Drink up! It’s good for you!

Champagne

We usually think only of food. Should we reduce our intake of saturated fat? Are whole grain carbs better for us? Is too much sugar a bad thing? Will eating half a plate of vegetables at each meal reduce our risk of heart attacks and cancer? (The answer is yes, yes, yes, and yes).

We’re usually stressed about what we eat. And what we eat often adds to our stress. But our drinking habits may not be helping us. Here’s a closer look at the health benefits (or lack of benefits) of what we drink:

Alcohol
Previous studies found that moderate drinking reduced the risk of heart attacks and strokes. This has lead us to think that having a drink a day helps. A 2015 prospective study which followed 15,000 middle-aged adults for 24 to 25 years found that heart failure rate was lower among moderate drinkers, those who drank up to 7 drinks a week, than heavier drinkers. But the same study also found that heart failure rate was highest for former drinkers.

There’s a reason why they stopped drinking. Not everyone can have just that one drink. Which is why mental health professionals argue that “there is no such thing as a safe level of alcohol consumption” (Guardian, March 2011). Drinking impacts our sleep, immune system, our ability to think, remember, and make decisions, and most importantly, our mental health.

Moreover, research indicates that it’s exercise not wine consumption which improves cardiovascular health. Both red and white wine lower undesirable cholesterol levels (LDL), but only exercise increases desirable cholesterol (HDL).

In fact, health experts advocate cutting down on alcohol. Why? Because it doesn’t actually protect against heart attacks or stroke. A 2015 prospective study of 53,000 people found little or no health benefit to drinking alcohol. And two other recent studies confirm the benefits of drinking less: Researchers who studied those who get easily flushed from drinking and who therefore drink less over time, have better cardiovascular health.

Need help? Read this.

Soft drinks
It’s getting more and more difficult to recommend diet soft drinks. A 2012 prospective study which followed over 2,000 adults over a decade found that drinking diet soft drinks every day increased the risk of stroke and heart attacks.

recent study found that those who drank diet soft drinks ate more than those who drank the regular version if they were overweight or obese. Another recent study showed that diet soft drinks increased the risk for diabetes.

Diet drinks don’t help us save on calories. Sugar substitutes tell your body to expect energy-rich food but when none comes, your body goes into energy preservation mode: It stores fat.

What about having the real thing, but in smaller amounts? Some nutrition experts suggest a mini can of Coca-cola to be a good snack (more about that here). But beware the 90 calories in that teeny weeny can of sugar.

Here are the figures (http://cspinet.org). Know the facts (http://hsph.harvard.edu) and make up your own mind.

Coffee
Coffee drinking has a number of known health benefits, but can we have too much of a good thing?

2014 prospective study which followed health professionals found that increasing coffee intake by 1 cup a day over a period of 4 years reduced the risk of diabetes, while other studies show that coffee consumption helps our cardiovascular health. Moderate coffee intake — 2 to 4 cups a day — reduced the risk of heart disease by 20%, while drinking at least 1 cup of coffee (or 3 cups of green tea) a day reduced the risk of stroke by 20%.

Coffee increases our stress hormones and raises our blood pressure, but the current consensus is that drinking up to 6 cups of coffee a day doesn’t spell bad news for our heart (read this article). Research finds that coffee increases the risk of fatal heart attacks, but this is because more smokers drink a lot of coffee. A 2014 prospective study which followed 131,401 Paris residents for 3.5 years found more smokers among heavy coffee drinkers (e.g., 4 cups a day) than moderate and non-drinkers. When the researchers took into account the effect of smoking, they found that coffee was not a risk for heart attacks.

So, have your cup of java. But don’t be fooled into thinking that it’ll give you immunity.

Black tea
Surprisingly, black tea may be better than green tea for slowing the glucose absorption, thereby being of benefit to people with diabetes.

But the cool thing is that our stress response recovery improves with black tea consumption. In a 2006 study where the smell and taste of tea were masked, elevated stress hormones induced by a stressful event returned to baseline levels more quickly in those who drank tea four times a day for 6 weeks than those given a placebo. That sounds like a lot of tea, but it’s not an unusual amount for those who live in the land of scones and clotted cream, fish and chips, and overcast skies.

Cuppa for me, please.

Green tea
A 2014 study found that green tea improved cognitive functioning through improved neural connectivity, while a 2013 study found that green tea enhanced frontal brain activity.

A recent study indicates that an active ingredient in green tea may be responsible for suppressing the growth of pancreatic cancer cells. In addition to the potential use of green tea for lowering the risk of pancreatic cancer, flavanols known as catechins consumed from a daily dose of green (or black) tea have been shown to reliably lower cholesterol levels and blood pressure.

Unlike black tea which is usually brewed at temperatures near boiling point, green tea is best brewed at about 80° Celcius. And it’s not just about taste. A 2011 study that finds the best way to extract catechins is to brew green tea at 80° Celcius for half an hour. So it pays to wait for your water to cool (or you can pour it into cups and back again, especially if you’re the kind that stands around and impatiently paces or taps the kitchen floor).

So now you can’t say that you don’t know how to get a nice cup of longjing (龙井).

Herbal tea
You might already know about the sleep inducing benefits of drinking chamomile tea. But you might not realise that the same properties which induce sleep also relieve muscle spasms, suggesting that chamomile tea can be helpful for getting us to relax.

Two other teas also have calming properties. Peppermint tea and ginger tea are known to help with digestion. Peppermint tea soothes inflammatory pain in the gut, providing relief from irritable bowel syndrome which can be related to stress, while daily intake of ginger reduces muscle pain.

Fresh juices
Along with red wine and tea, citrus juices which are high in flavanones have been found to reduce the risk of ovarian cancer. But watch out for that delicious thing known as fructose – it’s easy to consume more than the recommended serving size when you’re drinking juice out of a bottle.

So, the moral of the story is you can have more coffee and tea. But beware of the sugar-laden condensed milk that you’re adding to your kopi-kosong or teh-siu-dai!

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Having too much fun — why we shouldn’t drink to that

Problem drinking

“Alcohol dependence” and “teenagers” aren’t words we would normally put in a single sentence.

But drinking more than double the lower risk guidelines for alcohol consumption is gaining notoriety in some parts of the island. Having 5 drinks for men and 4 drinks for women in a single session at least once in the previous two weeks – known as binge drinking – is increasingly common: A 2012 study reported that 10% of young adults aged 18 to 34 binge drink, and that 5 in 100 have alcohol-use problems

Statistics from a 2004 WHO report put alcohol dependence among local residents at .06% (based on a 2000-2001 study). According to 2004 statistics, 3% of the population had problems with alcohol abuse and only 5% of them sought help. Figures from 2012 indicated that over 3% of the population had alcohol-use problems (in contrast, 5% of young adults did).

And the problem’s not exactly going away. A local article in Nov 2013 indicated an increase in the demand from clients wanting to address their alcohol-use problems. Another thing that’s on the climb is anecdotal evidence about excessive drinking.

Excessive alcohol is bad for our physical and mental health. Not surprising, really. Too much alcohol over the long-term does not just do invisible things to us, such as cause scarring of the liver and inflammation of the pancreas. But overconsumption of alcohol also impacts us in ways we can appreciate: It impairs our memory capacity and cognitive function.

We would faintly recall that when we had too much alcohol, we would have had difficulty making good decisions and coordinating our eyes, brain, and limbs in a cogent manner. But we might not recall a blackout or memory loss (well the fact is, we couldn’t remember). Too much alcohol is also responsible for permanent brain damage (though fret not — brain cells can be recovered through aerobic exercise).

More lethal effects of alcohol abuse and dependence are the risks of head and neck cancers, liver cancer, and colorectal cancers, which arise from heavy drinking.

But here are some other facts you may not be aware of:

1. The proportion of young men (aged 18 to 29 years) who were binge drinkers in 2012 was 18.7%. It’s not a dissimilar proportion from that reported in 2004, which was 18.9%.

2. The proportion of young women (aged 18 to 29 years) who were binge drinkers in 2012 was 12.2%, which is higher than the proportion reported in 20014, which was 9.4%.

3. Studies show that university students who binge drink are much more likely to miss classes and fall behind in their work and grades

4. But not everyone has a drink problem. The first step is to find out if problem drinking is an issue: Try this quiz or this self-assessment.

5. There are other ways to get high and to de-stress: There’s no shortage of suggestions in this, this, and this post. One can also try exercise which doesn’t feel like “exercise”.

6. Parents can have a major impact on their children’s drinking if they talk to their children about it in the preteen and early teen years or before they go to university.

7. Everyone should know the risks of drinking and driving. The standard unit of .6 ounces of alcohol (a glass of wine, a shot of vodka, or a can of beer) is within the legal limit, but the lesson about not mixing drink and driving is one that should be learnt early (here’s a fact sheet).

8. Cognitive behavioural therapy (CBT) has been shown to be an effective intervention for changing drinking habits (CBT is explained here). Motivational Interviewing (MI) has also been found to be effective as a brief intervention for reducing drinking behaviours (more about MI here).

9. A mega meta-analysis in 2002 made it clear that interventions which combined CBT and MI with craving-reducing medications (more about them here), are more effective than abstinence programmes, even with adolescents.

Getting your facts straight

Recent media attention on substance abuse, problem gambling, and other addictions has put the thorny issue on the spotlight yet again. Although acupuncture is a new addition to the current multidisciplinary treatment approach comprising medication and counselling (“IMH takes a stab at helping addicts”, Straits Times, 6 Sept 2013), there are a number of existing resources available to address the problem of addictions:

1. Local resources

  • National hotline for all addictions: 6-RECOVER (Mon to Fri, 8.30am to 10pm)
  • National hotline for Problem Gambling: 1800-6-668-668 (24h hotline)
  • Resources and services | National Addictions Management Service (NAMS)

2. Problems with substance use

Drug addiction is a complex disease (NIH). It’s important to have the facts:

3.  Problems with alcohol use

When does drinking become a problem? Find out from this NAMS fact sheet.

4. Problem gambling

Activation of brain reward areas of people with problem gambling is similar to those of people with alcohol use disorders. It’s important to know the signs: