Alcohol - The risks

High risk As the amount we drink and the number of times we drink increases, then so do the risks. The risks to you: Raised blood pressure which increases the risk of Stroke; stomach disorders; depression and emotional disorders; cancers, particularly of the mouth, throat and gullet; hepatitis and cirrhosis of the liver; malnutrition; accidents, at home, at work and on the roads; suicide. The risks to your family: Violence, accidents (perhaps influenced by you); less to spend on food; poor role model for children; increased risk of divorce.

Advice If you don't drink alcohol don't start! If you do drink alcohol you can lower your health risks by cutting down or even stopping now. If you drink less you will be less at risk from major illnesses, you will be less at risk from violence and accidents, you will feel more healthy, and you will influence your family's healthy lifestyle.

HEALTH CONDITIONS AND ALCOHOL Multiple studies suggest that consuming alcohol can affect the risk of developing certain health conditions. Cardiovascular disease ² Cardiovascular disease, including disorders of the heart, blood vessels, and blood circulation, is the leading cause of death in the United States. However, several studies suggest that moderate alcohol use, as compared to heavy drinking or abstaining, decreases the risk of coronary heart disease (CHD) and the most common type of stroke (ischemic stroke) by 40 to 70 percent. High blood pressure ² People who consume more than two drinks per day have up to a twofold increase in the incidence of high blood pressure compared with nondrinkers. However, the effect of drinking less than two drinks per day on high blood pressure remains unclear. Heart attack ² Drinking a moderate amount of alcohol is associated with lower risk of having a heart attack. Peripheral vascular disease ² Peripheral vascular disease can cause pain in the calves with walking, also known as claudication. Moderate alcohol use reduces the risk of peripheral artery disease in healthy men. Stroke ² Alcohol consumption has been shown to affect the risk of stroke in contradictory ways, depending upon the amount of alcohol consumed and the type of stroke. A stroke occurs when brain tissue dies as a result of a sudden, severe disruption of blood flow and insufficient oxygen. Strokes may be due to a blockage (ischemic stroke) or rupture and leakage (hemorrhagic stroke) of one of the blood vessels supplying the brain. Heavy alcohol use increases the risk of both ischemic and hemorrhagic stroke in all ethnic groups. Moderate alcohol use is associated with fewer ischemic strokes; the risk appears to be lowest in people who consume one to two drinks per day. In contrast, the risk of hemorrhagic stroke appears to rise even with minimal alcohol use. Breast cancer ² There is consistent evidence that breast cancer risk is higher for women consuming moderate to high levels of alcohol (three or more drinks/day) compared with abstainers. Drinking as little as one to two drinks per day is believed to increase this risk. (See

and hypothermia are more common in those who use alcohol.Taking folic acid (folate) may reduce the effect of alcohol consumption on breast cancer.08 percent.02 percent. the risk of having an accident while driving doubles at a BAC of only 0. However. the legal BAC limit for driving is 0. burns. However. although this is a matter of some controversy. and snowmobile. and others around them. People with chronic hepatitis should avoid alcohol Cirrhosis ² Low levels of alcohol do not clearly cause cirrhosis. which prevents normal growth. Suicide ² Alcohol abuse is associated with an increased risk of suicide. falls. occupational injuries. Perception of health and quality of life ² Excessive and frequent alcohol use reduces quality of life for individuals. People who drink and smoke have a greater risk than would be expected from either factor alone. Pancreatitis ² Heavy drinking increases the risk of both sudden (acute) and long-term (chronic) inflammation of the pancreas (pancreatitis). It has been shown to impair a pilot's ability to fly and an operator's ability to control a boat. even at low levels of consumption. heavy drinking may reverse this benefit. interpersonal problems. drinking may increase the risk of hepatocellular cancer in people with inflammation of the liver (hepatitis) due to infection with certain viruses (ie. This may be related to liver scarring (ie. Heavy drinking (at least five drinks daily) is generally required to cause cirrhosis in men. In addition. Accidents and trauma ² Alcohol use increases the risks and severity of injury from motor vehicle accidents. Exposure to alcohol is generally measured in blood alcohol concentration (BAC) rather than drinks per day or week. Alcohol is involved in more than one-quarter of all rapes. and one-half to two-thirds of all homicides. Moderate alcohol consumption may also be harmful. particularly in heavy drinkers. bicycle. intellectual disability (mental retardation). and driving ability is impaired with BACs as low as 0. drownings. Cancers of the head and neck and digestive tract ² Alcohol use has been linked to several types of cancer of the head and neck and digestive (gastrointestinal) tract. experts advise completely avoiding alcohol during pregnancy. even at low levels. Cancer arising within liver cells (hepatocellular carcinoma) has been linked to alcohol use. suggesting that women who drink alcohol may benefit from a daily multivitamin fortified with folic acid.05 percent. malformations of the skull and face. IS ALCOHOL SAFE FOR ME? The bottom line is that it is difficult to weigh the benefits and risks of alcohol. moderate drinking does not appear to raise suicide risk. Thus. several important conclusions can be drawn: y Beginning to drink alcohol may be inappropriate for people who have been lifelong abstainers. . However. potentially leading to failure at work or school. which corresponds to about 4 drinks for a 200 pound man and 2. Pregnancy ² There is a significant risk of birth defects related to use of alcohol use during pregnancy. cirrhosis) that occurs in people who consume excessive amounts of alcohol since cirrhosis is a major cause of hepatocellular carcinoma. Osteoporosis ² Heavy drinking increases the risk of hip fractures because it increases the risk of both osteoporosis and falls. Low levels of alcohol do not clearly cause cirrhosis. at least one-half of serious assaults. Heavy drinking can cause fetal alcohol syndrome. In most of the United States. and physically hazardous situations. Alcohol also increases the risk of injury from other sources. However. Gallstones ² Moderate alcohol use has been shown to lower the risk of gallstones. and other findings. hepatitis C virus). There is no known benefit of alcohol use during pregnancy. There is no evidence that abstainers who begin drinking will lower their risk of any disease. Nevertheless. their families.5 drinks for a 150 pound woman.

moderate alcohol use increases the risk of the most common causes of death. Adults should model responsible drinking for children and adolescents by either abstaining from alcohol or drinking in moderation. Multiple factors must be considered in any such "risk-benefit analysis. In France. they advise y y No more than two drinks daily for men No more than one drink daily for women What is the best approach in my case? ² The following guidelines may help in making an informed decision about alcohol use: y y y y y Consult a healthcare provider to determine the specific risks and benefits of alcohol use. diet. children exposed to alcohol abuse in their parents are more likely to become alcoholic themselves. no amount of alcohol is considered safe. smoking. Gender differences ² Established recommendations for safe levels of drinking do not address an "ideal" level of alcohol consumption. other studies indicate that all alcoholic beverages offer cardioprotective benefits. In these younger age groups. Men under age 45 years also may experience more harm than benefit from drinking. possibly due to naturally occurring compounds known as flavonoids. An "ideal dose" of alcohol ² As mentioned above. Speak with your child's doctor about preventing alcohol use and abuse in children and teenagers. Never consume alcohol before or while driving or operating any potentially dangerous equipment. men. the healthiest dose of alcohol appears to be in the range of 0. Clearly. Whether beverage type matters for specific diseases other than CHD remains uncertain. planes. physical fitness. and people with CHD risk factors (eg. although most evidence suggests that it does not. Consuming less than one drink daily appears to be safe (that is. hypercholesterolemia. follow recommended guidelines concerning moderate drinking. Unfortunately." including age. For these groups. personal medical history. this may be done by introducing children to the ceremonial use of low-proof alcoholic beverages at meals and providing information about appropriate social uses of alcohol. such as breast cancer and trauma. death from CHD is lower than would be expected from the high rate of smoking and saturated fats in the diet. limiting intake to no more than one drink daily for women or two drinks daily for men. experts advise that women should stop drinking when trying to conceive. If drinking alcohol is appropriate. although even that level of drinking can be dangerous for some people (see next section). For young to middle-aged adults. boats. this can be a deadly combination. Americans are commonly introduced to alcohol during adolescence. diabetes mellitus). among others. However. particularly women. Some experts suggest that we may save young lives if the drinking experience precedes legal driving. moderate alcohol use is unlikely to reduce the risk of dying.5 to 1 drink of alcohol daily.y y The diseases that may be prevented by moderate drinking (eg. or construction equipment) Wine versus other alcoholic beverages ² Some research suggests that wine provides the strongest protection against cardiovascular disease. However. and certain lifestyle choices such as smoking. Women should not drink any alcohol during pregnancy. However. around the same time that they are introduced to automobiles. for some people. sex. family history. for example. Reasons to avoid alcohol ² Alcohol use is not recommended for individuals who: y y y y y y y y Are younger than the legal drinking age (21 years in most states within the United States) Are pregnant Have a personal or strong family history of alcoholism Have a personal or strong family history of breast cancer Have had hemorrhagic stroke Have liver or pancreatic disease Have precancerous conditions of the digestive tract Operate potentially dangerous equipment or machinery (including cars. coronary heart disease and ischemic stroke) are most prevalent in older adults. ie. in addition. if not done before or while operating a car or heavy equipment). hypertension. for individuals without such conditions. moderate alcohol use may substantially reduce the risk of dying. this "French paradox" has been attributed to frequent red wine consumption. .

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