[Kevin]
Hello, and welcome back to Nutrition for Noobs. I'm the Noob, Kevin.

[Michelle]
I'm Michelle.

[Kevin]
And we are back for another listener question. So Michelle, I'll hand it over to you because I think you were actually in touch with a listener.

[Michelle]
Yes, I ran into a lovely old colleague of mine back from the banking days who told me that she was a listener and that she loved the podcast. She and her husband loved the podcast, which was so lovely to hear. And Sheila asked about where we were chatting because we were both in the same restaurant.

And it's a vegetarian vegan restaurant in downtown London that doesn't serve alcohol, they only serve tea. And of course, and it wasn't my restaurant. And she made some comment about like, you know, I mean to write in and ask if, is alcohol really that bad for you?

Because we were chatting about the guidelines had changed. And so I said, well, that would make a great podcast episode. So let me address that listener question.

[Kevin]
And lo and behold.

[Michelle]
Yeah. And you know, you know, what's ironic about you and I talking about this, Kevin, the listeners probably don't don't realize that you and I have an annual sort of getaway that we do, a bestie trip, and we do wine tasting usually. And I still, you know, I don't drink a lot of alcohol, Kevin.

I still really enjoy going, though, for like, I'm a sommelier. I like taste evaluation. I like that whole experience.

But it's not like in my youth where, you know, I used to binge drink and over consume or needed to always have a glass of wine with my meal, you know, back in the younger years, particularly the intense project management, you know, 60, 80 hour a week workaholic, you know, everything about our lifestyle was unhealthy back then.

[Kevin]
I remember those days, not so fondly.

[Michelle]
Yeah, for sure. So I understand everybody's anxiety around the update that happened recently to Canada's guidance. So the document is called Canada's Guidance on Alcohol and Health, and it just updated in 2023.

I heard about that. So I had thought it was I couldn't remember. I think I mentioned this in a prior episode and I said 2019.

I couldn't remember. I knew it had updated recently, but it was really, really recent. I guess it all kind of all of these guidance updates sort of blend together in my mind at some point.

[Kevin]
Yeah, I'm sure.

[Michelle]
When it comes to alcohol, sort of the guidance that we were all in those years working when there was a lot of work culture of going for a drink after or discussing things afterwards after a long work day when you're overnight in a city on a project. Right. So the 2011 guideline indicated a standard weekly drink limit of 15 drinks for standard drinks for men and 10 for women.

So that was that was kind of considered the threshold that would sort of minimize risk. And then the risk escalates if you move from that sort of low consumption to moderate to high consumption. And and then we've had other guidelines all along.

Gosh, there's a there's a slide that I often taught from when I was teaching nutrition school about the modifiable risk factors that could significantly improve anyone's health and alcohol. Drinking of alcohol was one of the top five modifiable risk factors for.

[Kevin]
Makes sense. Makes sense.

[Michelle]
For chronic disease, along with smoking, physical inactivity and under consuming fruits and vegetables per day.

[Kevin]
Right.

[Michelle]
So we used to say on that slide to reduce your consumption of alcohol. And now we would actually put a strike through that and to say eliminate your consumption of alcohol based on the new guideline. If we're dealing with a population that does already have a diagnosis, they're already they're already at sick or they're high risk for for an illness.

So the new the new guidance, instead of being, you know, what what did I say that it was 15 for 15 per week and 10 for women per week. Yep. It's now considered for all individuals, a low consumption level would be two standard drinks or less per week.

[Kevin]
Right.

[Michelle]
And a moderate drinker is now considered someone, whether they're male or female, that drinks between three and six per week.

[Kevin]
Right. Which is less than one per day.

[Michelle]
Oh, my God. I can remember when my friend and I would empty two bottles of wine. You know what I mean?

Like.

[Kevin]
Oh, yeah, exactly. That's that's not very much.

[Michelle]
Yeah. We would order a bottle of wine for the table and then we'd order another one and we wouldn't be driving or anything like that. But we'd be walking back to our hotel room.

[Kevin]
Yeah. And you wouldn't really think anything ill of that.

[Michelle]
That would be an average Thursday. Yeah, exactly.

[Kevin]
Exactly.

[Michelle]
Oh, my goodness. It's amazing that I'm that I'm still alive and that I became a nutritionist after that, by the way.

[Kevin]
Yeah. Yeah. Thank you.

Thank you for clarifying. That's good. That's good.

[Michelle]
And then a high drinker or a high consumer of alcohol is considered those who consume seven standard drinks or more per week.

[Kevin]
Right.

[Michelle]
Well, here's another clarification in their guideline. I'm reading right from the government document here. Consuming more than two standard drinks per drinking occasion is associated with an increased risk of harms to self and others, including injuries and violence.

[Kevin]
Well, that's more the social rather than the health aspect of alcohol.

[Michelle]
Yeah, that's a social impact of health. But then they're also saying that there's that there's increased risk of oral cancers in particular and liver problems. But it's funny.

It's not funny at all. It's interesting to me how this intentional injuries is. Really emphasized in this document, I guess, since covid-19 lockdowns and everything that occurred with the pandemic and then making it possible for alcohol deliveries to be made to the home.

There's there's been a skyrocket of alcohol consumption and alcohol abuse in Canada. So I think that's one of the inputs that has weighed into their evaluation of current evidence and influencing these guidelines. But there are a number of studies that they appear to have referenced some Cochrane reviews.

It's a very extensive panel of medical professionals. There's no industry at the table here again that we see. Same with the Food Guide.

It's just such a massive change from before that it's taken a lot of Canadians by surprise. It's like, wow, like two, not two per day, two per week.

[Kevin]
Yeah, exactly.

[Michelle]
Exactly.

[Kevin]
It's a huge, huge decrease. And just to broaden this globally a little bit, at the very beginning of January 2023, so just a little bit over a year ago, the World Health Organization, the WHO announced that no level of alcohol consumption is safe.

[Michelle]
That's correct. They did.

[Kevin]
Period. End of story.

[Michelle]
No level, no safe level of alcohol consumption at all, if you're actually looking at your long-term health outcomes. Right.

[Kevin]
They say when it comes to alcohol consumption, there is no safe amount that does not affect health.

[Michelle]
Yeah.

[Kevin]
Which I think is just, I mean, it's basically saying alcohol is a poison. I mean, you know, I'm paraphrasing, but, you know, you can't have any.

[Michelle]
It is a carcinogen. So that's undeniable. It's really created quite a lot of anger in the public.

[Kevin]
I think part of the issue might have been the timing of this, because during COVID, there were a lot of lockdowns all over the world. And rightly or wrongly, I'm not judging, myself included, a lot of people did turn to alcohol because there wasn't very much to do, which then increased alcohol consumption throughout the globe. Again, not a good thing, but people needed a bit of a release.

I'm not trying to justify it, but it's just a fact. And then to come off of that and be told, no, zero alcohol is the only safe amount. It's eye-opening.

And we need this news. We need this information. We need to know that we're poisoning ourselves.

But I mean, I'm not going to lie and say, you know, my alcohol consumption absolutely increased over COVID. And, you know, I reverted back to my old bartender days and I started exploring.

[Michelle]
Oh, you make a good Cosmo, Kev.

[Kevin]
Yeah. Oh, I went way beyond Cosmos because I wanted to add something special to my life. You know, if my life is going to be 24 hours in my house with the same people, you know, with the same seven-year-old kid, you know, I needed a bit of a release.

And so I experimented. I discovered paper planes, which are just delicious.

[Michelle]
Paper plane is a drink?

[Kevin]
It is. It is.

[Michelle]
What's in it?

[Kevin]
It's got whiskey, Aperol, Montenegro, and a little bit of lemon juice.

[Michelle]
Do you even have all of those ingredients in your liquor cabinet?

[Kevin]
I do.

[Michelle]
Oh my gosh. You know, it's so funny that you, I mean, everybody experienced this differently, but we were the exact opposite in our house. We actually stopped consuming alcohol.

And I think, you know, I think what we, looking back, I think one of the reasons would be that we don't really drink at home anyway. We drink when we have company over. We offer them a drink.

Like we open a bottle of wine and it's more of a social thing, or we go out for dinner. Well, we stopped going out for dinner and we stopped having people over and we stopped being invited over to people's houses. So we didn't really drink.

And, you know, I think too, my, my mom was elderly. She was in that high risk category and we were all, we were really, you know, conscious of what we were, how much exposure we were having to the public. And I was going to work at the, at the hospital at that time as a project manager and, uh, I guess, you know, when we had to limit our choices of where we went out to get things, the liquor store was not top of our list.

[Kevin]
See, I used the delivery services. That was, there was delivery. And I think, I mean, again, everyone's, oh, see, no, there's, but I mean, everyone's different as you say.

And one thing we did is, you know, because we had a seven year old at home. So, you know, that added, you know, a certain stress to it with homeschooling.

[Michelle]
I think, I think I would have drank too.

[Kevin]
And just trying to keep them entertained without being able to go anywhere. Cause remember there was a time when even, again, I don't know how globally, but in Canada, uh, park playgrounds were closed for the first six months or so in those early days, you couldn't even play in a playground, like swing and slide sets in public parks. So there was literally nothing to do with kids.

Again, I'm not commenting on lockdowns, anything like that. This is not a political podcast. You're not going there, but all I'm saying is there was no whole lot to do to entertain my kid.

So what we would do is every Friday night, we would put the kid in front of a movie and we would pretend our kitchen would become a bar and we would sit down at the island on our stools. I would make a fancy schmancy drink and we would pretend that we were outside of the house at a bar.

[Michelle]
Oh, you know what? And you, and you weren't, it's not like you were like pounding them back or anything, you were just enjoying a cocktail, right?

[Kevin]
It was, the focus was on making something different. And, and the focus was more on the flavors and trying new combinations than just, you know, chugging back shots of tequila or whatever.

[Michelle]
You know, what we missed during that time was having rich experiences, right?

[Kevin]
Yes, absolutely.

[Michelle]
Like we, we never saw much more than the insides of our own walls or our own backyard.

[Kevin]
Right.

[Michelle]
The guidance on alcohol and health final report indicates that one of their opening phrases is that this guidance is based on the principle of autonomy in harm reduction. And a fundamental idea behind it is that people living in Canada have a right to know. That's why we're setting this guideline.

And, you know, I for one do believe that, that people have agency and they have the ability to make their own free choices about what they eat and drink. I've always said that, but my issue has always been that most of the pervasive messaging out in the, in the public media and on the internet and on pop culture sources about food and drink is usually incorrect. It's usually based on somebody having a private financial interest in something and construing a message to benefit themselves.

It's not, it's very difficult to distill what's true and what's not true about what actually introduces harm. And I'm always going back to two sources. What does the largest population data say about, about our, our links between diet and disease?

And what do the healthiest populations on the planet eat and drink? The ones that actually don't live with these risks, when we live in one of the most, the sickest populations on the planet, what do the least sick populations on the planet, what do they eat and drink? How do they live and how are they different?

And those are always the two barometers that I go from. Where are the survivors?

[Kevin]
Yes.

[Michelle]
Show me what the survivors are doing and show me what the actual evidence says on gigantic population basis. Forget what I think and what you think. And like, you can't make a health decision based on an outlier.

I, cause I hear these examples all the time. Oh, but Betty Davis, you know, smoked and drank and lived to be, you know, whatever. Okay.

That's great. But Betty Davis is an outlier.

[Kevin]
That's a study of one person. That's not, that's not very scientific.

[Michelle]
Yeah. And that's, that's not what we're seeing in our population. And if you think that you're a Betty Davis, then good for you.

Yeah.

[Kevin]
And you're also cherry picking the one person who lived a long time. Yeah. My mother always used to say that about the queen mother.

Oh, you know, she lived to 101 and she drank gin every single day and all that. But it's ignoring for every one person who that maybe works for because of great genes or whatever, you're ignoring the thousands of people who died young or died a miserable death with cirrhosis of the liver at 45.

[Michelle]
Yeah.

[Kevin]
You know, who, who didn't have that experience.

[Michelle]
Right. Well, and when, when we have kids at the ages of 10 and 12 years old now that are developing fatty liver disease without alcohol consumption, right. Just, just from, from a standard American diet and then get older and you add alcohol to that, that fatty liver disease, like they're set up to be very ill at a very, very young age.

[Kevin]
Right.

[Michelle]
So, um, I think it's very responsible of this one area of the government to do the right thing and, and warn us that, you know, what our alcohol guidelines before were too liberal based on what we're seeing.

[Kevin]
They've looked at the health studies, they've looked at the science and they've said, Hey, stuff changes all the time. Same as the food guide. It changes as we learn more as a science community, as a society, and we need to adjust and we need to do a pretty major adjustment because we were way off the first time.

[Michelle]
Yeah. Yeah. So let's talk about, um, what constitutes a serving of alcohol.

[Kevin]
Okay.

[Michelle]
Um, cause I thought that was kind of an interesting, cause that's, that's what came to mind for me when they say, you know, less than two drinks a week. Well, well, what's a drink? Is that a tall boy or, you know, like, what is that?

[Kevin]
Right. Yeah, exactly.

[Michelle]
Define that.

[Kevin]
Is that one bottle?

[Michelle]
Yeah. Is it a bottle of wine? Because that, you know, there are in some circles that can be one serving.

[Kevin]
Yeah, exactly.

[Michelle]
But, um, a, according to their guideline and they actually have a infographic about this, um, one standard drink means, um, uh, a beer, a 30, 341 milliliter or 12 ounce beer of 5% alcohol, uh, one, five ounce glass of wine of 12% alcohol. Oh my gosh. I never order a five ounce glass of wine.

[Kevin]
Now the truth is coming out.

[Michelle]
No, I'm trying to, I can't even remember. What are the sizes that they offer you? Five or?

[Kevin]
Five and eight, generally.

[Michelle]
Five and eight. Yeah. So I, oh yeah, I always order.

[Kevin]
And eight is always priced so much better.

[Michelle]
It is. And, and I'm usually, I'm usually done the five before I'm finished the meal.

[Kevin]
Yeah.

[Michelle]
So if I get the eight, I can, I usually only need one. But if I, if I get the five, I have to order two. Yeah.

[Kevin]
Yeah.

[Michelle]
So, okay. So, but, so I guess what, that's like one and a half I'm having then, right? So I've had one, I've had one, yeah, I've had one eight ounce glass of wine with dinner.

That's like basically almost my allocation for the week.

[Kevin]
Almost your weekly allocation. Yeah.

[Michelle]
Interesting. Um, and then spirit, um, how many spirits? So whiskey, vodka, gin, et cetera, one and a half ounces of spirits of 40% alcohol.

[Kevin]
Right. So that's pretty much unchanged. Cause I do remember that infographic from the old rules when it was 15 per week.

And that's pretty much unchanged.

[Michelle]
Yeah. 15 for you, it was 10 for me.

[Kevin]
Well, 15, yeah, exactly. But that was always one, one, one shot of liquor is the equivalent to one beer is equivalent to one small glass of wine. That was always the equation.

So that's, that's unchanged pretty much. It's just the quantity per week.

[Michelle]
Yes, exactly. Exactly. So there's a, there's an interesting, um, infographic that they have.

Let me just tell, guide the listeners here. It's on page 12 of the, of the guidance document, which is freely available on the internet. You can just Google it.

Uh, and it goes by elevated level of risk, uh, with, uh, average weekly alcohol consumption. So it starts at zero, not drinking has benefits such as better health and better sleep.

[Kevin]
Right.

[Michelle]
And then one to two, which is the low risk guideline that we talked about. You will likely avoid alcohol related consequences to yourself and others.

[Kevin]
Okay.

[Michelle]
Uh, they're really emphasizing this, um, this harm, like this harming yourself and others, like the, the tendency for people to become aggressive, um, or even, you know, even violent or, or suicidal.

[Kevin]
And well, and some of that can all, but some of that can also be passive. Um, and I'm thinking especially around parents with young kids, like if you've been drinking, you might not get violent and you might not get, you know, but you might just, you know, talk sharply to a kid or be less patient or just ignore them altogether or something. So there's, there's also sort of a non-violent, uh, or, or it could, it might not be kids, it might be a partner or a spouse or anything else or friends, but, you know, ignoring them or being sharp tongued with them or whatever.

[Michelle]
That's a really great point. That's such an important point.

[Kevin]
Alcohol brings out our true selves and there are some fun, happy drunks and some nastier drunks.

[Michelle]
Yeah. You know what? On that point, that's true because there were case studies that we studied in nutrition school, that there are some people, and I think they even know they, they develop an understanding of who they are, but there are certain people that have like allergic, allergic reactions to certain amines and certain wines and things like that.

And that they know that, like, for example, I can drink this type of red, but this type of red makes me really aggressive or I can't drink this type of wine or it makes me really aggressive. But there was even, there was even one case study, this guy that, um, completely blacked out and murdered his coworkers.

[Kevin]
Oh my God.

[Michelle]
And he had, he had no memory of having done it. He completely blacked out and they had this guy in jail and they were trying to understand, um, because he had no history of violence and no criminal record, like was always that, you know, that nice guy, you know, very, you know, good demeanor. And they couldn't understand, you know, these, I guess he was in some sort of a psychiatric hold at this point.

[Kevin]
Right.

[Michelle]
They couldn't figure out what triggered him. And then they asked him what he had for dinner that, um, the, the night that this occurred. And he told them and they gave him the exact same meal and the, and the, and the exact same wine that he had drank.

And he blacked out again and got erratic.

[Kevin]
Oh, wow.

[Michelle]
So they, and they determined that it was, um, some constituent of this particular red wine that had such a severe allergic reaction to his brain.

[Kevin]
Interesting.

[Michelle]
That it caused this blackout and, um, with violent, uh, uncontrolled violent behavior.

[Kevin]
Wow. Really bizarre. That's crazy.

Yeah.

[Michelle]
So, I mean, that's extreme and very, very, very rare, but I mean, it just kind of speaks to this fact that like the great point that you made there, there are other, you know, unknown consequences depending upon a person's own individual biology and how their body may react to certain substances. So then they say, uh, in the moderate risk category, three to six standard drinks per week, your risk of developing several different types of cancer, including breast and colon cancer increases, um, and seven or more standard drinks per week, your risk of heart disease or stroke increases. And each additional standard drink radically, so anything over six, each additional standard drink radically increases the risk of, um, any alcohol related consequence.

[Kevin]
Wow.

[Michelle]
So, yeah. So it's, um, it's pretty strongly worded and then, you know, this particular infographic doesn't mention the oral cancers, but the oral cancers are mentioned in other research, um, is a, is another consequence. So, yeah, but they really, they really emphasize unintentional injuries, violence, heart disease, high blood pressure, inflammation of the gastrointestinal system, uh, and risk of developing an alcohol use disorder.

[Kevin]
Sort of the good news, the coming out of all of this is I have seen that there is sort of an entire social change going on and alcohol is, it's becoming more accepted to not drink and there are some amazing, I went to Ireland several months ago and discovered, I mean, I don't want to stereotype, but Ireland is often known for indulging in alcohol, but everywhere throughout all of Ireland, you could get Guinness double zero.

They called it and it was de-alcoholized Guinness and it was everywhere. Every single pub had either Guinness zero or Heineken zero. And people were ordering it and, you know, the first time I ordered it because I love Guinness. So I said, oh, I'll try this.

[Michelle]
I love Guinness too.

[Kevin]
And I actually liked it better than regular Guinness because I could have more. But it had zero alcohol. Did it taste as good, Kev?

It did. Honestly, if you did a side-by-side comparison, you would not tell the difference other than not getting a buzz. But taste-wise, you'd have no idea.

[Michelle]
Well, I'm going to have to try it. It's funny because when you were experimenting, you know, being a bartender, I was experimenting with iced teas and just making copious amounts of iced tea. But yeah, you know, we've always enjoyed, my husband and I, a nice pint of Guinness sometimes when we go out on a, you know, a hot summer night and we just want to sit on a patio somewhere.

But that's good to hear. And, you know, I think we just recently, didn't we just recently do an episode on some of the hottest like food trends, things that were happening? I don't know if I mentioned it in that episode or not, but this space that you're mentioning right now of non-alcoholic drink innovations is one of the hottest spaces of development.

It's one of the hottest, like the younger generation doesn't want to be as abusive to substances, period, as we were. Absolutely. They're less into drugs and more into microdosing.

They're less into alcohol and more into non-alcoholic drinks and healthier lifestyles and things like that. So they're really catering to these new food trends. And I think it's fantastic, especially for the sober movement.

The sober movement has always had a tough time, in my opinion, that, you know, it's always been, how do they continue to be sober and socialize in this world where everybody else drinks around you versus we have more of a cultural shift towards healthier behaviors and healthier lifestyles for everyone and encouraging more sober community, even among the people that don't have an abuse problem, right? So I think that's fantastic.

And, you know, there's a lot of amazing events, even, I don't know if you've seen them in Toronto, but in London, we have them. We have like, actually, they're actually sponsored as sober events. And they're not just for recovering alcoholics.

[Kevin]
They're for everyone who wants to enjoy, yeah.

[Michelle]
For families, for families to come out and enjoy and not have to worry, you know?

[Kevin]
Of course. Just yesterday, I was at my local, you know, our local restaurant, and they've just introduced a bunch of mocktails.

[Michelle]
Nice.

[Kevin]
So I decided to try one yesterday. And honestly, it was better than a regular alcohol drink. Like, it was better than a beer.

It was a cocktail. It had some herbs in it. It had some cloves in it.

I don't even know what was in it. But it had the complexity of a traditional mixed drink, because sometimes mocktails are just, you know, fruit layered on fruit layered on fruit.

[Michelle]
Or they're just full of sugar.

[Kevin]
Yeah, exactly. I don't like a sweet, fruity drink.

[Michelle]
I cannot stand, like, when a mocktail is, like, filled full of that simple syrup, and it's nothing but pure sugar suspended in liquid.

[Kevin]
Yeah, no, that's gross. But this one that I had, it had a bit of, I think it had a bit of, like, peach nectar. I don't know what it had.

But it had herbs. It had cloves. The cloves definitely came through.

It was really, really good. And it was delicious and a complex flavor. And I ordered two of them throughout the course of the meal.

And I loved it.

[Michelle]
Nice.

[Kevin]
I was completely sober afterwards.

[Michelle]
How do they compare in price, Kevin?

[Kevin]
They were cheaper than a mixed drink. Okay. I mean, but more expensive than a Coca-Cola.

[Michelle]
Right.

[Kevin]
You know, so it's in that middle ground. But it was definitely cheaper because there was no alcohol. But it was nice.

And it's also just nice to, you know, we were with a few people. It was a few families getting together. And it was nice that I could have what looked like a fancy drink in front of me.

Not that I'm, I mean, I don't care about, you know, people if they say, oh, he's not drinking. But it was just nice to feel included because people had beer and people had wine, people had mimosas. And I had my fancy drink that, you know, looked special.

And, you know, so I could join in on the fancy drink party.

[Michelle]
You know what? I often do stuff like that. I often, one of my most common tactics now is that instead of having a glass of wine, I will have a wine spritzer.

And then that way, when I have two drinks, I've really only had one. Or I will, if it's somebody else's, like it's not out in a restaurant and it's somebody else's gathering and you know how you BYOB, I will bring an iced green tea.

[Kevin]
Yeah.

[Michelle]
And I will drink it in a wine glass and people don't know that I'm not drinking alcohol.

[Kevin]
Exactly. I'll often bring my Guinness Double Zero with me to a BYOB. And as far as they're concerned, I'm drinking Guinness and I don't have to explain myself.

[Michelle]
Yeah. And it's not like I'm afraid to tell people, no, I'm not drinking. It's just.

[Kevin]
Why have that conversation?

[Michelle]
Yeah, I don't need to make a spectacle of it. I'm just going to drink what I want to drink. Exactly.

Have a normal conversation. And, you know, I guess none of us want to feel judged, even if we're being judged for doing something healthier.

[Kevin]
Exactly. No, it's just, it's just why have that conversation? Why?

Because you never know the other person's reaction. So I'd rather just not open myself up to a potentially bizarre or uncomfortable conversation.

[Michelle]
Yeah. If people ask me, I'll tell them, but yeah.

[Kevin]
Yeah, no, I mean, I don't, I don't care. Like go ahead and judge me.

[Michelle]
Draw attention to yourself and go, look at me, look at how healthy I'm being.

[Kevin]
Exactly. I'm not, exactly. I'm not trying to be holier than thou and all that.

They even act, just they even have, when I was in Ireland, they even now, and maybe I'm just late to the game, but they even have de-alcoholized spirits now. Like I found a 0% gin there.

[Michelle]
See, you just need to replace the things in your bar.

[Kevin]
Yeah, exactly. It's not here in Canada yet, because I did look, but I had a gin and tonic with 0% gin and it didn't taste the same. I think it's very hard to replace that gin flavor, but it was close-ish, but it was there.

It had some of the undertones of it. It was better than just drinking tonic water by itself.

[Michelle]
Right. So, I just have one more little thing I want to highlight from this document, if I can. I thought it was kind of cool that they actually have a section about the reasons for the new guidance, so that they actually explain specifically what the science said about the specific links between alcohol and certain disease states.

[Kevin]
Okay.

[Michelle]
That led to them making this guideline.

[Kevin]
That's good. They have some transparency.

[Michelle]
Yeah, yeah. It's not like we've just decided because the WHO said so.

[Kevin]
Yeah, exactly.

[Michelle]
Alcohol and cancer is top of the list. Cancer is the leading cause of death in Canada, which you've heard me say over and over again. Right.

However, the fact that alcohol is a carcinogen, as I've said, that can lead to specifically seven types of cancer. This fact is often unknown and overlooked. The most recent available data shows that the use of alcohol causes, like it's directly linked to nearly 7,000 cases of cancer death each year in Canada.

[Kevin]
Wow.

[Michelle]
And most of those cases being breast or colon cancer, followed by cancers of the rectum, the mouth, and the throat, liver, esophagus, and larynx. That last bunch are the oral cancers that have been mentioned. According to the Canadian Cancer Society, drinking less alcohol is among the top 10 behaviors to reduce cancer risk.

[Kevin]
Wow. See, it's funny. Maybe, again, this could be the inner noob in me not understanding, but what I find fascinating about that is that I would have assumed that liver cancer would have been the number one cancer as a result of alcohol because alcohol goes through your liver and it can create cirrhosis of the liver and all that.

[Michelle]
Yeah, we definitely always associate it with that, don't we? Yeah.

[Kevin]
And yet, apparently, it's colon and breast cancer that are the two highest ones. And I just find that interesting, you know, how the body reacts to the alcohol that we ingest in not necessarily the most direct way that I would imagine.

[Michelle]
Well, and keep in mind, the carcinogenic contribution of alcohol would be combined with other dietary and lifestyle behaviors that may also be compounding that risk.

[Kevin]
Right, oh, that's true. Yeah, yeah.

[Michelle]
Yeah. Okay, the second thing that they mention is the links between alcohol and heart disease. So after cancer, heart disease is the second leading cause of death in Canada.

And for many years, the commonly held belief that drinking in moderation offered protection against coronary artery disease has been widely publicized. But research within the last decade is more nuanced. And the most recent and highest quality systemic reviews show that drinking a little alcohol neither decreases nor increases risk of ischemic heart disease.

But it is a risk factor for most other types of cardiovascular disease, including hypertension, heart failure, high blood pressure, arterial fibrillation, and hemorrhagic stroke. Hemorrhagic stroke is the type of stroke where you have a brain bleed.

[Kevin]
Oh, okay, okay.

[Michelle]
Okay, alcohol and liver disease, which was what you just mentioned.

[Kevin]
Yeah.

[Michelle]
Well, you expect liver cancer, but that's a form of liver. But there's other disease in the liver, fatty liver disease, which I mentioned. Statistics show that liver disease is on the rise in Canada, and alcohol is one of its main causes.

Drinking a large amount of alcohol, even for just a few days, can lead to a buildup of fat in the liver. And this is called alcohol-associated fatty liver. A more severe form of alcohol-related liver disease is called alcohol-associated hepatitis, which is generally caused by alcohol abuse or less commonly when people consume a large amount of alcohol in a short period of time, such as binge drinking.

[Kevin]
Oh, okay.

[Michelle]
And eventually, ongoing alcohol-related liver injury can lead to the development of scar tissue in the liver, termed fibrosis, which can lead to the life-threatening cirrhosis and liver cancer. So there you go. There's your cirrhosis of the liver.

[Kevin]
That's the more direct link that I think of with drinking. And sort of you're messing up your liver big time, because it's trying to process all of this poison you're putting into your body. It's trying to keep you healthy.

[Michelle]
I think you're right, though. I think that that's kind of been what we most often associate. And I think it's really quite eye-opening and prudent for this guidance to make us aware that you know what?

[Kevin]
It's more than that. Significantly more than that.

[Michelle]
Significantly more than just cirrhosis of the liver. And then the next guidance that they, the last guidance that they mentioned that influenced this guideline based on their research was alcohol and violence, which is why we hear that language repeated throughout this very, very, very long document. Alcohol is frequently associated with violent and aggressive behavior, including intimate partner violence, male-to-female sexual violence, and aggression and violence between adults.

Alcohol can also increase the severity of violent incidents. No exact dose-response relationship can be established, but consuming alcohol increases the risk of perpetrating alcohol-related violence, and it is therefore reasonable to infer that individuals can reduce their risk of perpetuating aggressive and violent acts by limiting their alcohol use. Based on consistent evidence, it is highly likely that avoiding drinking to intoxication will reduce individuals' risk of perpetrating alcohol-related violence.

[Kevin]
Makes sense.

[Michelle]
There you go. And then, you know, for the people that really want to nerd out on there, there's like another, I think, 80 pages.

[Kevin]
Nice bedtime reading if you can't get to sleep one night, I'm sure.

[Michelle]
Yeah, like they go into minutiae about the studies and about how they made their calculations. They seem to be like there's charts and like they're very painfully thorough in being transparent about the evidence, where the evidence came from. Yeah, so that is not an uplifting episode, but I think, you know, back to my friend Sheila, I think it was a really important question, and yeah, it's just not a piece of information that we've been raised to believe, you know, as young people, you know, university age, whatever, where, you know, these behaviors are often quite glorified.

And then even in your young urban professional days, you know, working in the work world and the social behaviors of let's go out for a drink after work and, you know, getting together with friends and parties, et cetera, they often, you know, the culture has been like the Canadian beer commercial, right? It's been very alcohol-centric.

[Kevin]
Exactly. And it's part of that culture.

[Michelle]
Yeah.

[Kevin]
Like it's part of the culture of what makes us Canadians, Canadians.

[Michelle]
Yeah. And you can't shift that culture where people don't know.

[Kevin]
Exactly. So no, it's, you know, you said it wasn't very uplifting. I actually thought it was very uplifting because knowledge is power.

And I'd heard of these changes in recommendations, but I didn't know the whole story behind why. And again, I just stupidly thought, oh, it's basically liver, liver damage, liver, blah, blah, blah, you're screwing up your liver. But there's so much more to it, to the problems with drinking alcohol.

And I find that fascinating that it's multilayered.

[Michelle]
Yeah. Well, I think you've done like an exceptional job in this episode, Kevin, if I might say, at really drawing from your experience and giving people inspiration to try some of these other things. Like you can still be a mixologist at home, but, you know, try some of these non-alcoholic versions of spirits and of beers.

And was it really the buzz you were after? Or was it just the social experience of enjoying a drink with friends and having those different taste experiences? And, you know, I would say the same thing with tea.

Tea cocktails or tea mocktails are, you know, I know that at one point they were listed as one of the top trends in New York City restaurants were tea cocktails and tea mocktails. So I'm always doing different weird things with tea and adding bitters and stuff like that to them. And you don't even know sometimes that you're not drinking an alcoholic drink.

And I think it's just a paradigm, right? That we feel like if we don't taste alcohol or we don't, you know, we don't really feel like we're able to be those social animals because the alcohol loosens you up or whatever, but we can enjoy each other's time in each other's company. And I think the sober movement, like being around some of those events and some of my friends that are a part of that movement, you know, have really emphasized that for me that they have a lot more fun together when they're just authentically themselves and engaging on a real level and not some, you know, alcohol-induced state.

Right.

[Kevin]
Yeah, yeah, yeah. Yeah, no. For me, it was always about the flavor and the taste.

And that's where I think some of the mocktails that are coming out now, and I have actually seen tea mocktails on, I haven't tried one as of yet. I need to. It's on my list of things to do, but I have seen them on a few menus.

But I think mixologists are getting more creative and more inventive. And I think that's amazing. And I'm willing to try them all.

I love it, I think, because I want that flavor. I want the different flavor combinations rather than just, again, you know, one of the standard like pops or whatever for juice. Yawn, boring.

[Michelle]
Well, I look forward to your guidance on that. Maybe we'll have a future episode where Kevin brings some of his top mixology, non-alcoholic cocktail recipes.

[Kevin]
Totally, totally.

[Michelle]
Hint, hint.

[Kevin]
Oh, I'm seeing this, okay. We'll get that just in time for summer.

[Michelle]
Right, because that's where I'd be the noob. You would be the expert.

[Kevin]
Okay, I will take that as a challenge.

[Michelle]
Challenge accepted.

[Kevin]
Challenge accepted.

[Michelle]
Awesome. Okay, well, thanks so much, Sheila. And thank you, Kevin, as always.

Loved diving into that, because it gives me reason to access the actual document and look a little bit deeper in it so that I could share that with everyone.

[Kevin]
Exactly, see the science behind it. And yes, thank you, Sheila. That was amazing.

If anyone has any feedback or questions for Michelle or me, but mostly Michelle, feel free to email us at n4noobs at gmail.com. That's n4noobs at gmail.com. And it's that time of the podcast when we have the bad joke.

[Michelle]
Dun, dun, dun.

[Kevin]
Are you ready? This is a long one, so bear with me. It's a bit of a shaggy dog joke.

Okay. A guy stumbles through the door of a bar, ambles up to the bartender and orders a beer. The bartender looks at the drunk man and says, I'm sorry, sir, but I can't serve you.

You've already had too much to drink. The guy just swears and walks out of the bar. Five minutes later, the guy comes flying through the side door of the bar and yells for beer.

Again, the bartender says, I'm sorry, sir, but I can't serve you. You've already had too much to drink. 10 minutes later, the same guy comes barreling through the back door of the bar, storms up to the bartender and demands a beer.

Again, the bartender says to the man, I'm really sorry, sir, but you've had too much to drink. You're going to have to leave. The guy looks quizzically at the bartender and says finally, my God, man, how many bars do you work at?

Oh my gosh.

[Michelle]
Okay. That was bad.

[Kevin]
Yes, it was very bad, but, but you're still chuckling. So there you go.

[Michelle]
Oh, well, I think it's you. I think it's you. I'm just, I'm just laughing at your jokes.

[Kevin]
Oh, so thank you, Michelle, for sharing all this. I appreciate it as all our listeners do.

[Michelle]
Thank you, Kevin.

[Kevin]
And until next time, eat your greens and be real. This has been Nutrition for Noobs. We hope you're a bit more enlightened about how your fantastic and complicated body works with the food you put into it.

If you have a question or a topic you'd like Michelle to discuss, drop us a line at n4noobs@gmail.com. That's the letter N, the number 4, N-O-O-B-S at gmail.com. If you haven't already, you can subscribe to the podcast on whatever your favorite platform might be.

Also, please consider leaving a review or telling your friends. That's the best way to spread the word. We'll see you next time with another interesting topic.

The views and opinions expressed on Nutrition for Noobs are those of the hosts. It is not intended to be a substitute for medical, nutritional, or health advice. Listeners should seek a personal consultation with a qualified practitioner if they have any concerns or before commencing any actions mentioned in the podcast.