How Much Harm Can Drinking Once Per Month Do?

Regular 10almonds readers will know that not only is alcohol not healthy in general, but also that not even the “small glass of red” is healthy, no, not even for your heart.

See: Can We Drink To Good Health? ← this was mostly about the purported heart health benefits, and the answer to the question is: no, we cannot, and as WHO has declared, “the only safe amount of alcohol is zero”)

Similarly: How Much Alcohol Does It Take To Increase Cancer Risk? ← the answer is “any” (although, the risk is dose-dependent, so if not abstaining completely, less is still better than more)

So, what if we don’t have the habit of drinking often? How much difference can a day with alcohol make, if it’s just once in a while?

“Occasional drinking” very often means “binge-drinking”

Here’s an interesting trio of facts:

1. “Occasional drinking” is often seen as healthy
2. Binge-drinking often comes in the form of “occasional drinking”
3. The Threshold For Binge-Drinking Is Lower Than Most Think

…and as we wrote in the above-linked article:

The term “binge-drinking” typically conjures images of people in the 18–22 age range (general figure; if we get geographic about it, then perhaps 21–25 in the US, or 15–21 in Europe) swinging around lampposts while very drunk, very loud, minimally-clothed, and liable to waking up somewhere new and exciting that they’ve never seen before.

But in fact, while definitions do vary a bit, a prevailing and representative scientific definition is:

❝consuming four or more standard drinks on one occasion for women and five or more standard drinks on one occasion for men❞

Learn more: Heterogeneity of definitions and measurements of binge drinking in research on adolescents and young adults

Now, that paper’s looking at research on adolescents and younger adults because that’s where most of the research is, but it doesn’t mean older adults are magically immune—quite the opposite!

So, let’s take a closer look at that when it comes to older adults…

“Let’s just liver little”

As we say, “alcohol is bad for your liver” is something most people know, but often the actual mechanism at hand can remain a mystery. So, let’s demystify it a bit:

The liver is a remarkably self-regenerating organ; we wrote about it here: How To Unfatty A Fatty Liver

…but there’s more to it than that. Liver tissue is remarkably regenerative (cut away 49% of an otherwise healthy liver, and it’ll just regrow itself), but large alcohol doses (again, by the above definitions, not just by what most people think are large doses) at once can overwhelm your liver, increasing inflammation and accelerating fibrosis (scarring), particularly in already metabolically stressed livers.

Scar tissue is different from regular tissue in its structure and composition, and the same is true for scarred liver tissue, and that makes a difference, greatly reducing, if not outright halting, its regenerative ability.

Recently (published today at time of writing!), a team of researchers (Dr. Vatsalya Vatsalya et al.) (no, that’s not a typo; that’s really her name) analyzed data from 43,447 adults (median age 47, mostly women) participating in the US National Health and Nutrition Examination Survey (NHANES) between 1999 and 2020.

This study also used the definition we saw before, about “consuming four or more standard drinks on one occasion for women and five or more standard drinks on one occasion for men”, so let’s quickly note something: that means a single unit, which means for example if it’s a double-shot of hard liquor, or all but the smallest glass of wine, it’s two drinks in one glass. So, drinking two of those drinks means you are already hitting the binge-drinking threshold.

What they found, in few words, was that the odds of advanced liver fibrosis increased with binge-drinking frequency, with the strongest association among women who binge-drank at least monthly.

More than that, women who binge-drank monthly had 3.34 times the adjusted odds of advanced fibrosis.

You can find the paper itself, here: Sex-Specific Risk Thresholds of Binge-Drinking Frequency for Advanced Fibrosis in MetALD and ALD: Analysis of the NHANES Cohort

Want to learn more?

If you’d like to rethink drinking for yourself, then feel free to check out: Rethinking Drinking: How To Reduce Or Quit Alcohol

Or for a deeper dive, we recommend: Quit Drinking – by Rebecca Dolton

Worried you’ve already done too much harm?

It’s never too early to quit drinking, but it’s also never too late:

What Happens To Your Body When You Stop Drinking Alcohol ← for a detailed timeline which parts of your body recover when

Take care!