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Alcohol and Your Brain

A recent study, published in the British Medical Journal, brings into question existing recommendations in the US and UK, many of which are now being revised, for moderate alcohol consumption. Previously, we believed there was a bell curve-like relationship between consumption and brain heath, with high risk existing for those who abstain and those who drink heavily, and a slight reduction in risk for those who drink a modest amount.

But this new study, which measured the size of the hippocampus in drinkers, brings new evidence to light that contradicts this commonly held belief.

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  • Dario Ruiz

    Good morning Dr. Perlmutter,

    It is not clear to me if you still recommend moderate consumption of alcohol, ie a glass of red wine every day.

    My concern is about the figures presented in this study. They set unit consumption as 8 g of alcohol and say that even moderate alcohol consumers 14-21 units / week have three times more risk of hippocampal atrophy. A glass of red wine contains (assuming 7 to 8 glasses per bottle – 750 ml) 100 ml of wine, and with an average of 13.5% vol alcohol means 13.5 g of alcohol, ie 1.7 units. These calculations show a consumption of 11.8 units per week, which is very close to the lower limit of the moderate consumption range. As they state in the study that there was no protective effect of light drinking (1- <7 units / week) about abstinence and yet there are many other studies that conclude that moderate alcohol consumption is beneficial in preventing neurodegenerative diseases, I was wondering if the recommended dose of alcohol remains in a glass of red wine per day (11.8 units / week) or should be reduced to a glass every other day (approx 6 units / week).

    Sorry if there are too many figures in the comment.

    Thank you in advance and best regards.

    • eileenfb1948 .

      Thank you for those figures, I was lazy and didn’t check them out. You are correct.
      We make alcohol in our body anyway so a very small amount for a healthy person should be okay. I can’t cope with it at all.

  • Karen Holt

    Is there a link to the published study at all?
    Thank you,
    Karen

  • CRISTINA

    I am wondering if the age has any bearing on this since the average age in the study was 43 and most people with cognizant issues develop problems when they are over 60 years of age.

  • calle

    My take has always been that any amount is not good.
    And on thing not mentioned here is that any alcohol is bad for the gut. Loosens the tight gut junctures.

    Our gut drives our brain, and it also allows food particles to get into the blood stream thus causing inflammation and allergies.

    Food and chemical sensitivities etc.

    I do drink Kombucha, and Kefir for good gut bugs.

    The cost, empty calories are factors for me.

  • Gary Pollitt

    Are they really telling anyone anything they don’t know? Life is hard. You pay a price for drinking. But sometimes a drink is just what the dr ordered. Well, maybe not Dr P. . . . .

    • Vanessa

      Yeah, the treat of some red wine is not something I’m willing to let go of at this point. Not shocking at all that it probably isn’t good at all for general health.

      • Jean Brodie

        As mentioned in my response to Gary, let’s limit our drinking to one small glass of wine when dining with friends. I agree that it would be difficult to say that we’re never going to drink wine again. But that one glass of wine when we’re out with friends will be such a treat, and we’ll appreciate it all the more. Imagine how dreadful our lives would be if we reached the stage where we didn’t even know what wine was …!

    • Jean Brodie

      But we don’t want to pay too high a price Gary. Perhaps we could limit our drinking to one small glass of wine when we’re dining out. At home, we can drink something such as Perrier which has no sugar. I’m hoping to lose weight while keeping my brain intact!

  • Sally Bode

    If you have family members who got dementia in old age, like me, it is advisable to skip the occasional drink. If you have one twice a year, no more. My maternal grandmother got AD and never touched a drop, but my dad and beer were best friends. He died from AD. Find other things which relax you like chamomile tea, or put on some music and have a glass of chilled cranberry juice in a crystal glass, you’ll feel like you had wine without the risks.

    • Joanne McCormack

      I agree

      • So sad so few comments on such an important health issue. It would be great if Dr. David would participate a bit more.

  • rily

    Of Course Alcohol is toxic to the brain, in any given amount!! But, Nobody is getting out of here alive, regardless if you drink or not!!! You can quit everything you like, and still get killed by getting struck by lightning, or hit by a car while walking across the street, or murdered by some freak nutcase. Why worry about everything, unless you actually have a problem with it? Then yeah, go find help!!!

    • Jean Brodie

      You’re correct that no one is getting out of here alive. As you say, there are no guarantees that we’ll live to a ripe old age whether we drink alcohol or not. But that’s like saying don’t save for your old age in case you die young! It’s not a responsible attitude. If I manage to reach my 80’s or 90’s, I’d like to be aware of what is going on around me. A friend of mine (a few years younger) has the beginnings of Alzheimer’s, and if passing on alcohol will help prevent it, then count me in. The regular consumption of alcohol
      is only a bad habit and once you’ve kicked that habit, it won’t be missed.

  • Marco Argentati

    Good morning Doctor;
    sorry if I write it here. I wanted to ask you if had read the mails sent to success @. There are important information about the ketogenic diet that I have proposed in her beautiful book. Let me know, kindly. Thank you and have a good day!

  • eileenfb1948 .

    What came first? The shrinking hypocampus with a greater feeling of benefit when drinking alcohol . . .
    I rarely drink as I feel grotty from even a small amount but in view of this new info I will be recommending NO alcohol except a toast on special occasions.
    I am interested to see what further info comes from this. Thank you for keeping us informed.

    • Jean Brodie

      Since it’s our liver that bears the brunt after drinking alcohol, it would probably be helpful if you had a liver cleanse.

      • eileenfb1948 .

        Thank you for that reminder. I had been too ill to do a cleanse but now I’ve improved I should look again at doing a liver cleanse.

        • Jean Brodie

          I’m so glad to hear that you’re going to do a cleanse. Besides the cleanse, it would be a great idea to have filtered water with the juice of half a lemon first thing every morning and before you go to bed. This will really help you too.

          • eileenfb1948 .

            I can start the lemon and water today. My liver seems stuck on phase I and needs more phase II detox. Dietician advised bone broth but hard to get bones where I live.
            Thank you for your advice it is most helpful.

  • Rochelle

    I agree with the BMJ study, my opinion is that alcohol is poison, we must stay away from it. We have many healthy sources of polyphenols, there’s no need for consuming alcohol at all, and the downsides are far greater than the eventual health benefits.

    • Jean Brodie

      You’ve hit the nail on the head!!!

  • Herbie Gallant

    Brilliant Doc

  • Mike Walker

    Dear Dr. Perlmutter, a question to merely clarify, and I apologize if I missed this, but – atrophy of the hippocampus in this study is strictly limited to alcohol consumption, and any potential positive correlation and resulting effect from the sugar in the alcohol is not contemplated / was not measured – correct? Secondly, like Dario Ruis, I too, have basically the same questions regarding quantity, based on the measures used – I’ll hope and look for your response on this. Many thanks and best wishes!

  • Carol Brenner

    I feel horrible after regular wine weekly. It takes about ten days to recover. I’ve had DNA testing but nothing showed up. My liver has a problem processing it.

    • Jean Brodie

      Your liver could do with a cleansing. You’ll notice an enormous difference afterwards.

  • Joanne McCormack

    As a family doctor I have long recognized that alcohol is the sole cause of dementia in a few of my patients who drink to excess, and have had suspicions about moderate drinking in relation to cognitive decline. Alcohol is not safe or beneficial at any level for those who already have liver disease or a history of alcohol dependence and so I never understand the general advice that some alcohol is better than none for all people. It is not. We cannot diagnose early brain disease at the same level as say early liver disease(with liver function blood tests) so we are taking a chance with alcohol and our brains, and assuming that our brain function is good enough to cope with whatever we call or feel is moderate. Maybe for some of us, abstinence is the best course of action, especially if we have already started to notice some cognitive decline, or if we have a family history, or genetic predisposition, to dementia.

    • Jean Brodie

      An excellent assessment!

  • Jean Brodie

    Thank you Dr. Perlmutter! I’ve been looking for a reason to stop drinking Chardonnay for a long time. I’m weak-willed though and I usually give in, feeling that I need to treat myself for one reason or another. This information has hit it home to me that I’m only harming myself. I will have a 5 oz glass of Chardonnay when I go out to dinner with friends but that will be the extent of my drinking from now on. I’m 69 years old, and at this age I’m beginning to notice some differences in my abilities. Let’s hope there is no progression. Perhaps you’ve saved my life …!!!

    • Kristym

      what do you notice?

      • Jean Brodie

        I used to have “instant recall” and recently I’ve found myself trying to remember someone’s name. It’s very frustrating, although I’m not saying that it’s a major problem—it’s only happened a few times. If I keep trying to remember the name, it’ll eventually come to me. I’ve been told that this is simply part of the aging process, but perhaps if I limit my consumption of Chardonnay I might return to normal. If not, I’m hoping that at least it won’t progress.

  • Russel Kukla

    Dr David, Please view http://www.CreateK12Change.com As children we are not taught how to memorize so we do not stimulate our brain’s hypacampus. I’d greatly appreciate an opportunity to speak with you about this. Thank you! Russell

  • Possibly the #1 key to greatly reduce dementia? Positively stimulate our hyppocampus. My advise to everyone, especially seniors is to Learn How To Create as taught by my favorite author, Robert Fritz. 1 of Robert’s many books on this subject, Your Life as Art. And, Learn How To Memorize, as taught by my favorite author, Harry Lorayne. 1 of Harry’s many books on this subject, Super Memory, Super Student, My wife and I have been seeing the slow but sure decline in mental health with our 97 year old mother in law, Dolly who is now in a memory ward. My father in law, Vaughn has been doing his best to comfort her. He’s been an artist, painter for over 70 years so although he as always been a bit mentally “off” his mind is still very sharp. Creating and Memorizing stimulate our brain in the same way. We try our best to visit and help Dolly and Vaughn. I hope to receive help from Dr. Perlmutter to prove my Scientific Hypothesis.

  • Paula Bourque

    What I would ask about that study is the already existing factors from the test subjects. Were they drinkers before? Were they on medication? Their previous diet? Also, I heard somewhere that alcohol depletes the stomach of digestive enzymes. If that’s the case, wouldn’t that affect the gut, which in turn affect the brain?

  • Loretta

    I have believed for decades that alcohol did more harm than good and decades ago, while still in my twenties, gave it up cold turkey. My husband did not and I believe it was very causal in his recent death from a heart attack. I believe that a link between alcohol consumption and cancer is also quite plausible.

  • Kathryn Villano

    I’m so perplexed by the post and especially the comments. This study shows only that the hippocampus is smaller in those who drink, not that they developed AD at higher rates. There a multiple other larger studies that show no correlation with actual AD a correlation between moderate alcohol use and decreased rates of AD. It reminds me of the med school admonition, “Treat the patient, not the labs.” Likewise, the MRI is not the patient. It is easy to find these other studies. Two (from the Lancet (>5,000 patients) and JAMA) are cited by the authors of the BMJ article itself. And others are cited by those two articles.

    Interestingly, MRI findings were specifically mentioned in the JAMA study they cited: “In an analysis of subclinical abnormalities of the brain seen on magnetic resonance imaging (MRI) studies among Cardiovascular Health Study (CHS) participants, moderate alcohol consumption was associated with greater brain atrophy but fewer silent infarcts and less white matter disease, associations that might influence risk of dementia in opposite directions.”

    I’m not suggesting we recommend alcohol to patients who don’t drink but most of the comments here seem like confirmation bias pure and simple-maybe comforting to the commenter but not helpful in the search for real answers.

    • TJ

      You made some really great points….when reading research, we can’t assume causation just from findings. Other factors could come into play…you have to look at the population, where they live, what they do. Perhaps those that drink have other habits that may alter the hippocampus size. It may not be the alcohol itself. The psychoneuroimmunilogical systems are complex and we know there are always numerous factors at play. I’m not making a fight to drink more, I am agreeing with your points that we can’t extrapolate these findings out to say that people are definitely going to get AD from drinking. AD is coming to be known to have a gut/sugar connection–and yes, alcohol is thereby implemented

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