Tracking your alcohol consumption can help reveal if you are a "moderate" drinker or not. Photo / 123rf
Many of us are prone to wishful thinking when it comes to our booze intake, as one writer found when she totted up her weekly units.
I’m a social drinker. Warmer, friendlier, after a few glasses. I never drink at home but when I’m out with friends (I work alone during the day), it’s a joy to split a bottle of wine at supper, then put the world to rights over another glass.
I’d class myself as a “moderate drinker”. But am I really? The UK NHS defines “moderate” as 14 units of alcohol a week and urges both men and women to make this their upper limit.
The problem is I tend to assume a large glass of wine is a unit, but in my heart I know this is wishful thinking.
A small glass (ie a 125ml thimble of wine) is actually 1.5 units. While a large glass of wine is 3.1 units. In the back of my mind I knew this but have been turning a blind eye. Research shows most of us are prone to this glass half-full mentality when it comes to wine. We can’t do the maths. So challenged by the health editor of this paper, I download an app and keep track for a week.
The MyDrinkaware app is a free online calendar that aims to help people understand what impact their drinking might be having on their health. When I fill out the initial questionnaire I feel slightly smug. No, I haven’t blacked out, injured myself or another person, forgotten the events of the night before. Three times a week I might have four drinks – but that’s moderate, isn’t it? Big mistake.
The app tells me bluntly that I’m at “increasing risk” of being dependent on alcohol. “Your drinking is dangerous to your health, increasing your risk of serious health problems, including seven types of cancer, liver and heart disease and high blood pressure. Unless you cut down, you are at risk of damaging your health.” Gulp.
When I consult professor David Nutt, director of the Neuropsychopharmacology Unit in the Division of Brain Sciences, Imperial College London (and co-creator of non-alcoholic drink Sentia), he warns that if we discovered ethanol (alcohol) today, and it was put through the food safety testing requirements, the maximum recommended limit would be a single glass of wine per year.
“Even drinking below the 14 unit per week threshold does increase the risk of breast cancer,” he says. “If you have a family history of this or have the genes that predispose, then the risk is greater, so you might decide not to drink at all. However, whatever risk category you are in, the less you drink the lower your risk.”
I’m shaken. The new moderate me rarely goes over 14 units, surely? So each day for a week I log my drinking on the app. It’s a slightly unusual week – including a 60th birthday, the 40th anniversary of a friend’s beauty brand at Claridge’s, the party for The National Gallery’s reopening of The Sainsbury Wing, and a book prize. So there will be a bit more celebrating than usual. But I’m hopeful I can hold the line.
Then – bad news – a dear friend reveals she’s having a trial marriage separation, and inevitably our cinema evenings involve a bottle or two. “I’m made of wine at the moment,” she says bravely. Oh dear, my audit isn’t looking good.
Saturday
The first shock is how many empty calories I’m putting away. On Saturday, I have a girls’ lunch (four small glasses of white wine), then supper and a film with my friend (four small glasses red). Those eight drinks constitute a whopping 728 calories. And, the app tells me, I’ve used up 13 units. So I’ve nearly bust my total already. I try not to do lunch and supper on the same day (it’s too easy to forget the lunchtime units), but this is scary.
Monday
On Monday I have a money-saving picnic by the river (my friend decants two large glasses of white wine from her flask) before Sondheim at the theatre. I’m feeling quite proud of myself but the app meanly informs me that’s 6.5 units (364 calories).
Tuesday
I meet a friend for a martini before The Book Awards on Tuesday. She’s an actor, so the wine waiters are particularly attentive at the awards (did I mention my house rule is never to turn down champagne?). But it’s an own goal. The app informs me I’ve consumed 10.5 units (588 calories).
Wednesday
On Wednesday at Claridge’s, there’s free-flowing champagne again. By my conservative estimate, I had five glasses, then a nightcap at my friend’s house – and the app registers 9.13 units (511 calories). Oh God, it was probably more than that.
The next day I feel hungover. I’ve been very proud of myself for giving up free sugar (for this paper). I’ve stuck to it for three months and lost several inches. But heavens I’m tempted to have biscuits. Only pride helps me not to succumb. Booze does lead to poor food impulse control.
Thursday
Normally I’d go into purdah for a few days to atone. But unfortunately it’s The Sainsbury Wing party the next night. I am deeply grateful to their champagne sponsor (these days parties in the arts are pretty dry), but I rack up 9.75 units (546 calories). I’m actually the plus one this evening – there to support my friend, carry her bag. All fine, but I’m beginning to realise that being the bridesmaid (not the bride) makes you drink more. No one is terribly interested in you, so you hit the drinks tray more often. At the 60th birthday supper I manage to stick to a double G&T and small glass of wine, but that’s still 5.25 units (294 calories), way over my daily allowance.
Nervously, I consult the MyDrinkaware dashboard. “In the last seven days you have had 36 drinks – that’s 62.26 units,” it informs me. I’m horrified. I knew it was going to be a bit over the “safe” 14 units. But the health implications are clear. Apart from the cancer risk, ONS figures show alcohol-related deaths from liver disease are rising substantially (the highest is women in their 50s).
“When you drink a unit of alcohol, your liver has to pause the 500 vital functions in the body, encompassing tasks like filtering the blood, producing bile, and metabolising nutrients, just to get alcohol out of the system as quickly as possible,” Dr Curran of London’s Reborne Clinic tells me. “These functions are crucial for digestion, detoxification, and overall health.”
He doesn’t drink himself. “I don’t want to come across as judgy, but 14 units may still be too much in women who are struggling with hormone imbalance, excessively high oestrogen in particular. Alcohol can exacerbate a propensity for oestrogen access, which in turn can fuel uncontrolled proliferation in oestrogen-sensitive tissues or tumours such as breast, ovarian and endometrial (lining of womb). Alcohol metabolism also depletes nutrients required for the effective processing and elimination of oestrogen from the body.”
I naively believed I was cutting back on booze. And yes, last week was a perfect storm (like Christmas in May). Life chez Hoggard is normally far less exciting. But the truth is even a “modest” night is over my daily allowance. “If it’s a strong wine, 250ml can be three units,” warns Richard Piper of Alcohol Change UK (who also have a Try Dry app).
He agrees the 14-unit recordation is fairly arbitrary. “There’s 200 medical conditions caused by alcohol. For every single medical condition, there is a different risk chart. So how do you alight on a single number above which things are higher risk?” He’d prefer us to adopt the Canadian system where we talk about zero risk (not drinking), very low risk, low risk, moderate risk and high risk. Very low risk would be two to three units a week.
He doesn’t think consumers should take all the blame, however. It’s an addictive substance. “Let’s keep the pressure on government and on the industry,” says Dr Curran. “It’s one of the wealthiest profit-making industries on the globe. Most of the drinks we consume are actually produced by multi-global companies not based in the UK. So it’s UK consumers paying the price for other countries’ profits.
“Alcohol is more addictive than cocaine, more harmful than tobacco, but we’re not told that story, and it’s so normalised in our society that we reject that message. But the science behind the cancer risk has really developed over the last 20 years. The challenge for us as an organisation is how to tell that story, without being alarmist, and how to support people to just put alcohol back where it needs to be, as a dangerous product that’s also pleasurable. In a democratic society, we’re not for banning stuff. Our position is it’s up to you to choose.”
I’m determined to cut back and have started ordering alcohol-free beers when out with friends (they’re so good now I can barely tell the difference). On a seaside jaunt, I don’t drink and the drive-back at 5am is surprisingly bearable with a clear head.
I won’t deny it’s been a shaming wake-up call. Just typing the figures into an app makes it harder to ignore the truth.
“Cut one unit, two units out a week, and your chances of living a longer, healthier life increase,” says Richard Piper.
Check the alcohol volume
Not all wines are equal. You can find the ABV on the labels of cans and bottles, sometimes written as “vol” or “alcohol volume”, or ask bar staff about particular drinks. For example, wine that says “12% ABV” or “alcohol volume 12%”, means 12% of the volume of that drink is pure alcohol. A large glass of ABV 12% such as Cabernet Sauvignon, Chardonnay or Sauvignon Blanc, is three units.
Build in more alcohol-free days
It’s recommended to have two to three alcohol-free days each week, ideally consecutively. Abstaining from alcohol for two to three weeks can significantly reduce liver inflammation and improve overall health, especially for those with fatty liver. “Even in your 50s and 60s you can have a huge impact by reducing the amount of alcohol you drink,” says Debbie Shawcross, professor of hepatology and chronic liver failure at King’s College London.
Don’t drink on an empty stomach
“The worst thing you can do is drink without food,” says Shawcross. “You very quickly get drunk and the liver becomes overloaded because it can only break down alcohol at roughly one unit of alcohol an hour. But if you have a meal that keeps alcohol in the stomach for longer, it slows absorption of alcohol into the bloodstream.”
Measure your drinks
Home spirit measures are notoriously difficult to judge, so use a measure (25cl of standard 40% spirits is one unit). Most people think they are having a double, but it is more like a triple, says Salim Khakoo, professor of hepatology at the University of Southampton.
Know your triggers
Is it being in a bar? At home watching TV? When you socialise with certain friends? Identify any potential weak spots and find an alternative.
Have something fun planned for the morning after a night out
If you know you have something to look forward to the next morning, then you’re more likely to want to avoid a hangover, and drink less as a result.
Downsize your glass sizes (especially when at home)
Studies show it helps you drink less, says DrinkAware.
Put ice in wine
This will dilute the strength, but still gives the taste. Or add a mixer, like soda, to make it a spritzer.
Follow the 20-minute rule
Take a 20-minute break after you’ve finished one drink before buying or pouring your next. Your craving will often go away or soften.
Go dry at events associated with alcohol
Identify one thing you would normally do with alcohol – picnic, festival, restaurant – and do it without alcohol, advises Richard Piper. “What people find is it’s just as fun, sometimes more so, particularly with gigs, where you find yourself queuing to get the beer, and then queuing for the toilet. Say to yourself: ‘I did pay quite a lot of money. I want to be fully present’.”
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