LAST BUT NOT LEAST... THE DRINK DILEMMA

100 I’vealways hadtwoor threeglassesofwine atnight.DoIreally needtocutdown?

YOU feel fine, and it’s a habit that seems to have caused you no harm over the years, so why should you have to cut down on your drinking now that the guideline amounts have dropped to a maximum of 14 units a week? It’s a question often posed by older patients, and the answer is simple, say experts.

‘You really do need to cut back,’ says Dr Stephen Ryder, a consultant liver specialist at Queen’s Medical Centre, Nottingham. ‘Alcohol can lead to inflammation and scarring or cirrhosis of the liver. For some people this will happen at a relatively low intake: some are just genetically more prone to it.’ The problem is you probably won’t know about this damage until cirrhosis begins. It usually causes symptoms such as nausea and tiredness to begin with, but ultimately can lead to liver failure.

‘The liver can heal itself to a degree, but it becomes less able to do so or withstand injury as we get older. Risks of scarring rise with age. What you may get away with when you’re younger — such as two glasses of wine a night — is no longer acceptable.

‘At what age this happens varies between individuals, but if you drink like this at 20, you have less risk of scarring than if you drink like this at 50, which has less risk than if you drink like this at 70,’ says Dr Ryder. According to NHS Digital figures, 45 per cent of all alcohol-related hospital admissions in 2015-16 were among those aged 55 to 74. There were more alcohol- related hospital admissions in the over-75 age group than in those aged 16 to 24 or 25 to 34. ‘It can also lead to obesity and a buildup of fat around the liver. This increases the risk of type 2 diabetes,’ says Dr Ryder. ‘It can push up blood pressure and cholesterol level and so increases the risk of heart attacks and stroke. ‘But there are other things people don’t think about as being a side-effect of alcohol — for example, the skin complaint psoriasis can be worsened by it.’ Alcohol is thought to encourage the production of inflammatory chemicals that can lead to overproduction of skin cells, which causes the red scaly patches of skin that are the key symptom of psoriasis. ‘The idea that there is any safe limit for alcohol — it is essentially a toxin — is being called into question, but sticking to 14 units seems to be a pretty good limit, in terms of minimising detrimental effects it may have on your health,’ says Dr Ryder.

‘If you want two or three glasses of wine one night, fine, but try to allow two alcohol-free days after that to let your liver and other organs recover.’