How Alcohol Affects Your Health, Hormones, and Body Composition

By Dr. Brooke Kalanick
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For many of us, alcohol goes hand in hand with fun and relaxation. It is called "happy” hour, after all.

So it’s no wonder why many women want to know how much booze they can get away with drinking and still achieve their health, fitness, and body composition goals — whether that's muscle gain or fat loss. As a wine lover myself, I really, really want to tell you that this article will end with the kind of advice I’d like to hear: “Go ahead! Drink as much wine as you want and effortlessly reach your goals.”

Unfortunately, it’s just not that simple. And as fun and delicious as a glass of wine can be, it may not support your current goals. I’m sorry. Really, I am.

The Chemistry Of Cocktails

It’s likely that you’ve heard from a fitness expert or read in a magazine that alcohol turns instantly to fat. That’s not exactly true, but it’s become a go-to sound byte.

Here’s what really happens: Once alcohol (a.k.a. ethanol) passes your lips and gets absorbed into your system, your body converts it to acetaldehyde, then to acetate, and finally to acetyl-coA.

So your body doesn’t convert ethanol or its metabolites directly into fat. In fact, your body can use both acetate and acetyl-coA as fuel. However, as far as fuel sources go, they are both pretty inefficient. That means that it takes more calories to convert them into energy than it does to convert glucose, AKA sugar, into energy.

That might sound like a good thing. However, since your body doesn’t like inefficiencies, it doesn’t like to burn acetate or acetyl-coA for fuel. But because our bodies can’t store the metabolites, we still have to burn them off. ASAP. So, while your body’s cells work on burning through that acetate and acetyl-coA build up first, other fuel sources, like sugar and fat, just hang around.

In other words, when we drink alcohol, fat and sugar burning come to a temporary halt.

So while that glass of chardonnay won’t instantly be converted to fat, when you drink alcohol (i.e. when there is acetate and acetyl-coA around), your metabolism as a whole is in fat-storing mode.

At the same time, after you drink, your liver and muscles don’t do a great job of storing sugar as glycogen for later. This is evident when, after a few glasses of wine, you fall asleep and find yourself wide awake around 3am with low blood sugar. Fitful sleep or outright waking up during the night is typically the result of low blood sugar. While this can happen to anyone after drinking, it’s going to be worse if you already deal with low blood sugar issues, in particular waking unable to go back to sleep, waking anxious, waking hungry, etc.

And of course, blood sugar swings beget more blood sugar swings. That’ll be especially true for you if you already have insulin or cortisol issues. As these two hormones battle it out, you’ll feel the effects in terms of sleep issues, cravings, and irregular appetite.

In short, alcohol primes your body for storing fat and then makes a mess of your blood sugar and energy levels, which can easily increase both hunger and cravings.

Beyond Blood Sugar: Alcohol’s Other Effects on Cravings and Appetite

Beyond blood sugar fluctuations when you drink, changes in brain chemistry can also drive you to eat more.

The feel-good neurotransmitter dopamine immediately increases when you drink alcohol. Unfortunately, dopamine fires up the reward-seeking pathways in your brain, making you want more alcohol along with all the highly palatable foods (e.g. chips, guac, fries, pasta). Again, this effect is usually more pronounced in those of us who already run low on dopamine. Symptoms of low dopamine levels include a short fuse for stress (i.e. “snapping”), depression that comes and goes, disorganized attention, lack of focus, and low libido.

Alcohol also affects levels of the stress-related hormones adrenaline and cortisol. First, when we drink, the booze quickly ramps up our levels of the fight-or-flight hormone adrenaline, which causes our bodies to release sugar into our bloodstream. And, when we don’t use that influx of energy to say, outrun a lion, that glucose can more easily be stored as fat. Then, in time, the alcohol also raises our levels the stress hormone cortisol, which can further increase hunger and cravings.

When you hit up happy hour before a meal, it can have a direct effect on your appetite. In my experience, this seems to be worse with a cocktail or mixed drink compared to wine. My best advice here is to not drink too much before dinner or you’re likely to eat more than your body needs when mealtime comes around.

What’s more, if you’re drinking booze at night, it’s important to remember that alcohol lowers your body's levels of the sleepy-time hormone melatonin. This hormonal drop in conjunction with the low blood sugar levels we already talked about make troubled sleep almost inevitable. As we all know, lack of sleep will do nothing favorable for our health, hormones, or our next-day cravings and energy.

Alcohol and Your Health

By wreaking havoc on our hormones, alcohol does much more than spike our hunger. Blood sugar swings can create chronically high cortisol levels, increase inflammation, and surges in insulin can worsen estrogen dominance.

What’s more, when we drink, our growth hormone levels drop, and we may also see a rise in testosterone related to alcohol intake. In women, this rise in testosterone can worsen insulin resistance, hinder ovulation, make us break out, lead to facial hair growth, and increase our risk of both diabetes and cardiovascular disease. And as you may have guessed, if you lean toward any of those things already (hello, PCOS!) then these effects can be even more dramatic.

If you’re trying to build or keep your lean mass, alcohol isn’t doing you any favors.

Finally, when it comes to preserving lean mass and recovering from workouts, a couple of important events are affected by alcohol consumption: There is a decrease in glycogen synthesis (you’ll have less in the tank for your next workout after you drink), your muscles don’t rehydrate as well, and cytokine signals that trigger post-workout muscle repair are altered, and not for the better.

I think most of us can report that our workouts after a night of drinking are not as good—and research backs that up. No surprise there, right?

Drink the Right Way

So while there isn’t clear-cut research proclaiming that if you drink exactly three glasses of cabernet per night you will miss out on specifically losing two pounds or hinder muscle gain by 3%, here’s what you can do to make sure alcohol doesn’t interfere with your goals, whether you want to gain muscle and strength or lose body fat:

1. Don’t overdo it.

Research does show that most of the downsides we’ve talked about happen after we’ve had 0.5g/kg of alcohol. So the number of glass you down certainly does matter. For a 154 pound (70 kilo woman) woman, that's around 35 grams of alcohol. In the U.S., one standard serving of alcohol (5 oz of wine, 12 oz, of beer, or 1.5 oz of liquor) contains about 14 grams of alcohol. That means more than 2 drinks and you'll likely start experience the negative side effects. If you're going to drink alcohol try sticking to one serving and hydrating with plenty of water.

2. Reach for protein.

Since you’re likely to store fat and sugar rather than burn it after drinking, if you have a fat loss goal, eat protein and veggies instead of a meal or snack that’s high in carbs or fat alongside your drinks.

3.Remember, every woman is different.

Always take your individual chemistry into account. For example, even though it gets the research thumbs up, red wine contains histamine. If you’re already dealing with a heavy allergy burden or are under some stress (histamine raises cortisol and bogs down your liver), red wine is gonna be tougher on you.

4. Consider Vitamin B.

If you’re taking estrogen medications or have a hormone-secreting IUD like Mirena, have a low B vitamin intake, or have a methylation defect like many women with the MTHFR gene mutation, you will likely have greater issues with alcohol. If any of these apply to you be sure you take at least a B complex containing only the natural form of folic acid and consider 200mg of B6 daily.

5. Know your hormones.

If you have PCOS, are on the other side of menopause, or have estrogen dominance issues like fibroids, then you’ll likely have worse estrogenic effects and more difficulty losing weight when you drink. Similarly, if you’re hypothyroid, remember that thyroid hormones are crucial keeping your liver humming along and efficiently processing that acetate and acetyl-CoA.

6. Support Glutathione.

Glutathione is a very important antioxidant that exists in every cell in your body and can neutralize free radicals before they build up and cause damage. If you have autoimmunity like Hashimoto’s, in addition to an increased inflammatory burden, you are compromised in your levels and function of glutathione, which is an important part of alcohol metabolism. This is why many women with Hashimoto’s find their alcohol tolerance to be really unpredictable. One night they are fine with a couple drinks, and another night they have one glass of wine and wake up feeling like a wreck. Glutathione can be supported by taking a nutrient called NAC (n-acetyl-cysteine), but with Hashimoto’s, often other support for the entire glutathione process is necessary, not only for being able to tolerate alcohol, but for calming the immune over-activity as a whole. Compromised glutathione is also why many women with Hashimoto’s struggle with workout recovery. Couple this with the effects of alcohol on recovery, and it’s that much harder for you ladies.

7. Reduce inflammation.

Anything that decreases inflammation and oxidative stress will be helpful, like turmeric and resveratrol. The classic herb silymarin (also know as milk thistle) is known to specifically be protective to oxidative stress on liver cells.

8. Keep your goals in mind.

If happy hour with friends, or a glass of wine with dinner, or a margarita on Taco Tuesday is something that bring you immense joy and adds to your life and you're able to drink alcohol responsibly — by all means, there's no need to give it up. Just keep in mind it will likely be easier to gain muscle and strength or lose body fat, if you're drinking less alcohol overall. It's all about tradeoffs, and what's most important is that you're making choices that align with your goals and values.

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About the author:  Dr. Brooke Kalanick

Dr. Brooke Kalanick earned her Doctorate in Naturopathic Medicine from Bastyr University. Known as “The Hormone Whisperer,” Brooke's balanced approach to health, using both conventional and alternative therapies, allows her to successfully treat patients with Hashimoto’s Hypothyroidism and PCOS as well as other female hormone imbalances. Learn more about Dr. Brooke on her website and connect with her on Facebook and Twitter.

References

  1. Raben, et al. Meals with similar energy densities but rich in protein, fat, carbohydrate or alcohol have different effects on energy expenditure and substrate metabolism but not on appetite and energy intake. American Journal of Clinical Nutrition. January 2003;77(1):91-100.
  2. YeomansMR. Short term effects of alcohol on appetite in humans. Effects of context and restrained eating. Appetite. December 2010;55(3):565-573.
  3. Kokavec, A., Lindner, A., Ryan, J.E., & Crowe, S.F. (2009). Ingesting alcohol prior to food can alter the hypothalamic-pituitary-adrenal axis. Pharmacology, Biochemistry & Behavior, 93, 170-176.
  4. Heikkonen, et al. The combined effect of alcohol and physical exercise on serum testosterone, leutininzing hormone and cortisol in males. Alcoholism, Clinical and Experimental Research. June 1996;20(4):711-716.

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