For years we have been told that moderate amounts of alcohol, and specifically red wine, can protect our heart from cardiovascular disease and inflammation. And while that may be true, what if you are managing an autoimmune disease? Does alcohol have the same anti-inflammatory effect?
Moderate Alcohol Consumption and Inflammation
Alcohol, in general, has an anti-inflammatory effect when consumed in moderate amounts (1). A moderate amount means 1 serving for women and 2 servings for men, and one serving is 5 oz of wine or 12 oz beer or 1.5 oz liquor. Studies have looked at the effect of alcohol and inflammation. In a 2018 study of participants with rheumatoid arthritis, moderate amounts of alcohol had a positive effect in lowering CRP, an inflammatory marker, but had no effect on joint inflammation. As alcohol consumption increased, so did CRP levels, indicating that higher amounts of alcohol have a pro-inflammatory effect (2). In another study, researchers found that moderate consumption of alcohol decreased the risk of developing rheumatoid arthritis (3). Another study of healthy participants found similar results that moderate intakes of alcohol with regular exercise reduced CRP levels and were linked to lower mortality risk (4).
When Alcohol Becomes Harmful…
It’s common knowledge that an excessive amount of alcohol is not good for you. Even in the studies mentioned above, inflammatory markers increase when alcohol consumption increases. However, if you have an autoimmune disease, if autoimmune diseases run in your family or you have digestive issues, alcohol can be especially harmful because of what it does to your gut. There is a general belief that an unbalanced gut microbiome and/or leaky gut can trigger an autoimmune response (5,6). An increase in alcohol consumption can stimulate bacterial overgrowth and promote dysbiosis, or imbalance, in the gut microflora. Additionally, alcohol can disrupt the production of bile acids. Bile acids are produced from your liver, and help digest fats and regulate your gut microbial balance. Low bile acid production can also lead to further bacterial overgrowth and inflammation (7).
Alcohol can also suppress the immune response of the gut mucosa, allowing more pathogenic bacteria to thrive. Additionally, alcohol can weaken the tight junctions in the gut mucosa, allowing pathogenic (or bad) bacteria to sneak through and escape into circulation. This is otherwise known as a “leaky gut” (7).
Does This Mean Complete Abstinence from Alcohol?
Part of my overall philosophy about food and nutrition is you should never restrict foods. Given that moderate intakes of alcohol have some protective effect against inflammation, I believe it is okay to drink responsibly (and legally). However, if you are in the process of healing your gut, I would be very careful about how much alcohol you consume. With some of my clients, I recommend saving alcohol for a special occasion, and make sure that if you choose to drink, choose wisely. Similar to food, not all alcohol is made the same. Opt for organic wine and/or sustainably produced alcohol. Some wines are also made with less sugar. If you prefer mixed drinks, be mindful of how much sugar is in them. Try to minimize concentrated juice and soda as mixers. Remember, alcohol can have benefits if consumed in moderation. Being mindful about your alcohol choices and cutting back during the healing process will make a difference in the long run.