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It¡¯s natural to wonder how the substances we consume affect our bodies. Many Americans choose to drink, so it¡¯s no surprise that alcohol¡¯s impact on the body is of particular interest.

We spoke to physician , researcher , and senior clinical dietitian Victoria Lee to learn how alcohol impacts the body and the best way to proceed.

Alcohol increases cancer risk

Consuming alcohol in any quantity has been shown to increase the risk of cancers including:?

• oral cancer
• throat cancer
• colorectal cancer
• esophageal cancer
• liver cancer
• breast cancer

In fact, the ?writes that an estimated 5.5% of new cancer diagnoses and 5.8% of cancer deaths worldwide are linked to drinking alcohol.?

Karam-Hage says the longer someone has been drinking, the more likely they are to develop cancer.?

Here are a few of the reasons why alcohol increases cancer risk.?

Alcohol is a toxin

No matter what type of alcohol you drink ¡ª be it wine, beer, or liquor ¡ª it contains ethanol, Lee says. She notes that when your body breaks down ethanol, it produces a carcinogen called acetaldehyde that damages DNA.?

¡°DNA is a molecule needed by nearly every cell in our body for information on how to properly function, repair and regrow,¡± Lee says. ¡°If cells cannot properly repair themselves, cancer can grow.¡±?

Karam-Hage adds that alcohol impacts all of our organs, but particularly the brain, liver, esophagus and stomach. ¡°Alcohol has a toxic effect on many organs,¡± he says.

Alcohol isn¡¯t nutritious

Alcohol has what Daniel-MacDougall describes as empty calories. ¡°It provides calories, but no other nutrients,¡± she says.

Consuming more calories than your body needs can lead to weight gain. Excess body weight increases a person¡¯s risk for cancer and other diseases.?

Alcohol changes how the body uses nutrients

When you drink alcohol, your body is less able to absorb and use a variety of nutrients that can protect it from cancer, Lee says. These nutrients ¨C which include Vitamins A, B1, B6, C, D, E and K, folate, iron and selenium ¨C help to keep the body healthy, protect cells, create and repair DNA, and reduce inflammation.

Alcohol can change hormone levels

Alcohol can also affect your hormones.?

¡°It can increase estrogen levels which might increase risk of breast cancer in some women,¡± Lee says.

Alcohol alters the gut microbiome

Alcohol can also alter the body¡¯s oral and gut microbiome, which Daniel-MacDougall describes as the balance of bacteria, viruses and fungi that help to keep the body healthy.?

One of the microbiome¡¯s roles is to separate alcohol toxins so the body can remove them. ¡°The gut microbiome is a critical link between the digestive system, the liver and the immune system, playing a big part in how our body metabolizes alcohol and manages that amount of ethanol or toxins that come from alcohol,¡± she says.?

While Daniel-MacDougall notes a healthy body may be able to break down and remove a limited amount of alcohol, many factors can impact how your body reacts when you drink. On top of that, drinking too much rapidly alters the gut microbiome with short- and long-term consequences.

One of those short-term consequences? That ¡®sick to your stomach¡¯ feeling you might experience after overindulging.

¡°There¡¯s a reason why drinking too much alcohol makes us sick to our stomachs from vomiting to diarrhea," she says. ¡°You¡¯re sort of overwhelming the system.¡±

Over time, she explains that an unhealthy gut microbiome can wear down the gut¡¯s protective lining. From there, toxins can move into the bloodstream and on to the organs. This can increase the risk of cancers both within the gastrointestinal tract and beyond.?

¡°Those toxins get into the bloodstream, and then they start to cause things to go awry beyond the gut microbiome,¡± she says.

Alcohol?increases other long-term health risks

Beyond its link to cancer, alcohol is also linked to a variety of other health concerns, especially when consumed in excess, Karam-Hage says.

According to the , the long-term health risks of drinking excessive amounts of alcohol include:?

• high blood pressure
• heart disease
• stroke
• liver disease
• digestive problems
• weakened immune system

Alcohol affects sleep

If a drink or two leaves you ready for bed, you might be surprised to learn that drinking alcohol is linked to insomnia, or trouble falling ¡ª and staying ¡ª asleep.?

¡°The interesting thing about alcohol is that it¡¯s sort of deceiving. When people drink, they feel sleepy or tired. They go to sleep, and then they have what we call rebound insomnia: in the second part of the night, they wake up and they cannot fall back asleep,¡± Karam-Hage explains.

Alcohol-related sleep issues aren¡¯t just limited to nighttime, however. Karam-Hage says they can have a real impact during the daytime hours. ¡°Insomnia can affect your day-to-day functioning,¡± he says.

Alcohol can have negative effects on fertility and pregnancy

Drinking alcohol can impact many stages of the journey to parenthood.

¡°There is the risk of infertility for both men and women,¡± Karam-Hage says. ¡°But for women who get pregnant, a major problem is fetal alcohol syndrome.¡±

The CDC that fetal alcohol syndrome disorders may result in ¡°lifelong physical, behavioral and intellectual disabilities,¡± which can occur when a fetus is exposed to the alcohol in a mother¡¯s blood.

Drinking any amount of alcohol while pregnant can increase the risk of fetal alcohol syndrome disorders, Karam-Hage says.?

¡°It used to be thought that it¡¯s only heavy alcohol use, but now the understanding is that any alcohol during pregnancy can expose the unborn fetus to fetal alcohol syndrome,¡± he says.?

In addition to the risk of fetal alcohol syndrome disorders, the CDC writes that drinking alcohol while pregnant can lead to miscarriage or stillbirth.

Alcohol impacts mental health and brain function

Alcohol can impact the brain in many ways. For example, Lee notes that heavy alcohol use can lead to:

• alcohol dependence?
• anxiety
• depression
• learning problems
• memory problems?

In addition to being a depressant, Karam-Hage says alcohol can cause brain atrophy by speeding up the death of neurons in the brain. The resulting damage to brain cells and cell death can reduce cognitive function and cause problems with memory, concentration and executive functioning.?

To date, research has mainly focused on excessive drinking; Karam-Hage says studies have even linked heavy drinking to increased dementia risk. More research is needed to determine how light alcohol use impacts the brain.

¡°Some people think that any alcohol causes some loss of neurons, which, of course it would because alcohol is toxic,¡± Karam-Hage says. ¡°But the question is whether it's significant or not. That's the part that we don't know.¡±

How to proceed?

When it comes to preventing cancer, not drinking alcohol is the safest choice.?

Men who choose to drink should limit themselves to two drinks per day, while women who choose to drink should limit themselves to one drink per day.

A standard drink size looks different depending on the type of alcohol you choose. According to the , a standard U.S. drink includes 0.6 ounces of pure alcohol; the same amount of pure alcohol is generally found in 12 ounces of beer, 5 ounces of wine and 1.5 ounces of 80-proof distilled spirits or liquor.

If you¡¯d like to drink less, Lee notes there are many options you can try.?

¡°Try nonalcoholic beer or wine, replace a cocktail with a mixed drink that contains only a splash of alcohol or none at all or make several days out of the week alcohol free,¡± she says.

or call 1-877-632-6789.

As a who studies diet and the microbiome, I often hear questions about how everyday choices impact the body.

One area that people are especially curious about is alcohol. How much is safe to drink? Can drinking harm the microbiome? How can I repair my microbiome if I drink too much?

Below, I answer common questions about how drinking alcohol can affect the body¡¯s microbiome and what it means for our overall health.

What is the microbiome??

The microbiome is our body¡¯s non-human inhabitants, such as bacteria, viruses and fungi. Humans have an oral microbiome and a gut microbiome.

When we are talking about the gut microbiome, we're mostly talking about our bowel: our colon all the way down to our rectum.

Normally, the gut microbiome has a healthy balance of bacteria. These bacteria help our bodies by:

• supporting our immune system?
• supporting our metabolism
• regulating inflammation
• working with the liver to defend against toxins
• helping to prevent chronic and infectious diseases?
  

How does drinking alcohol affect the body¡¯s microbiome?

Diet, or what we ingest, has a huge impact on the microbiome. When we drink alcohol, it impacts everything from the oral microbiome all the way through the digestive system. It also involves a lot of other organs along the way.

Here are three things that can happen in the gut microbiome when we drink alcohol.

Alcohol changes the balance of bacteria in the gut microbiome.?

First, alcohol can change the composition, or balance, of the gut microbiome. This can cause the gut microbiome to go from a state of homeostasis where everything is happy and calm into a state of dysbiosis where things start to go out of whack.

Metabolites can harm the microbiome

The gut microbiome works to metabolize the different components of alcoholic drinks. In doing so, it creates products, called metabolites, that are used to signal between the gut microbiome, liver and blood. Some of the metabolites that are created when your body breaks down alcohol can be toxic.

Leaky gut?

There is a protective mucus layer on the intestinal lining of our gut. When our gut microbiome starts to get out of balance, it begins to eat at the protective layers between the gut, the rest of our body and our circulating blood. This causes a change in gut integrity, or a leaky gut.

Does the microbiome play a role in alcohol¡¯s link to cancer?

Alcoholic drinks contain ethanol. Ethanol is considered a carcinogen. It's a toxin that causes DNA damage and ramps up reactive oxygen species, which are mechanisms associated with cancer.?

If you have a leaky gut, toxins from metabolizing alcohol can get into the bloodstream and cause things to go awry beyond the gut microbiome, usually starting with the liver.??

However, these toxins can also increase cancer risk outside the gastrointestinal system. Cancers that are linked to drinking alcohol include:

• esophageal cancer
• colorectal cancer
• stomach cancer
• liver cancer
• oral cancer
• breast cancer ?

The gut microbiome is really opening up how we understand this problem. Alcohol affects both the oral microbes and gut microbes which play important roles in cancer risk.

How else can alcohol impact the microbiome?

The gut microbiome is a big part of how our body metabolizes what we eat, what we drink and the medications we take. Working in a delicate balance with the liver, it helps to control the amount of ethanol or toxins that impact our health more broadly.?

Alcohol can cause gastritis. The enzymes in the stomach lining can be overwhelmed, and the lining can start to break down. There¡¯s a reason why drinking too much alcohol makes us sick to our stomach and can lead to vomiting and diarrhea: you¡¯re sort of overwhelming the system.??

How should we proceed?

Going forward, it is helpful to know about alcohol dosage and your personal alcohol sensitivity.

Understand alcohol serving sizes

MD Anderson says that for cancer prevention, it is best not to drink alcohol. However, for those that choose to drink, men should limit themselves to two drinks per day, while women should limit themselves to one drink a day.?

Some people are surprised to learn that a standard drink looks different depending on the type of alcohol. The ?writes that a standard drink has 0.6 ounces of pure alcohol. This is the amount of pure alcohol that is usually in 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof distilled spirits or liquor.??

There may be a limited or acceptable amount of alcohol that a healthy body, with everything working in perfect harmony, can get out of the system appropriately. However, everyone is different, and things can go wrong at different places along the way.

Know why people respond differently to alcohol?

People break down alcohol differently. A well-documented example of this is the difference in how men and women break down alcohol.?

I didn¡¯t understand the recommendations that suggest women drink half as much alcohol as men until I went to graduate school. I thought it was all about size. I thought, ¡®I¡¯m a 5¡¯8 woman, why is my recommendation different than a 5¡¯8 man?¡¯?

I later learned it doesn't have to do with size; it has to do with metabolic function. People's personal biological and genetic sensitivity to alcohol, and how well they break down alcohol into its toxic and nontoxic components, is based on how much of an enzyme called alcohol dehydrogenase (ADH) they have.?

ADH levels are different in men and women, as well as in people of different racial and ethnic backgrounds. This is determined by our genetics.

Although we give recommendations for alcohol consumption, they might not apply to everyone. Some people may be so sensitive to alcohol that they can¡¯t tolerate that amount. That's why MD Anderson and other organizations have said there¡¯s no safe amount of alcohol for cancer risk. At the end of the day, we don't know what your specific situation is.??

Can your microbiome be repaired?

When it comes to alcohol and other nutritional components, if you're having a bad week, you can put your microbiome in quite a bad state.?

The good news is that, typically, if you make an effort to go back to healthier ways, the microbiome will go back to the same state it was in before.

Something interesting I¡¯ve seen with diet and alcohol is that the decline happens faster than the repair. For example, maybe it takes eight weeks to build this really healthy microbiome, but in less than two weeks, you can turn that around in the wrong direction.??

What is important is how far down you go and how long you stay there. If you put your microbiome in a state of stress for an extended period of time, it's actually pretty selfish and it will put its own needs over yours. That's why it starts to eat things like the mucus layer. It doesn't want to starve and die, so it starts taking from you. That's when things start to really go in the wrong direction.?

The gut microbiome is really important for immunity. People joke ¡°I'm going to drink alcohol and kill all the bad stuff,¡± but that's not how it works. You want your gut microbiome to be really healthy to fight infections; it's a critical part of our overall immune system. It is also really important for regulating inflammation not only in the gut, but throughout the whole body. Infection, poor eating habits or smoking can create pro-inflammatory conditions. When you drink alcohol on top of that, it's like adding fuel to the fire. The microbiome can't bounce back to take care of you. It¡¯s our friend until it's in trouble, and then it is not our friend.

or call 1-877-632-6789.

Can as little as one alcoholic drink a day raise your breast cancer risk?

Studies say yes. But does that mean you should steer clear of alcohol completely? And what about that glass of wine that¡¯s supposed to be good for you?

Alcoholic drinks come in three choices: beer, wine and liquor. A drink is defined as 12 ounces of beer, 5 ounces of wine or 1.5 ounces of liquor. If you choose to drink, exceeding the recommended limit of one alcoholic drink a day increases your breast cancer risk.

¡°But that risk is very low,¡± says Therese Bevers, medical director of MD Anderson¡¯s?Cancer Prevention Center. ¡°You need to be more concerned if it becomes a routine in which you drink more than one drink each day.¡±

have looked at the association between alcohol consumption and breast cancer risk in women. These studies, although observational ¨C meaning they draw on inferences from researchers - have consistently found an increased risk of breast cancer associated with alcohol intake.

¡°We always question the validity of observational data, but with this we¡¯re seeing it over and over again,¡± Bevers says.

And while some studies show that one glass of wine a day can be good for your heart, you shouldn¡¯t have more if you¡¯re trying to stay healthy.

How does alcohol affect breast cancer risk?

So, why does alcohol intake increase breast cancer risk specifically?

¡°We don¡¯t really know, but we do have a few guesses,¡± Bevers says.

Reasons why alcohol consumption may lead to breast cancer include:

• Alcohol is empty calories and can lead to unwanted weight gain. Excess fat can lead to increased cancer risk.
• Alcohol can increase levels of estrogen and other hormones associated with breast cancer.
• Alcohol users are more likely to have increased amounts of folic acid in their systems, which can lead to increased cancer risk.

Men should also limit their drinking, but not because of breast cancer risk. While men can develop breast cancer, alcohol consumption doesn¡¯t really increase their risk for breast cancer.

¡°Breast cancer in men is so rare, if they do develop it it¡¯s usually because of genetics, not diet or alcohol,¡± Bevers says.

Alcohol has been shown to increase risk for , including head and neck, esophageal and liver cancers.

To cut back on your alcohol consumption and lower your breast cancer risk, follow these guidelines:

• Select low-calorie options to avoid unwanted weight gain.
• Stay away from 100-proof liquor. Researchers believe that it¡¯s the ethanol or alcohol in beer, wine and liquor that causes increased cancer risk.
• Avoid alcohol as often as possible.

¡°You can still enjoy alcohol on occasion,¡± Bevers says. ¡°Just don¡¯t make it a routine.¡±?