You may wonder at what point your drinking becomes harmful to your health, and how much is too much.
This article explores alcohol's effects on your health and reviews intake limits and recommendations.
Alcohol Intake Recommendations
Standard drink size and alcohol intake recommendations differ between countries.
In the United States, a standard drink contains approximately 14 grams of pure alcohol, which is the amount typically found in 12 ounces (355 ml) of regular beer, 5 ounces (150 ml) of wine, or 1.5 ounces (45 ml) of spirit (1).
According to the Dietary Guidelines for Americans, U.S. Department of Agriculture, and U.S. Department of Health and Human Services, moderate drinking involves up to one drink per day for women and up to two drinks per day for men (1, 2 Trusted Source).
Research suggests that only about 2% of those who drink within these limits have an alcohol use disorder (3).
Problematic drinking can relate to binge drinking, heavy drinking, alcoholism, or alcohol dependence.
The Substance Abuse and Mental Health Services Administration (SAMHSA) defines binge drinking as four or more drinks for women or five or more drinks for men on the same occasion, meaning at the same time or within a couple of hours (1).
Heavy drinking or heavy alcohol use is defined as binge drinking on five or more days of the past month (1).
Alcoholism is when you have impaired control over alcohol, are preoccupied with its use, and continue to use it despite adverse consequences (4 Trusted Source).
Moderate alcohol consumption is one drink per day for women and two drinks per day for men. Alcohol use disorders include binge drinking, heavy drinking, and alcoholism.
The Effects of Alcohol on Your Body
Excessive drinking affects your health and almost every part of your body. It can not only damage vital organs but also affect your mood and behavior.
Consuming too much alcohol can have devastating effects on your central nervous system.
Several factors affect how and to what extent it impacts your brain, including how much and how often you drink, the age you started drinking, your gender, and more (5 Trusted Source).
The initial effects of alcohol on your central nervous system include slurred speech, memory impairment, and compromised hand-eye coordination.
Many studies have associated heavy chronic alcohol use with memory deficits (6 Trusted Source).
Alcohol dependence is a major risk factor for developing Alzheimer's disease, especially in women (6 Trusted Source).
Furthermore, it's estimated that alcohol-related brain damage may account for 10% of early-onset dementia cases (7 Trusted Source).
Although brain damage appears to be partially reversible after a longer period of sobriety, chronic and excessive drinking can permanently impair your brain (8 Trusted Source).
Liver damage is another consequence of chronic binge drinking.
Most of the alcohol you drink is metabolized in your liver. This produces potentially harmful byproducts that can damage your liver cells. As you continue drinking over time, your liver health declines.
Alcoholic fatty liver disease is the earliest stage of alcohol-induced liver damage. This condition can occur over time when too much alcohol leads to a buildup of fat in your body's liver cells, which can hinder liver function (9 Trusted Source).
The effects of alcohol can be mentally and physically addicting.
Feeling a compulsive urge to drink, worrying about where or when you'll have your next drink, and finding it hard to enjoy yourself without drinking are all common signs of alcohol dependence (13 Trusted Source).
The cause of this dependence can be complex. It may be caused in part by your genes and family history, but your environment can play a large role as well (14 Trusted Source).
There are many other side effects of chronic alcohol use. While health effects vary between individuals, drinking is often linked to depression and anxiety.
Some people may use alcohol as a quick fix to improve their mood and reduce anxiety, but this typically only provides short-term relief. In the long term, it can end up worsening your overall mental state and health (15 Trusted Source).
Drinking may also affect your weight and body composition.
While drinking in moderation is safe for most individuals, excessive alcohol intake and abuse can have detrimental effects on your physical and mental health.
Gender and Genetics Affect Alcohol Metabolism
Your gender and genetics can affect the rate at which your body metabolizes alcohol.
The primary enzymes involved in alcohol metabolism are alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) (18 Trusted Source).
Women often have lower ADH activity than men. Therefore, women may metabolize alcohol at a slower rate, making them more vulnerable to its effects. That said, some men have low ADH activity as well (19 Trusted Source, 20 Trusted Source, 21 Trusted Source).
For instance, women's bodies have more fat and less water than men's bodies, on average. This may result in higher blood alcohol levels in women, even if they drink the same amount as men (24 Trusted Source).
Gender, genetics, and body composition affect alcohol metabolism. Women may be more vulnerable to its effects than men.
Certain People Should Abstain From Alcohol
For most people, having an occasional alcoholic beverage typically doesn't cause harm. However, in certain situations and among specific populations, alcohol should be avoided.
Pregnancy and Breastfeeding
Research has shown that there is no safe level of alcohol use during pregnancy (25 Trusted Source).
Many studies have concluded that alcohol use during pregnancy increases the risk of miscarriage, birth defects, and cognitive and developmental problems (26 Trusted Source, 27 Trusted Source, 28 Trusted Source).
One study found that birth defects are four times more likely if the mother has been drinking heavily in the first trimester (29 Trusted Source).
According to the Centers for Disease Control and Prevention (CDC), alcohol use during pregnancy is the leading cause of preventable birth defects, developmental disabilities, and mental retardation in the United States (30 Trusted Source).
It's important to note that alcohol can also pass into breast milk if consumed by the nursing mother (31 Trusted Source).
Breastfeeding mothers should wait for the complete elimination of alcohol from breast milk after drinking. This takes about 2–2.5 hours per drink, depending on your body size (32 Trusted Source, 33 Trusted Source).
Additional reasons to abstain from alcohol include:
- Medical conditions. Alcohol may worsen preexisting health conditions like liver disease, diabetes, and kidney disease (9 Trusted Source, 34 Trusted Source, 35 Trusted Source).
- Medications. Alcohol can interact with over-the-counter herbal and prescription medications, including antidepressants, antibiotics, and opioids (36 Trusted Source).
- Underage drinking. Underage drinking, especially heavy and frequent intake, has been associated with immediate and chronic consequences (37 Trusted Source).
- Current and recovering alcoholics. Recovering from an alcohol use disorder can be difficult. Recovering alcoholics should stop drinking completely and avoid their triggers for abuse (38 Trusted Source).
Alcohol use during pregnancy increases the risk of birth defects. It's recommended to abstain from drinking if you have certain preexisting medical conditions, are underage, or take certain medications.
The Bottom Line
While drinking in moderation is safe for most individuals, heavy and chronic alcohol use can have devastating consequences for your mental and physical health.
Many factors play a role in alcohol metabolism, and the effects of alcohol vary by individual, making it tricky to set intake recommendations.
American Dietary Guidelines recommend limiting your alcohol intake to one drink per day for women and two drinks per day for men.
However, some people, such as those with certain medical conditions and pregnant women, should avoid alcohol completely.
Reposted with permission from our media associate Healthline.
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By Bob Jacobs
Hanako, a female Asian elephant, lived in a tiny concrete enclosure at Japan's Inokashira Park Zoo for more than 60 years, often in chains, with no stimulation. In the wild, elephants live in herds, with close family ties. Hanako was solitary for the last decade of her life.
Hanako, an Asian elephant kept at Japan's Inokashira Park Zoo; and Kiska, an orca that lives at Marineland Canada. One image depicts Kiska's damaged teeth. Elephants in Japan (left image), Ontario Captive Animal Watch (right image), CC BY-ND
Affecting Health and Altering Behavior<p>It is easy to observe the overall health and psychological consequences of life in captivity for these animals. Many captive elephants suffer from arthritis, obesity or skin problems. Both <a href="https://doi.org/10.11609/JoTT.o2620.1826-36" target="_blank">elephants</a> and orcas often have severe dental problems. Captive orcas are plagued by <a href="https://doi.org/10.1016/j.jveb.2019.05.005" target="_blank">pneumonia, kidney disease, gastrointestinal illnesses and infections</a>.</p><p>Many animals <a href="https://doi.org/10.1016/j.neubiorev.2017.09.010" target="_blank">try to cope</a> with captivity by adopting abnormal behaviors. Some develop "<a href="https://doi.org/10.1016/j.applanim.2017.05.003" target="_blank" rel="noopener noreferrer">stereotypies</a>," which are repetitive, purposeless habits such as constantly bobbing their heads, swaying incessantly or chewing on the bars of their cages. Others, especially big cats, pace their enclosures. Elephants rub or break their tusks.</p>
Changing Brain Structure<p>Neuroscientific research indicates that living in an impoverished, stressful captive environment <a href="https://doi.org/10.1016/j.jveb.2019.05.005" target="_blank" rel="noopener noreferrer">physically damages the brain</a>. These changes have been documented in many <a href="https://doi.org/10.1002/cne.903270108" target="_blank" rel="noopener noreferrer">species</a>, including rodents, rabbits, cats and <a href="https://doi.org/10.1006/nimg.2001.0917" target="_blank" rel="noopener noreferrer">humans</a>.</p><p>Although researchers have directly studied some animal brains, most of what we know comes from observing animal behavior, analyzing stress hormone levels in the blood and applying knowledge gained from a half-century of neuroscience research. Laboratory research also suggests that mammals in a zoo or aquarium have compromised brain function.</p>
This illustration shows differences in the brain's cerebral cortex in animals held in impoverished (captive) and enriched (natural) environments. Impoverishment results in thinning of the cortex, a decreased blood supply, less support for neurons and decreased connectivity among neurons. Arnold B. Scheibel, CC BY-ND<p>Subsisting in confined, barren quarters that lack intellectual stimulation or appropriate social contact seems to <a href="https://doi.org/10.1590/S0001-37652001000200006" target="_blank" rel="noopener noreferrer">thin the cerebral cortex</a> – the part of the brain involved in voluntary movement and higher cognitive function, including memory, planning and decision-making.</p><p>There are other consequences. Capillaries shrink, depriving the brain of the oxygen-rich blood it needs to survive. Neurons become smaller, and their dendrites – the branches that form connections with other neurons – become less complex, impairing communication within the brain. As a result, the cortical neurons in captive animals <a href="https://doi.org/10.1002/cne.901230110" target="_blank">process information less efficiently</a> than those living in <a href="https://doi.org/10.1002/dev.420020208" target="_blank">enriched, more natural environments</a>.</p>
An actual cortical neuron in a wild African elephant living in its natural habitat compared with a hypothesized cortical neuron from a captive elephant. Bob Jacobs, CC BY-ND<p>Brain health is also affected by living in small quarters that <a href="https://doi.org/10.3233/BPL-160040" target="_blank">don't allow for needed exercise</a>. Physical activity increases the flow of blood to the brain, which requires large amounts of oxygen. Exercise increases the production of new connections and <a href="http://dx.doi.org/10.1126/science.aaw2622" target="_blank">enhances cognitive abilities</a>.</p><p>In their native habits these animals must move to survive, covering great distances to forage or find a mate. Elephants typically travel anywhere from <a href="https://www.elephantsforafrica.org/elephant-facts/#:%7E:text=How%20far%20do%20elephants%20walk,km%20on%20a%20daily%20basis." target="_blank">15 to 120 miles per day</a>. In a zoo, they average <a href="https://doi.org/10.1371/journal.pone.0150331" target="_blank" rel="noopener noreferrer">three miles daily</a>, often walking back and forth in small enclosures. One free orca studied in Canada swam <a href="https://doi.org/10.1007/s00300-010-0958-x" target="_blank" rel="noopener noreferrer">up to 156 miles a day</a>; meanwhile, an average orca tank is about 10,000 times smaller than its <a href="https://www.cascadiaresearch.org/projects/killer-whales/using-dtags-study-acoustics-and-behavior-southern" target="_blank" rel="noopener noreferrer">natural home range</a>.</p>
Disrupting Brain Chemistry and Killing Cells<p>Living in enclosures that restrict or prevent normal behavior creates chronic frustration and boredom. In the wild, an animal's stress-response system helps it escape from danger. But captivity traps animals with <a href="https://doi.org/10.1073/pnas.1215502109" target="_blank">almost no control</a> over their environment.</p><p>These situations foster <a href="https://doi.org/10.1037/rev0000033" target="_blank">learned helplessness</a>, negatively impacting the <a href="https://doi.org/10.1155/2016/6391686" target="_blank" rel="noopener noreferrer">hippocampus</a>, which handles memory functions, and the <a href="https://doi.org/10.1016/j.neuropharm.2011.02.024" target="_blank" rel="noopener noreferrer">amygdala</a>, which processes emotions. Prolonged stress <a href="https://doi.org/10.3109/10253899609001092" target="_blank" rel="noopener noreferrer">elevates stress hormones</a> and <a href="https://doi.org/10.1523/JNEUROSCI.10-09-02897.1990" target="_blank" rel="noopener noreferrer">damages or even kills neurons</a> in both brain regions. It also disrupts the <a href="https://doi.org/10.1016/j.neubiorev.2005.03.021" target="_blank" rel="noopener noreferrer">delicate balance of serotonin</a>, a neurotransmitter that stabilizes mood, among other functions.</p><p>In humans, <a href="https://doi.org/10.1006/nimg.2001.0917" target="_blank" rel="noopener noreferrer">deprivation</a> can trigger <a href="https://doi.org/10.3389/fnins.2018.00367" target="_blank" rel="noopener noreferrer">psychiatric issues</a>, including depression, anxiety, <a href="https://doi.org/10.3389/fnins.2018.00367" target="_blank" rel="noopener noreferrer">mood disorders</a> or <a href="https://doi.org/10.1177/1073858409333072" target="_blank" rel="noopener noreferrer">post-traumatic stress disorder</a>. <a href="https://doi.org/10.1007/s00429-010-0288-3" target="_blank" rel="noopener noreferrer">Elephants</a>, <a href="https://doi.org/10.1371/journal.pbio.0050139" target="_blank" rel="noopener noreferrer">orcas</a> and other animals with large brains are likely to react in similar ways to life in a severely stressful environment.</p>
Damaged Wiring<p>Captivity can damage the brain's complex circuitry, including the basal ganglia. This group of neurons communicates with the cerebral cortex along two networks: a direct pathway that enhances movement and behavior, and an indirect pathway that inhibits them.</p><p>The repetitive, <a href="http://dx.doi.org/10.1016/j.bbr.2014.05.057" target="_blank">stereotypic behaviors</a> that many animals adopt in captivity are caused by an imbalance of two neurotransmitters, dopamine and <a href="https://doi.org/10.1016/j.neubiorev.2010.02.004" target="_blank" rel="noopener noreferrer">serotonin</a>. This impairs the indirect pathway's ability to modulate movement, a condition documented in species from chickens, cows, sheep and horses to primates and big cats.</p>
The cerebral cortex, hippocampus and amygdala are physically altered by captivity, along with brain circuitry that involves the basal ganglia. Bob Jacobs, CC BY-ND<p>Evolution has constructed animal brains to be exquisitely responsive to their environment. Those reactions can affect neural function by <a href="https://www.penguinrandomhouse.com/books/311787/behave-by-robert-m-sapolsky/" target="_blank">turning different genes on or off</a>. Living in inappropriate or abusive circumstance alters biochemical processes: It disrupts the synthesis of proteins that build connections between brain cells and the neurotransmitters that facilitate communication among them.</p><p>There is strong evidence that <a href="https://doi.org/10.1523/JNEUROSCI.0577-11.2011" target="_blank">enrichment</a>, social contact and appropriate space in more natural habitats are <a href="https://doi.org/10.1111/j.1748-1090.2003.tb02071.x" target="_blank" rel="noopener noreferrer">necessary</a> for long-lived animals with large brains such as <a href="https://doi.org/10.1371/journal.pone.0152490" target="_blank" rel="noopener noreferrer">elephants</a> and <a href="https://doi.org/10.1080/13880292.2017.1309858" target="_blank" rel="noopener noreferrer">cetaceans</a>. Better conditions <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5543669/" target="_blank" rel="noopener noreferrer">reduce disturbing sterotypical behaviors</a>, improve connections in the brain, and <a href="https://doi.org/10.1038/cdd.2009.193" target="_blank" rel="noopener noreferrer">trigger neurochemical changes</a> that enhance learning and memory.</p>