That nightly glass (or more) of wine many people rely on to relax at the end of the day is getting new scrutiny from health experts — especially if you’re a woman.
No amount of alcohol is protective against cardiovascular disease, a recent study confirmed, so drinking red wine or spirits in the name of heart health may not have any benefits.
The research is especially timely, as Americans have been drinking more alcohol since the start of the COVID-19 crisis, a habit that can have deadly consequences.
Between 2019 and 2020, the rate of alcohol-related deaths rose about 25%, reflecting the “hidden tolls of the pandemic,” such as increased drinking to cope with pandemic-related stress, researchers reported in JAMA Network Open in May. For context, the death rate for all causes of death increased 16.5% during this time frame.
The study also found that the alcohol-related death rate rose for all ages and sexes, but increased the most for people 25 to 44 years old. The number of deaths caused by alcohol-related mental and behavioral disorders rose 35%, while the number of deaths caused by alcohol-associated liver diseases increased 22%, the study found.
The death rate from that latter cause accelerated for both men and women during the pandemic, another study confirmed. This “troubling” trend calls for a “nationwide effort to reduce national alcohol consumption,” the authors wrote last month in Clinical Gastroenterology and Hepatology.
‘Women need an intervention’
In particular, the pandemic has had a disproportionate effect on women’s drinking, said Dawn Sugarman, Ph.D., a research psychologist in the division of alcohol, drugs and addiction at McLean Hospital in Belmont, Massachusetts.
Women have increased their alcohol consumption at a higher rate than men, particularly their heavy drinking days — those when they have four or more drinks within a couple hours, she noted.
The health effects for women can be especially concerning because they absorb and metabolize alcohol differently than men, so the alcohol stays in a woman’s body longer, increasing the risk of liver disease, heart disease and certain cancers, she added.
“Women who have fewer years of alcohol use compared to men have more of these physical consequences. So essentially they’re getting sicker faster than men from alcohol,” Sugarman told TODAY.
“In relation to mental health, women already have twice the risk of men for depression and anxiety. We know that women are more likely than men to drink to cope with these negative feelings, and alcohol use just exacerbates depression. It exacerbates anxiety. It makes insomnia worse.”
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In an essay published this month in The New York Times, a woman described her own experience with alcohol dependence: “I thought of nights I had put my children to bed while tipsy and how they noticed the change in my voice when I drank. I thought of arguments with my husband, insomnia, dry mouth, headaches and regret,” author Ericka Andersen wrote.
Her sobriety journey began when she typed “Do I have a drinking problem?” into a search engine.
“Women need an intervention. Our physical and mental health is suffering because of drinking,” she wrote. “More women need to speak out about it — and seek help.”
But even before the pandemic, women's drinking levels were concerning experts. TODAY reported in 2018 that women were drinking almost as much as men, closing a historically wide gap.
Women, particularly in the mom age group, have been “just bombarded” with alcohol advertising over the years, Sugarman said. Ads and social media posts can create the expectation that wine-soaked days are healthy fun, but the negative health consequences are real.
Drinking less reduces heart risk
If they can’t give up alcohol all together, women and men might see health benefits just from cutting down on their drinking, said Dr. Krishna Aragam, co-author of the recent JAMA Network Open investigation that found no amount of alcohol was protective against heart disease.
It’s true that when you group people by how much they drink, those who imbibe light to moderate amounts of alcohol appear to have lower rates of heart disease compared to others, he noted.
But those same light-to-moderate drinkers also tend to have healthier behaviors such as regular exercise, lower rates of smoking and maintaining a lower body weight. When Aragam and his colleagues adjusted for those factors, any protective associations with alcohol pretty much disappeared.
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For someone who’s otherwise healthy, the cardiovascular risk was still “fairly modest” at low levels of alcohol consumption — one drink a day or less — but it escalated exponentially beyond that amount, he noted. People who had three or more drinks per day had several-fold increases in risk, the investigation found.
“Our results warrant kind of a doubling down on the heavy drinkers and really trying to make focused efforts to get people to cut back because everything we’re seeing suggests that alcohol consumption at those levels is contributing to higher blood pressure, higher cholesterol, greater rates of heart attack,” Aragam, a preventive cardiologist at Massachusetts General Hospital in Boston, told TODAY.
“Maybe they’re actually going to get the majority of their benefit if they can reduce intake to one drink a day. That’s sometimes a lot more achievable for people than going cold turkey.”
One standard drink is defined as 5 ounces of wine, but many modern wine glasses have room for several times that amount so it’s easy to pour much more and think it's only one drink. Wine glass capacity has increased sevenfold over 300 years, one study found.
Current U.S. guidelines advise limiting alcohol to two drinks or less per day for men; and one drink or less per day for women. It might be better to be conservative and stick with one drink per day or less for everyone, Aragam noted.
But even that may be too much for many women, depending on their mental health or family history of drinking, Sugarman said.
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How to gauge your relationship with alcohol:
Sugarman advised making a pros and cons list of the effects of your drinking. Don’t be reluctant to list the positives, such as the immediate stress relief, because the pros section can help you figure out what to do to replace the alcohol. Can you try exercise instead of wine to relieve stress, for example?
Other questions to ask yourself about your alcohol use include:
- How much of my time is taken up drinking and then recovering from the effects of alcohol?
- Am I drinking even though I know it’s making my mental or physical health worse?
- Are friends and loved ones telling me they’re concerned about my drinking?
- Am I trying to hide my drinking?
- Do I feel very possessive of alcohol and don’t want it taken away?
- Am I giving up activities in order to continue drinking or to recover from the effects of drinking?
- Can I take a break from alcohol for a week or a month? If not, why not?
Women are less likely to seek and get treatment, Sugarman said, noting there’s a lot of stigma around women and alcohol use. If you suspect you have a problem, talking to your primary care doctor can be a first step, she advised.
The National Institute on Alcohol Abuse and Alcoholism has more resources on how to find alcohol treatment.
“There needs to be just more overall public awareness of the concerns around women’s drinking, and I don’t think we’re there yet,” Sugarman said.
“It’s important to help people understand the risks because they’re not going to be motivated to make any changes if they only see the benefits of it.”