differently next week.
• You're not the only one – use websites such as Hello Sunday Morning, which frame alcohol-free living in a positive light and help to remind you that many others are trying to change too.

Gillian's tip:

Segment the week. Keep your weekdays alcohol-free, so that you can enjoy a couple of drinks on the weekend.

Feeling good

Ms Needleman says those wishing to reduce their drinking may feel a bit fearful. But it doesn't need to be that way, she says. "A lot of women report how wonderful they feel once they reduce their intake," says Ms Needleman.

"Many will have been unaware of the pervasive effect alcohol has been having on their mood, weight, motivation, and overall functioning."

"It may be hard at first, but if you make it fun and reward yourself in other ways, in time you'll find your new routine and a new lease of life."

This article was originally published in Volume 1, 2019 of the Jean Hailes Magazine.