Rethinking Your Drinking - healty drinking is not just about alcohol
Dry January aside, mindful intake of liquids can prove beneficial
As the dry January brigade prepares to leap - or tentatively disembark - from the alcohol-free wagon, the opportunity presents itself not only think about our booze consumption but to also consider our liquid intake in general. Unlike food, we are less likely to keep track of what we're drinking, the annual month of abstinence being a notable exception. Fluids tend to be unthinkingly consumed, which is not an issue if your beverage of choice is water but may be a cause for concern for anyone regularly downing several soft sugary drinks or a 500kcal-plus blended coffee concoction per day. Yet it pays to be mindful of what we're drinking. "We can survive for several weeks without food but we can only survive for several days without water," says dietitian Orla Walsh. "Fluids are important nutrients to the body but are quite often not seen as nutrients."
Across the board, water is the health professional's drink of choice. We know this yet several studies have suggested that Irish adults are under hydrated. According to dietitian Orla Walsh, the simple calculation is 35ml of water per kilogram and 30ml per kilogram if you're overweight, which equates to approximately two litres of water a day for women and 2.5 litres for men. "The easiest way of checking hydration is your urine," says Walsh. "There are three things to look at: the colour and the lighter the better; the frequency with which you're going to loo which should be every few hours and its duration, which should take longer than a few seconds."
For those who have difficulty keeping track of how much water they're drinking, fitness expert Karl Henry suggests making it visible by using 1.5ml bottles instead of trying to count glasses.
His preference is for still water.
"If you find it bland, flavour it with cucumber and mint which is remarkably delicious for something so simple," he says.
"Regular, fluoridated tap water is the best of the lot from a dental perspective because fluoride helps you fight cavities and washes away any cavity-causing food or bacteria," says Dr Paul O'Dwyer.
Even fans of sugary minerals are unlikely to be surprised that there is little to recommend them nutritionally.
"There are 10 teaspoons of sugar per 330ml can and that's a lot of sugar," says Karl Henry. "Every now and again, it isn't a problem but daily it definitely is. It's an instant hit of sugar that causes a blood sugar drop, making you inclined to go for more sugar, like chocolate. In terms of skin, internal health and the obesity problem, it's not good in large quantities."
Orla Walsh agrees. "There is no such thing as a bad food, there are only bad diets," she says. "But generally speaking, soft sugary drinks are not good for us; they're not required and there are alternatives. The only people who have additional benefits from soft drinks might be type 1 and type 2 diabetics who have hypoglycaemia." In terms of sugar-free soft drinks, she advises that a systematic review has suggested that consumption of these could lead to health ill effects in time.
Dr Paul O'Dwyer warns that diet fizzy drinks and 100pc citric fruit juices can be surprisingly bad for teeth. "Most people are aware that drinking sugary drinks can cause tooth decay but another cause is dental erosion or the wearing away of teeth and this can be caused by exposure to acid, which naturally occurs in these drinks," he says. Beverage trends in recent years have seen an influx of options like coconut water and aloe vera water on shelves but the advice, as ever, is to check the label in relation to how much sugar they contain. "Aloe vera juice can have a laxative effect and can be high in sugar so it wouldn't be my top choice," says Orla Walsh, whose roll call of beneficial liquids is water, milk, tea and coffee. However, she believes that the introduction of a tax on drinks with more than 5g of sugar this April will bring positive effects, such as industry reformulation of drinks.
"I do think it [the sugar tax] will bring a lot more variety to shelves. However, I think that people need to be aware that water and a glass of milk are extremely healthy choices, and they don't have to go out and buy these extremely pricey versions," she says.
In relation to sports drinks, Karl Henry says that there's an unnecessary over-subscription to them at present. "It's fine if you're on the Dublin team playing Croke Park in the final where lasting that 1pc longer is going to have an impact," he says. "If you're going out for your run or your five-a-side football and you're having a sports drink, you're negating the impact of that sport on your health because you're filling yourself with sugar beforehand."
Once the drink of choice at the Irish dinner table, milk is now just as likely to be supplanted with a glass of wine. But milk consumption is important for bones and teeth at all ages, and not just for children.
"Milk is rich in calcium, phosphorus and magnesium and many milks are also fortified with Vitamin D and it's more easily absorbed if we drink it," says Dr Paul O'Dwyer. "If you're watching your calories, skimmed milk will give you the same levels of calcium as whole milk."
According to dietitian Orla Walsh, milk is a source of iodine, a mineral important for metabolic health and thyroid function. She advises that the calcium obtained through milk has a bigger impact on bone mineral density than that given in a supplement and also urges that you consider alternatives to animal milks carefully from a nutritional view point. "Almond milk wouldn't be a protein source and neither would coconut milk so if someone wanted a choice of something other than ordinary cow's milk, I would encourage them to choose soy milk because it contains protein," she says.
Advice on how to drink alcohol sensibly is widely available - have two to three alcohol-free days per week; stay under the recommended units; choose good quality drinks over quantity; alternate glasses of water with alcohol and eschew beers and ciders for spirits and dry wines for weight loss.
But if you're excited about the retox after the detox, there are other issues to consider before starting to imbibe again.
"The incidence of cancers of the mouth and throat are increasing and alcohol is a contributory factor in relation to this," says Dr Paul O'Dwyer, group clinical advisor at Dental Care Ireland.
"You're six times more likely to develop oral cancer among drinkers rather than non-drinkers. Alcohol works synergistically with smoking so if you're smoker and a drinker, this increases your risk.
"Oral cancer tends to present quite late and survival rates aren't quite [so] good so prevention and early intervention is the key. From a tooth point of viewing, red wine causes staining. Also if we overindulge in alcohol that tends to affect our saliva rate and a lower saliva rate means less buffering capacity for saliva against the teeth, meaning a propensity for more cavities."
Despite our readiness to embrace any studies that suggest some health benefits associated with drinking alcohol, dietitian Orla Walsh draws attention to the fact that in Britain, guidelines for alcohol consumption for men have been revised down from 21 units to 14 units, with women's recommended amount remaining at 14 units. In Ireland those figures are 17 units for men and 11 for women.
"Alcohol is good for very few people," Walsh says. "Only a small percentage of the population, which is women over the age of 50, have some benefits in consuming a small amount of alcohol.
"Red wine has come out as one of the most favourable choices because of its polyphenols (which may reduce the risk of heart disease and cancers) but there other healthier ways to get them - a bag of popcorn is high in polyphenols."
Then there's the unavoidable link between drinking alcohol and weight gain. "Most drinks have 100-200 kcal per drink, which is significant," she says.
"Irish people could easily consume over 1,000 calories in a night and if you only need 2,000 kcal in a day, you can see how quickly it might result in weight gain. And then there's the knock-on effect and the calories you might eat on the way home, and the calories you'll consume over the next day."
The good news is that while caffeine drinks are often demonised, they do have health benefits, according to Orla Walsh. “Coffee and tea are good for you being high in antioxidants, and recent research has shown that coffee might help some people live longer. Although they have been shunned in the past, they are a healthy choice and they are a hydrating choice. Often people talk about teas and coffees dehydrating their bodies but the diuretic effect is small.”
Those health benefits might be mitigated, however, if you’re drinking too much caffeine or if you’re adding large amounts of sugar to your hot drinks. “If you enjoy your coffee or tea with sugar, that then becomes an issue,” says Dr Paul O’Dwyer, who points out that caffeine can also cause tooth staining.
“Our teeth undergo an acid attack every time we take something in. Most dentists will tell you that the best thing to do is have all your food and drink at meal times and not have anything between meals except for water.” According to Karl Henry, caffeine before a workout can help improve performance. “Teas and coffees generally help you train harder because they’re stimulants — and green tea is good to drink on the go,” he says. “There is definitely a subliminal element to it as well and you think that because you’ve had your caffeine, you can work harder.”
All juiced up
We are in the midst a juicing revolution, but it can be a somewhat divisive area. Orla Walsh says that many fruit and even vegetable juices on shelves can be high in sugar and her advice is: “When it comes to fruit and veg, where possible, eat it, don’t drink it.”
Chef and author Domini Kemp (right) is the co-founder of Alchemy Juices, whose juices are made predominantly with vegetables and some fruit and are cold pressed to ensure the optimum value of nutrients. “Mass-produced juices and smoothies are not the same as cold-pressed ones made by independent stores and many juices found in convenience stores have been subject to some type of pasteurisation. They taste great because they are sweet but some reports suggest they contain the same amount of sugar as certain soft drinks,” she says. “Yes, they do have some goodness. But sugar — even in the form of healthy fruit — when served as a juice or smoothie can make the fructose too readily available.” Alchemy’s products include low-carb options the Mean Greens, which is 95pc made from green vegetables with small amounts of apple, lemon, ginger and mint and the Golden Shot, a blend of fresh lemon, turmeric and ginger juice mixed with flaxseed oil and black pepper. She maintains that juicing is a good way to get nutrients into someone who may have issues with fibre and find it hard to digest or who someone who has a poor appetite. “Juices get a bad rap from some dietitians as people go on juice “detoxes”, or “juice cleanses” and this can sometimes have the same effect as any crash diet,” she says of the role of juices in the diet. “I like to drink juices slowly and thoughtfully rather than gulp them down as thirst quenchers. But I think they are a wonderful and convenient way of getting green goodness into you, especially when on the run or feeling poorly.”