Ok – this is a scary moment for me…
I’m starting to write a book on my approach to lifestyle medicine….

…but I’m very dyslexic so writing does not come easily to me….

Regardless, an important part of using lifestyle tweaks for optimal health is to avoid toxic substances – one of those is alcohol.  Below are some of my observations on how I see alcohol being used and some surprising affects.  At the end, I’d love it if you be able to give me some feedback on this style of writing and whether or not you’d like to read more articles like this.

On a recent trip to England I was shocked about how much drinking I was asked to do.  Don’t get me wrong, I like a beer or two but there are limits.

I kept hearing phrases like this:
“Mate, glad you’re back, go time for a cheeky pint?”
Or“I’m super busy this week but I can squeeze in a few beers on Wednesday night.”
Or
“How about we meet in …..there’s a great little boozer round the corner I want to show you…”

And so it goes on….

By contrast when I went back to Canada I had these types of invitations.
“Welcome back buddy, do you play frisbee golf?”
Or
“I’ll come and pick you up, we can run the 10km loop down by the park together”
Or
“I’m skiing with the family this weekend, do you want to come?”

>Obviously it’s a cultural thing.  Traditionally the pubs in England have been a  cornerstone of society.  Historically they were a place to go that was warmer and nicer than your house, some of them are even cultural icons.   By contrast, the pubs I saw in  Canada are commonly located in stripmalls, some exude a sleezyness and as I was told by one Canadian friend in Calgary.

“You don’t go to the pubs around here unless you’re a deadbeat.”

I don’t know how it is for women but for men in the UK the pub culture leaves them in a quandary.  What do they do to catch up with old friends, or even meet new ones that doesn’t involve a pub.
Most of the time, things like fishing, playing golf or many of the other activities commonly associated with the male sphere are just done to delay the inevitable trip to the pub.  Or worse still football, cricket and rugby have drinking pretty much built into the culture whether you are playing or just watching. 

Not so in Canada, or Nicaragua where I am currently living.  It’s very acceptable to suggest a hike (in Canada) or surfing in Nicaragua, no bars in sight!

Back to the UK – Pub culture isn’t the only problem, there is also the dinner party culture where one bottle of wine per person isn’t that extraordinary.  In fact I think I’ve saw more people sloshed in their houses than I did in the pubs.  A while ago I was cleaning out some of old boxes in my mother’s house and I found a while glass from the 70’s or 80’s.  It was tiny.  So tiny I would  have been embarrassed to put it on the table next to the pint size ultra thin glasses that seem to be the fashion today.  Has our tolerance for alcohol changed that much in 40 years…I think not.

Where is all this going?
Well, medicine has been subtly changing over the years and there has been a small but perceptible shift away from disease control to disease prevention. In the UK it started by trying to get people to quit smoking.  Canada was way ahead of the game here and back in 2010 it was voted the best country to live in if you wanted to quit smoking.

I remember going to my GP for something or rather about 20 years ago and was surprised when he asked me if I had ever smoked.  I had, of course I’d tried it, so he then asked me if I still smoked, I said I didn’t.  I noticed him smile and I asked what that was all about. 
“Oh”, he said, “I can mark you down as having stopped smoking and my GP practice gets rewarded for the more people I manage to help stop smoking.”
I think he may have missed the point of the public health campaign but at least at least it was an attempt by medicine to change a person’s lifestyle to stop them becoming sick.

Lifestyle Medicine
This is now one of the tenants of lifestyle medicine, avoid, where possible, toxic substances, alcohol being one of them.  We’ve all heard of the direct implications of drinking too much over a lifetime but with 70% of deaths caused by non-communicable diseases AKA lifestyle diseases, I’m suggesting we start to question some of these social norms and look out for ourselves.

You see, the occasional beer isn’t really a problem.  However, it has effects that ripple out and we are mostly unaware of them.  For example, I once met a exercise scientist who was working  the Navy Seals.  He was analyzing their blood to see if they could be pushed harder in training or needed more rest.  He told me that everything was normal apart from Mondays. You see on Mondays the Seals had almost no testosterone and high levels of estrogen in their blood.  Basically they were the most masculine, demasculinized men around. 

Why was going on?
Well, every Friday night this particular group would go drinking and let off some steam…but the effect that alcohol has on testosterone suppression lasts for about 96 hours.  Which meant any physical  training that the Seals did on  Saturday, Sunday and Monday was a waste of time and their incidents of injury would go up.

Navy seals aside we all know that after a few drinks  we tend to get hungry.  This is because the sugars in alcohol disrupt your blood sugar levels, which then means you get the inevitable cravings for starchy fatty good. People make poor nutritional decision when they are under the influence.
Having a drink can also affect your sleep. One way it does this is by making you pee.  That’s because  alcohol is a diuretic which means you pee out more than you put in…not a recipe for a peaceful nights sleep.  Matthew Walker, in his book ‘Why We Sleep’,  goes into this topic in great detail but essentially interrupted sleep can cause a myriad of health problems that we would not traditionally associate with alcohol.

On a societal level excessive drinking has been linked to increased crime, abuse, homicide and criminal behaviour….but the pub going, dinner party hosting, middle classes of England feel that has nothing to do with them.

And they are probably right.

But on an individual level, the cultural expectation to have a drink can have long lasting, health damaging consequences that, to be honest, are completely avoidable.

I’m certainly not a teetotaler and doesn’t expect other people to be either, but I think holding up the mirror and being honest with yourself about exactly how much you drink is an important first step when addressing lifestyle changes for optimal health.

I’d like you to figure out how much you actually drink.
For reference the UK guidelines for maximum booze consumption per week are:  14 units per week spread out over 3 days or more (it’s strange that it’s the same for men a women)

To work out how many units are in your drink you simply take the alcohol content multiply it by the volume and divide by 1000.
So a pint of strong beer would be as follows:
6%vol x 568ml  ÷ 1000 = 3.4 units  – so over the course of 3 days you can have 4 pints .  4 pints in the same night would be too much….yup – it’s not much…so you can see how easy it is to damage your health.

Or with wine it would like this:
13.5%vol x 750ml ÷ 1000 = 10 units – or almost all your  units.

Sure you might not drink a bottle of wine in a night by yourself…but you can see how a glass or two before dinner, something with the food and then a G&T as a night cap quickly adds up!

Please let me know in the comment below if you would read more articles like this.

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