How Risky Are Those Holiday Cocktails, Really?

’Tis the season to be jolly … and for many of us, that may mean indulging in a glass of brandy at festive cocktail parties, a glass of wine at celebratory dinners, a flute of champagne to ring in the new year. 

Alcohol consumption rose during the pandemic, especially among women. But drinking has since returned to pre-pandemic levels, and in the last few years there’s been another trend happening: an increase in people who are interested in cutting down or cutting out all kinds of alcohol completely.

More and more people are choosing to toast with a mocktail or a glass of club soda, as new studies show that alcohol’s effects on the body may be even more harmful than previously thought. “People are starting to recognize the hazards of drinking and question their own alcohol use. We’re wondering, do we need alcohol in our lives?” says Reham Attia, MD, an addiction specialist at Kaiser Permanente Los Angeles Medical Center.

Read on for the latest research on how alcohol affects your health ... and for ways to cut back on your drinking, if you decide that’s a good idea.

What Does Booze Do in the Body?

Most people are aware that alcohol affects the brain, can damage the liver and can affect a pregnant woman’s developing baby. But that’s not all the havoc it can wreak. “Because alcohol is water-soluble and disseminates through the entire body, there’s not a single organ that’s not affected by heavy alcohol use,” says Dr. Attia.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA, part of the National Institutes of Health), here are just some of the negative health effects drinking has on your body: 

Brain: Alcohol affects the brain’s communication pathways, which can change mood and behavior, affect coordination and make it harder to think clearly. 

Heart: Alcohol can raise blood pressure, cause arrhythmias (irregular heartbeat) and cardiomyopathy (a stretching or drooping of the heart muscle), and raise the risk of stroke.

Liver: Alcohol can lead to liver diseases such as steatosis (fatty liver) alcoholic hepatitis, fibrosis (scar tissue that’s formed when the liver tries to repair damaged tissue) and cirrhosis (permanent damage from scar tissue). Says Dr. Attia, “The liver is probably more affected because the way we ingest alcohol is through the gastrointestinal system, so it makes sense that the first organs to be affected are the organs of this system: the esophagus, stomach, liver.”

Pancreas: Alcohol use can make the organ produce toxins that cause pancreatitis, a dangerous inflammation that impairs the ability of the pancreas to make the substances necessary for proper digestion.

Immune system: Drinking too much can weaken the immune system, making the body more susceptible to disease. In fact, according to NIAAA, “Drinking a lot on a single occasion slows your body’s ability to ward off infections—even up to 24 hours after getting drunk.”

Cancer: Drinking alcohol regularly over time can raise the risk of several types of cancer, including head and neck cancer, esophageal cancer, liver cancer, breast cancer and colorectal cancer. The International Agency for Research on Cancer has labeled alcohol a Group 1 carcinogen—like asbestos, radiation and tobacco. In addition, drinking has been linked to greater risks of developing osteo­porosis and dementia. And recent research is showing that in addition to harming a developing fetus, alcohol use can inhibit fertility for both men and women, making it more difficult to get pregnant in the first place.

These detrimental effects are just a sampling of how alcohol can harm the body. In fact, alcohol is known to contribute to 200-plus health conditions.

“One thing that most people don’t connect with alcohol is mental health,” says Dr. Attia. “A lot of times people use alcohol to self-medicate depression and anxiety symptoms. In the short term, it may appear that alcohol is helping. In the long term, it’s worsening the problem.” Alcohol can also counteract the effect of medications designed to treat anxiety and depression, she adds.

But wait, haven’t you read that alcohol, especially red wine, has some positive health benefits?

“There’s a polyphenol [a type of plant compound] called resveratrol in red wine that is beneficial,” says Dr. Attia. “It decreases inflammation in the epithelial cells that line the blood vessels. It penetrates the blood/brain barrier and has protective effects. It reduces platelet aggregation and can prevent the formation of blood clots.”

But before you grab that bottle of cabernet, consider this: “These polyphenols can be found in other substances, like grapes, raspberries and peanuts, or by taking supplements,” says Dr. Attia. “So even if there is a benefit to red wine, you don’t need to drink red wine to get this benefit. Eat the grapes instead!”

Is There a Safe Level of Drinking?

Considering that alcohol is a risk factor for so many serious health problems, is any amount considered safe? According to the Dietary Guidelines for Americans 2020-2025 from the US Department of Health and Human Services and US Department of Agriculture, adults can drink in moderation by limiting intake to two drinks or fewer for men and one drink or fewer for women on days when alcohol is consumed. Overall, the guidelines continue, “drinking less is better for health than drinking more.”

Other organizations go further. The American Cancer Society recommends that for cancer prevention, “it is best not to drink alcohol.” The World Health Organization says that “when it comes to alcohol consumption, there is no safe amount that does not affect health.” Dr. Attia agrees: “Any drinking is hazardous to the body. There is no safe amount of drinking.”

Are You 'Sober Curious'?

In 2018, author Ruby Warrington coined the term sober curious to encourage people to examine their drinking habits in the context of the rest of their lifestyle. Why, she asks in her 2018 book Sober Curious: The Blissful Sleep, Greater Focus, Limitless Presence and Deep Connection Awaiting Us All on the Other Side of Alcohol, are so many people eating healthy, exercising, meditating and taking other steps to be healthy, but not really looking at or seeing how their alcohol drinking affects them?

“The purpose of adopting a sober curious lifestyle is to gain a deeper understanding of one’s drinking habits, motivations and how alcohol affects well-being,” explains Kerry Benson, a registered dietitian and the co-creator of the Sober Curious Dietitians website (thesoberdietitians.com). “How this awareness shapes future choices will differ from person to person.”

Being sober curious doesn’t necessarily mean complete abstinence from alcohol, she says, but some people may find, after examining their habits and experimenting with not drinking, that alcohol no longer fits in their lives.

Before becoming a registered dietitian, Benson worked in a neuroscience lab researching the impacts of alcohol on brain development. During the early months of the pandemic, when alcohol consumption was rising in the United States and abroad, Benson and her Sober Curious Dietitians partner, Diana Licalzi, began questioning their own relationships with alcohol.

They immersed themselves in scientific literature on alcohol’s health effects and engaged with the sober community. They became aware of how society had normalized drinking. And in the summer of 2020, they decided to embark on their own alcohol-free challenge.

“We noticed improvements in our skin, sleep, energy levels—and finances,” says Benson. Now they hope to encourage more people to examine their drinking habits and to reap the psychological and physical benefits of abstaining. Benson’s and Licalzi’s experience of feeling healthier once they stopped drinking is typical. Since alcohol affects nearly every part of your body, you can expect to feel the difference soon after you stop or cut down.

“The first thing that improves is sleep,” says Dr. Attia. “Most people who drink complain of insomnia.” She adds that people will notice they have more energy and feel less anxious. “Blood pressure improves. Cholesterol levels improve. That can happen within 30 days. And because you improve blood pressure and cholesterol, you also lower your risk of cardiovascular disease, meaning heart attack and stroke,” she says. “People also notice healthy weight loss. And they notice improvements in their energy and mood.”

What Are Some Tips for Cutting Back or Cutting Out Drinking?

December can be a difficult time of year to suddenly stop drinking alcohol. In fact, overindulging over the holidays is one reason for the Dry January movement, which encourages people to give up alcohol for the entire month. “Popular alcohol-free challenges like Dry January and Sober October give people a structured opportunity to take a break from drinking,” says Benson. “These initiatives not only help to destigmatize abstaining from alcohol but also provide a manageable way for individuals to examine their drinking habits.”

But you don’t have to wait until January or October to question or change your drinking habits. A great place to start, says Benson, is by practicing mindful drinking. “Observe how alcohol makes you feel as you drink it, as well as the next day, both physically and emotionally,” she advises. Think about why you’re drinking. Because you feel that you should in a social context? Out of habit? To relax or as a reward? Also, think about the drinks you consume: Do you even like the taste? 

“Based on my own sober curious journey, my top recommendation for cutting back on alcohol is to keep substitutes readily available,” she says. These could include nonalcoholic beer or sparkling wine, creative mocktails, flavored seltzer water or kombucha. Try serving them in elegant glassware, she suggests. “Viewing this transition as an opportunity to explore new flavors rather than giving something up can be empowering,” she says. 

Other tips include:

• Don’t keep alcohol in your home so you won’t be tempted.
• If there’s a friend or family member you trust—especially someone who lives with you—share your plan and use this person for support.
• Consider setting specific guidelines and goals for yourself. “For instance, you could establish a monthly budget for alcohol expenses or a ­maximum number of drinks you will consume on an occasion,” says Benson.
• At social events, if you aren’t ready to stick to sparkling water, try alternating alcoholic and nonalcoholic drinks or diluting your drinks so they only contain half as much alcohol. For instance, switch from wine to wine spritzers.
• Benson also recommends making an effort to practise self-care, like journaling, connecting with friends, taking walks, indulging in baths or practicing yoga—all of which are better, healthier ways to manage stress than drinking.
• Dr. Attia recommends that people talk to their primary care doctor about how much they drink. Then the recommendations they get for less hazardous drinking levels or giving up alcohol completely can be tailored to their age, medical condition, medications, etc.

Many people, she adds, are not aware that there are medications to help people reduce their drinking. “As a generalization, though, it’s a good idea to cut down your total consumption by about 20% every week,” she says. “That’s a way to cut down slowly without any major complications.”

Dr. Attia often negotiates with her patients, urging them to agree to stop drinking for 30 days or 90 days. “I tell them it’s easily reversible if they don’t like it,” she says. “And then once they do a period of complete sobriety, they get an understanding that life can go on without drinking, and that it’s not as important in their lives as they first thought it was.”