A medical review of the documentary The Truth About Alcohol
This 2016 BBC documentary stars Dr. Javid Abdelmoneium, an A&E doctor (equivalent to an ER doctor in the US) who works at St. Mary’s Hospital in London, England. The driving force of the documentary was the change in UK guidelines that recommended a decrease in alcohol consumption to 14 units per week for both men and women. The reduction was a direct result of the new understanding of the link between alcohol use and cancer risk.
What is a unit?
The “unit” is a UK thing, created to make things simpler by adding complex math that very few people understand. According to the NHS description, a unit = the percent alcohol (ABV) x volume (ml) ÷ 1,000. Got it? For those who don’t want to whip out their calculator in pubs and bars, a small shot of liquor is 1 unit, a glass of wine is 2-3 units, and a can of beer is 2 units.
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And the US recommendations?
The 2015-2020 US Dietary Guidelines for Americans recommend that alcohol should be consumed, if at all, in moderation, defined as up to one drink per day for women and two drinks per day for men.
The CDC defines “a drink” as 12 oz of beer, 8 oz of malt liquor, 5 oz of wine, or 1.5 oz of liquor (or distilled spirits).
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Using the UK unit formula above: “a drink” converts to 1.7 – 1.8 units for each of the four examples. In addition to the difficulty in translating one drink into units, the US guidelines are for daily (not weekly) intake, making it even more challenging to compare the US and UK recommendations.
For example, if you are a woman and you drink one glass of wine daily (in unit terms, 2×7=14 units per week), you would be in compliance with both recommendations. But if you drank the 7 glasses of wine over 3 days during the week, you would be a binge drinker in the US and just fine in the UK.
And the world?
Here is an excellent article about global alcohol consumption. You can peruse the site at your leisure. Bottom line: In 2016, the average liters of pure alcohol consumed per person (over 15 years old) in the US were 9.8 vs. 11.4 in the UK. As you might expect, France was higher at 12.6. And the winner (or loser, in this case): Moldova at 15.2.
Back to the documentary (and the UK)
Throughout the documentary, we follow Dr. Javid, an amiable fellow who comes across both energetic and knowledgeable. He performs several experiments, often on himself, to answer various questions about the effects of alcohol. He’s easy to like, but an odd choice to lead a documentary purported to be about the dangers of alcohol. One of the first things we see is a measure of how much alcohol he drinks. It turns out that he is, in American parlance, a binge drinker. Even by UK standards, he drinks well over the 14 units per week goal.
And yes, Dr. Javid is a physician seeing emergencies that are often the direct results of alcohol-related tragedies like motor vehicle crashes, violence, sexual risk behaviors, stroke/heart attack from high blood pressure, and cancer. And it’s not just him: all of the scientists and physicians he interviews about the risks of drinking discuss how much they enjoy drinking. The documentary is less of a PSA and more of a party.
What are the findings?
Still, the documentary does cover a lot of ground, even if its conclusions are not especially surprising. We learn that the benefits of red wine are in polyphenols, which cause blood vessel dilation and can lower blood pressure. But then, the effect is minimal, and other foods contain polyphenols like walnuts, almonds, apples, blueberries, and dark chocolate, so you don’t need to drink wine to get them.
Alcohol is not very good for your brain, limiting multi-tasking and decision-making. It doesn’t keep you warm; it just makes you think you are warmer by causing dilation of blood vessels, which actually causes you to lose body heat. It doesn’t help you sleep but rather disrupts deep sleep. It can make you fatter from both the calories of alcohol and by increasing your appetite.
Eating before drinking will limit your alcohol absorption. The best way to improve your tolerance for alcohol is to build muscle (muscle holds more water than fat and will dilute the alcohol better). There isn’t much you can do for a hangover, although Dr. Javid makes a case for eating borage before drinking, then concedes that ibuprofen has the same anti-inflammatory effect.
Most disappointing is the conclusion that the protective effect of alcohol and heart disease is marginal for most people. For women over 55, there is a more significant benefit but only with drinking up to 5 units per week (a beer and a full glass of wine). Above that, the adverse effects outweigh its benefits.
So what was the point of all this?
The premise of the documentary is that the change in the UK guidelines is due to the link between alcohol and cancer, a connection that many understand poorly. Dr. Javid briefly discusses this at the end of the documentary, but not in nearly as much detail as it deserves considering this is new information for many people. So let’s be clear. Alcohol is linked to seven different forms of cancer: liver, breast, bowel, mouth, throat, esophageal, and laryngeal cancer.
Conclusion:
If you are interested in watching a documentary that discusses the many issues of alcohol and health, you’ve come to the right place. If you can overlook the disconnect between the drunken party atmosphere and the sobering information, maybe you’ll learn something. If not, there are worse ways to spend an hour.
Are you interested in calculating your unit intake per week? Write down every alcoholic drink you consume over the next seven days and plug it into the calculator. If you consume over 14 units a week, you are at increased risk for alcohol-related cancer. Also, high blood pressure, heart disease, stroke, liver disease, and digestive problems. Cheers!
The Truth About Alcohol is available for streaming on Netflix.
About the Author
David Z Hirsch, MD is the pen name of the author of the award-winning novels Didn’t Get Frazzled and Jake, Lucid Dreamer, both available for purchase on Amazon or may be read for free with Kindle Unlimited. Didn’t Get Frazzled is also available on Audible.
He is an internal medicine physician with an active practice in Maryland.
Check out my other reviews:
A medical review of the documentary Cowspiracy
A Medical Review of the documentary End Game
A medical review of the documentary Fed Up
A medical review of the documentary Feel Rich
A medical review of the documentary Forks Over Knives
A medical review of the documentary Heal
A medical review of the documentary In Defense of Food
A medical review of the documentary Sugar Coated
A medical review of the documentary Super Size Me
A medical review of the documentary The C Word
A medical review of the documentary The Magic Pill
A medical review of the documentary What the Heath
A medical review of the documentary Why Are We Getting So Fat?
And the video 5 Netflix Health Documentaries Worth Streaming
