Can I avoid liver damage?
Everyone reacts to alcohol in different ways so it is difficult to tell in advance who is most likely to suffer liver damage. However, research shows that the following three groups may be more at risk than most:
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women, partly because of their smaller body size and build
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people who are overweight
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people who inherit genes that don’t allow proper metabolism of alcohol.
Studies suggest that immune response (how the body recognizes and defends itself against invading illness) may be a factor. This means that drinking alcohol triggers an aggressive physical reaction in some people that attacks their liver. This may explain why cirrhosis, unusually, can occur quite quickly in some drinkers.
There are, of course, not only physical risks attached to excessive drinking. You might encounter financial difficulties. You may experience relationship problems with your family and friends, in your job and in many other social circumstances.
How much can I drink?
If you are healthy and eat a balanced diet then sensible drinking should not give you problems. But what is sensible drinking?
Women are more susceptible to liver damage than men, even if they drink less. Women are generally smaller than men. A greater proportion of their body mass is fat tissue which means they have less body water. This results in higher blood alcohol levels (blood alcohol concentration, or ‘BAC’) for each unit of alcohol they consume.
The Department of Health currently offers the following guidelines for sensible drinking:
The British Liver Trust supports these guidelines. However, we advise you to avoid alcohol for a minimum of two days a week to give your liver a break.
When not to drink
These occasions are generally well-known, but here’s a reminder. Don't drink alcohol:
What is a unit of alcohol?
One unit of alcohol is ten millilitres (ml) or eight grams (g) of pure alcohol.
Units have been used for 25 years in the UK to describe amounts of alcohol. In the past, one unit could be identified as one drink. A unit was a measure of spirits, half a pint of beer, lager or cider (at 3.5% abv) or a small glass of wine at 9% abv.
However, the alcohol content (abv) of drinks and the standard measures of drinks served have increased over time. This means the old rules of thumb about how much it is healthy to drink or to remain under the drink-driving limit no longer apply. Spirits used to be served in 25ml quantities, now it is often 35ml; wine used to be served in 125ml quantities, today it is usually in 175ml or even 250ml glasses. The strength of lager used to be 3.5% abv – now it is commonly 5% abv.
If you’re partial to a particular beer or cider, be aware that abv might fluctuate between draught and canned or bottled versions. Non-draught can be significantly higher.
The abv, which stands for ‘alcohol by volume’, is shown on the bottle, box or can. It tells you how many units there are in a litre, i.e. a strong beer at 6% abv means there are 6 units in a litre. If you drink half a litre (500ml or just under a pint) of beer at this strength, then you have had 3 units. A bottle of wine (750ml) at 14% abv will contain 10.5 units of alcohol.
Calculating units
Calculating units is also complicated because we commonly use a mixture of imperial (pints) and metric (ml) units. There are a number of unit calculators available to help you overcome this from some of the organisations listed on pages 31 and 32. An accurate way of calculating how many units you are drinking is to multiply the abv figure by the size of your drink in millilitres and divide by 1,000.
For example, a typical can of beer these days is 440ml, at 5% abv strength. Therefore: 440 x 5 = 2,200; divide this by 1,000 = 2.2 units.
You can use this formula to work out other drinks:
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a standard glass of wine (175ml) at 12% abv is 2.1 units and a large 250ml glass is 3 units
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a measure (35ml) of spirit (40% abv) is 1.4 units
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a bottle (275ml) of ordinary strength alcopops (5% abv) is 1.4 units
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a ‘shot’ (35ml) of spirits, typically between 35% and 40% abv, is 1.3 units
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a pint (568ml) of low strength (3.5-4% abv) beer or lager is 2.3 units
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a pint of regular cider (alcohol 5% abv) is 3.4 units
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a standard measure of port or sherry (50ml) is 1 unit.
When you’ve worked out how many drinks you can have in one session, make this your target. Mixing non-alcoholic drinks in between is a good idea.
Binge drinking
Binge drinking used to be thought of as getting drunk and staying drunk over an extended period of time, possibly days. This view is changing and is now more associated with shorter, more intensive drinking sprees (usually in one evening) where people intentionally get themselves very drunk. Binge drinking is also now regarded as a public health problem.
But binge drinking often happens at home, at parties or other gatherings, particularly where there are frequent top-ups to glasses, a free bar or more supplies to hand from the cupboard or fridge.
Wherever you are, when you drink a certain amount of alcohol – eight units for men and six for women – in one session, that counts as binge drinking. This is because drinking double the amount in the recommended guidelines in one day is an agreed definition of a ‘binge’.
Many women are surprised to learn that consumption of two large glasses of wine over lunch or after work is classified as a binge. Remember, two large glasses of wine equals two thirds of a bottle. This shows just how easy it is to consume alcohol at a level which could be damaging to your health.
Although statistics show that binge drinking is mostly seen in young people aged 16 to 24, many people in their thirties and older are also drinking at these levels. It is estimated that 12.5 million people drink more than the sensible drinking guidelines.
Just over a quarter of men drink more than 21 units and 15 per cent of women manage more than 14 units a week.
Drinking heavily over a short period leads to a rapid rise in blood alcohol and consequently to drunkenness. The effect on behaviour varies from one person to another. It ranges from relaxation and exhilaration to violent behaviour and coma.
A rapidly rising blood alcohol level can make you reckless. You might say things or behave in a way that will embarrass you later. More ominously, it can lead to physical accidents, vehicle accidents (involving drivers, passengers or pedestrians), unsafe sex and leaving yourself vulnerable to rape or sexual assault.
Very high blood alcohol levels can cause your brain's control over the respiratory system to paralyse, leading to heart irregularities, strokes and other potentially fatal occurrences.
The scale of the problem is made clear by the number of people who end up in Accident and Emergency departments as a result of alcohol related problems. These account for almost three quarters of all admissions from midnight until 5am at weekends, at an estimated annual cost to the National Health Service of £1.7 billion.