Why a drink with alcohol hits harder with age : NPR

Once at a holiday party, a glass or two went away without any problems. This is a recipe for disaster the next morning.

Sound familiar? Dr. Monica Christmas of the University of Chicago Medicine say this is a common regret as people reach middle age.

“You are not alone,” says Christmas. “I’m also at this age, and absolutely [drinks] I need to spread it out, otherwise all this will go to my head, and the next day I will have to sleep for half a day.”

There are physiological explanations for why our ability to tolerate alcohol declines as we age. Firstly, research shows liver enzymes that break down alcohol become less effective.

“This means our bodies metabolize alcohol a little differently,” she says. “As we age, we also lose more muscle, and that muscle is replaced by fat tissue.”

This is important because muscles store water, and water dilutes the alcohol in our blood, he says. Johannes TrulAlcohol and substance abuse researcher and assistant professor at the Johns Hopkins Bloomberg School of Public Health. He says less muscle mass means alcohol will stay in our bodies longer.

“What this means is that the same drink that may have felt normal before now results in higher blood alcohol levels,” Trul says. “You feel the effects longer.”

These changes happen to both men and women when they reach middle age. But for women in perimenopause, Alcohol can worsen symptoms associated with hormonal fluctuations, such as mood swings and irritability, says Christmas, who directs the Menopause Program and Center for Integrative Women's Health at the University of Chicago.

“Alcohol is already known to be a depressant,” she says. “All of this can also increase underlying symptoms of anxiety. Alcohol can also disrupt sleep. If you are already experiencing all of these symptoms, the situation becomes even worse.”

While hangovers that get worse as you age may not seem like a good thing, think of it as your body nudging you in the right direction. Downsizing is a good idea, says Dr. Ken Advicegeriatrician at the Cleveland Clinic because risks of drinking alcohol increase with age. This includes increased risk of cancer, liver disease, worsening high blood pressure, memory problems and cognitive decline.

“Drinking alcohol can cause dementia,” he says. It can also interfere with the action of many medications and lead to balance problems and frequent falls.

Conchiglia says he always discusses the benefits of cutting back with his patients.

“These conversations about drinking – active among people in their 50s and 60s – have a huge impact on their health and wellbeing when they're in their 80s and 90s,” he says.

Johannes Troul of Johns Hopkins University says many people don't realize that alcohol is classified as Group 1 carcinogen – in the same category as tobacco and asbestos. “Every drink you drink significantly increases your risk of developing several types of cancer,” he says.

Trul says that while the healthiest option is not to drink at all, even small changes in cutting back can have health benefits. For example, during holiday parties, he says, try alternating alcoholic drinks with cocktails or other non-alcoholic options. And be sure to drink plenty of water to help your body metabolize the alcohol you drink.

“Why don’t you just try it and see how it feels?” says Trul. “Because you might be surprised how well it actually is that when you sleep better, you have less anxiety the next day.”

He says your body will thank you.