Alcohol often plays a part in many people’s health journey. Sure, when abused it can be detrimental to health. However, can social drinking actually have some benefit or protective effect in preserving brain health? Here Dr. Ken Litwin and Lara Zakaria discuss what the research really says about the link between alcohol and cognitive decline and how to use that information to reduce your risk of cognitive issues.
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Lara: 00:02 Hi everybody. My name is Lara. I’m one of the nutritionists here at the Sandy Hook Clinic and I’m here with Doctor Litwin today and we’re going to be talking about cognitive decline and alcohol. This is a question I get a lot about whether or not alcohol is safe to drink if you’re worried about cognitive health – if it’s actually healthy for you or if it’s just bad for you. And I’m sure you get this question all the time, Dr Litwin. So from a research perspective, I’m curious if you could give us a little bit of a background of what you have found the research to say on the topic.
Dr. Litwin: 00:33 Thanks Lara. Yeah, definitely. I get this asked this question all the time. The reason it is something that people enjoy and they don’t want to give up. Or maybe they’ve heard it’s actually good for them. I’ve reviewed the literature on this and there are quite a few studies relating alcohol and cognitive health and more recently on alcohol and risk of cognitive decline and dementia. And people will be happy to know that the conclusion of most of these articles is that light to moderate alcohol consumption may reduce your risk of cognitive decline or dementia, or at least it’s neutral.
Lara: 01:28 Okay. So what does that mean? If I’m worried about my risk of cognitive decline and I come to your office and I want some advice on whether or not I should go to happy hour more frequently how does that translate when you’re creating a plan for somebody?
Dr. Litwin: 01:48 So when you’re talking about an individual person, you cannot look at these studies and use them as you might like to because these are population studies. It’s a difficult thing to study people under-report how much they’re drinking. The definition of what’s light or moderate or heavy drinking varies between studies and what alcohol people were drinking, whether they drank it with, coke or whatever [mixer]. It’s variable. So for an individual, you have to assess their individual risk factors for cognitive decline when you’re taking into account whether or not and how much they should be drinking alcohol. Also, you have to take into account APOe4. Most of these studies have shown that APOe4 kind of neutralizes the benefit that you get from drinking alcohol. Some said it didn’t matter, but I don’t buy that. The other factors involved would be whether or not the person has had any head injuries, concussions, whether they have heavy metal toxicity, whether their gut has good bacteria, or presence of toxins, whether they have had chronic Lyme disease or whatever [else]. And all of these factors play into whether or not that person can handle alcohol and whether their system has enough resources to take care of, metabolizing the alcohol and take away from anything else that their system should be doing.
Lara: 03:38 It sounds like you’re taking into consideration multiple factors, not necessarily just whether alcohol is good or bad for cognitive decline, but with each individual person’s variability, how it might be affecting all the factors that contribute to cognitive decline.
Dr. Litwin: 03:56 Exactly everyone’s different. I mean, if you’re in your 20s, you’ve never had any health issues, you don’t have APOe4 you can probably handle more alcohol than somebody who’s older and has APOe4 or other issues that increase the risk of cognitive decline. So you gotta keep that in mind.
Lara: 04:18 Right. Great Point. So that side, if folks want to enjoy some alcohol here and there what is your recommendation in terms of the choices that they should be making? And do you have any recommendations in terms of what constitutes safe levels of consumption in terms of moderation?
Dr. Litwin: 04:37 All right, let me start the second part of that question and just say it’s clear from the evidence and drinking more than one drink a day for women or two drinks a day for men is not, not a good idea. And if you’re drinking three or four drinks a day, you’re in the heavy drinking category. Whether you think so or not? And you’re going to be increasing your risk for dementia and cognitive decline. As far as the frequency, I think it’s better just to calculate your total drinks per week. And so for women more than seven or for men more than 14 and keep it below that. If you don’t drink, don’t start drinking just because you heard it was good for you. But if you are drinking, you got to keep those limits in mind. As far as what kind of alcohol is best or at least not worst? You have to keep in mind different factors. So you may be a person that just doesn’t tolerate wine or doesn’t tolerate red wine. And the fact that you don’t tolerate it means you shouldn’t drink it. Not just because you know that red wine has a little bit of resveratrol in it which is really kind of a drop in the bucket for what your body actually needs. Don’t drink red wine. It’s causing inflammation, which is probably increasing your risk of cognitive problems. Then just keep in mind, wine has carbohydrates, sodas, beer, and so do mixed drinks, if you’re mixing with soda that has sugar in it, and if you’re drinking mixed drinks with Diet Soda, well, I don’t think that’s a great idea because we all know that aspartame is a neurotoxin. And then keep in mind that certain alcohols have gluten, particularly beer and some people shouldn’t be consuming gluten. You may be one of those people, it doesn’t matter that much for, but just keep that in mind. So what do I recommend for people? If you do tolerate red wine, a glass [glass = 5oz.]* of red wine, a few times a week, that’s great. If you don’t tolerate it, don’t drink it and have maybe a mixed drink that has vodka or gin or something like that without any carbs or artificial sweeteners in it. And, and I’ll just make this point that nobody said you had to drink when you’re out with friends or with friends. You can ask for from the bartender or if you’re at someone’s house, just ask for some sort of sparkling water drink with lemon in it and you’ll be happy. You’ll be in an environment where you’re getting social connections, having a good time. And that’s really more the benefit of the alcohol I think than the alcohol itself, is where you’re drinking it and why you’re drinking.
Lara: 07:57 Right. I think it’s a really great point that you bring up too. Like using alcohol as a way to connect socially versus drinking alcohol alone as a way to decompress or even as a way to cure insomnia for example. A lot of people do end up reaching for it at night I think makes a very, very big difference.
Dr. Litwin: 08:17 That’s right. Yup. That’s really important. Don’t drink just cause you heard might help your health. It’s probably often used more from the social aspect than anything else.
Lara: 08:34 Great Point. Well, that’s really helpful. So it sounds like if you’re going to drink, keep it to those minimums maximums that you talked about. One drink a day or average of seven drinks a week for women. Average of 14 drinks per week for men. Choose options that are lower in carbohydrates, avoid mixed drinks, anything that has too much sugar. And I definitely avoid any diet sodas and in for red wine only if it suits you. Some people don’t tolerate red wine very well. But it is an option for folks and beer is probably not a great choice for most of us. Does that summarize it?
Dr. Litwin: 09:10 Yeah.
Lara: 09:12 All right, great. So we’re ready to hit happy hour. Thank you very much, Dr. Litwin. Appreciate it. And thanks for anybody who’s listening. Do you have any questions? Please don’t hesitate to comment on the video and thank you for listening and cheers.
I’ve noticed in the subset of the research that I’ve read is that a “drink” in European and U.K. studies is the equivalent of a 1 oz or 30ml serving of alcohol whereas U.S. studies use a 1.5 oz or 45ml “drink”. However both sides of the Atlantic seem to come out with similar results as you mentioned: 1 “drink” per day; it’s just that the U.S. drink is 50% bigger than the U.K. / European “drink”. Did you find that difference and what are your thoughts?
Also, in my opinion it would be worth specifically clarifying in the blog what you mean by a “drink” in terms of beer and mixed drinks, noting that the transcript already mentions 5 oz as the portion size for wine.
Thanks for your interest and observations.
The problem with studies on alcohol and health is that they are really not standardized well. What one author views as “moderate or light or heavy” alcohol use varies greatly.
And as you say, there is a difference between the US and Europe.
I stated 5 oz for wine because this is what the NIH uses as a standard drink. For Beer they use 12 oz, and for liquor it’s 1.5 oz. These are all = to 14grams of pure alcohol.
I think it would not be possible to separate out 1.5 oz vs 1 oz for the purposes of deciding what a safe amount is to consume for cognitive health purposes, at least not using these types of studies. We would need a randomized controlled trial using various amounts over many years, rather than just looking back and analyzing what people say they were doing which is not very precise. But I don’t think we will see that happening anytime soon. — Dr. Litwin