When it comes to healthy eating and lifestyle guidelines, there’s a lot of conflicting advice out there. One generally accepted source is the Dietary Guidelines for Americans, published every five years by the U.S. Departments of Agriculture and Health and Human Services and compiled with input from leading nutrition and health experts.
Much of those recommendations relate to food and supplements, but alcohol is included. While some studies suggest that red wine may bestow certain health benefits (e.g., increases in the “good” HDL cholesterol, decreases in the omega-6/omega-3 ratio), innumerable ones have shown an association between alcohol consumption and increased risk for certain types of cancer.
As a result, the government guidelines recommend “moderate drinking,” which they define as one drink a day for most women and two drinks a day for most men. It doesn’t matter what kind of alcohol: 12 ounces of regular beer (about 6 percent alcohol by volume), 1.5 ounces of 80-proof spirits (like vodka or whiskey) and 5 ounces of wine (12 percent alcohol by volume) all equal one “drink.”
For people the world over, myself included, wine is one of life’s great pleasures. But over the years, many of us start to notice that our tolerance for wine changes. Perhaps it takes fewer sips to make us feel tipsy or drowsy. Or we wake up with a raging headache.
Our ability to metabolize alcohol diminishes with age. Changes in our body, like reduced muscle mass or menopause, reduce our energy level and cause fatigue, increasing the sedating effects of alcohol. But fatigue is just one chapter in a bigger story.
(MORE: Alcohol's Effect Changes as People Age)
The Role of Metabolism
According to Intoximeters Inc. (II), which has been supplying alcohol-measuring devices to the law-enforcement and medical professions for 67 years, a healthy liver eliminates the equivalent of a five-ounce glass of wine every hour. To accomplish this feat, a liver enzyme, alcohol dehydrogenase, breaks ethanol (wine alcohol) into acetaldehyde, which is further broken down into harmless acetic acid (vinegar). Women process this enzyme more slowly than men, which partly accounts for the gender difference in the USDA guidelines.
Furthermore, as we age, we all produce less of this enzyme. And with the stomach less actively involved in metabolism, a greater strain is placed on the liver.
A slower metabolism means that it takes longer for the liver to detoxify the alcohol, and that effectively guarantees diminished tolerance. Consequently, as we age, the overall volume of wine that we consume needs to be taken at a pace slower than the liver’s elimination of five ounces per hour.
As you may recall from biology class, about two-thirds of our bodies are water. When we drink, some of the alcohol is absorbed (and diluted) by water before it actually enters our bloodstream — a natural alcohol filtration system. But over time, we begin to lose the lean muscles necessary for water retention. Adding “insult” to “injury,” as we age, we build fatty tissue, which is averse to absorbing alcohol, and women harbor more than men — another reason for the guideline differential. As a result of these changes, our body’s ability to metabolize a portion of alcohol before it enters the bloodstream decreases.
We can’t change the way our liver eliminates alcohol, but we can take action to help things along. By drinking at least one glass of water for every glass of wine we consume, we increase available water to absorb some of the alcohol. We can also slow down the rate at which alcohol enters the bloodstream by being sure to eat foods like bread, crackers or cheese when drinking wine. Finally, hard as it may be, we can keep fatty tissue to a minimum — with regular low-intensity exercise.
Not Tonight: I Have a Headache.
The most common negative and almost immediate reaction some people have to wine is a headache. And while many are quick to point the finger at the natural and added sulfites in wine (which retard spoilage), there’s no scientific evidence to back up the so-called sulfite headache claim. If anything, the main deleterious effect of sulfites is on the respiratory system of asthmatics. The far more likely culprit is a declining immune system, which increases our chances of developing headache-inducing allergies.
Complex potential allergens called biogenic amines (histamine is one of them) are naturally occurring in grape skins. These amines can trigger what’s known as the red wine headache. This is more common with red wine because it, unlike white wine, is fermented with the grape skins intact. It’s also typically subjected to secondary fermentation to soften its acids, and is often aged in oak to add flavor and complexity. Both methods introduce amines. Yet wines of any color can be subjected to secondary fermentation or to oak aging, so some white wines can give you a headache, too.
If blood or skin tests determine that you have become sensitive to amines, you could try taking one of the five top over-the-counter antihistamines before drinking wine. (But since many medications, not just antihistamines, increase the sedation effects of alcohol, you should talk to your health care provider about whether drinking might have a bad reaction with any meds you're taking — including Tylenol.) If you do just have a mild allergic reaction, you might consider limiting your wine choices to any of the thousands of amine-free crisp, clean, acidic white wines on the market.
Then again, the cause of that headache could be overindulgence — and you might not even realize you’re overdoing it. For a variety of reasons — riper grapes (with more sugar) as a result of hotter temperatures; advanced winemaking techniques that bring out more flavors; influential wine critics’ personal preferences — table wine alcohol content has been steadily rising. It is not difficult to find wines with as much as 30 percent more alcohol by volume than the 12 percent standard on which the USDA based its five-ounce measure.
You may have to search for it — or take out the reading glasses — but the only way to determine a wine’s alcohol content is to read it on the label.
Liquid Portion Control
OK, you’ve started consuming more water, eating food with your wine, minimizing fatty tissue build-up and dealing with potential allergies. Yet you still prefer some of those higher-alcohol wines. What to do?
The answer is in your glass.
The typical consumer wine glass holds 12 ounces. For appearances and to enjoy wine’s aromas, we traditionally fill it about halfway; thus, an average pour of six ounces exceeds the recommended daily limit by one ounce per drink. Couple that with a potential 30 percent more alcohol per glass, and suddenly you’re way over the limit.
One solution: Fill an eight-ounce glass halfway — meaning four ounces, or one-third less wine to compensate for the increase in alcohol. Better yet, fill that smaller glass halfway with wine containing 12 percent alcohol. This way you’ll be under the guidelines by one ounce per glass, reducing the volume of alcohol that your liver needs to expel. As a bonus, by forgoing that ounce, you avoid some empty calories too. But that’s a topic for another story.