We all know the health risks of drinking – is there a 'least bad' alcohol choice?

CNA

2 days ago

If you've heard that red wine is better for you than beer or liquor, or that clear liquor like vodka or gin is less harmful than dark liquor like rum or whiskey, we have bad news.
'Alcohol is alcohol,' said Jurgen Rehm, a senior scientist at the Centre for Addiction and Mental Health in Toronto. Drinking any type of alcohol, in any amount, is bad for health.
Still, experts say, it's sometimes not reasonable or even practical for people to avoid alcohol entirely. So if you're going to drink, there are some strategies you can take to reduce your risk, and to avoid some of the other unpleasant effects of drinking, like hangovers.
WHY ALCOHOL IS SO HARMFUL
When you have a drink, your body turns the ethanol that's present in the alcoholic beverage into a 'really nasty substance' called acetaldehyde, which can damage your DNA, said Timothy Stockwell, an alcohol researcher at the University of Victoria in Canada.
Many tissues in the body, including those in the mouth, throat, liver, colon and breasts, are susceptible to this harm. And when that DNA gets repaired, cancerous mutations may arise.
This is why drinking increases the risk for developing at least seven types of cancer, said Katherine Keyes, a professor of epidemiology at Columbia University. Excessive alcohol use – which includes having eight or more drinks per week for women or 15 or more per week for men; or four or more drinks per occasion for women or five or more for men – is also linked with many other health conditions. These include heart and liver disease, depression, anxiety and memory problems, according to the Centers for Disease Control and Prevention.
The more ethanol in your drink, the more harmful it is, Dr Keyes said. One way to assess this is to look at a drink's alcohol by volume, or ABV, which manufacturers must list on product labels. If you're choosing between two beers of the same size, for instance, and one is 4 per cent ABV and the other is 8 per cent, the 4 per cent beer will expose you to half as much ethanol.
In general, beer has less ethanol than wine per ounce, and wine has less than liquors like vodka and tequila, Dr Keyes said. But there can be large variations within these categories, Dr Stockwell said. Some strong beers, for instance, have ABVs that are higher than those of some wines (or even some liquors, on the extreme end).
HOW TO DRINK WISELY
A good rule for reducing your exposure to ethanol is to generally choose drinks with lower ABVs, the experts said. But it's important to pay attention to how much you're drinking as well.
A standard 12-ounce pour of a 5 per cent ABV beer typically has the same amount of ethanol as five ounces of a 12 per cent wine or 1.5 ounces (or a shot) of a 40 per cent liquor.
It can be tricky to calculate the ABV of cocktails, said Dr Peng-Sheng (Brian) Ting, an assistant professor of clinical medicine at the Tulane University School of Medicine, since they are often made with sodas, juices and sometimes multiple types of alcohol. For this reason, he recommends sticking with wine or beer in situations where you want to know exactly how much ethanol you're consuming.
Some types of alcohol are also quite high in calories, which when consumed in excess can increase the risk of weight gain and obesity. And some cocktail mixers, like juices and sodas, can contain added sugars, also raising the risk for obesity and other health conditions like Type 2 diabetes and heart disease.
Dr Keyes also recommended against consuming alcoholic drinks that are mixed with caffeine (like espresso martinis or vodka Red Bulls). The energy boost you get from them may make you feel less inebriated than you really are, potentially prompting you to drink more and to become more drunk, Dr Keyes said.
And while there's no evidence that darker liquors are more harmful to health than clear ones, there is limited research suggesting that some darker liquors can cause more severe hangovers, said Damaris Rohsenow, a professor at the Center for Alcohol and Addiction Studies at Brown University. Darker alcohols (like bourbon, rum and brandy) tend to have higher levels of congeners, substances that are created during the fermentation process and contribute to a drink's flavor, aroma and color. More congeners typically translates to worse hangovers, Dr Rohsenow said.
There can be exceptions to the 'clear is better' rule, however, Dr Rohsenow added. Some tequilas, which can be clear or light-coloured, for instance, can be high in congeners and may lead to worse hangovers.