Q&A: ‘Dry January’ provides opportunity to reevaluate drinking for liver, overall health
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Many individuals look to the new year to follow through their resolutions such as diet and exercise and some are now attempting ‘Dry January’, to reset after a holiday full of drinking.
“For the average person who doesn’t have alcohol-related health consequences, 1 month is like going to the spa for a month of health concentration,” Nancy S. Reau, MD, FAASLD, AGAF, The Richard B. Capps Chair of Hepatology and professor of digestive diseases and nutrition in the department of internal medicine at Rush University, told Healio. “Relook in February with a new perspective. Are you going to resume drinking safely, or are you going to go back to drinking the same way you were before? Dry January shouldn’t be seen as something miraculous.”
Healio spoke with Reau about the impact of alcohol abstinence on liver and overall health and the importance of evaluating alcohol consumption and other unhealthy habits.
Healio: Do you encourage Dry January or in general taking time off drinking?
Reau: I think it is important to concentrate on health and consider Dry January to be about more than just alcohol abstinence, but rather kind of a reset to a healthy lifestyle. If someone thinks they have an alcohol problem and it is affecting their job or social function, then attempting Dry January is important, but it should not just be a month off. It should be an evaluation for how to be healthy going forward. It cannot just be a month of vacation from something that is potentially more problematic.
Healio: What recommendations do you give people who are trying to reduce or reevaluate their drinking?
Reau: If you are a social drinker, you are going to be able to stop without any kind of health hazard. But if someone is a heavy, regular drinker, they can get quite sick when they abruptly stop. For those who fit within the CDC guidelines of reasonable recreational alcohol use, Dry January is a nice time to concentrate on overall health. There are a lot of bars that now do virgin cocktails, so you can feel like you are doing something fun. I think that Dry January is more appropriately a time where you can look at your health consequences and not just assign all health value to alcohol load. It is probably not good enough to stop drinking if you still are eating a bag of chips and or a lot of fast food and you are not exercising.
Healio: How does excessive drinking affect the liver?
Reau: In the United States, alcohol- and non-alcohol-related fatty liver disease are the two most common reasons for liver complications and liver-related morbidity and mortality. That does not mean that everyone who has problematic drinking develops liver failure. There are certainly people who drink what is considered a reasonable amount of alcohol who develop liver-related consequences. It is important to recognize that genetics or other health-associated factors, such as gastric bypass surgery or metabolic syndrome, may increase your risk for alcohol-related liver injury. The most common consequence from alcohol use is fat deposition in the liver, and if you stop drinking, the fat deposition goes away. It is a reversible thing. However, alcoholic hepatitis is a much more dangerous liver injury in which your body reacts to the alcohol injury and causes a lot of inflammation. Patients do not always develop cirrhosis, although many will have cirrhosis at the time alcoholic hepatitis is recognized. This condition can improve with alcohol abstinence, but if you do not take good care of yourself, it can be dangerous and progress to liver failure, even if there is not cirrhosis.
Healio: What are some of the potential health benefits of taking 1 month off from drinking?
Reau: We know that drinking alcohol causes leaky gut and changes the microbiome, so halting consumption can improve those things. But a 1-month period of abstinence also allows you to cut calories that are probably not nutritious. I do not encourage cleanses but taking a break from alcohol is a natural cleanse because we are what we consume. By not drinking something that is potentially harmful, you give your body the ability to recalibrate. If you want to resume drinking, maybe you give up soda or avoid fast food.
In general, I think that a period of abstinence is always going to be beneficial. But if you have health consequences because of alcohol, you have to make a behavioral change. People cannot think 1 month eliminates all risk and that they can start back over in February. One month is nice, but it is also an awesome opportunity to figure out what to do when that 1 month is over.
Perspective
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Jamile’ Wakim-Fleming, MD
I agree with Reau. A Dry January to cleanse the body from the effects of heavy drinking during the holidays has many health benefits and, if continued beyond January, may not only help the liver but also other organs in the body.
Alcohol ingestion affects the body in a couple of stages. During the period while you are drinking, liver becomes fatty and inflamed, but also other parts of the body may be damaged and inflamed. This first stage of inflammation may be reversible with a Dry January. It is a very good beginning.
If this process is not stopped at this stage of liver inflammation with a dry time, or with persistent abstinence, you will lose the benefits from Dry January, and the inflammation can progress to the second stage, where the damage may become permanent, irreversible and lead to cirrhosis, dementia, cancers and death.
Any time you stop drinking, you are resetting to a healthy lifestyle. Studies have shown that when people practice a Dry January, they feel the benefits and they are more inclined to have more dry periods and for a longer duration. They also realize that in addition to their overall health, their relationships, mental concentration and work performance, and their safety and that of others improve.
Dry January is the beginning of a healthy choice. In the absence of medications that stop you from drinking, the choice to be healthy starts with a personal decision.
I find it beneficial to have conversations with my patients about their alcohol habits so that a plan for long-term health can be discussed.
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