Booze: Why you need a day off
January is detox time. But experts now believe that taking an alcohol ‘holiday’ each week can be just as important as counting units. Hugh Wilson reports
Tuesday 13 January 2009
Christmas was a little too merry, New Year passed in a blur, and now it's January, the traditional month of the purge. If you've overindulged with alcohol over the past few weeks, there's every chance that you're having a fortnight of self-imposed prohibition, or even thinking of taking the whole month off. The party season must be paid for, and a little self-control is what body and soul require.
And the good news is that your body will thank you for it (we can't give any guarantees about your soul). However hard you partied in December, a couple of weeks off (or more) in January will do you good. Increasingly, alcohol experts and liver specialists believe that breaks from alcohol are one of the best things drinkers can do for their health. An abstemious fortnight is more than just a token effort.
"In my opinion, it's an excellent idea for a number of reasons," says Dr Nick Sheron, consultant hepatologist at the University of Southampton. "For a start, alcohol shares the inherent property of nearly every drug. If you drink on a regular basis, you will develop a tolerance. You need more alcohol to have the same effect. Having a rest from it can help to reset your tolerance levels." In other words, taking January off will make your first drink in February more potent. You'll need less alcohol before you feel you've had enough.
Sheron also believes that a January break can be a useful litmus test for your relationship with alcohol. If you resolve to take a fortnight off and find yourself nursing a large glass of merlot after a week, you may be slipping into dependency. Stopping shouldn't be hard.
Dr Elizabeth Murray, a GP and director of the e-Health unit at University College London, agrees that the January purge can be useful. "We're keener on a healthy lifestyle throughout the year rather than a binge and purge cycle, but we're realistic," she says. "A period of abstinence can mean that people return to more moderate drinking afterwards. And if they feel better when they're on a break from alcohol, they may listen to what their bodies are saying."
Two weeks off in January is one thing. But there's also a growing recognition that breaks from drinking – especially on a weekly basis – are one of the most important components of a healthy relationship with alcohol. And there's growing bemusement among experts that this key advice has quietly slipped from most government messages on alcohol consumption. Clinical evidence is mounting that alcohol-free days are at least as important to health as sticking rigidly to government guidelines. As yet unpublished research from Sheron and others at Southampton suggests that, as far as serious liver disease is concerned, long-term daily drinking, rather than weekly binge drinking, is by far the biggest risk factor.
"If we look at who gets scarring of the liver – cirrhosis – they're pretty much all drinking on a daily basis," Sheron says. "That's not hard to fall into. In your early twenties, you might be going out at weekends. As your twenties and thirties progress and you have added pressures, drinking might creep back through the week, until it ends up as a nightly habit. For those people, cutting out drinking from Monday to Wednesday, say, would be good for their health."
Which is why he thinks that "talking purely about daily limits can be quite dangerous". The Department of Health has moved its focus from weekly limits to daily ones, which are two to three units for women and three to four for men. For a start, Sheron says, that's hopelessly unrealistic. If you're a man who likes a drink, are you really going to go out and drink less than two pints on a Saturday night?
And more importantly, and presumably without meaning to, daily guidelines seem to sanction daily drinking. "But that builds tolerance," Sheron says. "And it's very easy for half a bottle of wine shared between two people to become a bottle. Once you're drinking every day, it's quite easy to consume the number of units that start making liver doctors worried."
In other words, daily limits demonise those who drink four pints on a Saturday night (binge drinking, by official standards) followed by six alcohol-free days, and ignore those who drink on a daily basis.
Official advice does mention taking 48 hours off after a heavy session to let your body recover. But many experts worry that what they see as a misguided concentration on daily limits is missing the key message that several alcohol-free days every week are essential. Sticking within the old weekly limits (21 units for men, 14 for women), with three or four days off, is more sensible.
In fact, like Sheron, Murray doesn't quite know why official advice changed from weekly to daily limits. "At a behavioural and practical level, it's easier to advise people to keep Monday to Thursday free rather than sticking to daily limits," she says. "There was certainly some disquiet [among experts] when the message was changed." Indeed, there are those in the medical profession who point to the undue influence of a powerful drinks industry lobby. Drinking every day and building tolerance, they argue, suits drinks makers just fine.
Others disagree. Libby Ranzetta, who runs alcoholpolicy.net, a website for professionals in the alcohol harm-reduction field, says the introduction of the daily limit was simply intended to stop people drinking their entire weekly limit on a Friday night. However, Ranzetta agrees that alcohol-free days are important, though she cautions that people with alcohol dependence shouldn't have alcohol-free days without medical guidance.
For the rest of us, maintaining a healthy relationship with alcohol means taking time off from it. A few weeks of abstinence in January is a very good start. On top of that, three or four alcohol-free days every week should be everyone's new year resolution.
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