Choosing to do a ‘Dry January’ has become increasingly popular over the last few years and I’ve known quite a few people who have done it. Dry January is an idea being driven, among others, by a charity called Alcohol Concern. Alcohol Concern’s website states that the reasons for doing a Dry January include: “enabling you to take control of your relationship with alcohol” and “driving a conversation about alcohol: why do we drink it, what does it do, and how can we reduce the harm it can cause?”
It says that the potential benefits include better sleep, improved skin, weight loss, having “an amazing sense of achievement at the end”, and saving money (according to Alcohol Concern the average person spends £50,000 on booze in their lifetime).
This all sounds terrific. So when BBC Focus asked me if I fancied getting ahead of the game and giving ‘Dry November’ a go, I thought, “why not?”. I enjoy a bit of self-experimenting and one of the advantages of doing it in November is that there are only 30 days in that particular month, so it would require one less day of total abstinence.
I am not and have never been a heavy drinker. Even at medical school, where there was a culture of heavy drinking among certain groups (mainly the rugby players), I hardly ever drank more than two or three pints in a single session. Once alcohol hits my brain I have about an hour of uninhibited fun before I go into a slump. Drinking does not make me good company. Nonetheless I have got into the habit of drinking most evenings, mainly red wine, so I thought it would be an interesting challenge.
I started off by logging everything I drank for a couple of weeks in the lead up to November, and it worked out at around 20 units a week. While this isn’t a huge amount of booze, it is well over the current UK government guidelines of 14 units a week for men and women. The guidelines used to be 21 units a week for men, 14 for women, but they were changed in December 2016, when the Department of Health announced that, “there is no justification for drinking for health reasons”.
I was surprised and somewhat sceptical about the definitive nature of this statement for reasons that I will come to in a moment, but it did give me further reasons to attempt an alcohol-free November. I went off and got some bloods taken, in order to measure my fasting glucose, liver enzymes and cholesterol levels, and I also weighed myself and measured my blood pressure. I put the bottles of wine out of sight and I was good to go.
The first couple of weeks were challenging, because I had got into the habit of having a drink with my evening meal and I did miss it. I thought the best way to get through the month was to tell people what I was doing so it would be too embarrassing to backtrack.
My friends were understanding, and it also meant that when we met for a drink I was no longer tempted to eat crisps at the bar. I found that I was better company when I went out in the evening because I was less likely to have a postprandial slump. I did not, however, notice much improvement in my sleep or any impressive changes in my skin.
It seemed that there were good reasons to stick to Dry November, but I wondered whether there would really be any lasting benefits if I kept it up. Is alcohol, at the relatively modest levels that I’ve been drinking it for the last few years, really that bad?
According to the Department of Health if you are drinking 14 units of alcohol a week, let alone the 20 units that I was averaging, then you are increasing your chance of dying by around 1 per cent. That figure sounds quite scary, but Sir David Spiegelhalter, Winton Professor of the Public Understanding of Risk, at Cambridge University, has crunched the numbers and put some context on the 1 per cent chance of dying claim.
“An hour of watching TV a day, or eating a bacon sandwich a couple of times a week, is more dangerous to your long-term health,” he explains. “It all seems to come down to what pleasure you get from moderate drinking.”
So not that scary after all. But what about the claim that moderate drinking is worse for you than total abstention and that “there is no justification for drinking for health reasons”. This is certainly the view of Prof Tim Stockwell, director of the Centre for Addiction Research at the University of Victoria in Canada. He has advised many governments, including our own, on alcohol guidelines and thinks there are no biochemical benefits to drinking. However, he does concede that moderate drinking can be sociable, and may be beneficial for us purely for those reasons.
“There are 60 different ways at least that alcohol can make you unwell or kill you,” he explains to me over a glass of water. “It’s not just the obvious things like liver disease. A man drinking three to four units a day increases his risk of developing prostate cancer. Alcohol, at whatever level, raises a woman’s risk of breast cancer. There’d be 10 per cent fewer deaths from breast cancer worldwide if there was no drinking.”
Stockwell thinks the studies that suggest moderate drinking is protective are flawed. He says the problem is that the group of people who ‘don’t drink’ often includes former alcoholics and people who are in poor health, and that skews the apparent benefits of moderate drinking. He recommends abstinent days, abstinent months, and if you actually don’t miss the stuff, abstinent years.
Dr Alexander Jones, a consultant cardiologist and clinical scientist at University College London, agrees that alcohol raises your risk of a wide range of cancers. He believes, however, that there is evidence that alcohol can be beneficial for the heart, at least in relatively low doses.
“Heavy drinkers have a much higher risk of developing heart disease than non-drinkers,” he says. “But there are large prospective studies which show that if you drink modest amounts of alcohol, up to say two units of alcohol a day, then you are less likely to develop coronary heart disease or stroke later on in life.”
So who is right? The best way to assess the impact of moderate drinking would be to take a large group of non-drinkers and randomly allocate them to either drinking alcohol or water, then follow them for many years. Such a study would be almost impossible to do. But a study along more modest lines was published in 2015 in the Annals Of Internal Medicine. For this study, researchers at Ben-Gurion University in Israel took 224 type 2 diabetics who rarely drank and randomly allocated them to either a 150ml glass of red wine, white wine or mineral water with their evening meal, every evening, for two years. For context, 150ml of wine a night works out at roughly 14 units of alcohol a week. The wine and water were provided free of charge and the empty bottles collected afterwards to make sure they really were drinking regularly.
Into the drink
So what happened during my experiment? Well, as a red wine drinker who struggles with their blood sugar levels I was delighted to read that when it came to measurable health benefits the red wine drinkers came out on top, with the white wine drinkers a close second, followed by the mineral water drinkers.
The researchers concluded that red wine was found to be superior in improving overall metabolic profiles, mainly by modestly improving the lipid profile, by increasing good (HDL) cholesterol and apolipoprotein A1 (one of the major constituents of HDL cholesterol), while decreasing the ratio between total cholesterol and HDL cholesterol.
Prof Iris Shai, principal investigator of the trial, said that while the two types of wine contained roughly the same amount of alcohol, “the red wine had 7-fold higher levels of total phenols and 4- to 13-fold higher levels of specific resveratrol group compounds than the white wine”.
The study found that drinking 14 units of alcohol a week did not have any measurable negative effects on blood pressure, liver function tests, or lead to increased fat gain. In fact, surprisingly enough, sleep quality significantly improved in both of the wine-drinking groups, compared with the water-drinking group. Interestingly, the people who got the biggest benefit (and the only ones who saw improved blood sugar control) were those whose livers broke down alcohol particularly slowly, meaning the alcohol hung around in their systems for longer. This suggests that although red wine contains beneficial compounds, alcohol also plays a role.
This was a smallish study done for a relatively short period of time and with a particular group of people – type two diabetics. Therefore, the team was rightly keen to point out that it should be treated with caution. It adds, however, to what I think is compelling evidence that the occasional glass of wine is unlikely to do harm and may well do good.
So what effects did an alcohol-free month have on me? When I reached the end of November, I stepped on the scales and saw that I had lost just over two kilograms, which was a pleasant surprise. A bottle of red wine contains about 630 calories, so a month of not drinking had saved me consuming around 5,000 calories, which adds up to around 0.7kg of fat. I suspect eating fewer crisps also helped.
It is hard to estimate how much money I saved, because when I went out for a drink or a meal I still paid for my share of the alcohol. At home I may have saved around £40 on the bottles of wine I didn’t buy.
As for my biochemistry, well along with the weight loss there was a slight fall in my blood pressure and a modest improvement in my fasting glucose and cholesterol levels. My liver enzymes were unchanged.
All in all it was an interesting experiment to try. As a consequence of my findings, I will attempt to reduce my drinking to 14 units a week, as that is where the sweet spot seems to lie. So good luck to anyone who is giving Dry January a go. I will be cheering you on from the sidelines.
If you are concerned that you or a loved one has a problem with alcohol, please contact your GP or ring Drinkline (0300 123 1110) for confidential, free advice.
This is an extract from issue 317 of BBC Focus magazine.
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[This article was first published in January 2018]