Episode Transcript
[00:00:01] Speaker A: Welcome to the alcohol tipping point, podcast. I'm your host deb Maisner.
[00:00:05] Speaker B: I'm a registered nurse, health coach, and alcohol free badass.
[00:00:09] Speaker A: I have found that there's more than one way to address drinking. If you've ever asked yourself if drinking is taking more than it's giving, or if you've found that you're drinking more than usual, you may have reached your own alcohol tipping point.
[00:00:22] Speaker B: The Alcohol Tipping Point is a podcast for you to find tips, tools, and.
[00:00:26] Speaker A: Thoughts to change your drinking.
[00:00:28] Speaker B: Whether you're ready to quit forever or a week, this is the place for you. You are not stuck and you can change.
[00:00:35] Speaker A: Let's get started.
Thanks for listening to this episode of.
[00:00:44] Speaker B: Alcohol Tipping Point podcast.
[00:00:46] Speaker A: This is going to be a science heavy one. It's going to be all about alcohol and your heart health. I actually gave this as a presentation for one of my groups and I just felt it was really important to release it to the podcast because I was at work the other day, actually have returned to work. I work as a registered nurse and health coach at our local hospital. And I work in the wellness department's, corporate health and wellness, and we do health screenings for employers and so we do a lot of preventative health.
Anywho, I went down to the mailroom and there were all these flyers for an event that our hospital was holding. And the flyers. The event was wellness. Women and wine.
I about lost my shit. It's learn about women's heart health. And again, this is an event put on by our hospital and they are having female cardiac providers talk about women's heart health. And you also are able to taste new wines, support your community.
And I just felt like, oh, I thought we were shifting the tides here. I thought that we were getting away from equating wine with wellness and it just pissed me off. And especially since this is a cardiac event, I wanted to release an episode just for the general public because I just think it's sending the wrong message to people about heart health.
And so this episode will go into how alcohol affects your heart and it's going to talk about what you can do also to take care of yourself, take care of your health. But I think this is such a big problem. People don't realize cardiovascular disease is the leading cause of death in the world worldwide. And so we aren't doing a good job. I think it is important to have these kind of events and talk about women's heart health and heart health in general.
Just don't tie them to wine and drinking.
And this podcast will talk about how it's a myth that alcohol is good for your heart, and we'll go into details about that, but also for women. We have had skyrocketing alcohol problems in the last 15 years, 80% increase in women and alcohol problems.
And so it makes me irate and not just heart health, cancer and other health factors related to alcohol. Anyway, I just wanted to share this episode. I think you'll learn a lot from it and I hope you find it helpful. I was using a PowerPoint slide deck so I will be referring to pictures in the episode. So I think you will still get a good overview about this topic even without the pictures to follow along. Thanks so much for listening.
This class is going to cover alcohol and heart health. We're going to talk about the French paradox. We are going to cover how tides are turning. We're starting to see a lot of shifts in national and worldwide policy related to alcohol and heart health. And I'm going to talk about some numbers for you to look at when you are doing your own health screenings and then give you some tips so that you can love and take care of your heart.
Let's first talk about the heart and just the purpose of the heart. I love geeking out on the body because I think it's amazing. Think it's amazing that your body is taking care of you and doing all these things for you to keep you alive without you even having to think about it. I just think that's crazy. But it's great. So your heart, the purpose of your heart, it's a vital organ of your body obviously, right? We couldn't live if our heart stopped. Basically what it does, it circulates your blood, it supplies oxygen and nutrients and it gets rid of metabolic waste like carbon dioxide.
It beats 100,000 times per day and it pumps over 2000 gallons of blood every 24 hours. Your heart does all of this for you without you having to think about it. Let's talk about how alcohol affects your heart in the long term. The more you drink, the harder your heart has to work. And what it's going to do is weaken the muscles of your heart and lead to high blood pressure, increased heart rate, irregular heartbeat, and raising fats in your blood like triglycerides. All of these things are going to lead to long term consequences and very high risk things like increased stroke and heart attack, increased heart failure and increased risk of alcoholic cardiomyopathy. In fact, some studies have shown that binge drinking increases your stroke risk by 39%.
So it's no joke. Alcohol definitely has some harmful effects on your heart. I am going to get into some more details just about how that works. Let's talk about how alcohol increases your blood pressure.
When you drink, alcohol releases hormones like Cortisol, Renin and vasopressin. And what those do is cause your blood vessels to constrict. You see in this picture, there's a constricted artery and there's a dilated artery. And so when your heart has to push harder to get more blood out against a constricted artery, it's going to raise your blood pressure.
You also have these barrel receptors in your body that help regulate your blood pressure. And when you drink, alcohol prevents the body's barrel receptors from detecting a need to stretch those blood vessels and increase their diameter. You want a bigger diameter of your arteries so that blood can flow through easier. When you constrict it, it's like squeezing off a garden hose. It makes it harder for the blood to get through. And so when your barrel receptors are affecting the size of your arteries as well and causing more constriction, well, then that leads to elevated blood pressure.
And then there's other factors, alcohol use that increase your blood pressure. And we'll talk about them some more. But one thing that drinking does is it leads to higher levels of cholesterol. And high cholesterol is associated with constricting your arteries, which, again, is associated with high blood pressure. Let's talk about how alcohol increases your heart rate. When you first drink, alcoholiday actually dilates your blood vessels. That makes them get larger in the short term, and so that causes your heart to actually beat faster. Now, we did talk about how your blood pressure is related to vasoconstriction. In the long term, alcohol does constrict your blood vessels, leading to high blood pressure. But in the short term, when you're actively drinking makes them dilate a little bit, and they get larger, and that can increase your heart rate.
It also makes your heart muscle pump more blood because, remember, the purpose of your heart is to get blood circulating throughout your body. It's getting oxygen to all your cells, and then it is getting all the carbon dioxide and other toxins back from all of your cells, and it's just completing the process again and again, right? And so, when you're drinking and your blood vessels are dilated, makes your heart work harder, essentially, so it's got to beat faster.
And then also when you're drinking, that leads to dehydration. So when you don't have enough fluid, when you're not hydrated enough, that also increases your heart rate.
One of the cool things I've seen with people who are giving up drinking is they notice immediately that their resting heart rate goes down. A lot of people are using trackers Fitbits or whatnot. And you can see, even day to day, the days that you drink, your heart is working harder. And your resting heart rate, your average heart rate is definitely higher than on the days you don't drink. So you can see immediate results, which is really cool. And it's just showing you in real time like, oh, my heart's not having to work so hard. It doesn't have to beat so fast, which is great. We're talking about how alcohol speeds up your heart rate or your heartbeat. Another thing that alcohol use can do is lead to an irregular heartbeat or arrhythmia.
And how this happens is that our heart uses an internal electrical system to keep it pumping consistently and at the right speed.
And alcohol dehydrates us. We talked about that before. And when we're dehydrated, we also deplete our electrolytes. And so what that does is changes that internal electrical system of your heart. And we know that because we get EKG readings of our heart, right? And so that is showing us our actual electrical reading of our heart.
And why it's concerned is that when we get an irregular heart rate or an arrhythmia, especially one like atrial fibrillation, then that can lead to heart attack and stroke, because our heart is not pumping efficiently, and it's not pumping regularly, and it's not getting, like a full contraction, a full release of all the blood back into the system. And you get some pooling. You increase your risk for blood clots. And a blood clot to the brain, as you know, is a stroke. So it's something that we do want to keep an eye on and it is something that you can check for too. And see, you can just feel your pulse and sometimes you can tell if you have an irregular heartbeat. That would be something you will want to check out with your doctor. Let's talk about alcohol and cholesterol. Here's the thing. I'm going to start here. I have a little laser pointer.
Cholesterol is made in the liver. I think a lot of us kind of forget that or don't even know that when you think about your liver. And when you're drinking, your liver is doing a lot of work. When you drink, alcoholiday is broken down and rebuilt into triglycerides and cholesterol in the liver. Triglycerides, those are those fatty acids that we don't want. We don't want cholesterol either, but we'll talk more about the different types of cholesterol. But those are the main things that are getting made in the liver when alcohol is being broken down. And so what happens when you drink is it raises the levels of triglycerides and cholesterol in your blood. And those buildup of triglycerides in your liver can lead to fatty liver disease. And then your liver also can't work as well to remove cholesterol from your blood. So cholesterol levels rise. You can see how drinking affects not only your heart, but it affects other organs of your body, but that in turn affects your heart health as well. Let's talk about alcohol associated cardiomyopathy. One of the long term effects of alcohol in your heart can be this condition. And it's basically when your heart pumping function gets weaker and your heart gets larger due to changes from heavy alcohol use over a long period of time. And this can lead to heart failure. You can see there's a picture of a normal heart next to a dilated cardiomyopic heart. And this just makes it harder and harder for your heart to work efficiently, makes it harder for your heart to pump enough blood sufficiently to nourish your organs. And that can lead to oxygen deprivation or ischemia. And then that can lead to severe damage to other organs and tissues. Now this we don't see as often, but it is something to think about and be concerned about as we're thinking about how alcohol affects our heart. Some of the symptoms of alcohol associated cardiomyopathy include shortness of breath, at rest or at exertion, cough, fatigue, swollen legs and feet, and an irregular heartbeat. And like I said, this is something we are concerned about because it can lead to heart failure. And guys, this is a big problem.
Heart health and the effects of alcohol on our health are a big problem.
What we see is that cardiovascular disease is the leading cause of death in the world.
In the world.
And we also see when we're looking at the United States, that there are more than 95,000 people that die from alcohol related causes. This actually makes it the third leading preventable cause of death in the United States. The first is tobacco and the second is poor diet and physical inactivity.
Globally, we see that alcohol is the 7th leading risk factor for premature death and disability.
And among people who are 15 to 49 alcohol misuse was the first leading risk factor for premature death and disability.
I guess the big question is how did we get here? How did we get to where we have so many deaths from cardiovascular disease and so many preventable deaths from alcohol use?
Well, while it's true we've been drinking for thousands of years, humans have been drinking since we figured out how to make alcohol, what we have really seen is a huge increase in drinking. And it all started in the 1980s with something called the French Paradox. And that was where they noticed that French people had a relatively low risk of heart disease despite all the cheese that they consume and the croissants and whatnot. And so they thought, oh, maybe it's the wine, right? And that's when reservatrol was first discovered. So if you remember, reservatrol is a type of plant compound that's found in red and purple grape skins. It's also found in other fruits, vegetables and nuts. And it's thought to act like an antioxidant that protects the body from damage. And so the wine industry, everybody really glammed onto this idea of red wine and the fountain of youth and just thinking that oh, it must be resveratrol. Which is a really hard word to say too, by the way.
However, they have found that it's maybe not the magic antioxidant that they thought it would be. They also had one study that showed you'd have to drink the equivalent of 1000 glasses of red wine daily to get the improved benefit. I think we all know no one's going to do that and that's not going to help you. And we also know that it might not have been the red wine when we were looking at the French people.
It may have been under reporting of heart disease deaths by French doctors it might have been different lifestyle and dietary differences. They've also noticed that heart disease rates in Japan are lower than in France, and you don't see a lot of Japanese drinking red wine. And so that's where the French Paradox started. And it really took off with one episode of a classic TV show you may be familiar with. It was 60 Minutes that really changed the trajectory of getting that French Paradox message out there. There was one episode of 60 Minutes in 1991 that really promoted the use of alcohol. And at that time, 60 Minutes was the most watched news show in America. And they found that millions of people watched this show with Morley Safer. I'm sure you guys remember.
I even remember this episode, but he really went into the French Paradox.
And what happened was people watch this show, right that segment. They think that somewhere between 25 million and 50 million people watch that. They found within weeks that wine cells increased as much as 40%.
You also started to see the US dietary Guidelines start promoting a glass of red wine per day. Remember the Mediterranean diet? That was the heart health diet y'all and what was promoted on it was red wine. So we start to see more people drinking. We start to see more women drinking and we start to see the alcohol industry marketing to women. And I just think this graph is so crazy, but it's showing this is US. Wine consumption from 1981 to 2017. And you can see where in the 90s it just skyrockets.
And the other thing we see that skyrockets in the deaths, deaths related to alcohol. Between 1999 and 2017, US alcohol related deaths in women rose 85%.
That is huge amount.
They also showed that the number of women who demonstrated problem drinking soared by 84%.
Now, I'm not blaming it alone morally safely, but you can see that there really became this cultural narrative that alcohol and especially red wine, was good for your health. And so people started drinking and started being okay to drink, and then they started marketing to women and women started drinking more. You really see the effects of it over time, and we're seeing it now still.
The good news is the tides are turning. The World Heart Federation came out very strongly against alcohol use. They even had this statement, which I like to call their Mic Drop statement, where they said in brief, our position is that studies showing a significant cardioprotective effect of alcohol consumption have by and large been observational inconsistent funded by the alcohol industry and not subject to randomized control. Furthermore, any potential cardioprotective effect is negated by the well documented risk and harms, rendering our judgment that no amount of consumption can be considered good for heart health.
And I do think it's important to dig into those past studies and some of the problems with them because they've been used again and again just to justify drinking. One of the things is that they're based on observational studies.
They're not raw data. Right. They're also, like, reported data, self reported data.
You're also comparing people who don't use alcohol to people who have different social, cultural, religious, or medical reasons not to drink. Right. What you're doing in a lot of those studies is you have your non drinkers, and then you have your drinkers, basically your moderate drinkers.
They did a deep dive and I'll link to this podcast, but they did a deep dive into the study participants and criteria for some of his studies. A moderate drinker, they considered someone who drank at least, like, a couple of times a year with someone who was drinking a couple of times a day or a couple of glasses a day.
That's huge. That is a really big difference. And so you can see how the health results of those people could be vastly different. Right? And then the other thing is, they were mainly conducting studies on older people over 55 and Caucasian populations.
Some of the studies that showed positive effects are funded by the alcohol industry.
You also see that alcohol use is often associated with other heart disease risk factors, including tobacco use, access to health care, and other social determinants of health. So really what they found was a lot of their non drinkers in the study stopped drinking because they had other health factors. They might have had diabetes. They might have had hypertension. They might have had a heart attack. They might have had a problem with alcohol, and so they stopped drinking. That was part of their non drinking population. So you're comparing these non drinkers who have preexisting health stuff. You're comparing them to moderate drinkers, which could be anyone from drinking a couple of times a year to drinking daily. And so those were some of the problems with the past studies. And I think one of the cool things about science right now is we have so many new tools, so many new ways to study the body, and we're finding more and more scientific evidence. We're finding more and more information just about how alcohol affects our health. We're starting to see more and more changes.
And the other reason that some of those studies are bad is that there haven't been randomized controlled trials to confirm any health benefits of alcohol. So that's just how you would do a very sound scientific study.
What we're seeing is more and more organizations are coming out, and they're saying no amount of alcohol is good for heart health.
We're talking about heart health in our presentation today, but they're also saying no amount of alcohol is good for any kind of health. We had the World Health Federation come out. The World Health Organization. The global burden of disease study. Canada just passed their new guidelines. Ireland is coming up with their own guidelines. Italy is just we're starting to slowly turn this ship around, which is good, but it does take some time to change policy. And science is a little bit slower than other things, let's say, which is good because science is really evidence based and they want to get as much good evidence as they can before they make a guideline. So I think we're going to start to see more and more guidelines that no amount of alcoholiday is good for your health, which is fantastic.
All right, let's about you and what you should be looking for when you are identifying your own heart health. The main numbers that we look at are blood pressure and your lipid panel. Your lipid panel, that is a lab test and that's going to check your cholesterol numbers and we'll get into more detail about what we're looking at. But those are the main Identifiers that we're looking for when we do a health screening. We're looking at blood pressure and lipid.
Let's talk about your blood pressure, your blood pressure. We're looking at two numbers. We're looking at the top number, the systolic, and we're looking at the bottom number, which we call diastolic. And that top number is going to indicate the force when your heart is actually pumping blood, so it's active. And then the diastolic is when your heart's at rest. There's still a little bit of force in heart doesn't completely relax, but there is still some force there. And that is what we call diastolic blood pressure.
This graph is going to go over what is normal blood pressure. And so normal blood pressure is less than 120 over 80. So 120 over 80 or below. That is what we are looking for. Now. I like to point out to people that in the last couple of years, I think it was only like two or three years ago, right before the pandemic, the American Heart Association and other organizing bodies changed their parameters for hypertension. Hypertension or high blood pressure, used to be considered anything over 140 over 90 or above. Right, that was hypertension they changed. Normal is 120 over 80 or below elevated, that could be between 120 and 129, again in less than 80. So stage one, hypertension now is 130 over 80 or above. That's different.
Why did they change that? I think you just saw heart disease is the number one killer in the world. And we have found that when we can target blood pressure, when we can get your blood pressure under control, then we can prevent heart disease, heart attack, further problems associated with high blood pressure. So hypertension stage one is at this 130 range over the 80s. Hypertension stage two, that's now anything over 140 over 90 and then they consider a hypertensive crisis. Get Ye to a doctor emergency room, over anything over 180 over 120.
Let's talk about cholesterol. Cholesterol, like we said, is made in the liver and it's released in the bloodstream. So your liver makes all the cholesterol you need. The rest of your cholesterol in your body comes from the foods that you eat. And the body does use cholesterol. We do need cholesterol, uses cholesterol to form cell membranes, helps aid in digestion, helps convert vitamin D in the skin and make hormones. Cholesterol does serve a purpose. It's just that when we get too much cholesterol, that's where we get concerned.
So I recommend getting a cholesterol lipid panel. That's a blood test. And what that's going to tell you is different levels of different kinds of cholesterol in your body. It's going to give you your total blood cholesterol. That's going to be a combo of your HDL, LDL and 20% of your total triglycerides. We aren't as concerned with your total blood cholesterol. We really like to break it down into these other units like the HDL, LDL, which I'll talk about next. So, triglycerides, that's part of your lipid panel, like I said, it's the most common type of fat in the body. And triglycerides store excess energy from your diet. Triglycerides are one that you're going to see show up when you have drank too much. If you've had like sometimes people come in for a lab draw and they've had steak and cheese and eggs, or they've had a really heavier diet, heavier fat diet, and they'll have really elevated levels of triglycerides in their blood. You'll also see elevated triglycerides in people with diabetes.
High density lipoproteins, that's HDL cholesterol. That is the heart healthy cholesterol that you do want. High levels of that kind of cholesterol goes in, it removes the bad cholesterol and may protect against heart attack and stroke. Now, this is the cholesterol that winemakers like to glam onto. Oh, wine increases HDL. Alcohol increases HDL. Now, we have seen that some studies have shown an increase in HDL cholesterol when you drink. However, we don't know that much about HDL cholesterol. We know that it has heart health benefits. We don't know how much is too much. And they've actually had some studies that have shown once you get over a certain point of HDL, they've shown it to be just kind of like junkie cholesterol, like unusable cholesterol, basically.
So it's kind of interesting. Like I said, we're still learning about it. And science, I think sometimes people think of science as black and white and it's really gray. There's still a lot of things that we don't know, and there's a lot of mechanisms in our body that we don't always know how they work. So I like to keep that in mind. But when we are talking about HDL cholesterol in general, more is better.
Our other cholesterol is the LDL, the low density lipoproteins. That's lousy cholesterol. That is what, we don't want to be too high, right? Because too much LDL contributes to fatty buildups in the arteries, and that narrows the arteries and it increases the risk for heart attack, stroke and peripheral artery disease.
Here is a graph to show you what we're looking at when we get your lab results back. So we're looking at total cholesterol, and what we want is less than 200. Remember that total cholesterol is HDL, LDL, and 20% of your triglycerides.
We don't look at this as much as we look at LDL and triglycerides. Honestly, HDL 40 or higher is what we're aiming for. Actually, I've heard 60 or higher would be a good level for HDL LDL. That's the lousy one. This is what we want less of. So good is less than 100.
Anything higher than that, then we want to start taking some dietary lifestyle actions, mainly dietary. And even considering medication, high would be 160 or higher.
Triglycerides, again, the fatty acids in your blood, we want less than 150.
Anything above 150, borderline. Again, diet and exercise can actually really help clear our cholesterol levels. Exercise works better at raising HDL, and lowering these works better than red wine, that's for sure.
But it's definitely one of the more effective tools besides changes in our diet.
All right, let's talk about tips to love your heart. Take action and love your heart. First, get your yearly screenings.
I know that there is some conflicting advice about, oh, you don't need to get your loves. You could get them every two years.
I think that at least get a baseline reading. If you have not gotten one, at least get your blood pressure checked every six months, at least every year, right? But for a lot of you, your health insurance covers your yearly screenings. And these tests that we talked about, the lipid panel that is included, that's considered like a preventative wellness test. So that should be covered. And what we know in my work, because this is what I do at St. Alphonse, is we do health screenings, and we do it on a working population. These people are working adults, right? They seem just fine, right? They're able to go to their jobs, they're living life, and they come in for a health screening because it's part of their wellness program. It's part of their employer benefit. And what we find is a lot of underlying health problems that go unnoticed or untreated. Blood pressure is a huge one. A lot of people don't realize that they have high blood pressure until they come to a screening. And their blood pressure is high.
Sadly, but maybe correctly, hypertension high blood pressure is called a silent killer. And that's because for a lot of people, there are no symptoms. And same with your cholesterol levels. You will not always have symptoms. So it's a good idea to get those numbers checked. I know that it can be scary, but what we're doing is we're just getting data, and then that can help us make some more informed choices as we move forward.
And that's what I recommend. Recommend a yearly screening for all y'all.
The other thing that you're already doing is. Don't drink. Reduce your drinking or don't drink at all. That's why you get a gold medal for this one that is going to help your health tremendously. So keep that up and don't smoke. Don't take that up. I think this one, this is one we already know about. And my goal is to have drinking be the same way, to be like, yeah, we know don't smoke. That's not good for your health. Well, we need to get there with drinking. That needs to be a no brainer. Duh of course, drinking a carcinogen, a poison, is going to lead to health problems. Duh. We're getting there.
Bear with us. We are getting there. And by us, I mean the medical community and culture in general.
And move more exercise. Like I said, that can be one of the most effective ways to improve your heart health. And you can do 30 minutes a day. You can do 10,000 steps a day. I mean, the main thing is just to move more to exercise. That will really get your good cholesterol up and lower your bad cholesterol levels. Focus on that.
And when you're focusing on food, I just like to keep it simple. Limit your processed meats. Watch your sodium, fat, and sugar. Eat your veggies. It's kind of funny. I worked with a dietitian, and she says if you have a question about diet and health, the answer is veggies. Any question you have about diet and health, the answer is veggies. So always eat your veggies. Mom was right. Conventional wisdom was right. That has remained the same. Eat veggies and then focus on whole foods as opposed to processed foods. Focus on foods that are as close to the source as possible.
And those are like really simple things you can do just to put some healthy foods into your bond.
Reduce stress. That is actually a pretty big cause of some heart disease and heart related problems. Again, we always know why or the connection. But what we do know is that when you are under stress, you have more of your stress hormones like adrenaline and cortisol. And so these hormones cause the fight or flight response that's going to cause your blood vessels to constrict. That's going to increase your heart rate and raise your blood pressure.
And what also happens when we're experiencing stress is you also get an increase in cholesterol in your blood for increased energy production. And when you have increased cholesterol and fatty acids, like triglycerides in your blood, because your body is like in this fight or flight mode that's going to raise your blood pressure, it's not good for your overall health, right? The other thing that stress does is it increases your blood sugar. Again, because your body thinks, oh, we got to fight or flight, right? It's getting ready to battle or run away. It needs energy that comes from sugar. And so chronic stress with high blood sugar, that can lead to diabetes.
Diabetes also associated with numerous heart health conditions.
All right, so this would be an area of your life to concentrate on it's reducing stress, and whether you do that with journaling, with connection with mindfulness or meditation, it is something that you do want to pay attention to to help your heart health.
And that's it. That's all I have for you today.
I want to thank you for giving me the opportunity to talk to you about your heart health. I hope that you learned something today, and I hope that you recognize that just by changing your drinking, just by decreasing your drinking or completely not drinking, you are already doing so much to help your health. I am so, so proud of you.
[00:40:11] Speaker B: Thank you so much for listening to this episode of the Alcohol Tipping Point podcast. Please share and review the show so you can help other people, too.
[00:40:19] Speaker A: I want you to know I'm always.
[00:40:21] Speaker B: Here for you, so please reach out and talk to me on Instagram at Alcoholiday tipping point and check out my website, alcohol Tipping Point Free Resources and Help. No matter where you are on your drinking journey, I want to encourage you to just keep practicing, keep going. I promise you are not alone and you are worth it. Every day you practice not drinking is.
[00:40:43] Speaker A: A day you can learn from.
[00:40:45] Speaker B: I hope you can use these tips we talked about for the rest of your week. And until then, talk to you next time you.
