In the first weeks of lockdown, sales of alcohol rose by 22% in the UK. The nation was coming to terms with the alien concept of being locked indoors with little else to do, and for many people that meant turning to alcohol to while away the hours.
I am one of those people. I've gone from being the person who drinks at weekends (okay, all weekend) plus the odd weeknight (but only when I'm out), to being a regular on Majestic.co.uk, stocking up my wine rack with a fresh batch of bottles every month. Oh, and the crates of beer and bottles of gin that now appear to be commonplace on my shopping list.
Throughout the coronavirus pandemic, drinking habits have largely changed. We've transformed from a society known for binge drinking, to one where regular, sustained alcohol consumption is the norm. It gets to 6pm, I shut my laptop, and I pour myself a glass of wine. That's my new routine, and I quite like it. Research carried out by Alcohol Change UK suggests I'm not the only one, with around one in five drinkers (21%) surveyed saying they had been drinking more frequently since lockdown. If that pattern is reflected across the whole country, it would suggest booze intake is on the up for around 8.6 million adults in the UK.
But how bad for you really is this new level of sustained drinking? What's worse? Drinking several days' worth of alcohol in one go at the weekend but then giving your liver a few days off? Or drinking little but often and never giving your body a break? I decided to face up to it and ask a doctor.
The bottom line is: neither extreme is ideal. "The recommendations are to drink less than 14 units a week limit, spread out over different days, and to have 3 or more drink-free days during the week," explains Dr William Alazawi, a Consultant Hepatologist at the London Digestive Centre part of HCA Healthcare UK.
Binge drinking usually means drinking more than 6 units in a single session for women or 8 units for men. But, the doctor points out: "The liver processes alcohol at the same speed no matter how much you drink. So when people binge-drink, the alcohol and its toxic effects hang around for longer causing damage and inflammation."
He explains: "When we drink a small amount of alcohol, the liver processes it and breaks it down into harmless substances. But drinking too much alcohol can overwhelm these processes, leading to a build up of fat in the liver, causing damage and eventually preventing the liver from carrying out vital functions in the body."
But if you take an alternative approach, drinking less than the weekly limit but not leaving yourself any alcohol-free days, you're also harming your body. This is because if the liver is constantly exposed to the toxic effects of alcohol, it's under pressure to process it each day, as well as all the other things the organ has to do. "The calories in the alcoholic drinks (which also often contain sugars) can further damage the liver, as well as contribute to weight gain," Dr Alazawi adds.
How much alcohol is too much?
Too much alcohol, in the long run, lead to liver damage. "The liver has a reputation for being able to regenerate itself and this means that many of us assume it is a forgiving organ. However, if the liver is damaged repeatedly or over a long period of time, then it can reach the limits of this regeneration, leading to liver scarring," says the expert.
It's not possible to know what each person's risk of liver damage is, because the impact of alcohol is repaired differently in different people - depending on genes, our diet, our behaviour, and our environment. However, the official NHS guidance across the board is that we should keep our alcohol intake below 14 units per week, spreading our drinking over at least 3 days in the week, with several alcohol-free days.
"One unit is the same as half a pint of weak bitter, a small glass of low strength wine or a single measure of a spirit in a pub or bar," explains Dr Alazawi. "If you’re drinking a drink with a higher percentage of alcohol in it: a stronger lager, cider or a fuller bodied wine, then it will have more units."
Is drinking at home worse for you than drinking when you're out?
As the doctor has laid out, neither binge drinking when you're out nor sustained consumption of smaller quantities of alcohol at home are recommended, because both provide challenges to the body. "Whether you drink alcohol at home or in the pub, it gets broken down in the liver and can damage the liver in the same way," points out the doctor.
But drinking at home, as has become so commonplace over the last three months of lockdown, does have its specific risks. "Drinking at home might mean you drink more because you serve yourself more generous amounts, because you have lots of cans or bottles in the house or because you don’t have to get home at the end of the evening," notes Dr Alazawi. "It might also be easier to drink at home at times of the day when you wouldn’t normally drink if you were out of the house."
Then there's the impact drinking regularly at home can have on your diet; you become more tired because you sleep less well after alcohol, drink less water, and often don't feel like doing as much exercise. "This might lead to you putting on weight, which can lead to a build up of fat in the liver just like alcohol can, making the liver damage worse," says the doctor. One big, full, unhealthy circle.
What other ways can drinking harm the body?
We know too much alcohol is bad for your liver. If you get to the point of drinking so much that you develop liver scarring, you must ensure you reduce the amount you drink (or stop drinking altogether), as well as adopt a healthy diet and take regular exercise. But it's not just the liver that's vulnerable to the toxic effects of booze.
"Drinking in excess also affects a person's behaviour, emotions and judgement which can be harmful in different ways," says Dr Alazawi. "Some people can become depressed if they drink and more so if they drink alone. Especially in these times of lockdown, we need to be aware of our own mood and mental health as well as that of those around us," he advises.
If you’re feeling low, it can be helpful to talk about your mood with family, friends or even seek help. The NHS has a range of helplines and support groups that can offer expert advice.
Signs of liver damage (for which you should seek medical attention):
- Yellowing of the skin and eyes (jaundice)
- Abdominal swelling
- Itchy skin
- Dark urine
- Pale stool
- Abdominal pain
If you are worried about your liver or about your general physical or mental health, seek out medical advice. Dr William Alazawi is a Consultant Hepatologist at the London Digestive Centre part of HCA Healthcare UK.
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