Alcohol Manifesto

The Alcohol Manifesto

From Whole9, as a preface to our Manifesto series:

manifesto-definition1
As we wrote in It Starts With Food, “We have a theory about food that directly influences the rest of this book. The food that you eat either makes you more healthy or less healthy. Those are your options.”

Of course, we spend the rest of the book explaining why a concept that sounds so simple is not that simple at all in practice. That’s why our Good Food (and drink) recommendations are based on not just one foundation, but a combination of three:

Nutrition-Pyramid-Web-NEW

Based on the science as we understand it today, and our vast clinical experience with the tens of thousands of people who have completed our Whole30 program, we make some general recommendations as to things which may make you less healthy–including alcohol. Below, we’ll outline the basics of our case against consumption of alcohol as part of your daily diet. But until you undertake your own self-experiment (via the Whole30) for yourself, you’ll never know for sure how consumption of alcohol are affecting how you look, how you feel, and your quality of life.

Our Manifesto: Alcohol

Consumption of alcohol provokes an unhealthy psychological response by reducing inhibitions—thus making it all the easier to make poor food choices when under the influence of even small amounts of alcohol. Furthermore, the effects on the brain carry over until the next day, which means a drink or three on a Friday night may lead to a weekend’s worth of junk food. And remember how sugar is “empty calories”? Alcohol is nearly twice as calorie-dense, with no micronutrition to speak of.

From a hormonal perspective, alcohol consumption interferes with glucose regulation (disturbing normal blood sugar levels), in part by disrupting the action of regulatory hormones like insulin and glucagon. That disruption can promote systemic inflammation, a root cause of many lifestyle diseases and conditions. In addition, acute and chronic alcohol consumption are also known to alter some reproductive hormone levels.

Alcohol, even moderate amounts, has been shown to alter the balance of gut bacteria, potentially contributing to dysbiosis. Since the delicate balance of gut bacteria have a tremendous impact on our overall health, anything (including alcohol consumption) that disrupts that balance can impact long-term health in a negative way.

Finally, alcohol is acutely neurotoxic, even in small amounts, altering the normal activity of your nervous system, causing damage to nerve tissue, and disrupting or even killing neurons, the cells that transmit and process signals in the brain and other parts of the nervous system.

It’s difficult for us to make a case that any alcohol – even red wine, gluten-free beer, or 100% agave tequila – makes you more healthy. But while we exclude alcohol in all forms for your Whole30 program, we aren’t saying you should never have a drink ever again. All we are saying is that if you do choose to drink, don’t try to justify it with “heart health” or “gluten-free.” (The fact that it’s just plain delicious and you really enjoy it is reason enough!) Just understand that the less you drink, and the less often you choose to imbibe, the healthier you’ll be.

It Starts With Food

These manifestos are not intended to be a comprehensive dissertation of our research or recommendations. For more information on the psychological impact of our food and drink choices, the effects of alcohol on health, and scientific references used to support our position, please refer to our book, It Starts With Food.


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Comments

  1. says

    Did you miss all the research reports linking judicious alcohol consumption with longer lifespan and reduced cardiovascular disease? For example, see the reference below.

    I readily admit that the literature is not unanimous on this idea.

    -Steve

    Reference: Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, & Ghali WA (2011). Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ (Clinical research ed.), 342 PMID: 21343207

  2. Jon T. says

    @Steve:

    “I readily admit that the literature is not unanimous on this idea.”

    Are there any studies that show moderate consumption is harmful? I was under the impression that all studies of moderate consumption either showed a positive or a neutral effect. But I am no doctor or nutritionist, so I am just relying on the second-hand reports of those who are.

    I It would be greatly appreciated if you could provide a link or two to articles that show actual harmful effects.

    Thanks in advance,

    Jon

  3. says

    Steve,

    We did not miss those observational reports, no. As an educated individual, you’ll know that observational epidemiology gives us essentially no valuable information about cause and effect. It’s that same overvaluation of epidemiology that got us to the place where cholesterol,has been demonized and whole grains are perceived as healthy. As you know, many studies have observed the association between red meat intake and various types of cancer. So… is red meat really as bad as they suggest it is, or are there many more moving parts here that we have yet to fully understand?

    We place far more value on human studies, in vitro & in vivo studies, and animal studies (collectively) than straight epidemiology. I have yet to read a study that shows direct health benefits of alcohol (not just observational research). So while we observe that both shark attacks and ice cream consumption rise in the summer months, we’re unconvinced that one causes the other. If you’re interested in some good papers on ETOH, here are a few that detail some mechanistic underpinnings of its effects:

    http://www.sciencedirect.com/science/article/pii/S0022480408006823
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2614138/pdf/nihms-69177.pdf
    http://onlinelibrary.wiley.com/doi/10.1111/j.1530-0277.2007.00584.x/full

    Also, we don’t use life span as a primary metric of “health”, since people who simply eat far fewer calories likely live longer, but at what cost to the quality of their life? Vitality and “longevity” are better markers of improved health, in our opinion, than life span. Those, of course, are harder to quantify. And you likely know that alcohol is a solvent, which is part of the reason that it reduces CV events (reducing ischemic events by reducing clotting). That mechanism is partially understood, but we believe that the net effect of alcohol is still a negative one. Thanks for your comment.

    Jon,

    See the above-listed studies for some details. Alcohol directly impacts gut permeability and immune function, even with moderate consumption. Spend some time on Google Scholar – there’s a TON of data out there about alcohol intake.

    Dallas

  4. Adam says

    Dallas,
    That’s a great comment/reply, very well spelled out and hard to disagree with at face value. I do, however, have a few comments for the ‘other side’. First, I should possibly disclose my biases: that I am a MD (gastrointestinal pathologist in training) and in the same general mindset as Steve (above), and I am a homebrewer :) .

    You correctly pointed out the problems with the majority of ‘pro-alcohol’ studies in that they are epidemiological in design. However, there have been so many, well conducted, with huge numbers of patients of from every walk of life, and ‘X” factor you can think of it is hard to deny there is some sort of benefit to moderate drinking. This article says that a little more eloquently than I:

    Kannel, W.B. & R. C. Ellison. 1996. Alcohol and coronary heart disease: the evidence for a protective effect. Clin. Chim. Acta246: 59–76.

    The article also eludes to more than just ‘epidemiological studies’ but in fact animal studies that show effects. (I didn’t have enough time to dig through all the literature to find them, as i’m sure you know there is an unbelievable amount of alcohol related research out there). Also, besides the ‘solvent’ point you made before it is believed…. and I believe ‘shown definitively’ that ethanol increases HDL.

    Also, the articles that you included did as you described and demonstrated effects at the cellular level with basic science, high level research. However, I’m not so sure they were convincing that alcohol is just ‘bad’, period. The first one demonstrated why it was bad in a trauma scenario, i agree a beer after you’ve been T-boned is not a great idea. The other two were great at the cellular level but were focused on individuals with excessive…, excessive alcohol intake “Alcoholic Liver Disease” to be specific, so it’s hard to use them in a discussion about moderation in my opinion. In fact the 3rd article doesn’t even specify about the ‘controls’ they used beyond that they didn’t have ALD, but for all we know could be heavy drinkers (not nearly all heavy drinkers get ALD), moderate drinkers, just had a shot of jack 1 hour prior or people who have never drank in there entire life so i’m not sure how this helps us.
    Either way, it’s a good discussion. It’s always easy for someone to sit around and ‘poke holes’ in your opinions or even in your science if they have the time. I think everyone can agree that excessive alcohol is bad, period. As for moderation, I think (obviously) that its either neutral/or slightly advantageous and I am comfortable with the amount of ‘science’ supporting that.
    Keep up the good work, I am a fan of this website even when I may disagree here and there.

    Here are a few more good articles, but are most useful possibly for the list of references:

    O’Keefe J, et al. Alcohol and cardiovascular health; the razor sharp double edged sword. J Am Coll Cardiol. 2007;50(11):1009-1014. doi:10.1016/j.jacc.2007.04.089

    ELLISON, R. C. (2002), Balancing the Risks and Benefits of Moderate Drinking. Annals of the New York Academy of Sciences, 957: 1–6. doi: 10.1111/j.1749-6632.2002.tb02900.x

  5. Nicole says

    Alcohol is one of those funny things that most of us enjoy doing, so it is natural that we try to justify our use of it. And I like to often relax with a nice cocktail…so I just want to be clear on that ;)
    I should also disclose, that even though I am NOT an M.D., I am on a working group for the Low Risk Drinking Guidelines that are currently being adopted in Canada.
    I know that many believe that moderation, or “a glass of red wine or 2 a day” has shown to be beneficial or “heart healthy.”
    And I can’t dispute the many studies listed above…but what has also been proven and should be clearly stated, is that it is beneficial in only a certain demographic. Those that are over 60 years AND who have a history of ischemic heart disease.
    The problem is, as our population ages, those that fall into this age range is increasing dramatically at an annual rate (our baby-boomers).
    So, in the interest of public health campaigns and education, to make a National blanket statement saying that NOT drinking is the best policy, is simply not true for a huge part of our population.
    But the truth remains, that individuals that do not fit into the above demographic profile, should abstain from alcohol for maximum health.
    Great discussion!

  6. says

    @Adam, you’ve really demonstrated beautifully one of the main themes of our book (and our recommendations in general)… you can’t rely solely on the science to make decisions about food and drink. Because for every article I quote citing alcohol and depressed testosterone, alcohol and dysregulation of blood sugar, alcohol and depression, you can find three more that talk about alcohol’s effect on longevity or heart health.

    Relying on the science alone is tricky, because we don’t (and will never, unless human ethics dramatically changes) have peer-reviewed, fully controlled, randomized, double-blind studies involving people and food. Nobody is putting babies in cages and controlling all aspects of their environment just to look at food’s effect on the body!

    Which means we’ve got to have other inputs for our recommendations. We rely heavily on clinical experience – the tens of thousands of people who have done our Whole30 and reported wonderful quality of life and health benefits from the protocol. But even that isn’t enough, in our opinion – you need self-experimentation too. Because despite what all the studies say, if drinking red wine gives you a massive headache, or alcohol in general makes it impossible for you to stay lean in the midsection, then it doesn’t matter what the scientists say – alcohol doesn’t make YOU healthier.

    The discussion is interesting, but what’s most important is that people decide for themselves, based on the science, clinical evidence, and their own self-experimentation, what works for them. All we can do here is present our best conclusions based on the evidence we’ve seen and experienced. (And as we learn more, update those recommendations as we need to – which is part of why we’re revamping our Manifesto series in general right now!)

    Thanks to all for a lively discussion! We’re big fans of healthy discourse, and appreciate the intelligently worded counterpoints from smart folks.

    Best,
    Melissa

  7. Susie Bodurtha says

    I’m just finishing day 5 of the whole30 and its really going very well. I had scaled back on carbs 15 years ago and a little at a time over the years have also learned more about general nutrition and applied what I’ve learned. I reduced gluten about a year ago, but have never given it up altogether and never given up dairy. So, some of the Whole30 plan is familiar and easy for me, and other parts are new and interesting. I do miss dairy, but I’m really doing fine and don’t feel deprived. I’m also a red wine drinker and I miss that some, though its not been as difficult as I thought. I’ve got a few weeks to go yet and anything can happen in that rime to change my perspective, but I suspect, that I will likely go back to having whole cream in my two cups of coffee in the morning, an occasional dove dark chocolate, and red red wine in moderation. My question is this: is there a best practice on drinking whine if you’re going to do it? I’ve tried to have food with it and use a water chaser. But, I thought you may have some other ideas. Thanks for the book and program. I appreciate being able to participate. Susie

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