Awareness around the damaging effects of alcohol on our physical and mental health has given rise to a growing sober curious movement. Yet it’s estimated that over 16 million adults in the UK are still drinking in ways that are risky to their health.
Richard Piper, CEO at Alcohol Change UK points out that having just one alcoholic drink a day, say a medium glass of wine or pint of beer, can tip you over the “low-risk” guidelines of no more than 14 units per week.
“Even if we drink little or no alcohol during the week, making up for it at the weekend is risky,” he continues. “Faster, heavier drinking is a big shock for the body, making the liver work hard to process the alcohol, while also carrying more immediate risks.” Binge drinking is defined as exceeding eight units of alcohol for men and six units for women on a single occasion (or around four pints beer and four glasses of wine, respectively).
Regularly exceeding weekly drinking guidelines can raise blood pressure over time and increase your chances of developing long-term health conditions, including mouth, throat, liver and breast cancer, as well as cardiovascular disease, stroke, liver disease, dementia, anxiety and depression, he adds. “The more we drink, the greater these risks become.”
The good news is that, in many cases, the body begins to recover – in some ways surprisingly quickly – when we reduce or stop drinking, even after periods of heavy drinking, Piper says. “Taking a sustained break from alcohol can improve liver health and reduce blood pressure, cholesterol and diabetes risk, while better sleep, energy, mood, memory and concentration can follow too.”
It is never too late to address your drinking habits. Below, experts delve into how to reverse the damage done from drinking to excess.
Enforce several no-drink days every week
“Drinking too much too often causes a step-wise progression of liver injury,” explains Tamara Gall, consultant general and hepato-pancreato-biliary surgeon at Cromwell Hospital. “The liver breaks down alcohol, creating acetaldehyde, which causes hangover symptoms and also directly injures liver cells. Repeated injury drives inflammation and leads to scarring (fibrosis).
It is possible to manage some early alcohol-related liver damage. “The liver has amazing regenerative properties so stopping drinking, either temporarily or permanently, can help it recover,” Gall says. “Depending on the damage to your liver, you can see benefit within a week; more serious damage will require a much longer period of abstinence to recover. If the bingeing was very heavy or prolonged, there can be residual scarring of the liver which is more serious and raises the risk of cirrhosis, which is not reversible. In this case, lifelong abstinence is recommended to manage the disease.
“Even if you don’t want to give up alcohol completely, drinking less and building alcohol-free days into your routine (ideally at least several a week) will support a healthier liver,” Gall says.
It’s harder to reverse the impact of alcohol on the brain
Gareth Roderique-Davies, professor of psychology at the University of South Wales, points to alcohol’s neurotoxic effect on the brain “as the single most consequential mechanism of alcohol harm”. This, he explains, is linked to chronic neuroinflammation; thiamine (vitamin B1) deficiency from impaired absorption; and disruption of neurotransmitter systems. “What makes this the most damaging is that it’s cumulative, often silent in its early stages, and touches nearly every aspect of a person’s functioning and quality of life, well before physical disease becomes clinically obvious.”
The potential for alcohol-related brain damage is poorly understood, he says. “Unlike a damaged liver, which can be identified and monitored through blood tests, early cognitive and emotional changes are frequently missed or attributed to other causes, meaning damage accumulates before it’s recognised.”
Whether or not you can reverse the effects of heavy drinking on brain health isn’t a simple question, says Roderique-Davies. Physiological recovery can occur quite quickly after stopping drinking, but it’s difficult to say whether or not this constitutes reversal of damage. “Generally speaking, individuals who give up alcohol will possibly have a short-term dip, then begin to see improvements in sleep, cognition and mood regulation over the subsequent weeks and months,” he says.
“An individual who has drunk excessively for a number of years and is diagnosed with Alcohol Use Disorder and/or Alcohol-Related Brain Damage may not experience improvement in brain health – but crucially they shouldn’t degenerate any further. Some do experience improvement.” He adds that for a person who is dependent on alcohol, stopping suddenly can be dangerous, as they may experience life-threatening withdrawal symptoms “which themselves can cause brain damage”.
How to reduce your alcohol risk, without giving up the booze
Some research suggests risk may be mitigated by factors such as diet and exercise. “Being overweight, particularly alongside conditions such as type two diabetes, increases someone’s risk of serious liver disease, especially when combined with alcohol,” Gall says. “Good nutrition is incredibly important in supporting liver function, including processing alcohol, which is important to maintain if you do drink.”
A recent indicated that people with poor diets are more susceptible to alcohol-related liver disease. “There’s evidence that a Mediterranean diet can reduce the risk of alcohol consumption, as well as evidence to indicate that exercise can moderate the risk,” Roderique-Davies adds.
from scientists in Norway found that while increased alcohol intake is associated with a higher risk of death, people who maintained higher cardiovascular fitness levels were associated with a lower risk of early death due to alcohol.
How diet can improve liver health (and what to avoid)
“Fruit and vegetables are a great place to start,” says registered dietitian Freya Perry. “They’re packed with fibre, vitamins, minerals and naturally occurring antioxidants, which help protect our cells from damage. Aim for plenty of variety and different colours across the day — whole fruit is a better choice than juice, but there’s no single fruit or vegetable that will ‘detox’ your liver.”
Replace foods high in saturated fat, such as butter, ghee, lard and coconut oil, with unsaturated fats, like olive or rapeseed oil, nuts, seeds, avocado and oily fish like salmon, mackerel or sardines, she advises. “Choose leaner cuts of meat such as chicken or turkey and trim visible fat before cooking.”
Increasing fibre intake can also help with cholesterol management (which is closely linked to liver health). “In particular, soluble fibre (found in foods such as oats, beans, pulses and ground flaxseed/linseed) binds with cholesterol in the gut and reduces its absorption, allowing more cholesterol to be passed out of the body in your poo. Adding ground flaxseed to porridge, soups or smoothies is an easy way to increase fibre intake.”
Coffee has been associated with potential liver benefits. Some observational studies have found that people who regularly drink coffee have a lower risk of liver scarring (fibrosis), cirrhosis and liver cancer (decaf counts too).
If you’re worried about your liver health, see your GP, who may arrange a blood test.