Sunday 26 May 2019

How much are we really drinking?

With at least seven standard drinks in a bottle of wine, those units can add up. KATHY DONAGHY reports

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Stock image

In association with the Health Service Executive

As we settle in to the second month of a new year and resolve to be the best and healthiest version of ourselves that we can be, now is probably a good time to ask ourselves how much we drink and to look at our alcohol consumption in terms of our overall health and wellbeing.

Be honest with yourself. How much did you drink in the last week? A couple of glasses with dinner, meeting a friend for a few beers after work and a late night over the weekend can soon push us over the healthy limit.

A standard drink has about 10 grammes of pure alcohol in it and it's defined as a pub measure of spirits, a small glass of wine, a half a pint of beer or an alcopop. A bottle of wine at 12.5pc contains about seven standard drinks.

The Government's recommended weekly guide to stay within low-risk limits is up to 11 standard drinks a week for women and up to 17 for men. And yet the statistics show we are completely ignoring this advice.

According to Bobby Smyth, a child and adolescent psychologist who works with young people with drug and alcohol problems, we are in fact drinking much, much more than the weekly limits.

"If every drinker in the country consumed this upper limit every week of the year, our annual per capita consumption would be about seven litres," says Smyth.

"In reality, it is more than 50pc greater than this. Worryingly, it is back on the rise once again, having fallen during the recession. Young adults are the heaviest drinkers. A while back, I calculated that the average young adult drinker in Ireland consumes their own body weight in pure alcohol between the ages of 20 and 25. Given that it is a Class 1 carcinogen, we could be doing better."

Even though the health risks of drinking have been well documented - from causing disease to trips to A&E - we are still swigging our way through vast quantities of booze every year. Experts agree that the best way to bring down our consumption is by understanding firstly that there is no safe level of drinking and being aware of the weekly limits.

On its website, the HSE has produced a very useful tool to help people figure out exactly how much alcohol they are drinking every week. The drinks calculator produces a list of drinks and asks you how much of each you drink. Then it asks how much you spend each week on alcohol.

Once you've entered the information, the calculator tells you if you are over the weekly limit or not, with lots of information about the impact on your health. It also calculates your spending on alcohol.

If you typically spend ¤40 on alcohol in a week, the calculator does the maths that you are spending ¤173 a month and ¤2,076 a year on booze - an amount that it calculates would typically run your car for a year in diesel, insurance and road tax.

It's sobering to put yourself through the test answering as honestly as you can about exactly what you drink. The point is that it all adds up and you might be shocked when you see your own results.

Marion Rackard, an addiction counsellor and psychotherapist, who is the project manager for the HSE's Alcohol Programme, says the most important thing is the impact of alcohol on our health.

"If your drinking is interfering with any aspect of your life, it's a problem. You need to ask yourself some questions: for example, on Sunday mornings, are you dragging yourself around with a hangover? Do you find that you're hungover every weekend and this is interfering with your enjoyment of the following day? If you're a parent and you're finding that your time with your children is reduced due to hangovers or bad moods, it means your children are missing out on your time together," says Rackard.

"If you're drinking and experience a blackout - this is not remembering things about the night before - this is a serious warning sign that your drinking is a problem. In our culture, people often boast about how they can't remember how they got home. As well as using the online calculator, ask those around you to be honest with you about your drinking and the pattern of your drinking."

Rackard points out that drinking heavily in your 20s is laying down fertile ground for disease in later life and the links between cancer and alcohol are now well documented, with one in eight breast cancers linked to alcohol. "When you're talking about alcohol and cancer, there's no such thing as no risk," she says.

In terms of being aware of exactly how much we are drinking - particularly as much of people's alcohol consumption is done at home - Rackard says it's really important to use a spirit measure for spirits and remember a small glass of wine, the equivalent of 100ml, is a standard drink.

"You should sip rather than gulp. On average, it takes the liver an hour to break down one standard drink. Try to pace and space your drinking. When you're doing your shop, avoid getting into the habit of buying alcohol on a weekly basis. If buying alcohol becomes like buying the milk, the message to children is: 'This is part of my life.' It should not be an everyday thing but a time-to-time thing and we treat it with respect," she says.

Kerry-based GP Dr Eamonn Shanahan says that while it's a cliché, moderation really is key. "People take a couple of drinks and feel merry. What's happening is that the alcohol is affecting the cerebral cortex of the brain, where we hold our inhibitions, and you can become disinhibited. You need to make sure you don't make mistakes or allow emotions to overflow that can cause problems," says Dr Shanahan.

"Alcohol is also a diuretic, so you get dehydrated. Pace yourself and have some juice or water to avoid dehydration. You get dehydrated when salts become more concentrated in the body.

"Your body can't break down the alcohol fast enough when you drink too much and it makes you feel ill as your body deals with it. The by-product in the body is toxic, leaving you feeling unwell," he says.

"There's this notion that you're not enjoying yourself unless you've had eight pints. If you had a few drinks spread over the course of a night, you'd be safer and healthier."

Dietitian Sarah Keogh says while you should be getting seven drinks out of a bottle of wine, large glasses can push you into several drinks while you convince yourself you've only had a glass. "We pour a hefty glass at home, and wine is where a lot of damage is done because people don't realise how much alcohol it is," says Keogh.

"If you buy a glass in a pub, it's about 175ml - people typically pour 200ml to 250ml at home. If you have a bottle of wine, that's the same as seven G&Ts."

She says as well as the increased calories - one or two drinks is the equivalent of a couple of chocolate bars - alcohol is an appetite stimulant, so you tend to eat more.

"If you have a social occasion, the first drink you have should be a glass of water. If your first drink is alcohol, you will drink quickly, but if you drink water first, you'll slow down a bit.

"Every second drink should be water. It takes a while for alcohol to hit the system - the first one won't even have arrived if you jump into the second. The water also stops the headache the next day," says Keogh.

She adds: "Try and finish a glass of wine before you top up, as that allows you to know where you are. I think people are better now at not pushing drink on others. That same pressure is not there like it was 20 years ago."

Life coach Pauline Harley says in trying to be sensible at a social occasion, you should remind yourself how you want to feel after the event.

"My motto now is simple: life is too short," says Harley. "Before and during any social occasion, I check in with myself on how I want to show up, interact and experience.

"I want to feel calm, confident and in control. I love to experience people and create memories. So I become people-focused rather than focused on excessive food and alcohol consumption."

Five facts about alcohol and you

1. Alcohol-related illnesses can be hard to spot

Drinking behaviours and problems increase over time. It is a factor in cancer, high blood pressure, strokes, insomnia, diabetes, anaemia, self-harm, depression, dementia, infectious diseases and nerve damage.

Health tip: Stay within low-risk drinking guidelines, which state that women aged 18-65 should drink no more than 11 standard drinks per week and men should drink no more than 17, with no more than six drinks at a time and at least two alcohol-free days per week.

2: Most heavy drinkers have a fatty liver, which can lead to liver disease - a silent killer

The first two stages of alcohol-related liver disease, fatty liver and alcoholic hepatitis, don't normally cause symptoms. By the time you reach stage three - cirrhosis - there's no cure. It may lead to fatal liver failure.

Health tip: Ask your GP about getting a liver function blood test. Your doctor may also advise a scan.

3: Alcohol is a depressant drug

Alcohol can give us a buzz and 'loosen us up' but its depressant effects on the brain go beyond the morning after; alcohol increases the risk of depression and anxiety, and can make symptoms much more severe.

Health tip: If you're feeling low, alcohol could be the problem. With support, you might like to consider reducing your alcohol intake or cutting it out. If this doesn't help, talk to your GP.

Fact 4: Regular heavy drinking can interfere with your relationships

Spending more time drinking, becoming irritable if you can't drink and thinking more about drinking are all signs that your relationship with alcohol is deepening. People who care about you may end up feeling distanced and rejected. You don't have to be dependent on alcohol for your drinking to affect your children.

Health tip: Taking care of your drinking pattern will avoid your loved ones being affected.

Fact 5: Your health is your wealth

Three people die each day in Ireland from alcohol-related harms. Many people do not recognise the signs.

Health tip: Regularly monitoring your pattern of drinking can reduce harm. Ask yourself: could alcohol be causing my problems or making them worse?

Visit to assess your drinking and calculate its impact on your health, weight and wallet. If you're worried, get checked by your GP or contact the HSE Alcohol Helpline on 1800 459 459.

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