The Family Health Guide

Alcohol over time: Still under control?

Currently, the word is that moderate drinking can be good for you. Various studies suggest that it promotes longevity, helps prevent cardiovascular disease, and lowers the risk for dementia and other ills. What hasn't made as many headlines are the downsides for women, especially drinking that starts at a moderate level but eventually becomes a problem. Why this happens and to whom isn't fully understood.

At every age, women develop drinking problems at lower levels of alcohol consumption and over shorter periods of time than men do. Women are also less likely to get medical attention for the problem, often because physicians don't recognize the signs in women.

You don't need to be addicted to alcohol to have a problem. For women, there's a fine line between healthful and harmful drinking. Moderate drinking means no more than seven drinks per week and no more than three in a single day. But even these levels don't guarantee safety. What constitutes moderation varies with many factors, including age, genetic makeup, and health. What's okay in your 30s or 40s can be risky after age 60. And if you have liver problems or a history of alcohol addiction, no amount of alcohol is moderate or safe.

No one should feel obliged to start drinking for the health benefits. There are plenty of other ways to safeguard your health, including exercise, a nutritious diet, weight control, and not smoking. But if you enjoy alcoholic beverages, it's important to know when and where to draw the line — and to be prepared to redraw it as you get older.

A special concern for women

Women are more sensitive to alcohol than men are. That's because their bodies contain proportionately less water and more fatty tissue than men's bodies. Water dilutes alcohol in the bloodstream; fat retains it. So women's brains and other organs are exposed to higher concentrations of alcohol for longer periods of time.

Age and alcohol use

Women's bodies contain even less water and more fatty tissue as we age, so blood alcohol concentration rises faster. We also metabolize and eliminate alcohol more slowly and less effectively. And older women are more likely to take multiple medications that may interact with alcohol, further raising the risk of accidents and health problems.

Weighing the benefits...

There's solid evidence for benefits from moderate drinking. For example, a large-scale, 30-year study of women's health, found that one drink per day, compared to no drinking at all, reduced women's risk for heart disease and stroke by 50%.

Some studies suggest that older women who drink moderately have improved cognitive skills, compared with women who don't drink at all, but it's not clear whether other factors might be at work, such as education or overall health habits

...and the risks

Alcohol — as little as one-half drink per day — is an established risk factor for breast cancer. One explanation: It raises estrogen levels in the blood, which can promote the growth of breast tumors.

Women are quicker to become alcohol-dependent and to suffer the consequences, which include brain damage; psychiatric problems; damage to the cardiovascular, musculoskeletal, and gastrointestinal systems; anemia; and fatal accidents

What's a drink?

In the United States, a standard drink is usually defined as 0.5 ounces (12 grams) of alcohol. That's about the amount in a 12-ounce beer, a 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits.

What to do

If you think you might have a problem with alcohol — especially if you feel depressed or irritable — speak with a trusted clinician or pastoral counselor, or make an appointment with a mental health professional. Having an alcohol problem doesn't mean that you're an alcoholic or that abstinence is the only solution — assuming you tackle the problem early enough, can learn to drink in moderation, and don't have a genetic vulnerability to alcoholism.

July 2006 update