Beer Abstinence: The Don't-Drink List

Beer is a popular alcoholic drink, with the average adult in the US consuming around 28.2 gallons per year. However, not everyone can or should drink beer. For some, it is a matter of personal choice, while for others, it is a health necessity. According to doctors, there are several groups of people who should avoid drinking beer due to potential health complications. These include individuals with diabetes, prediabetes, gluten sensitivity, irritable bowel syndrome, liver disease, heartburn, and those trying to lose weight. Additionally, while not a health concern, the Bible also mentions that kings and rulers should refrain from drinking beer, as it may cause them to forget the law and neglect their duties. With the growing awareness of health and wellness, the market for non-alcoholic beers is also expanding, providing an alternative for those who cannot or choose not to consume alcohol.

People with a history of diabetes or prediabetes

Impact on Blood Sugar Levels

Beer contains carbohydrates, and a typical 12-ounce can of beer has about 13 grams of carbs. This can significantly affect blood sugar levels, especially for people with diabetes who need to carefully manage their carbohydrate intake. Drinking alcohol can also interfere with the liver's ability to release glucose, leading to hypoglycemia (low blood sugar). This effect may be more pronounced when combined with diabetes medications, particularly insulin and sulfonylureas. Therefore, it is crucial for individuals with diabetes or prediabetes to monitor their blood sugar levels when drinking beer and ensure they don't drink on an empty stomach.

Calories and Weight Gain

Beer can be high in calories, and regular consumption may contribute to weight gain over time. Weight gain can further complicate diabetes management and increase the risk of other health issues. Therefore, it is important to be mindful of the calorie content of beer and practice moderation to avoid excessive calorie intake.

Alcohol Content

Different types of beer vary in their alcohol content. Some beers have a higher alcohol percentage, which can affect an individual's blood sugar control and overall health. Excessive alcohol consumption is associated with an increased risk of chronic diseases, including heart disease, liver disease, and kidney disease. Therefore, it is important for people with diabetes or prediabetes to limit their alcohol intake and follow the recommended guidelines.

Recommendations for Safe Consumption

For individuals with diabetes or prediabetes who choose to drink beer, it is important to follow certain guidelines to minimize risks:

• Drink in moderation: Limit consumption to no more than one to two 12-ounce beers per day. Excessive drinking can lead to higher blood glucose levels and increase the risk of complications.
• Pair with food: Drink beer with a meal or a snack to prevent hypoglycemia and minimize the impact on blood sugar levels. Drinking on an empty stomach can be dangerous.
• Monitor blood sugar levels: Regularly check your blood sugar levels, especially when drinking, to ensure they remain within a healthy range.
• Stay hydrated: Drink plenty of water along with beer to maintain hydration and dilute the effects of alcohol.
• Discuss with your healthcare provider: Consult your doctor or healthcare team about drinking beer, especially if you are taking medications for diabetes or other health conditions. They can provide personalized advice and help you make informed decisions.

In summary, while people with a history of diabetes or prediabetes may not need to completely avoid beer, it is crucial to prioritize their health and follow the recommended guidelines for safe consumption. Moderation and awareness of the potential risks are key to enjoying beer while managing diabetes effectively.

People trying to lose weight or who are overweight

If you're trying to lose weight, cutting back on beer and other alcoholic drinks can help boost your efforts. Here are some reasons why people trying to lose weight or who are overweight should avoid drinking beer:

High Calorie Content

Beer, especially craft beer and higher alcohol content beer, tends to be high in calories. A 12-ounce (355 mL) glass of regular beer contains about 150 calories, while a higher alcohol or craft beer can range from 170 to 350 calories. These extra calories can hinder weight loss efforts and contribute to weight gain.

Empty Calories

Alcoholic drinks, including beer, provide calories without offering any nutritional benefits. When you consume alcohol, you are taking in calories that will not fill you up and may cause you to replace potentially healthy and filling food choices. This can lead to an overall increase in calorie intake and hinder weight loss.

Impact on Food Choices

Drinking alcohol can also impact your food choices. Studies have shown that people tend to make poor food choices when drinking. Alcohol can enhance appetite and increase cravings for high-fat, savory foods. As a result, you may be more likely to consume unhealthy snacks or make poor meal choices, which can sabotage your weight loss efforts.

Sleep Quality

Alcohol can disrupt sleep quality, causing you to wake up in the middle of the night or leading to shorter sleep duration. Poor sleep can impact your metabolism and hormone levels, increasing your chances of gaining weight. It can affect your body's response to glucose, reduce insulin sensitivity, and increase levels of cortisol (the stress hormone). Additionally, lack of quality sleep is associated with increased levels of ghrelin (the hunger hormone) and reduced leptin levels (which regulate appetite), leading to increased hunger and appetite.

Fat Oxidation

Some research suggests that alcohol may impact fat oxidation, causing your body to burn alcohol instead of other nutrients. This can lead to higher body fat in the long run, as the excess nutrients may be stored as adipose tissue or fat.

Alternative Options

If you are trying to lose weight, there are alternative options to consider instead of drinking beer. Opting for lower-calorie drinks, such as light beers, low-sugar wines like Pinot Noir, or spirits with low-calorie mixers, can help reduce your overall calorie intake. Additionally, non-alcoholic beers are becoming increasingly popular, offering the option to enjoy the taste of beer without the alcohol content and associated calories.

People with known gluten sensitivity or a history of celiac disease

However, there are gluten-free beers available that are made with alternative grains such as rice, sorghum, buckwheat, and millet. These beers are considered "naturally gluten-free" as they are made with gluten-free ingredients from start to finish. Some examples of naturally gluten-free beers include:

• La Grosa Rita Maragrita-Style Ale
• Anheuser-Busch Redbridge
• Belipago by Jolly Pumpkin
• Brasserie Dupont Forêt Libre
• Brasseurs Sans Gluten Glutenberg Blanche
• Brunehaut Bio Ambrée
• Burning Brothers Brewing
• Dogfish Head Craft Brewed Ales: Tweason'ale
• Drummond Gluten Free
• Epic Brewing Company: Glutenator
• Glutenberg American Pale Ale
• Glutenberg Belgian Double
• Green's Discovery Amber Ale

In addition to these naturally gluten-free beers, there are also "gluten-removed" beers that use traditional gluten-containing ingredients like barley, but then use enzyme processes to break down the gluten. These beers typically contain less than 20 parts per million of gluten and are considered safe for most people with celiac disease or gluten intolerance. Some examples of gluten-removed beers include:

• Omission Lager and Pale Ale
• New Belgium Glutiny brand Golden and Pale Ales
• Peroni senza Glutine (Lager)
• Widmer Omission Lager
• Widmer Omission Pale Ale

While these gluten-removed beers are generally considered safe for people with celiac disease, it is important to note that individual tolerances may vary. Some people with celiac disease may still experience adverse symptoms when consuming these beers. Therefore, it is crucial to read labels carefully, monitor your symptoms, and consult with a healthcare provider and a dietitian to determine the best dietary choices for your specific needs.

People with a history of irritable bowel syndrome (IBS)

IBS is a common condition that affects a significant number of people in the United States, and it is characterised by intestinal symptoms such as cramping, stomach pain, bloating, gas, diarrhea, and constipation. While triggers vary from person to person, common triggers include certain foods, stress, and hormonal changes.

Alcohol is known to irritate the digestive system, and for people with IBS, drinking alcohol can lead to a flare-up of symptoms. Even a small amount of alcohol can cause increased cramping or bloating, and for those who are especially sensitive, it may trigger diarrhea or constipation. Beer, in particular, has been reported by many IBS patients to significantly worsen their symptoms.

The impact of alcohol on IBS appears to depend on the amount consumed, with heavy drinking more likely to worsen symptoms. A 2013 study found that women with IBS were more likely to experience diarrhea, nausea, stomach pain, and indigestion after a night of binge drinking compared to moderate or light drinking. Additionally, drinking a large amount of alcohol over a short period may worsen diarrhea, a common symptom of IBS.

However, drinking light to moderate amounts of alcohol may not increase IBS symptoms. Based on current studies and dietary guidelines, researchers recommend that people with IBS limit their alcohol consumption to safe amounts, with at least two alcohol-free days a week. A safe amount is typically considered no more than one drink per day for women and two drinks per day for men.

For those with IBS who choose to drink alcohol, there are some tips to reduce the risk of triggering symptoms:

• Limit alcohol consumption to the recommended amounts.
• Drink plenty of water to stay hydrated and help dilute the alcohol.
• Eat a meal before or while drinking to protect the stomach lining.
• Slow down the intake of alcohol to give the body time to process it.

While the impact of alcohol on IBS may vary from person to person, understanding how the body reacts to alcohol is crucial for managing this condition. Some individuals may find relief by reducing alcohol consumption or choosing low-FODMAP alcoholic drinks, while others may need to abstain completely to avoid triggering their IBS symptoms.

People with a history of chronic liver disease or cirrhosis

The effects of alcohol on the liver depend on how much and how long you have been drinking. Alcohol-associated liver disease typically progresses through three types of disease: steatotic (fatty) liver, acute hepatitis, and cirrhosis. Steatotic liver is the most common alcohol-induced liver problem and is caused by a build-up of fat inside the liver cells, which leads to an enlarged liver. Alcohol-associated hepatitis and cirrhosis are linked to long-term unhealthy alcohol use.

For people with liver disease who have not yet developed cirrhosis, alcohol use accelerates liver injury (fibrosis) and increases the risk of developing cirrhosis. For those with cirrhosis, drinking alcohol can cause alcoholic hepatitis, which can lead to acute-on-chronic liver failure, a condition with a high mortality rate. There is no safe amount of alcohol that can be consumed by patients with cirrhosis, and abstinence is recommended for all patients.

Cirrhotic patients with active alcohol use are usually not eligible for liver transplantation, as sustained abstinence can improve liver function. Participating in an alcohol use disorder treatment program and avoiding all alcohol are crucial for improving the likelihood of favourable outcomes.

Frequently asked questions