Although the damaging effects of the country’s most popular intoxicant can be a problem for everyone, they are of particular concern for women who imbibe.
A recent spate of publicity has promoted the moderate use of alcohol, especially red wine, as a part of a healthful lifestyle. But when it comes to gaining benefits from the bottle, women are not equal to men.
Not only do they become inebriated more quickly, but women also run risks men do not, such as breast cancer and damage to unborn children, often called fetal alcohol syndrome.
“An average woman just can’t keep up drink for drink with a man,” says Lee Ann Kaskutas, a scientist at the Alcohol Research Group at the University of California, Berkeley. “You don’t need a Ph.D. to figure that one out: She’ll get drunk faster. Women in general have smaller bodies than men.”
But there is more to it than body weight, says Dr. Charles Lieber, director of the Alcohol Research and Treatment Center at the Bronx Veterans Administration Medical Center in New York.
In most people an enzyme called alcohol dehydrogenase, or ADH, metabolizes some of the alcohol in the stomach before it can enter the bloodstream.
But women (and alcoholics) have less ADH in their stomachs, he says.
Because they start with less of the enzyme, women will get significantly more alcohol in their bloodstream than men who have drunk the same amount, he says. “What is moderate consumption for men is not for women.
“The worst case is alcoholic women. They have almost no gastric protection. For them, drinking is like shooting the alcohol into their veins,” Lieber says.
Moderate drinking for men is considered no more than two drinks a day: For women it is less than one drink, according to government guidelines. A drink is considered 1.5 ounces of 80-proof liquor, a 5-ounce glass of wine or a 12-ounce beer.
This inability to neutralize alcohol in the stomach means women are more susceptible to alcohol-influenced diseases, including liver ailments and high blood pressure.
One French study showed that while cirrhosis increased significantly in men who drank four to five drinks a day, the same increase was shown in women who drank only two to three drinks.
For women who drink there are other concerns, such as the risk of breast cancer.
In an analysis of the Nurse’s Health Study of almost 86,000 women, published in 1995 in the New England Journal of Medicine, Harvard University researchers found that women who drank more than three drinks a week had a significantly greater risk of breast cancer.
However, that study also showed that women older than 50 who drank one to three drinks a week had a lower death rate than abstainers or heavy drinkers. That may have been due to the alcohol’s protective effects against cardiovascular disease, the researchers said.
The best advice for women who are pregnant or thinking about getting pregnant is to not drink at all, says Dr. Douglas Milligan, professor of maternal/fetal medicine at the University of Kentucky, in Lexington.
It’s not that one drink necessarily will be harmful, he says, but it is very difficult to know what a safe level of alcohol use is during pregnancy.
“I tell my patients not to be upset about small amounts consumed infrequently–such as a glass of wine at a wedding reception. But you really can’t tell where the line is drawn. Alcohol can cross the blood/brain barrier, so a fetus is susceptible to what the mother drinks.
“It’s clear that heavy use is a major problem. Alcohol use in pregnancy is the largest single cause of mental retardation, and some studies suggest that even binge drinking may have effects that don’t show up until later in life.
“Even so, about 70 percent of pregnant women do consume some alcohol.”
The heavier and longer the use, the more pronounced the effects of alcohol on the fetus seem to be, he says. “But you never know what you might lose (by even light drinking). Who knows if you might be trimming 10 points off a baby’s IQ?”
Besides the physical detriments of drinking, women may have some unique psychological problems with it as well, Kaskutas says. Alcohol use often is related to depression, low self-esteem and high guilt as well some gender-specific situations, she says.
For many women who have a glass of wine with dinner or an occasional martini, these problems may be remote. But they provide something to chew on while standing in line for that second eggnog.
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Steven Pratt’s e-mail address is SMPratt@aol.com
