I drink alcohol often. What should I know about blood fats?

If you drink alcohol often, it helps to know that MedlinePlus, from the US National Library of Medicine, lists excessive alcohol use among the factors that can raise triglycerides, a type of fat in the blood, and that alcohol itself carries 7 calories per gram. What you can do is count what you actually drink each week, have several drink-free days, choose fewer fried and salty snacks, and have your blood fats checked at your health check, telling the doctor honestly how often you drink.

How is alcohol connected to blood fats?

A health check measures several kinds of blood fat. The one for which MedlinePlus lists drinking as a factor is triglycerides.

What triglycerides are

MedlinePlus explains that triglycerides are the most common type of fat in the body. They come from food, especially butter, oils and other fats, and from extra calories: calories you eat that your body does not need right away. The body turns these into triglycerides, stores them in fat cells and releases them when it needs energy.

Drinking is on the list of factors

MedlinePlus lists several factors that can raise your triglyceride level. The ones that are part of everyday life are:

• regularly eating more calories than you burn off, especially if you eat a lot of sugar
• cigarette smoking
• excessive alcohol use

Other factors, such as genes and certain medicines, are outside your control, so levels differ from person to person. Drinking, on the other hand, is a factor you can adjust yourself.

Alcohol is energy

The NHS explains that alcoholic drinks are made by fermenting natural starch and sugar, which is why they are high in calories. Alcohol itself contains 7 calories per gram, almost as many as a gram of fat. Mixers such as cola or tonic add more.

The NHS gives the example that 5 pints of 5.2% lager a week add up to 57,720 kcal a year, and 4 bottles of 12% wine a month to up to 32,400 kcal a year. Energy from drinks adds up without being noticed, and snacks add to it.

How much alcohol counts as a lot?

People who drink often rarely know their weekly total, because bottles, glasses and strengths vary so much. The NHS uses alcohol units to keep count.

What one unit is

The NHS defines one unit as 10 ml or 8 g of pure alcohol, around the amount the average adult can process in an hour. To work it out, multiply the strength (ABV %) by the volume in ml and divide by 1,000. The strength is on the label as ABV or % vol.

The beer bottle and can figures are calculated with the NHS formula. For whisky and soda, count the spirit poured into the glass, not the size of the glass.

The 14-unit guide

The NHS advises that, if you drink most weeks, men and women should not regularly drink more than 14 units a week, should spread it over 3 or more days if they drink that much, and, to cut down, should have several drink-free days each week. The NHS says 14 units is about 6 pints of average-strength beer. Using the same formula, four and a half large bottles of 5% beer already make about 14 units.

The number is a ceiling, not a target

The CDC says that drinking less is better for your health than drinking more, and advises people who do not currently drink not to start for any reason. So 14 units is a ceiling for people who already drink, not an amount to aim for.

If I drink often, how can I cut down and have drink-free days?

Changing a drinking habit does not have to mean stopping all at once. Start by knowing your own numbers, then adjust.

Count first, then plan

Write down which days you drink in a week, what and how many bottles or glasses, then convert to units. For example, four large 620 ml bottles of 5% beer in one evening already come to about 12.4 units. Then choose your drink-free days in advance, for example Monday to Thursday, in line with the NHS advice to have several each week.

What the NHS suggests while drinking

• have a glass of water after every alcoholic drink
• do not drink on an empty stomach
• drink at your own pace, because drinking in rounds can mean drinking more than you intended
• take small sips
• with wine, add a splash of soda water to make the drink last longer
• cut down together with a friend, which makes it easier to stick to

Fitting it to a Thai drinking circle

At a Thai table, glasses are topped up constantly, which makes counting hard. Tell your friends at the start how many bottles you will have, use a smaller glass, alternate with glasses of water, and avoid mixing spirits with sweet soft drinks, which the NHS notes add extra calories.

Which drinking snacks are worth paying attention to?

Calories from drinking often come with the snacks, which in Thailand tend to be fried and salty.

Fried food and packaged snacks

The NHS lists fatty cuts of meat, meat products, butter, lard, palm oil and coconut oil among foods high in saturated fat, and suggests choosing unsaturated fats instead, such as olive oil, rapeseed oil, nuts and oily fish.

Salt

The NHS advises adults to eat no more than 6 g of salt a day (around 1 level teaspoon), and lists cured meats and fish, cheese, olives and pickles among salty foods and soy sauce among salty condiments, and suggests unsalted nuts as a healthier snack. Many drinking snacks, such as salted fried peanuts, sun-dried pork and dipping sauces, are high in salt.

The NHS suggests choosing a healthier option if you reach for snacks while drinking. You do not have to give up fried food altogether; swapping some of the dishes on the table means fewer fried and salty dishes overall.

After a health check, what should I talk to the doctor about?

If you drink often, have your blood fats looked at during your health check, and be open about your drinking.

What a blood test can show

MedlinePlus notes that there is a blood test that measures triglycerides along with cholesterol. On a health check report, these usually appear under blood fats or lipids. If your package does not include them, ask the clinic whether to add them and how long to fast beforehand.

For blood fat results on a health check, see I'm in my early 30s. Should I start watching my blood fats?

Tell the doctor the real numbers

Say what you drink, how many days a week and how much each time. Using the units you worked out makes this clearer. The doctor can then read your results in the context of your daily life and tell you when to check again.

When to ask for more advice

• a result on your report is flagged, or you are not sure what it means
• you have tried to cut down on your own and found it hard
• you take regular medicines and want to know whether alcohol is a problem with them; ask a doctor or pharmacist

Reading the results and deciding what to do next is best done with a doctor who knows your history.