Drink less, enjoy it more

Philip J. Goscienski, M.D.

September 2012

Eventually those hard-partying college kids on spring break are going to reach late middle age and will notice that the world gets fuzzier on fewer drinks. Sometime in late middle age — about 75 or 80 — it becomes really obvious and we wonder what's going on. Like most things biological there are several factors involved. There is also the gender factor: women are more sensitive to alcohol at any age.

From birth to old age the water content of the human body goes down by about 25 percent. That leaves less water in which alcohol can be diluted so the blood level rises. It's no wonder that by the time we reach retirement age we get the same buzz from two drinks that we got from three during those college years.

Body size matters. On that basis the obesity epidemic should be making most of us better able to handle our liquor but fat is the enemy. Alcohol does not penetrate body fat. Women naturally have more body fat than men and for a given weight, less body water. That, plus their usually smaller size, helps to elevate alcohol levels.

At the start of their drinking careers young persons develop a tolerance for alcohol. This tolerance diminishes with age. An enzyme in the stomach breaks down some alcohol and the remainder is metabolized in the liver. Enzyme levels decrease with age and some studies indicate that women have lower levels than men. The differences, though real, could be explained by the proportionately smaller body size of women.

The lessened ability to handle alcohol is an important issue for seniors, who often deny it. Even mild inebriation affects balance, which leads to falls and fractures. Head injuries are a major cause of death among the elderly. Osteoporosis and alcohol are a serious, sometimes deadly combination, especially among women.

Men should limit their intake to two drinks per day and women to only one. (A drink serving consists of 5 ounces of wine or 12 ounces of beer or 1 ½ ounces of hard liquor.) An alternative guideline is one drink per hour, preferably taken with food that will slow absorption.

It helps to have a "party strategy" that limits intake to one or two drinks. Subsequent beverages should include soft drinks. That strategy is party-poopish but it might save your life.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.