Dynamic Dialogue with Danny Matranga - 366: Alcohol and Body Composition, Cancer Risk, Disease Risk + More

Episode Date: March 19, 2024

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Welcome in everybody to another episode of the dynamic dialogue podcast. In this episode, we're going to take a deep dive into alcohol. It's a compliment to episode 360, which came out a few weeks ago. It has a much deeper dive into the various ways in which alcohol can affect your health from gut, cancer prevalence, cardiovascular disease, body composition, sleep, as well as some guidelines for how to kind of incorporate it into your life in the long term and, you know, avoid the consequences that are so infrequently talked about in a space where we seem to talk about the consequences of largely inconsequential things. So enjoy the episode. Make sure that I'm hydrated and make sure that I'm getting ahead on my water intake throughout the day and not reliant on stimulants, but instead being somebody who's reliant on hydration and the proper balance of minerals and electrolytes.

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Okay, so folks, before we get into the episode today, just a reminder, this is a bit of an expansion on episode 360, where I kind of unpacked a more general and less specific breakdown of alcohol and its effect on your long-term well-being and health. So if you want something a little more abridged, go back, grab episode 360. You'll like that too. This is a little bit more in depth and it'll go into several different, you know, avenues. And I think it's going to be a bit more of a discussion that you guys will get quite a bit out of, I hope. So I've said this before, but when it comes to, you know, giving discussions about alcohol specifically, you know, it's a very polarizing topic. It's super

ubiquitous with, you know, within Western culture, uh, you know, throughout Eastern culture, you see this as well. Um, alcohol is just ubiquitous with human social behavior. So we all have a relationship with it. So I never want to come across as just like bashing it. In fact, my hope is that this gives you the tools to rationalize, or I shouldn't say rationalize, but come up with a rationale for alcohol's position in your life that you can stick with, that makes sense to you, that takes the social, cultural, and health-related components of alcohol all into one kind of holistic look at it so you can make really informed decisions about how you use it. I choose not to drink based on my breakdown of the cost-benefit analysis of alcohol consumption. You might choose to drink a little bit. You might choose to drink a lot. It doesn't matter to me. I think you can be

healthy, have a good physique, be productive, be effective, be at a good productive place in your life. So how are we going to fit alcohol in? I think the first thing we have to discuss is just how long humans have been engaging with the consumption of alcohol. So the earliest evidence we have actually comes from about 7,000 years ago in China, where there was found to be a particular residue in some of these archeological, you know, remnants, these pots, really clay pots, that what they were able to find was the remnants of alcohol, the metabolic byproducts of alcohol breakdown. And so this residue was just kind of left inside of these pots,

which are dated back to being like 7,000 years BCE. And so, you know, there was the kind of genesis of fermentation in, you know, preserving some type of fluid that helped humans actually survive, like as long, as far back as 7,000 BCE. So we've been engaging with alcohol as a species for an extremely long time. And if you talk to people who are experts in the field of alcohol, but also evolutionary biology, there seems to be somewhat of a consensus that alcohol was particularly beneficial because it has antimicrobial properties. It's able to preserve. You can bottle wine, you can bottle mead, you can bottle these more rudimentary alcohol products. They're not products. They were just kind of mainstays in ancient times, but you could bottle and preserve,

or to the point I made earlier about the residue in these clay pots, store in pots, these fermented beverages, which could, you know, imbibe different nutrients, health benefits, antibacterial in nature. They, again, they're not as likely to spoil and, you know, draw bacterial byproducts to them. This was a huge issue in Asian times. So alcohol was a really big deal at the early kind of, you know, we're talking about not eight, seven, big deal at the early kind of, you know, we're talking about not eight, seven, 7,000 BCE. So about 9,000 years back, um, we, we can identify, uh, alcohol consumption in civilization and alcohol is like so ubiquitous in culture. And as you know, humans started to evolve further and for more advanced societies. And we start to

see the proliferation of various religions. You see features like Dionysus, what's his name? What's his name? Bacchus. So Dionysus being the Greek god of wine, Bacchus being the Roman god of wine. We see Inari, the Japanese god of rice. Often, you know, we associate with rice sake or rice wine, Japanese rice wine. Ninkasi, a Sumerian goddess, and Nepethys, an Egyptian goddess, both of whom were representative and, you know, particularly fond or connected with beer. So alcohol is, you know, ubiquitous. It was a survival mechanism for us. It still exists today. It persists in so much culture and even its foundational component in some of these ancient mythology-based religions

is pretty remarkable. But when it comes to talking about alcohol and how it affects our health, one thing that I think really helps is removing from the product we like or that we're passionate about. People are passionate about beer. They're passionate like or that we're passionate about. People are passionate about beer. They're passionate about wine. They're passionate about tequila, whiskey, bourbon, because making it is artistic. It's an art form. And it can be really hard to have discussions with people who are passionate about something on a more artistic and emotional basis. And it's hard for them to get a full kind of clear view of the, you know, let's say negative health effects of that particular thing. In the same way for somebody who's not as invested

artistically or emotionally in the alcohol, you know, I don't know, I'm not a wine snob. For them, it might be difficult to rationalize why somebody would drink it in the first place. But the point is, when we talk alcohol, we're talking about ethanol, ethanol, ethanol, ethanol. How does alcohol affect the body? We're talking about ethanol. We're not talking about the bubbles in the beer, the sugar in the wine. When we talk about calories, yes, those things matter. But when we talk about how ethanol affects our body, or should I say alcohol affects our body, we're truly talking about how ethanol and its metabolism affects our body. So ethanol is by nature what would make a product over 21 consumption here in the United States. So some kombuchas have a small enough amount of ethanol

that they do not require this, but most kombuchas do have like the, just over the precipice, just over the line. And you actually need an ID to buy them, even though you don't think of them as an alcoholic beverage in the way you do like a beer or a bottle of wine or all of these various things that you would just grab and all automatically assume like, okay, I have to show my ID to buy this. If it contains just over enough ethanol, even a kombucha can be required to have a 21 and older limit because ethanol is what we're tracking for here. So ethanol is kind of the unit of alcohol. When we talk about how alcohol affects the body, it all kind of begins with ethanol. Now, a standard drink, we've talked about this in episode 360, but a standard drink,

I think this is very important to understand. And as a coach, as a trainer, as somebody that is working with clients, as a medical practitioner, as a, I'd even go so far as to say as a physical therapist, a manual therapist, a chiropractor, you know, anybody working in the allied healthcare field, being able to communicate to your clients about alcohol is huge because it affects so many organ systems. And just as a like brief, like vocabulary kind of, you know, give you the foundational cogs, you got to know, okay, a standard drink, how many standard drinks are we talking about? You know, what's the right amount of alcohol? What's the right amount of alcohol? What's a reasonable amount? You have to give people simple guidelines that they can take with them that can improve their health. Because if you're working in any allied health field, somebody's relationship with alcohol

is going to be a huge pivot point for how they respond to different interventions. Even psychological stuff. If you're screened for anything psychological, they're going to ask about your alcohol consumption because it's so interconnected to all these systems. So you need to know a standard drink that is 14 grams of ethanol. We just talked about that. If you have over 14 grams of ethanol, you will be categorically one standard drink. So this looks like 12 ounces of 5% alcohol by volume beer.

Think about a normal beer, okay? Not like a super dark, high alcohol by volume IPA. This is a five ounce glass of wine. Wine's typically around 12% alcohol by volume or a 1.5 ounce shot of something like gin, rum, vodka, or whiskey, okay? That's usually around 80 proof or about 40% ABV. Those are standard units. Okay. That's kind of the starting point. And you can give people a guideline or you can give yourself a guideline around your alcohol consumption. If you're a coach, you can give your clients a guideline around their alcohol consumption, right? I think that's super, super important.

Hey, here's what's reasonable. Here's what you can probably enjoy and get away with and not pay for it. This is where you go over the line. And I think a lot of people would have this discussion with themselves frequently if it was with something like cigarettes, which I think is more, you know, in the public conscious of being like, oh, that's not very good for you. And I'm not saying cigarettes are less healthy than alcohol by any stretch. I'm just saying, like, I think we have a substantially lower, you know, we're not on the right wavelength publicly about our alcohol consumption, the way we are about our cigarette consumption, given the likelihood of disease and issues this will cause in the dosages and the amounts people tend to drink. So you know a standard drink, you know what it looks like, it has to have more than

14 grams of ethanol, about a glass of wine, about a normal size beer, and about a shot. For women, it is not recommended that you go more than one standard drink per day. Going more than one standard drink per day will put you at increased risk for literally everything we're going to talk about from this point moving forward. And for men, the number is two. I would say this probably happens on a spectrum. Larger, taller women will be closer to two. Shorter, smaller men will be closer to one. The shorter you are, the lower your total body mass, the closer you are probably to the number one or even below that. And then the larger you are, the more muscle mass, fat mass, et cetera, that you have, the closer you likely are to two standard drinks a day. That said, if we're speaking purely on averages and we're going to use the CDC's models. Let's assume that we're going for men two or more and for women

one or more. So for women should probably keep it to one standard drink for men, probably keep it to no more than two standard drinks or 15 a week for dudes and eight a week for the ladies. Okay. Anything beyond that's going to cause, uh, going to increase probably for most people, you cannot say this is true for everybody, but if you go beyond these markers, you're going to start to see some issues. Now, just so you know, the averages, if we were going to kind of break out and just say, if you were walking down the street and looking to ascribe these averages to the people you saw in the supermarket, the average American, the people that you see are consuming about 535 drinks a year, which is about 1.5 drinks per day. So on average, that is higher than the

average woman should drink and pushing kind of the boundary of what the average man should drink. So culturally, societally, call it whatever you will. We are kind of running a national average that's right at that line, which I think is very interesting. And most of you probably know a ton of people who bring that line up with their drinking behavior. They're way above the average, but there's also people who don't drink at all. And, and many of them are probably sitting, you know, uh, in their car, listening to this podcast on their way to the gym. They're very healthy. They're very health centric. So they drink very little or they drink below the average, but on average, you're talking about about 1.5 drinks per day per person, 535 drinks per year. And since 2020, these rates have actually increased since around, you know, since around COVID, um, these rates have increased. There's only, uh, increases in 37

States, uh, three States registered, no net change on average in alcohol consumption. And it did decrease in 10 States. All of those 10 States have either recreational cannabis or have had either cannabis restrictions eased. So people are finding alternatives to alcohol. Cannabis seems to be the primary in states where it's legalized, but that's not what this topic is about. And I think when most people are trying to square their alcohol consumption up and figure out what works for them, they're mostly thinking about, is it going to make me look better? Is it going to make me feel better? Is it going to make me healthier and reduce my risk of disease? And like, what am I going to get out of reducing my

alcohol consumption? Or what am I putting myself at risk if I keep drinking? And a lot of people have questions, how does alcohol affect my physique? How does alcohol affect my brain, my disease prevalence? And I would say that in general, the more you drink, the more problems you're going to have. The less you drink, the less likely it is that you'll have problems, but you can never discount the people who are able to drink high amounts all throughout their life and never have issues. And this presentation discussion won't even go into really, in my opinion, the socioeconomic and sociocultural effect alcohol has. If you were to look at a chart of the most impactful drugs in American culture, based on their effect on the user and then on the orbitals around the user, the number one, every single time they

do this, the most damaging drug for the people around the user is always alcohol. And it causes the most damage societally because of some of the traffic fatalities that the high incidences of violence and the economic cost of it. So it isn't, it is ubiquitous, but it is not without danger. And I think that we don't even have the time to really get into that. We're just talking about how it affects the body, but it does kind of have a negative meta effect and a huge economic cost, especially when it comes to healthcare. And a lot of that has to do with what we're going to talk about next, which is the metabolism of ethanol and kind of where the root problems in the tissues of the body at the more granular level start to flare up where we start to see issues. And it's with the metabolism of ethanol into acetyl aldehyde. So when alcohol enters the

body, or I should say when ethanol enters the body, an enzyme called alcohol dehydrogenase binds to this ethanol and it is essentially transformed into the kind of superstar byproduct, which is acetyl aldehyde. That's what builds up in the blood. That's what makes you kind of start to feel tipsy, drunk, reduced inhibition, the enhanced kind of excitement. All the feelings you ascribe to alcohol are coming from acetal aldehyde. And that is eventually broken down into acetate and then acetyl-COA, which some of you might be familiar with as a kind of a byproduct that, hey, I've seen acetyl COA. We can use that. We can break that down. That is something that we metabolize the same way we metabolize a lot of macronutrients. Um, and so that then is the product that we are essentially ending with.

When we talk about ethanol metabolism, we get it to acetyl-COA, okay, we can get it out of the body. And if you have too much ethanol, too much acetylaldehyde, can't metabolize it quickly enough, you get lots of problems. And if you can't get it all the way to acetyl-COA, you also get a lot of problems. So that's why the more you drink in a shorter time period, the greater likelihood you have of getting sick, blacking out, having alcohol-related brain damage, having all kinds of alcohol poisoning. There's lots of different things that happen if you jam up this metabolic pathway. If you have too much alcohol coming into the system too quickly and this pathway gets kind of gunked up, you are going to get all kinds of issues. A hangover would essentially be, you know, the kind of,

I have way too much acetyl aldehyde built up. I'm super dehydrated. My brain is super inflamed. I just drank too much. I didn't drink enough water to cut it down. I'm very dehydrated. I have to, you know, flush these things, these literal toxins out of my body. And if the pace of drinking is too high and there isn't enough food to delay the absorption or water to dilute the kind of concentration of the alcohol in blood, these metabolites build up and we can see issues all throughout this pathway. But once you get everything out of the system, you've converted all of the ethanol to acetyl-CoA, you can metabolize it and get it out of the body at the cost of about seven calories per gram. And the metabolism of other nutrients takes more or less energy. That is alcohol generally at seven calories per gram.

Okay. So acetyl aldehyde, that middle component of this particular pathway, that's the toxic stuff. That's the stuff that when you hear about, oh man, alcohol can be really damaging. We tend to be talking about acetyl aldehyde, which kind of peaks in the middle of that pathway. And that's what has the most toxic effect on the body, especially on the tissues.

And believe it or not, people who are allergic to alcohol or people who get what is oftentimes colloquially referred to as the Asian flush, they don't have enough of the enzymes to break ethanol into acetyl aldehyde quickly enough, or I should say they don't have enough of the enzymes to break acetyl aldehyde into acetate quickly enough. So acetyl aldehyde builds up and it causes like flushing, alcohol poisoning, lots of problems. And there are a surprisingly high number of people who don't have enough of the enzymatic, let's call it arsenal to break it down. So alcohol just simply does not agree with them at all. And I want a question. I wonder, I didn't do enough research in this particular area.

didn't do enough research in this particular area, and this might be an area of interest for future research, is do people who can live longer lives with higher alcohol consumptions have a baseline higher level of the enzyme alcohol dehydrogenase? Can that be genetic? Can the amounts of alcohol dehydrogenase affect somebody's likelihood of becoming an alcoholic? I don't know. I'm sure that there has been research done on your kind of genetic baseline levels of alcohol dehydrogenase and your proclivity for alcohol consumption. But I would guess the more of that you have, the more you can drink without paying for it, or the more of it you're able to produce. Um, and just so to kind of circle the wagons, get, give you guys like the briefest breakdown of how this all works. Your body works very much like a sponge and that it can only hold so much alcohol. Once the sponge is too full, okay, it's going to start to leak. And when that sponge starts to

leak, if you have too much on the sponge and it starts to overflow, that's kind of what happens in the body when the liver, okay, cannot, the liver in this instance is a sponge, cannot work through enough alcohol. It's holding everything it can. It's trying to metabolize everything it has, but you keep hitting it. You keep pounding it with alcohol. This is that, again, going back to that rapid rate of drinking. The level of acetylaldehyde is going to build up in the blood so fast. A lot of times you'll just black out. You're not going to be able to see straight.

You're going to be woozy. You're going to be like, oh my goodness, what is happening? You know, these kinds of stages of drinking that I think most people would colloquial say like, at this point, I'm definitely drunk or I'm hammered or I'm, you know, I'm, I'm effed up. If you have reached that point, you can, a visual inside your body of basically what's happening is your liver is a sponge. It's full. There's your body is trying to metabolize alcohol, but its ability to do so is maxed out. Like the dials at a hundred percent. Imagine like the rides at Disneyland. And it's like, Oh, you have a two hour wait to get on this ride. Like you've got little ethanol, uh,

acetyl aldehyde, I should say byproducts lined up to ride the liver sponge and get the hell out of the body as acetyl COA. But But at this point, it's built up too far. It's built up too high and you are going to really start to feel it. So if you know, if you go out to get hammered, it's usually because you know how to game this pathway. You can get enough alcohol in quickly enough that your liver is basically like, can't do it. And that's why like if you drink water in between and you, you kind of dilute the concentration of, of alcohol, uh, it allows the line to, to move more, uh, rapidly in a, you know, metaphorically speaking. So something you will hear a lot, uh, from people, I find this to be

interesting because it has, I used to believe this, and this is something that has been around forever, but it's the idea that alcohol, because it is a toxin, is so metabolically disruptive, our body's going to prioritize the metabolism of the alcohol. It's going to say, not burning carbs, not burning fat, not building muscle. I have got to get rid of this alcohol. I got to get it out of my system fast. So I'm blocking everything. And if you were in a deficit or dieting, many people were led to believe that if you drank alcohol, your fat metabolism would stop

while your body metabolized the alcohol, not the fat. Your fat burning has been cut off. And so my question to you, the listener would be, do you think if you drank alcohol, it would block fat loss until your body got alcohol out of the system because the alcohol is so toxic? And a lot of people believe this. It's parroted a lot in the fitness space, but it's actually not true. We cannot store excess alcohol the way we can carbohydrate protein and fat. Okay. So what happens is our body kind of says, let's get through that of which we cannot store. And

that is clearly damaging, but it will not block fat metabolism. Okay. It will not. If you are in a calorie deficit, your body will work through these alcohol, you know, calories and the detoxification pathways will upregulate, but you will still be burning calories from food and you will still be requiring calories to fuel your body. And there is no blocking that occurs. Okay. It's not like you could be in a deficit every day, have a little bit of alcohol. Uh, like if you could be in a deficit every day, have a little bit of alcohol. Like if you were eating a thousand calories a day, but every four hours you took like a tiny sip of alcohol, it's not like those two forces would be fighting each other and you'd be shutting fat

loss on or shutting fat loss off. It's just more of these pathways, more of these metabolic pathways are going to be upregulated and more activity is going to be happening around the metabolism of alcohol than let's say the immediate breakdown of an ingested carbohydrate. So, but that, that really isn't the point. The point is you will not block fat loss. You will just divert more energy to alcohol metabolism, but things are happening in the body so dynamically. It's not a single stage on which only one biological process can happen. Alcohol metabolism and, you know, reaping energy from stored body fat can happen at the same time. But a lot of people care about how alcohol is going to affect their body composition. And so that's really where that myth kind of

has persisted and where it comes from. It comes from this like very, very real concern that high levels of alcohol consumption are going to fuck with how I look. And I wanna know what I need to do to get lean and to lose body fat. You know, alcohol consumption is very, very, very bad for body composition, in my opinion, especially if you're over those averages or over those benchmarks. I think if you're a dude

and you're having more than two drinks a day, or you're a chick and you're having more than one drink a day, you're gonna probably run into some problems for a few different reasons. Okay. Let's talk about what some of those might be. One is alcohol. And this is kind of paradoxical. It's actually going to bring your blood sugar down. Okay. So that can make you crave things that are very, let's say, likely to elevate your blood sugar. Think ultra processed food, think refined food, think non-satiating foods, things that are hyper palatable. So alcohol in all likelihood

via its ability to reduce your blood sugar is going to probably increase how much you want to eat stuff that we all struggle not eating in this food landscape. And this, this is very true for people who aren't super initiated in fitness, like many of the people who listen to this podcast. Obviously, the alcohol you choose to consume has calories all on its own. Think about 150 calories, 100 to 150 calories for each of the alcoholic options we went over earlier, be it a five ounce glass of wine, a 12 ounce beer, or around a shot of hard liquor. That's all around 100 to 150 calories. So when it comes to body composition, obviously it's the case that too many calories is going to cause issues.

Too many calories is going to cause a situation where you're more likely to store body fat. Not only will alcohol in all likelihood drive you to eat more, alcohol in all likelihood will drive you to eat more calories and consuming many of those calories in liquid form, like you would in an alcoholic beverage, has very little chance to keep you full. Another thing you have to remember is alcohol really disrupts sleep. And when you have substantial or even low level sleep disruption, it becomes harder to manage dietary cravings. It becomes harder to maintain dietary inhibitions. Just generally, willpower, like your health bar in a video game gets lower and lower, the less sleep you get. What's going on guys, Coach Danny here, taking a break from the episode to tell you about my coaching company, Core Coaching Method, and more specifically, our one-on-one fully tailored online coaching program. My online coaching program has kind of been the flagship for Core Coaching Method

for a while. Of course, we do have PDF programming and we have app-based programming. But if you want a truly tailored one-on-one experience with a coach like myself or a member of my coaching team, someone who is certified, somebody who has multiple years of experience working with clients in person online, somebody who is licensed to provide a macro nutrition plan, somebody who is actually good at communicating with clients because they've done it for years, whether that be via phone call, email, text, right? This one-on-one coaching program is really designed to give you all the support you need with custom training designed for you, whether you're training from home, the gym, around your limitations and your goals, nothing cookie cutter here, as well as easy to follow macro nutrition programs

that are non-restrictive. You'll get customized support directly from your coach's email, or they'll text you, or they'll WhatsApp you. We'll find the communication medium that best supports your goals, as well as provides you with accountability in the expertise you need to succeed, as well as biofeedback monitoring, baked-in accountability support, and all of the stuff that you need from your coach when you check in. We keep our rosters relatively small so that we can make sure you get the best support possible. But you can apply today by going over to corecoachingmethod.com, selecting the online coaching option, and if we have spots available, we'll definitely reach out to you to see if you're a good candidate. And if we have spots available, we'll definitely reach out to you to see if you're

a good candidate. And if we don't put you on a waiting list, but we'll be sure to give you the best shot at the best coaching in the industry. So head over to corecoachingmethod.com and apply for one-on-one coaching with me and my team today. And then a thing that I think is really bummer and really kind of shitty is alcohol does seem to kind of increase the divergence of fat away from typical areas and towards the midsection. So the more you drink, the more of visceral fat, the kind of central body fat in between the organs, fat in the gut fat, the dangerous, most dangerous fat storage you can have. That whole beer belly thing seems to be true. It's just not only true of beer.

Um, and there are even certain food reward pathways. I found this to be quite interesting, you know, as we study the genetic link, uh, links of weight gain and obesity, et cetera. One of the things that does seem to be true is there are certain genetic pathways, or I should say there are certain neural pathways and, you know, gene expression pathways that can be, you know, passed down genetically. And if you have these high food reward pathways or these high food reward genetic sequences, it seems to be the case that alcohol actually makes those and enhance, or I should say enhances those pathways and upregulates those pathways further. So if you are already predisposed to consuming more food for various, let's say genetic and

neural reasons, like alcohol, like really upregulates those effects. So it can be very damaging for certain folks when it comes to eating. I have some research here that I thought was interesting and worth going over. One of these is a study from SESA on Japanese men. The study was looking at the association of alcohol consumption with body fat deposits in men with atherosclerosis. with atherosclerosis. So these are metabolically disrupted men in Japan. So 998 of them. So I think when you think of those with atherosclerosis, you can probably think of like middle-aged men in America. You know, the average middle-aged man in America is probably at risk for atherosclerosis the way that we struggle with cardiovascular disease. So 998 men, mean age and mean body mass index, BMI. So this is interesting, 63. So like I said, right around middle-aged men. What this study found was that higher weekly alcohol consumption was strongly and significantly associated with higher fat storage in the center abdomen and a higher percentage of total fat

accumulating in the center abdomen and increased waist circumference. So greater expansion through the midsection. Okay. These adjustments remain significant after they adjusted for BMI. Okay. remains significant after they adjusted for BMI, okay, which is a really big deal. So this is a study of a thousand men, all of whom shared the same metabolic disruption that we see here commonly in the United States. All of them consumed regular alcohol consumption. And the more that they consumed, the greater deposits we saw in the midsection when it comes to body fat. Some other research that I thought was interesting from a study titled Moderate Alcohol Consumption and its Relation to Visceral Fat and Plasma in Androgens in Healthy Women. Okay, so that study looked at men, this study looks at women. And I thought this was kind of

interesting too, and this study found that moderate alcohol consumption correlates with abdominal distribution of body fat, likely due to enlarged visceral fat area and increased plasma androgenicity. Okay. Higher free total testosterone. That might not be bad for like performance. But one thing we know to generally be true is that when you get hormonal disruption as a female, higher androgenicity, greater percentage of total testosterone, we see this with people who have PCOS. There seems to be a greater increase in visceral fat, stomach storage fat. And it may be the case that even in women, some of this androgenicity and some of these kind of pathways for increased visceral fat consumption can lead to that quote unquote beer belly or alcohol-induced increased visceral fat through multiple pathways, just like we see in men. And so often

we think that beer belly thing is just the dude thing, but it may very well be the case that women are increasing their risk of storing additional quote unquote belly fat by drinking. Another thing that we know for sure to be true is that alcohol is probably going to make it impossible to gauge your caloric intake. And this was shown in a study titled effective alcohol consumption on food energy intake, a systematic review and meta analysis. So this looked at 22 studies and all 20 of these studies basically found. And remember guys, anytime you see a meta analysis, it's a study of studies. So all the studies on the topic, they thought 22 were worthy of being used. All 22 studies found

that participants did not reduce food energy intake to compensate for energy consumed from alcohol. So even if you know, hey, I'm drinking, I'm going to eat less. No, you're not. Alcohol's probably going to make you want to eat more or alcohol intake is going to reduce the inhibitions around monitoring your calories. So this is one of those things where maybe we extrapolate from this. Maybe we say, hmm, if we know by looking at a kind of aggregate of 22 studies that once people start drinking, even if they had the idea to like monitor their calories and maybe offset some of the calorie intake from the food that they were going or they wanted to give up food, but to make room for alcohol, they were not able

to do that. It's very difficult to maintain the, the accounting stringency that one had. Uh, once you begin drinking simple as that, you know, once you begin drinking simple as that you know once you begin drinking it's going to heavily disrupt your ability to kind of um make sense of the caloric landscape i suppose i shouldn't say make sense i think navigate would be better it's harder to navigate the caloric landscape uh when alcohol comes play. One last thing I thought was interesting is there's a neural pathway known as the AGRP pathway. And so you have these cells, AGRP cells that increase motivation for feeding. We call this like a, this would be what we would call like a neural drive to eat. If you had a lot of these pathways, you'd probably want to eat more. Um, and alcohol actually stimulates these fairly heavily and is

huge, huge driver for a lot of these, what are known as alcohol induced overeating events, common in binge eating, quite common in, you know, people who tend to drink a little bit and then have a binge after the fact, but maybe they're not binging. If they're not drinking, it's very common to see binge drinking and binge eating happen at the same time. So in generally, in general, I should say, we don't want to be drinking high levels of alcohol. If you stick to those one to two drinks a day target, it's going to help a lot. It's going to really decrease the likelihood that you'll have metabolic dysfunction from your drinking. I think, like I've said before, it's not the most unreasonable

target. Like you probably, if you're not willing to stop, you want to have limits that are like reasonable. You want to have targets. And I think one drink a day for women and two drinks a day for men or less is a fair target. It's not like fully pulling it out of your life. If you can keep it lower than that, I would. But the way most people drink based on the math, if you're drinking approximately 1.5 drinks a day for the average size man and woman, that could be between five and 15% of your total caloric intake coming from a metabolically disruptive kind of semi-toxic nutrient, very low nutrient density option. And I think if you're looking to lose weight, this would be analogous to like drinking a soda that also is going to maybe disrupt your sleep

and increase the likelihood of you having a more difficult time sticking to your diet. Okay. Alcohol is generally going to increase caloric consumption. Again, we know it dysregulates blood sugar and it dysregulates some of these neural pathways. And we do not want to see that if we're trying to lose weight, because I think it will make it substantially harder. And I've noticed through the encouragement of many quote unquote dry months with my clients, Hey, do a dry month. When they do a dry month, they feel fantastic and they have a substantially easier time with their fat loss. Here's a good idea of like what that can look like and what you can do for yourself. Do an audit of your drinking. Okay. Make sure you know how

much that you're drinking. Stick to that one a day two a day framework based on on your sex um and if you are binge drinking heavily or drinking like more you know like double those amounts like if you're drinking more than four drinks as a guy or drinking like more than three drinks as a girl and over the weekend in particular over like certain days you're drinking really spikes that could be particularly dangerous so if you are doing that i would strongly recommend from disengaging with that habit because that can really wreak havoc on different things and then just compare and contrast you know like truthfully if you wanted to lose weight you would probably know intuitively you shouldn't drink soda but in general most of these alcoholic beverages are calorically on par

with a soda, almost identically. So like a glass of wine is the same thing as like a 16 ounce Coke. And, you know, it also brings with it the metabolic requirements to break down ethanol. And there is a cost associated with that that will disrupt dieting and make it harder. You want to have a pretty homeostatic environment when you're trying to lose body fat, as few external stressors coming in as possible. And I think alcohol is a big external stressor and it's kind of like a little antagonist. It makes things a little harder than they need to be. And I think people need all the help they can get to live healthier. So having targets and having guidelines that allow you to include it in a reasonable amount or

exclude it altogether if you want should lead to better outcomes when you go through this. So questions I often ask when I'm trying to rationalize like, how is this affecting my health and the way I feel is like, you know, how is my alcohol consumption going to affect the production of things like testosterone, like estrogen? How is it going to affect my sleep? How is it going to affect my body composition, right? These are all like secondary and related components of how you quote unquote feel. And I'd say the chief of these things is probably how alcohol affects your sleep. And it's the case I find that generally during the week, people drink more in the evenings and

generally during the weekends they drink more in the entirety of their waking hours and they generally spread that out. So a lot of people do have a work situation where during the week most of their drinking is in the evening and what I have found to be generally true, and I think what the research parses out, is that this is not going to help with your sleep at all. So alcohol acts as a depressant. It's an anxiety-reducing, relaxation-inducing sedative, basically. It can make you feel a little excited. It can lower inhibitions., but generally it depresses nervous system activity. And this, interestingly, this kind of sedative effect, meaning like if you were to get knocked out after, you know, I have a glass of wine, I just knock out the sedative effect that

will allow you to maybe ease into sleep oftentimes leads to worse sleep. And we all, we sometimes see this with cannabis too, which is like, okay, it might help you fall asleep because it can have a depressive effect on the nervous system. But is that also going to impact your REM sleep? And we know that's true with alcohol. Alcohol is very, very effective at disrupting and kind of shrinking the amount of REM sleep that you get, which is not ideal because that's your most restorative and recuperative sleep. We also know that alcohol increases the risk of sleep apnea and snoring, probably for many of these same reasons, and that between 35 and 70% of regular alcohol consumers have some level of insomnia, which is difficulty falling

and staying asleep, which really sucks because you can end up in a kind of really negative cycle, which is I don't sleep that well. So I generally drink alcohol to help me fall asleep. Because I drink alcohol, my sleep quality kind of sucks because my sleep quality kind of sucks. I try to prioritize my sleep and I do that by trying to fall asleep drinking alcohol. It's very hard to pull that out of the equation once it gets started. And again, I would say to get better sleep, you want to be as close to zero servings of alcohol in the evening as possible. And again, that one to two framework might give you some power there because if you start trickling above that, I think it's really going to have an effect and it's not a particularly good thing for your clients. It's not a particularly good thing for your fat loss. You can replace evening alcohol

consumption with alternative, you know, kind of nervous system depressive effects or depressive interventions, shall we say, that don't have the negative effects on the body that alcohol does. And so I would start thinking about a warm tea. It could be a warm shower or using a sauna. You could ritualize kind of that moment that you have with alcohol, that relaxing, kick your shoes off, chill moment with something like a mocktail, you know, that can act as a relaxing opportunity. You can have a mocktail and be like, okay, you know, I'm replacing that with something, but that ritual is still there. That moment of relaxation is still there. This, this, the thing that used to be a glass of wine that would signify the end of my day. Now it's a mocktail

that can work too. If it's just that you have to crack open like a beer, you can switch to one of the hop waters that are very popular now, or you can even switch to something like a diet soda or an alcohol free beer. Um, the calories are still going to be there and alcohol free products, of course, but you'll find that because they don't have any ethanol and you're not, you know, opening up that alcohol pathway in the body, you're going to have a much higher quality of sleep. Uh, in, in most instances, if you can find evening replacements or evening alternatives to go from some to fewer or fewer to no alcohol consumption. And for some people in states where it is legal, cannabis might be

a viable alternative if you are somebody who is using alcohol to deal with pain, to deal with stress, and to help with falling asleep, and you do not want to use a pharmaceutical intervention for that. But there may, in fact, be similar trade-offs when it comes to sleep and appetite management with cannabis. It is in fact the case that it's substantially healthier for your liver and for various carcinogenic reasons, which we'll talk about right now. Alcohol is a group one carcinogen. So that means this is the most likely kind of shit to cause cancer. It's not the maybe stuff. It's the, yep, this definitely does it. And alcohol in particular is specifically linked. This is all alcohol, by the way, this is anything with ethanol. So remember what I said,

if I say alcohol, I really mean ethanol, regular ethanol consumption. Doesn't matter if it's from wine, doesn't matter if it's from wine. Doesn't matter if it's from, you know, organic grass fed fucking non GMO. I don't care wine. Okay. Literally if it has ethanol in it, you're going to see an increased risk and prevalence of mouth and upper throat, AKA oral and esophageal laryngeal or larynx esophagus or esophageal, laryngeal or larynx, esophagus or esophageal, breast cancer, liver cancer, bowel cancer. The reason that liver cancer is so small is if you have had liver cancer long enough for it to kill you, you've probably already died of something like cirrhosis or some of the various liver issues associated with alcohol consumption. But alcohol increases your risk of seven different types of cancer. And interestingly enough,

alcohol is a group one carcinogen like we discussed earlier. And some of the stuff that gets the most discussion in our space from people who are professionals is, you know, artificial sweeteners, which are way down in 2B. Like you see people talk about freaking 2B more than they talk about one. And people in the health and fitness space make a concerted effort to like make real content about artificial sweeteners and how they may affect gut health and like artificial sweeteners and how they may affect appetite, or they talk about various things, you know, some of the craziest, you know, things way down in group three, group four, but very few people actually talk about alcohol. And when it comes to your health, when it comes to how you feel, when it comes to how you age, if it is in group

one, you probably shouldn't, you would, you would, I would expect to see more people discussing it. Like I think cigarettes and tobacco smoking, we beat to death. Everybody gets it. Solar radiation, sun. I think a lot of people understand that that really increases the likelihood of developing skin cancer. So sunscreen has become fairly ubiquitous.

Okay. Processed meat. That's another one. Okay. Like that's one that people specifically talk about. A lot of times when people say like red meat causes cancer, they're really communicating the enhanced carcinogenic risk of a diet high in processed meats. Think about things like sausage, bacon, et cetera, but very few people talk about alcohol. And I do find it to be fairly interesting in the health and fitness community how few professionals and practitioners will communicate to their clients

that they should drink a little less alcohol. I think it's a problem personally, because it is a huge thing that if you adjust to a more normal level of consumption can make a massive difference in your health. I always talk about this anytime I discuss alcohol because of where I live. I live in Sonoma County where wine drinking is huge. And there is always, you know, this kind of debate between, you know, is the negative effect of ethanol or alcohol in wine offset by the nutrient density of wine of all of the alcoholic beverages? It is very much the case, in my opinion, that people believe wine to be the healthiest because it comes from fruit. And this is also, you know, a big deal. And it's been expanded and proliferated because of something known as the French paradox. And the French paradox is a over gosh, 1992. So it's over 30 years old. Now the study done in 1992, as you can tell the French love their wine. Um, but the French paradox, uh, refers to the very

low incidence of mortality and heart disease specifically in the French population, despite them having a very high fat diet and having, you know, high cholesterol and having high smoking and all of these things that were so closely correlated with, you know, having poor cardiovascular outcomes. And, you know, this study was from 1992 and you could, they'll get the name of the lead author, Renoir. I'm sure that's like Renoir or something, uh, or Rendo. I'm not a French expert, but basically the study was titled wine, alcohol platelets, and the French paradox for coronary artery disease. And the take home was like French eat really high fat. They smoke, They have bad cholesterol, but they have a low incidence of heart disease and heart attack.

And it's got to be the wine. And so this again was a study from 1992 and it became a favorite citation of the wine industry in the early to mid nins when wine sales were actually down and the kind of take-home message for consumers and for alcohol sales, wine shops, et cetera, was more wine equals less cardiovascular disease and less cardiovascular incidences. And, you know, this was a, I think, case of correlation does not necessarily equal causation, right? So it's a situation where we can say, hey, they drank more wine and they didn't die of heart attacks. Therefore, less wine causes less heart attacks. There's a correlation between the two, but it is not causal in that there's too many other factors. And I think the big argument was that because wine, specifically

red wine, has these polyphenols, specifically resveratrol, and that you can get, and by the way, you can get these from other dark red fruits, you know, that this was what made red wine so special. It comes from these special fruits, the antioxidants you often heard about, resveratrol you often heard about, but there has been research that I think more recently has kind of debunked this. Um, a few studies that I pulled that I found the findings to be quite interesting. One found regular consumption of one to two glasses of wine does seem reasonably safe from a health point of view. However, a recommendation to the general population for low wine consumption is still not justified. This was again because of the elevated cancer effects, or I should say the elevated cancer

risk and other risks, health risks associated with cardiovascular disease. Another finding from that one was that it just made sense to get these polyphenols from other areas. And then another finding was that anti uh, anti-cancer and anti-inflammatory effects of the free polyphenols is irrelevant given that they are absorbed as conjugates, meaning that the actual absorption of these, um, polyphenols is disrupted by the alcohol and it's not particularly as high as you would need it to be to offset the negative alcohol effects on your health.

So I do think that certain factors like cholesterol and saturated fat intake are worth monitoring when it comes to cardiovascular disease. But I am of the opinion that the French paradox was fairly flawed and that the French diet being as high as it is in protein, fiber, and vegetables, then generally having a lower body mass, then generally moving more, having a completely different lifestyle, really, paired with some of the admitted, you know, cardioprotective benefits of polyphenols, that is what gives them their insulation from heart disease, not the ingestion of red wine. And so here's a little picture that I have that I thought

was funny because it kind of captures it. The guy in the US is like super overweight, eating a very high sugar, big soda. It looks like he has a burger, French fries, and a baked potato all on his plate. And he's laughing at the French guy who's drinking, you can see, a very small glass of wine, okay, and a very modest serving of food. But he's very thin and he's like, oh, you're a wimp. And, you know, this guy's big, fat, and probably metabolically disrupted. And so I think that kind of captures exactly where the French paradox is driven from. I thought this cartoon was funny because we in America would see that tiny glass of wine and be like, look, it's the red wine.

And it's like, no, it's just the generally reduced caloric intake. That's why this population has such a high prevalence of cardiovascular disease. And if you replaced this with wine, it would probably make no difference whatsoever. For those of you who are listening on the podcast while I'm looking at this photo, it's a photo of a very large man in a big hat that says USA. And he's eating this big cartoon size, basically junk food meal. And he's laughing at this tiny little French guy next to him with a very modest sized plate of like peas, potatoes, small piece of meat, and it was like teeny tiny glass of wine. Kind of funny. So again, when it comes to cardiovascular disease risk, stay below that line. And I think this is the hammer home point for your clients. This is the hammer home

point for yourself. This is the hammer home point if you want to be healthier. What's the number of alcoholic drinks I can include? And again, I think the research shows it's probably going to be around one a day for women, around two today for men. The bigger you are, the more you can probably have. The smaller you are, the less you can probably have. But unequivocally, the best number is zero. Anything more than one is correlated with an increase in most of the stuff we're talking about today. Okay. So another thing you have to think about when it comes to alcohol is how it affects one of your most important organs, which is the liver. And so one thing we know about the alcohol is 47.4% of liver related deaths involve alcohol and a huge issue facing consistent regular drinkers

is fatty liver. And you've probably heard of fatty liver in many different ways. Some people call it NAFLD. Some people call it NASH. Sometimes it's called non-alcoholic fatty liver, which is the NAFL and NAFL and D is obviously for disease. It has a bunch of different names, but it's one of the kind of primary metabolic disruptions we'll see in one of our key organs from just generally normal drinking. Not like the normal ranges we're shooting for, but people who drink like three to four drinks a day, they set themselves up for this on a fairly regular basis. And you probably have people in your life or clients that you work with who easily hit that two, three, four drink a day threshold. We think about cigarettes and how they affect the

lungs. When you think about alcohol, I want you to kind of think about your liver. You know, your lungs take the big hit from smoking cigarettes. So it's the same with the cardiovascular system in general, but it is in fact the case that your liver kind of takes the main hit from alcohol consumption. And the more you drink, the more you damage the liver. Alcoholic fatty liver disease, which we talked about on the previous slide, is the first stage of liver disease. And it progresses all the way to different things like hepatitis and cirrhosis. And about 25% of people in the United States have non-alcoholic fatty liver disease. And if you have non-alcoholic fatty liver disease from eating too much food and you have fat kind of building up in your liver, that makes it even harder to process alcohol.

So alcohol metabolism tends to get worse. Crazy thing, crazy kind of fun fact, 30 to 50 grams of alcohol, okay, or 30 to 50 grams of ethanol, okay, is enough that over a five-year period, if you drink 30 to 50 grams a day, you can develop alcoholic liver disease, which is generally thought to be fairly irreversible. And what you have to look at here is the actual like shape, color, the audio version of this is never going to do it justice. But the shape and the color of the liver, like it is shriveled, it looks dry, it begins to yellow, it is no longer a dark color, it is like fading and turning kind of yellow, almost like a zombie kind of in The Last of Us, if you ever played that game or watched that series.

The liver takes a beating with 30 to 50 grams of alcohol a day, which is only about two to three drinks when you consider that an average drink has about 14 grams of ethanol in it. So it doesn't take a ton of drinking to start this process. It just takes consistent drinking. And a lot of people ritualize that and it makes committing to their health, their fitness, their weight loss, all of those things a lot harder. Other things that I think really drive home a point about how alcohol can affect us and affect our wellbeing and how we feel that are really popular right now are gut health. Gut health's a big one. And I often use this analogy

when I talk about alcohol and gut health, it's like, what do Listerine, rubbing alcohol, Purell and alcohol have in common? They all kill the alcohol on wherever, or they all kill the bacteria on whatever they touch. So when you swish around a bunch of Listerine, you're killing your oral bacteria and hopefully the smell associated with that. When you put rubbing alcohol in a wound, you're hoping to kill any pathogens or bacteria that may be in the wound. Um, or when you use it to, you know, eradicate, you know, something on a stain, you can use rubbing alcohol to remove paint. It's just a very good descriptor of how powerful an astringent it is. It strips shit down. Purell, obviously very strong, will eradicate the microbiome that lives on the dermis, on the skin, the dermal microbiome, which we all have.

That's actually a fun fact. One of the things that makes mosquitoes particularly drawn to various people, it's the dermal microbiome. They love the bacterial profile of your skin. And so if you're somebody who's been eaten alive by mosquitoes, it's probably got a lot to do with the microbiome of your skin. And then of course, alcohol, which when you drink, it goes all the way down your alimentary canal into your stomach. It just descend this way down your body. You end up in a situation where you can really disrupt the bacteria of your alimentary canal, which is your gut, your small intestine, your throat, but particularly the gut. And a lot of people are really concerned with the health and wellbeing of their gut. The gut is a really important pathway in the body.

It's a really important part of the body. And because alcohol is very disruptive, I have a photo here. It looks like little tiny alcohol molecules literally attacking the surface of the gut. Alcohol is so disruptive to the gut. It's such a powerful astringent. It can increase the likelihood of leaky gut or inflammation that kind of leaks through a more permeable gut tissue because the tight junctions are less tight than they should be. The inflammation itself results from oxidative and non-oxidative pathways of alcohol metabolism that lead to a leaky gut, bacterial overgrowth, dysbiosis, and alterations in the mucosal immune system. So regular alcohol consumption can lead to quote unquote leaky gut or increased

intestinal permeability, bacterial overgrowth, dysbiosis, and it can actually disrupt the mucosal membrane and the kind of immune membrane. Interestingly, just like many of the foods we eat, alcohol influences our microbiome generally for worse. And this study, study, the microbiome gut brain access regulates social cognition and cravings in young binge drinkers actually found that the more you drink when you're younger, the greater the alterations in the microbiome and the greater predictor of future drinking, um, alcohol and microbial disruption. I thought this was very interesting too, which, uh, again again should come as very little surprise.

Like alcohol is very disruptive to the actual microbiome itself. Alcohol is mainly metabolized in the liver by alcohol dehydrogenase. We talked about that quite a bit earlier, which transforms alcohol into acetyl aldehyde. We talked about that a lot earlier and causes serious toxic damage to tissue and gut microbes. And that is not all that surprising when you think about the fact that you can kill bacteria with various alcohol-based products on various different tissues and your body. And so I would say that in general, those are kind of the big things you have to take into account when you talk about alcohol consumption.

You have to talk about how it's going to affect your gut, how it's going to affect your liver, how it's going to affect your sleep, how it's going to increase your prevalence of liver disease and cancer, and how it makes it very hard to regulate your appetite. And I don't think there's a single food in our diet that has as high a likelihood of causing an issue in as many areas as alcohol. And so you need to find a plan that will work for you. And I think what will work for most people are the targets of one drink per day if you're an average-sized woman and up to two drinks per day if you're an average-sized man, aiming for the low end or zero as frequently as you reasonably can and trying to avoid binge drinking events. If you can do that, it is very

likely you can navigate life with a safe alcohol consumption and navigate the kind of landmine field that is alcohol. But you have to remember every kind of standard deviation you increase, every time you jump from zero to one, one to two, two to three drinks a day, the increased risk of having a harder time managing your weight, harder time managing your blood sugar, harder time spending on cardiovascular disease, gut issues, cancer, all this stuff. The more you drink, the greater the risk. It is a genuinely negative thing for, you know, a lot of these unfortunate health issues. And even though it's very social, very cultural, very enjoyable, and something that so many of us have built into our lives, we really just have to work to be more responsible with it.

And if you're a coach, I think being able to have these level, this level of nutritional discussion, the same way you talk to the client about like the importance of protein or the importance of avoiding ultra processed foods or the importance of like having balance or the importance of getting enough fiber, you need to be able to talk to your clients about the importance of navigating alcohol consumption. All right, guys, I hope you enjoyed this episode. It was a bit of a deep dive. If you did, I'd love it if you shared it with somebody who's, you know, looking at changing their, you know, health and fitness for the better. You can leave me a five-star rating

and review on Apple or Spotify. Both of those are huge. As well as share this again to your Instagram story and tag me so I can say thanks. I'll catch you on the next episode.