The Liz Moody Podcast - The Health Effects of Alcohol: Gut Health & Cancer with Dr. Robynne Chutkan & Dr. William Li

Episode Date: January 4, 2023

Today’s episode is the first in our brand new sober curious series that will be happening over the next three weeks. This week we brought back two of our favorite past guests: board-certified integrative gastroenterologist Dr. Robynne Chutkan and internationally renowned Harvard-trained medical doctor and cancer researcher Dr. William Li. On this episode, we talk about:  how long it takes for the effects of alcohol on the body to go away the safest amount of alcohol to consume, according to research  how alcohol impacts your microbiome and immune system the reason you feel sad or anxious the day after drinking  the best healthy foods to eat if you are going to drink alcohol  how world-class doctors approach drinking in their own lives if cannabis is a good swap for alcohol from a health perspective the truth about the health benefits in red wine the link between alcohol and cancer that you need to know about how drinking can impact your future children exactly why alcohol makes your skin and hair look worse and so much more!  We would LOVE to hear from you any thoughts, reactions, or takeaways you have as you’re listening, so definitely screenshot and tag me @lizmoody, Dr. Chutkan @gutbliss, and Dr. Li @drwilliamli on Instagram.  Check out my previous episodes with Dr. Li — What to Eat For Longevity, Inflammation, Cancer Prevention, Alzheimer’s, Diabetes, & More and Dr. Chutkan – Gut Health Secrets: The Truth About Leaky Gut, Viral Infections, Chronic Disease & Acid Reflux.  To join the Healthier Together Podcast Club Facebook group, go to https://www.facebook.com/groups/healthiertogetherpodcast. This episode is sponsored by Levels. Sign up at http://levels.link/HEALTHIERTOGETHER to receive an additional two free months of your Levels membership. This episode is sponsored by Wild Health. Go to wildhealth.com/liz or use code LIZ for 20% off.   This episode is sponsored by Thrive Market. Go to thrivemarket.com/healthiertogether to join Thrive Market today and get 30% off your first order plus a free $60 gift.  This episode is sponsored by AG1 by Athletic Greens. Visit athleticgreens.com/healthiertogether and get your FREE year supply of Vitamin D and 5 free travel packs today.  Healthier Together cover art by Zack. Healthier Together music by Alex Ruimy. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hello, friends, and welcome back to the Healthier Together podcast. I'm your host, Liz Moody, and I'm a best-selling author and long-time journalist. This podcast is all about helping you live your healthiest, happiest life, whether we're uncovering the most effective mental health hacks for dealing with stress and anxiety, finding out how to figure out our personal style, or learning science-backed ways to literally become smarter. And yes, those are all real episodes, so if any of those topics sound good to you, scroll on back in the archives.

We are starting 2023 with the launch of a very exciting series all about exploring our relationship with alcohol. Over the next few weeks, we'll be covering all facets of how alcohol impacts our lives, from what's really happening in our bodies, both short and long term when we drink, to navigating all of the tricky social dynamics that come with drinking or not drinking. To kick us off, I'm interviewing one of the top gut health doctors in the world, Dr. Robin Chuckin. Dr. Chutkin is a board-certified integrative gaming. gastroenterologist, microbiome expert, and the author of four digestive health books, including

most recently the antiviral gut. She's the founder of the Digestive Center for Wellness and also serves as a faculty member at Georgetown University Hospital. And you also might remember her from one of our most downloaded episodes last year called Gut Health Secrets, The Truth About Leaky Gut, Viral Infections, Chronic Disease, and Acid Reflex. We also have Dr. William Lee on this episode. Dr. Lee is an internationally renowned Harvard-trained medical doctor, researcher, and president and a founder of the Angiogenesis Foundation. His groundbreaking work has impacted more than 70 diseases, including cancer, diabetes, blindness, and heart disease, and his TED Talk, Can We Eat to Starve Cancer, has been viewed more than 11 million times. His best-selling

book, Eat to Beat Disease, is available wherever books are sold, and you also might remember him from the episode where he convinced me to drink coffee, what to eat for longevity, inflammation, cancer prevention, Alzheimer's, diabetes, and more. Dr. Chuckkin and Dr. Lee are not only well-versed on the latest research in the respective fields, in many cases they're the ones actually leading it. What they shared blew my mind and completely changed the way I think about alcohol. We get into how long it takes for the effects of alcohol on the body to go away if you stop drinking it, the safest amount of alcohol to consume according to research, how alcohol impacts your microbiome and immune system, the reason

that you might feel sad or anxious the day after drinking, the best healthy foods to eat if you are going to drink alcohol, if cannabis is a good swap for alcohol from a health perspective, the truth about the health benefits in red wine that you might have heard so much about, the link between alcohol and cancer that you need to know about, and it's actually a link between alcohol and a number of different cancers that I had no idea about. This was so interesting. I can't believe we don't talk about this stuff. We talk about how drinking can impact your future children,

exactly why alcohol makes your skin and hair look worse and so much more. They also both shared how they, as world-class doctors, actually approached drinking in their own lives, so that was super fascinating to hear. Dr. Chuckin, Dr. Lee, and I would all love to hear your thoughts and your biggest takeaways as you're listening to the episode, definitely screenshot and tag us both on Instagram. I am at Liz Moody. Dr. Chuckkin is at Gutblis and Dr. Lee is at Dr. William Lee. My goal with this series is to deliver actionable

science-backed information from some of the top functional doctors in the world so you can use it as you make choices in your real life. That being said, this episode is not meant to be medical advice and if you or someone you love is struggling with alcohol abuse, please contact a healthcare professional. I created this series because it was something that I was really personally interested in, but I know a lot of you are exploring what relationship that you want to have with alcohol. And I think it is so critical to have all of the information as we're making these decisions. I am never going to tell anyone not to have a drink again. I mean, the chances of me never drinking again myself are so slim if we're being honest. But I think we

should be empowered with the information that we actually need to make that decision for ourselves. For years, I thought that the impacts of alcohol started and stopped at our livers. And as you'll here in this episode that is so wrong, it's impacting our cancer risk, our stem cells, our gut health, our skin and hair, and so much more. If you know anyone in your life who is currently totally in the dark about all of this like I was, please share a link to this episode. As always, thank you so much to everyone who has been sharing the podcast and text to friends and family members on Team Slack. 2020 was an absolutely amazing year for growing this community, and I cannot wait to see what's to come in 2023. If you're new here, make sure that you're following the

pod on whatever platform you listen on. If you go to the main podcast page on Apple Podcasts or Spotify, like the one that lists all of the episodes, there should be a little plus sign in the top right corner or a button that says follow. So just give that a tap so you do not miss out on any future episodes. We're diving more into the health impacts of alcohol on our bodies next week, including the relationship that it has with our hormones. And then we're going to solve all of your real challenges with the social aspects of drinking less in the following episode. And then we will be back to our regular programming with a sleep hacks episode, a science-based sex advice episode, and an episode about overcoming the need to be liked, which I am so,

so excited about and so much more. All right, without further ado, let's get right into it, starting with Dr. Robin Chetkin. Dr. Chetkin, thank you so much for joining me today. It's such a pleasure to be back with you again, Liz. Thanks for having me. Can you just start us off by walking us through what goes on in the gut when somebody drinks alcohol? Like, what is the immediate effect?

The first thing that happens is that alcohol levels rise in saliva. And in fact, within a very short time of ingesting alcohol, your alcohol levels in saliva can be higher than they are in the bloodstream. And that's why, Liz, we see such high rates of different cancers and particularly cancers of the mouth and the throat. with alcohol ingestion because we see very high levels of alcohol in the saliva when we ingest alcohol. And of course, alcohol is also exerting an effect on the cells lining these organs. How long does the alcohol stay in our saliva? I've never heard that before and it's blowing my mind

a little bit. Yeah, it can stay in the saliva for several hours. And then eventually what happens is as it gets absorbed, the alcohol levels in the bloodstream rise and then the saliva falls. because alcohol itself isn't in contact with the mouth for that long, right? You swallow it. But that's why we see such high levels of cancers of the oropharynx. Some studies estimate that 30% of cancers of the mouth and oropharynx are related to alcohol, and it's because of the salivary influence, the high levels of alcohol in the saliva that, of course, is in continuous contact with those organs, even after the alcohol itself

has gone down into the stomach, et cetera. That is absolutely fascinating. I'm immediately thinking with you because obviously so much of your specialty is in gut health, how our saliva impacts our digestion and our gut health. So are there downstream effects in your gut to having this alcohol in your saliva? Well, the alcohol and the saliva is more the carcinogenic effect, but of course alcohol also affects production of different digestive enzymes. So in terms of enzymes like amylase and lipase, etc, it also alters levels of stomach acid, and we know that having sufficient quantities of stomach acid is essential for these digestive

enzymes to work properly. So it messes up digestion in other ways also because it reduces a stomach acid. It really loosens up that lower esophageal sphincter between the esophagus and stomach, so it makes you more prone to heartburn and reflux, and it makes the digestive enzymes less sufficient. And when you say it makes you more prone to heartburn and reflux, is that just when you are drinking the alcohol, or is that all the time? The effects of alcohol can be longer lasting, too. So the effect of loosening up that lower esophageal sphincter is more immediate, but it can last for several hours after. And we also see that alcohol can slow down emptying of the stomach.

It can decrease gastric motility, and that can also last for several hours after. Hopefully you're not drinking continuously throughout the 24 hours. But if you're drinking on a daily basis, some of these effects can almost have a 24-hour cycle, just depending on how frequently and how much you're consuming. It is crazy to think about especially because I do think it's pretty common to have a glass of wine after work every day. And then you are sort of drinking every 24 hours. And I'm curious, I don't know if this is possible to say, but is there an amount of time that all of these immediate effects would take to kind of stop? It depends on really what your baseline level is.

So if you are drinking a couple drinks a day on a regular basis, you're probably never really sort of burning off those effects. versus if you're drinking a drink hair and there. So the regular consistent drinking can be problematic for that reason. Each couple years, as the guidelines are revisited, as we have new scientific and clinical data, the amount of alcohol that seems to be safe decreases. In Canada, it recently went to zero. For a long time in the U.S. and the UK, the feeling was one or fewer drinks per day in women.

and by one or fewer, that meant than less than six a week. Now that number is down to four. And so it's important for people to remember that alcohol is a carcinogen. It's classified by the World Health Organization as a Class 1 carcinogen, which puts it in the same category asbestos and tobacco smoke. But here's a thing. If we are otherwise very healthy, if we eat a good diet, we get lots of sleep and exercise, we're not on other pharmaceuticals that can affect our GI tract and our liver,

we haven't taken a lot of antibiotics, particularly when it comes to the gut. We're really concerned about the liver and the health of the liver our main organ of detoxification and other drugs that can have a synergistic effect. So if all of that checks out really well, you can probably, from a gut health point of view, tolerate a little bit of alcohol on a regular basis. And when I say a little bit, I mean, yes, around a drink a day, not more. But if any of those things are a little bit off, if you're on an acid blocking drug, for example, if you've taken a lot of antibiotics, if you take a lot of Tylenol, acetaminopin, or other drugs that are metabolized through the liver, if you have a chronic autoimmune disease, if anything is just a little bit off, that really changes what you can tolerate

in terms of what's a safe amount for you to be drinking, if anything at all. We're going to get into a lot of different ways that we can kind of support our system if we are engaging with alcohol, but I would love to talk about the microbiome for a second. I'm curious what what, if any, impact alcohol has on our microbiome? Alcohol kills bacteria. I don't know if I can be any clearer than that. Before we had antibiotics, we had alcohol. If you watch some of these shows that were pre-penicillic late 1920s,

what you'll see is they used alcohol as the main antiseptic and what they used to sterilize a wound and sterilize the instruments and so in the operating room. And what's really interesting, Liz, is if you go today to get blood drawn at any commercial lab, What do they use? They use a little alcohol swab on your skin to clean the skin to kill microbes. So antibiotics kill bacteria. Alcohol kills bacteria. Now, fortunately, alcohol kills less bacteria than antibiotics, but it is what we call bactericidal. It does kill microbes. It also seems to do something

else, which is it disrupts a communication between the microbes and the immune cells. And that communication is really essential for good immune function, which is why we see alcohol having such a profound effect on so many things. For example, our ability to recover post-operatively, respiratory infections, response to chemotherapy, prognosis from cancer. And that's because really of the effect of the gut on the immune system. And a lot of that effect happens through disrupting the communication, the signals that the gut microbes gives the immune system to sort of tell it what to do. That's so interesting. From a microbial perspective, because your microbiome impacts your brain, it impacts your skin, it impacts so much more than that. What impact is killing those

bacteria having? When we talk about the gut brain connection, we know that somewhere around 70 to 80 percent of serotonin, the feel-good hormone, one of the main neurotransmitters, is really synthesized in the gut through the activity of gut bacteria. So when you are disrupting the gut microbiome, you are disrupting production of serotonin. Not only can that lead to mood disorders of depression, anxiety, et cetera, but serotonin is one of the precursor hormones for melatonin, the sleep hormone. So it's also going to disrupt sleep. And that disruption of sleep is also going to interfere with our immune system because we know sleep is this sort of magic elixir that resets our immune system. And when we're sleep deprived, we are less able to defend ourselves from

infection. We even see a significant decrease response to vaccines when we're sleep deprived. They can be less than 50 percent effective. And we see similarly that heavy alcohol consumption can also interfere with our response to vaccines. It really is all connected. The gut can affect things like mood and behavior, and the brain can affect gut secretion, absorption of nutrients, motility, etc. when you have this disruption in that bi-directional communication that occurs through the vagus nerve, one of the cranial nerves, you see effects on both, really. You see the effects on the gut as a result of the alcohol, but you also see these neurological effects. Is that why the day after drinking, I sometimes feel really sad or really anxious?

Absolutely. And think about that whole process of a hangover. And I like to remind people about the positive and negative feedback loops. So the positive feedback loops are like you get a great night's sleep. wake up, yay, I can take on the world, I feel amazing, or you start working out again and you have all the endorphins pumping. But the negative feedback loops, that's like acid reflux, you know, oh, I ate a cheeseburger at 10 o'clock at night, and then I had a slice of pizza and some bourbon, oh, I'm really feeling it the next day. But think about hangovers. If we did not get hangovers,

where we feel physically ill and often we feel depressed and our mood is sad, and we could just drink as much as we wanted, people would die from alcohol poisoning. So a hangover and everything that it entails, the dehydration, the stomach inflammation, the effect on your mood, all of that is designed to sort of put the brakes on to keep you from just consuming until you literally keel over. That makes so much sense. And I want to get into hangovers, but first I want to talk about skin. When we are impacting our microbiome in this way, is that showing up in our skin?

If somebody's having skin conditions or skin issues, would you say we could look to alcohol is a potential cause for that. It absolutely affects it. And we can think about the skin as sort of of the outside of our GI tract, because when we ingest food, it gets excreted out and it gets excreted through the digestive tract, but it also gets excreted through the skin. We can often see skin eruptions, allergies, reactions to food that we eat. Our skin is also an organ of elimination and an organ of digestion and ingestion like our GI tract. And just like our GI tract, where we have that one cell thick lining, the intestinal epithelial barrier, that protects us from the outside world, because, of course, when we're ingesting food and other things, it's not really in our body.

It's in this long tunnel, and it has to go through the gut lining to get absorbed. We know that alcohol disrupts that gut lining. It causes an increase in intestinal permeability. It makes that gut lining leaky. Well, it can do the same thing with the skin. It can also affect the barrier function of the skin. and it can affect the skin elasticity and permeability, making it easier for toxins to penetrate through our skin.

Why don't people talk about this stuff more? That's wild. Because they're busy selling alcohol. If I've had my drinks, I'm hung over the next day. I'm feeling anxious. I'm feeling sad. I'm feeling nauseous. Is there anything that I can do that I can actually start to mitigate those symptoms?

Well, hydration is a really key element there because alcohol, like caffeine, is a diuretic. It's basically telling your kidneys to produce more urine. And you might be drinking and going to the bathroom and thinking, oh, this is great. I'm peeing like I'm hydrated. You're actually peeing all the fluid out of your body. And so alcohol is incredibly dehydrating. So one of the things that is really helpful is just rehydration. A lot of the effects of heavy drinking revolve around dehydration and skin turgare and elasticity

will improve. So your skin will start to look and feel better. your GI tract will start to look and feel better. So hydration is really key. And that counts not just for the next day if you're hung over, but also while you're drinking, having a glass of water in between drinks is a great way to cut down the alcohol consumption and make sure that you're staying hydrated while you're imbibing. Are there any foods that can help us from a microbiome or gut or liver perspective in the

moment when we're drinking or when we're hungover? And then we'll talk about foods that might support us in a more long-term general sense. while you're drinking, probably the best thing you can do is make sure you're not drinking on an empty stomach. So make sure that you have some food that can slow down absorption of the alcohol. Because remember, alcohol is absorbed directly from the stomach lining right into the bloodstream, and that's fast. And lots of people, especially young people, they want to get a really deep buzz on. They like to drink on an empty stomach. But it means that your alcohol levels are going to rise much faster and you're going to be doing the damage that the alcohol is doing much faster. So don't drink on an

empty stomach, number one. The foods that you can eat are not so much things that are going to immediately alleviate the symptoms, not eating something like heavy, greasy fried food, just the kind of food you typically want to eat when you're drinking. But not eating those foods can be really helpful because those high fat foods also slow down the emptying of the stomach. And so those can just sort of exacerbate the symptoms. They're more likely to cause reflux. which the alcohol is also causing. So it's sort of a double whammy. But in general, what you want to do in terms of foods that you would eat, if you were also drinking, would be foods that support the health of the microbiome. Fremented foods high on that list. We know that foods like saucrout and kimchi

are this sort of magical combination of pre-pro and postbiotic. So it's a fiber to feed the microbes, the microbes themselves that are being produced in the fermentation process, and then all the metabolites that they're making like short chain fatty acids, et cetera. And you don't need a ton. I mean, a tablespoon of sourcrow is about 10 grams. That's going to give you typically over a billion microbes plus all the postmetabolites they're making. And high fiber foods in general, really helpful. In the immediate setting of drinking, high fiber foods can be very filling and they can

make you feel a little uncomfortable, particularly if you're drinking at night, which is more likely. If you're drinking in the evening, the gastric contractility and really the activity of the GI tract in general, slows way down once the sun sets. So for some people, whilst I'm always promoting high fiber foods and high fiber foods really help to move things in a sort of efficient manner through the GI tract, if you're drinking at night and you're eating a lot of fiber, that can have a similar effect to a high fat meal, can slow things down a little bit, make you feel really full, predispose you to reflux. So I'd recommend you have your fiber a little earlier in the day

and certainly high fiber foods as well as fermented foods are things to think about in terms of creating a healthy microbiome. I've heard that B vitamins are really good for replacing something that's depleted when you drink. Is there any truth to that? Well, people who are drinking frequently are often low in some of the B vitamins like thiamine, for example. And so where that came from, Liz, was when we would see people who were heavy consumers of alcoholic in the emergency room and someone, we'd always have to make sure that these levels were replete. But for the person who's not a really sort of heavy indulger, we don't have a lot of evidence that would be complex vitamin is going to do anything. It's more making sure that those levels are adequately repleted in somebody who's

a heavy consumer. And then is there anything else that you would recommend somebody who's a regular drinker who wants to have alcohol be a part of their lives? Is there anything else that you would recommend they add in on a regular basis to their diet to support their liver, their microbiome, or anything like that? Yeah, we know that there are some foods that can help support the liver, and those would be the really deep green vegetables like the Brassica family. Those can really help support the liver. We also want to make sure that you're not really doing other things that are really going to put a stress on the liver. So I talked about Tylenol, acetaminopin before, and lots of other drugs. I mean, most drugs are metabolized through the liver. And so I would

advise people to even look at some of the supplements or taking, et cetera, and see how you can sort of ease up the work that the liver has to do. There are things, too, that can support microbial health and liver health, like mushroom tea using shitaki or mitaki mushrooms, a couple dried caps of those mushrooms chopped up, steeped in hot water, making those teas can be helpful. There are some anti-east foods that can be helpful in this setting, because depending on what kind of alcohol you're drinking, If you're drinking a lot of Prosecco and sweeter drinks, margaritas and things like that, you could be at risk for fungal overgrowth depending on what the rest of your diet looks like. And of course, again, you're killing off a lot of healthy bacteria, sometimes allowing the yeast species to proliferate.

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masterclass.com slash Liz Moody. In your mind, is there a better or worse type of alcohol in terms of all of these effects that we've talked about? Definitely. I mean, the most important thing is really looking at how much you're consuming, you know, how many servings. And then that's followed a close second by the ABV, the alcohol by volume, the really strong sort of overproof thing. are problematic. And then you have to think about other things, too. Like if you have irritable bowel syndrome and you tend to bloat, drinking things that are highly fermentable like bear can be a problem. You might be better off with things like gin and vodka. So it depends a little bit on tolerability. But I think the things that trump everything else are the number of drinks you're

having and the alcohol by volume. And then if we are like, okay, that's it. I'm not going to drink anymore. I'm going to really stop drinking as much. At what point would we start to see our body heal itself from all the impacts of alcohol? It's pretty quick, usually within about two weeks, but there is one caveat to that. If you have been persistently and heavily drinking and you have liver disease, particularly if you have something called cirrhosis, which is scarring of the liver, that scarring does not really revert. What you can do is you can prevent further liver damage. So you may have a serotic liver and it's nodular and they're scarring, but you're not at a point where you need a liver transplant. And we know that alcohol consumption is one of the main

causes for needing a liver transplantation, that on viral hepatitis. So your cirrhosis may stay steady, but it won't progress and you may not need to have a liver transplant, which would be great news. But once you have a lot of scarring of the liver, we don't have a lot of evidence that that fibrosis and deep scarring can be reversible. For Unfortunately, I think most of the people who are listening to this are probably not drinking at that level or haven't been drinking for that long. So there is a really good degree of reversibility if you are somewhere before a serotic liver.

And if there's anything else people wanted to do to support their body healing from the effects of alcohol, once they decided to give it up, is there anything else that you would add in in terms of lifestyle practices or foods? Well, all the other things that support the microbiome are really helpful. So I like to distill all of that complex science down to three little things, dirt, sweat, vegetables. So get outside in nature, get exposed to soil microbes. That's really great for improving the health of your microbiome.

Work up a sweat. We have tons of data showing that exercise is the most potent, non-pharmaceutical intervention for our immune system, great for our gut health. And then eat lots of vegetables. Eat more vegetables and you're already eating, even if you're a good vegetable, eat our... I know a lot of people who are looking to cut down on alcohol lean into cannabis. And I'm curious if you have any insights on what cannabis is doing in terms of all of the effects we've talked about with alcohol in our brain, in our guts, all of that. I was just at a conference

in Orlando two weeks ago. And one of my fellow speakers, she's, I believe, from the Mayo Clinic, and she gave one of the best talks I've ever heard on the effects of cannabis on the gut. And it turns out that the amount of THC, et cetera, that you're getting is important. What we're seeing in the GI literature now is the effects of cannabis long term on the gut are quite problematic. We see things like cyclical vomiting and emesis syndromes where people have nausea and vomiting chronically as a result of that. And we also see significant effects on the brain.

So we don't recommend swapping alcohol for cannabis for consistent everyday regular use. that's a little bit from the frying pan into the fire in some ways or at least sort of a lateral swap. I mean, not as hard on the liver, but not so great for the brain and not so good for some other aspects of gut function, motility, et cetera. What does your drinking look like in your life? The alcohol is something that I go back and forth with a lot, primarily because of my family history of dementia. My mother has Alzheimer's and it's a very strong genetic family history with her mother, several of her aunts. She has two copies of the APOE4 gene. I have one. And so while I think that my alcohol meets the criteria for light alcohol consumption generally, because of that additional

family history of Alzheimer's and having one copy of the APOE4 gene, again, it's really all about it looking at our personal terrain and saying, okay, I eat really well, I get intensive exercise, I'm doing my wordle and spelling B, I'm giving my brain active, all of these things. But I I have this slightly increased risk for Alzheimer's over the general population. What are the risks that I can mitigate? I can't do anything about the family history, and I'm doing all the other things, but not drinking at all is probably ideal for me if I really want to dramatically decrease my risk of Alzheimer's.

So again, a drink a couple times a week, not a big deal in general, but if you are dealing with something like a strong family history of Alzheimer's and one copy of the APOE4 gene, definitely better off with no alcohol at all. So I go back and forth a little bit. I see a huge difference in my skin. I have rosacea. I see a huge difference within about four or five days when I'm not drinking. I see a huge difference in my sleep. I get fewer hot flashes. I mean, it's all like check, check, check. But there is an emotional component to alcohol. I mean, beyond the physiological piece where those dopamine receptors are firing and you have a sense of pleasure, there's an emotional attachment. And we know that for most people, it's sort of a Pavlovian attachment where even the thought

of alcohol, even the cork popping, people feel a sense of relaxation and euphoria. And for so many people, and I think me included in some ways, we have sort of attached this idea of relaxation and reward to the alcohol. And the book that I think really approaches this in such a novel and helpful way is Annie Grace's book, This Naked Mind. She talks about that association, and it's a fomo affair of missing out when we're not drinking because we associate alcohol with a pleasure and relaxation and a signal that the work is done. And her book, This Naked Mind, really talks about rather than white knuckling your way through every decision, every time you're faced with should I drink or should I not, if you make that one decision, if you shift that thinking in your mind

and acknowledge that alcohol is much more of a hindrance than it is a help. And you can really change the way you look at it, then it becomes a lot easier to make that decision whether to have some or not. It's a wand drug in our society that we have to justify not doing. If we're out there and we're not doing heroin, nobody's saying, well, why aren't you having any heroin? But if we're at a social event or something and we're not drinking, everybody wants to know, well, why aren't you drinking?

Like, what's up with that? is the idea that it's less about trying to replace all of the things that alcohol is giving you, like the social dynamic and feeling really good and relaxing and turning off from the day and more about acknowledging that alcohol is not actually the thing that is giving you any of those things. That's exactly right. It's going to a party and realizing it's not the alcohol that's making you have a good time. It's being out with friends. And in fact, when you're not drinking, you have a better time because you are really experiencing the most.

moment, you're remembering it the next day. We know that alcohol can affect our ability to form memories. You don't feel terrible the next day. You can be up at your 6 a.m. yoga class, all of those things. Once you let yourself experience that, you realize, wow, it really wasn't the alcohol. It's an association, right? It's not the actual alcohol. Are there any other health effects of alcohol that you've come across in your research or your practice that we haven't gotten to today? Well, we did touch a little bit on the malignancy piece. Alcohol works systemically. It's metabolized in the liver to acetaldehyde, a first cousin of formaldehyde. And I don't need to tell anyone that formaldehydehyde is not something we should be ingesting. So it has a direct impact on the mucosa,

the lining. So we talked about getting into the saliva. It has an effect on the esophageal lining, the squamous cells there, and that's why it's a risk factor for esophageal cancer. It has a lot of exposure to the stomach. It's exposed to the stomach, mucosa, the long. and we talked about it decreasing production of stomach acid. It can also affect the cells that make mucus, a goblet cells in the stomach, and that mucus layer is designed to protect the stomach lining from being digested by the acid. So it can interfere with that and cause ulcers and gastritis inflammation of the stomach. In addition to stomach cancer, and the interesting thing, Liz, is just one night of heavy drinking can really do significant damage to the stomach by

eroding through that mucous layer. And then we talked about it being directly absorbed into the bloodstream from the stomach and how it can raise alcohol levels. It can be directly absorbed from the lining of the small intestine, too, into the bloodstream. When it's metabolized in the liver, again, it's acetaldehyde. It's this poison for different cells in the body. It's also associated with colon cancer. We have studies that show that drinking up to four drinks a day can increase a risk of colon

cancer by about 20%, but drinking four or more drinks a day is associated with a 52% increased risk of colon cancer. And so, of course, I think when people think of alcohol, they think of pancreatic cancer, definitely a risk factor for that. But I don't think people realize how much of a risk factor it is for colon cancer. And again, you have to look at the sum total of things. So if you have a family history of colon cancer or you're at risk for colon cancer for other reasons you eat a diet that's high in animal protein and fat and low in fiber and you're drinking,

you're really increasing your risk. And I posted something recently about a study that showed that the maternal diet, a sugary, starchy, sort of high-sweetened beverage, high-sugar diet during pregnancy is associated with worse viral outcomes and babies. And I had so many women reaching out saying, gosh, I didn't know that. I wish I'd know that when I was pregnant. My child was born with bronchialitis or viral infection, asthma, et cetera. And then I had one or two people saying, like, oh, this is scare tactics or you're shaming mothers. And I said, when we realize the risk between cigarette smoking and lung cancer, we weren't shaming smokers by making that information public. I mean, there are millions of people walking around who wouldn't be alive if we hadn't made

that information public. So the same thing, giving people the information about the risk of alcohol and colon cancer, and esophageal cancer, and stomach ulcers, and mood and all of these different things, is not shaming anybody, and it's not trying to make people feel bad. It's giving people information so they can make well-informed choices about their health. And maybe the decision isn't none, but maybe it's less. We talked about when I interviewed you on our other episode, how colon cancer and gastrointestinal cancers are on the rise for young people. Do you think that's related to the alcohol connection?

Absolutely. I think it's related to alcohol consumption. I think it's related to consumption of ultra-process foods, which we now know make up more than 50% of the American diet. And I think it's also related to stress. Can you leave us with one final thought in terms of how we can start to think about alcohol from your perspective? I think we need to shift our thinking from alcohol as a treat to alcohol as a toxin. And to really think about, okay, how much of this toxin can I tolerate before I start to shift into a more taxed zone as opposed to a detox zone? I really think shifting that thinking really helps reframe it as it's not a treat. It's something that if the setting calls for it and I feel like I really want to have it, it's okay. But how much of it can

I tolerate before I realize it's a problem for my body. I tend to like champagne. It's bubbly. We didn't even talk about the carbonated alcohol and how that can bloat you, et cetera, but it's sweet and so on. And I'll pour a glass of champagne and my husband will be like, oh, that's a headache in a bottle. Like you just know you're going to feel terrible, even with one glass. So really focusing on, what are the things that kind of feel good going down but kind of feel bad after? The after is our body's feedback. Our body's giving us some really important information with that, as opposed to sometimes the things that don't necessarily feel as good in the moment, but they feel amazing after. In my case, that would be like going for a run where I'm like, oh, I'm struggling.

Why am I so slow? My knee hurts. And then after, I'm just like, oh, that was amazing. I feel like a million dollars. That's the lesson is the after effect. And really your body's, giving you incredibly important information with that after. And so even thinking about our alcohol consumption, can we keep it to the level where the after you feel okay? If you're getting that feedback, if you're getting the headache and, oh, I wish I hadn't done that and all of that, then I think you need to rethink, like whether this is serving you or whether maybe less could serve you better. And there's so many things that feel good in the moment and they feel good after, like spending time with people you love or having a great conversation with a friend. That feels

amazing when you're doing it and you feel so fulfilled and so satisfied afterward. That's so true. Yeah, getting a massage, walking in nature, all of those things. Just super, super, super fast because you mentioned it, you got to hit me up with your carbonation talk. Is carbonation extra bad for our gut? No, carbonation isn't extra bad, but if you are somebody who was bloated, you know, one of the hallmark studies for irritable bowel syndrome was this idea of visceral hypersensitivity. So the classic experiments were to blow a balloon up in the rectum of somebody who had irritable bowel syndrome. And the person with IBS would feel the distension of the balloon at a much lower volume than somebody who didn't have IBS. So they feel this,

the technical term is visceral hypersensitivity. And that hypersensitivity is for gas and air. It's for liquids and it's for solids. And that's why for some people with irritable bowel syndrome, when they have an urge to go to the bathroom, they feel really uncomfortable. And same thing, carbonation, that sort of distended feeling because of the carbon dioxide and the bubbles, where they feel super uncomfortable versus I might just play like, okay, I just need to burp and I'll be fine. And so the carbonation affects different people differently. But I do tell people, if you are somebody who's bloated, if you are prone to heartburn, if you tend to be somebody who burps a lot, bubbles are probably not your friend. You just reminded me of this because

as you mentioned poop, the morning after I drink, often my bowel movements are really different feeling than before I have drinking or if I didn't drink anything at all. Like, we always talk about the hangover poops and you don't feel better with your hangover until you take your big poop. Is that because of a microbial dysbiosis that's happening because of the alcohol or is there any reason for the poop shits? It's definitely physiological. So here's how it can work.

if you've drunk a lot, if you've had a lot of alcohol, you're dehydrated, it can make you more constipated. At the same time, it can increase mucus production in the GI tract because your body's trying to eliminate the alcohol. And so things can be a little slimier. It can increase or decrease motility through the GI tract. So things can be a little faster or slower. And again, it tends to inform your food choices. So if you're drinking and then you're at the big slice pizza place or something. In my opinion, people are typically not drinking and then saying, ooh, let's eat a kale salad. So one thing I always recommend is have a good meal ahead of time, because if you're drinking, again, you're more inclined to want French fries and a kale salad,

really make sure you've eaten something so you slow down the absorption of the alcohol, get your fiber in early, and then it doesn't matter if you're eating something not so great a little bit later because you've gotten a good fiber load in. But can definitely affect the stool the next day. Thank you so much. Dr. Chetkin, this was amazingly informative, as always, and I so appreciate you taking the time to share your wisdom with us. It's such a pleasure. Love having these conversations with you. Look, I'm never going to make everything that I wear organic, but your sheets, your pillows, your comforter are literally touching your skin for eight hours every single night. That is a third of your life right there with one simple swap.

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top way to support how I want to look and feel as I age. Support yourselves and how you age with mitopure gummies from Timeline. Visit Timeline.com slash Liz and save up to 39% on your Ritopeer Gummies. That is timeline.com slash Liz. Dr. Lee, to kick us off, can you talk about the latest research on the impact of drinking alcohol on our health? Like, what are the studies showing right now? First of all, let me kind of set the stage for this. And that is, alcohol is really part of human civilization. People have been drinking alcohol as part of social ritual for thousands of years. And alcohol is really not just with grapes and wine and beer, but it's also fermentation products from grains that actually have been domesticated and part of sort of moving from

our hunter-gatherer into really organized society. So although people in the medical community, we tend to be taught to lecture patients about the harms of alcohol and the dangers of alcohol, I'm somebody who really studies food and studies history and culture. And I think it's really important for us to remember that alcohol is actually quite important in terms of who we are as humans, as part of society. Having said that, I think that the rituals of alcohol really are very much designed for moderation and individuals who are participating in alcohol are responsible for that because alcohol is a substance that can be addictive. Alcohol is a substance that can be addictive. Alcohol is a substance that can actually foster disinhibition,

meaning that we're more likely to make decisions that we might not normally make, which might be bad decisions. Alcohol also interferes with our own body's metabolism, so it actually can alter the ability for our body to use energy in the most efficient way. And when taken to an extreme can damage some of our metabolic machinery. And then the other thing is that alcohol has been, clearly shown to interfere with our hardwired health defenses. So these are defenses that keep us healthy. They're hardwired. They were formed when we were in our mom's womb. And when we were born,

our health defenses, which helped us resist disease, are firing in all cylinders. And we do know for a fact that excessive alcohol use can compromise our health defenses and thereby make us more vulnerable to a whole host of diseases as well. So what you're asking is really a kind of a complex question. It's not only about what's new and what's newly known about alcohol. It's really how do we actually navigate this complex path of a valued part of human ritual and how do we actually help people maintain moderate use? What I would tell you is this, going back to this idea of tradition. I think that if you wanted to think about healthful opportunities to consume beverage, is if you are at a ritual, a family event or a celebration, where somebody is serving a glass of

champagne, a glass of red wine, and you're eating good quality food, plant-based foods and herbs and and spices, nis and lingoves, healthy oils, your alcohol is being dissolved along and diluted along with all the other good stuff you're eating. And you'll get some of the fermentation products of the grape skin, resveratrol being one of them, but you'd have to drink a lot of wine, like a ridiculous amount of wine. I mean, you probably poison yourself with the alcohol in order to be able to really get all the benefits of this virtual that people talk about. But as part of a ritual, as part of a celebration, as part of being with people, if you're not somebody who needs to be very cautious from a behavioral perspective, addiction perspective,

with drinking wine, I would say, that's okay, but please drink one glass. And that's basically where the danger zone is because it's a slippery slope. What I generally tell people is that when it comes to alcoholic beverages, the health benefits are never in the alcohol. And the more alcohol you drink, the more you degrade your health. Can you speak to the resveratrol thing? Because I hear that a lot, like my mom, for instance, she tried to turn herself into a glass of wine a day person to get the resveratrol benefits back when that was hugely popular in media. Is resperatrol that big of a deal? Is it an antioxidant that we should be prioritizing? Is wine the best way to get it? How should we think about resveratrol consumption?

in. Resveratrol is actually one of the bioactives that are found in wines. Wine isn't the only place you find resveratrol. And in fact, if you take a look at the dose equivalence of the benefits of resveratrol studied in the lab in mice, you'd have to drink something like 20 bottles of wine to be able to get something similar. So that's very unreasonable and taking so much more alcohol wouldn't be healthy. By the way, you can also get resveratrol in grape juice. You'd still have to drink a lot of grape juice, which has a lot of sugar into it. So, Where else can you get resveratrol? Turns out peanuts actually have a lot of resveratrol.

And peanuts also have dietary fiber, which can actually help with gut health and improve your circulation. What's another pleasurable source of resveratrol? Dark chocolate. Cacao actually also contains resveratrol. But, you know, by the same token, that doesn't mean that you should sit there and gobble chocolate bars all day long either. And yet people who think about wine and alcohol,

they sometimes use that as an excuse. I do think that's one of the dangers of isolating individual nutrients because people are like, oh, I need this nutrients, so I should load up on wine, I should load up on this thing. And then most studies, correct me if I'm wrong, but they're really about consuming a diversity of nutrients and how they work synergistically in your body. 100%. All the research has shown that diversity of eating, mostly plant-based foods, fruits, vegetables, nuts and legumes, healthy oils, seeds, and a whole variety of seafoods because of the omega-3 fatty acids,

the more different types of healthy foods you eat, the better your overall health. And every type of food contributes its own little bit of something really healthy. Our health is supported by not only the diversity of ingredients that we eat, but also how these ingredients come together in our body so that multiple beneficial substances and natural chemicals all come together in order to be able to activate our body's health defenses and to improve and streamline our metabolism. And then you're a cancer researcher. So I wanted to talk to you about the study that was published in The Lancet this summer, which said that smoking and alcohol consumption were the two leading risk factors associated with cancer-related deaths. Can you talk to me a little bit about that

study and your interpretation of it? Yeah. What that study did was to take a look at all the causes of cancer, like I think 30-some types of cancer, was funded by the Bill Melinda Gates Foundation. And they wanted to say, we live in a world that's increasingly complex that has threats to our health. One of the most important factors that, at least when it comes to cancer, we can actually do something about and decrease our own risk at the individual level, but also decrease our risk at the societal and community level. And what they found was really pretty striking that when you wanted to take a look at all these possible risks across certain different kinds of cancers, there were three things that really were avoidable risk factors or modifiable risk factors. One was smoking. We know smoking causes lung cancer, period. But it also causes other cancers as well, breast cancer, ovarian cancer, uterine cancer. The inhalation of these toxic chemicals that cause DNA mutations sets off a chain reaction of badness in the body. Years later, your body is still paying for it and still experiencing the

damage. Alcohol is kind of the same thing. Drinking too much alcohol, which is very, very common. It's a big problem. That's something we can control. Most of us can control. we can make an effort to control it. We can try to be mindful and conscious of the fact that the choice to consume alcohol at the outset anyway is a choice that we can actually make. And across 30 different types of cancer, you know, over 20-some years, I mean, over decades, these are the things that we can do with. There's not so much we can do with the sun.

There's not so much we can do with off-gassing of toxins from furniture and cars and car exhaust. Those are some of the things that we don't have as much control over. They're too big. but on a day-to-day operational level, conceptually, we can control whether we smoke or not. We can control how much we drink or whether we drink or not. What is the mechanism of action that's leading to the different types of cancer? It was very surprising for me to find out that alcohol was linked to all of these. I knew it impacted my liver, but I didn't think that it impacted all of these different types of cancer.

So can you explain to me how that's actually happening? Let's talk first about what is cancer. Cancer is a normal cell gone bad. And what does that mean? It means that a cell has got our own genetic information in it, and that genetic information has to be copy and pasted over and over again. So that's why we're still around tomorrow because our cells are being copied today. Now, in doing that copy paste, mistakes can actually happen.

And our body has 40 trillion cells, trillion cells, more cells in our body than you can see in the night sky of all the stars in the sky. And if I were to ask you to copy paste something 10 times by hand, to keep stroke it, you probably would do it perfectly. If I actually do it 100 times, you might make a mistake. Maybe not. If I ask you to do it 40 trillion times, I guarantee you you'll make a mistake. And your body does so, okay?

I'll tell you just without any alcohol, how many mistakes your body makes in your DNA every day, every 24 hours, 10,000 mistakes are naturally made when your body copies itself from one day to the next. Now, all of these have the potential to turn into cancers, whether you've had any alcohol or not. The good news is that your DNA can fix itself and your health defense has helped to fix itself. Enter something like alcohol. Well, alcohol damages your DNA's ability to fix itself. So it makes it easier for some of these mistakes to stick around. Now, your immune system will spot little microscopic cancers and wipe it out. What does alcohol do? It stuns your immune system.

It doesn't actually spot the bad guys as well, now the cancer cell might actually grow up a little bit more. It actually stokes inflammation. When inflammations are out, man, those little tiny cancers, those abnormal cells, love inflammation. Cancer loves inflammation. It's kind of like a campfire or a barbecue pit, loving the fuel you put on it to make it roar. You put some inflammation in there. That cancer loves with alcohol triggers inflammation in your body. It's not like, oh, drinking this kind of alcohol causes this kind of cancer.

It's that our bodies are naturally forming microscopic cancers. But what alcohol does, it lowers our defenses. It makes it that much more likely that the cancers that are there are going to start to rip, roar out of control. Now, there are some specific cancers that actually are directly alcohol damage-related, liver cancer. When your liver is poisoned and toxic and you start undergoing fibrosis because alcohol itself is a direct toxin to your liver, okay, the liver's trying to fix itself. Now it's going to make mistakes when it's trying to copy paste itself. Liver cancer more common in people who abuse alcohol.

Here's another one where alcohol is very common. People who are heavy drinkers, particularly with distilled spirits, they wind up actually chasing this toxic stuff down their esophagus. And the junction between your esophagus, which is what you swallow in, down to your stomach has a valve. And people who drink a lot, that valve loosens up. Now, stomach acid splashes up, and then the alcohol racing down damages the cells of your esophagus connected to your stomach. We'll call it the esophagal gastric junction.

Now the acid is splashing up, causing inflammation. The alcohol is damaging the cells. That damaged cell, copy paste. What are you going to get? You're going to get a cancer. So, esophageal cancer and stomach cancer, much more common than people who drink alcohol because the alcohol is going right down your gullet. It's a complex mechanism, but to recognize that all by ourselves, our bodies are fighting off disease without any alcohol. And when you actually drink alcohol, maybe a way to think about it

is that it's not so surprising because the excessive alcohol consumption weakens our health defenses. And then our shields go down and becomes a lot easier to get sick. When I interviewed Dr. Robin Chacken, she said that alcohol lingers in our saliva for hours after we drink, and then that leads to an increase of mouth and throat cancers. That's true as well. Alcohol kind of recirculates in our blood. This is, by the way, why when the state trooper pulls you off and you do breathalyzer, it's on your breath.

It's also in your saliva because your liver is working as fast as I can to detoxify your body from alcohol. If you drink a lot, it's in your breath and it's going to be also in your saliva. The longer alcohol, which is a toxin, is sitting around circulating in your saliva. saliva, it's a setup for weakening your health defenses and making you more likely. And because the mouth and the esophagus and the stomach, these are all frontline areas that are getting exposed to this toxin called alcohol, it makes it that much more likely can form cancers in that area. I'm curious if there's research on this. And if there's not, I would just love your speculation. But a lot of people are using cannabis as an alternative to alcohol. And I'm curious about the

mechanism of action with which alcohol is causing all these cancers to weaken your body's ability to repair itself in all these different ways. Do you know if cannabis is having that same impact or if it's a different impact on your body? You're raising a really interesting question. It's a different kind of thing. Both alcohol and cannabis activate pleasure and relaxation, different parts of our brain. So in that sense, they actually do kind of similar things. And alcohol is a toxin that if you swallow it, actually will have all those effects we just talked about. Cannabis, I think this is a little bit of a black box that a lot of researchers are working on right now. Is it harmful?

You know, it's a lot safer than alcohol when you eat it. Does it cause cancer? You know, not really clearly. Does it impact our health defenses? Not so clear what it does. And so there are lots of voices out there that are really pro-cannabis. And so they just like pump up all the good stuff with cannabis. And they say, well, and you don't have to drink alcohol and you don't have to smoke.

It's an interesting thing. Like we all look for ways to relax. We all look for ways to escape stress and manage our stress. We all look for ways to feel pleasurable sensations, right? And regardless of how we individually find those ways in different forms, some people exercise, some people have sex. There's a lot of different ways of doing it. It's really about just being mindful and aware that in any behavior you take, even exercise, if you take it too far, you wind up actually going on. off the cliff and doing something that could be harmful for yourself.

For cannabis, we're not 100% sure. It's not the panacea, like the get high with no health effects at all. Some research is starting to show at certain levels and certain ways. It might not be as safe as we think. Jury's out there at the end of the day, I think that we're still at the very beginning of understanding cannabis's effect because now it's a legitimate thing to really study. Alcohol we know a lot about.

Cigarettes we know a lot about. I think that it's really worthwhile looking at where is that gray line where embarking and consuming anything goes from being okay to dangerous. And I think for cannabis, we're not sure yet. I actually really appreciate when researchers say this is a nascent area of research and we're still finding out more versus here's the definite recommendation. I'm like, oh, you're somebody who's actually in the trenches and understands how science works when they're willing to say something like that. So thank you. I find that very refreshing. It's really interesting, Liz. I was listening to a TED talk by a researcher from NYU who basically have a whole talk about ignorance. And most people assume that

scientists, when they get together, they're talking about everything that they know and how smarty pants they are. But in fact, what this TED talk was talking about is that when scientists get together, we spend all of our time talking about the things that we don't know and the things that we're still not knowledgeable about yet. And you could call that ignorance, but we're not afraid of that. It's a challenge. It's an exciting thing to talk about. How do we study that? What do we need to know more? Why is that important? A true scientist has that kind of honesty about what we know and what we don't know. Yeah, I think, I mean, it's literally built into the scientific process or the scientific method, having a hypothesis and seeing if it's

wrong or right and going back and modifying it. And I just think when people are like, well, 20 years ago, the science said this and we haven't updated that, I'm like, well, that doesn't seem to be how science works, you know? That's right. Is there any other research that has really shifted how you think about alcohol in your life or that you think more people need to be talking about? Something that most people don't know about is how alcohol affects your stem cells. I'm a researcher that has studied stem cells that are natural in the body. So we're all formed from stem cells when your mom's egg met your dad's sperm and they got together. and they formed a little ball that would ultimately become you, all those cells were originally stem cells.

Some of them became your jaw. Some of them became your hair. Some of them became your heart, your liver, your lunger, your big toenail. And that's how we form over nine months. And Mother Nature was smart enough to make sure that we had enough stem cells that at nine months, we weren't running out. It's like painting your room. You imagine like if you didn't buy enough cans of paint,

like you're just at that last part in a wall and damn, I ran out. The way that Mother Nature has designed the body, we have overage of stem cells. So we've got about 75 million extras by the time we're born. In the baby, these extra stem cells, 75 million of them, a lot, gets stored in our bone marrow. That's the dark part that's in the center of our bones. And they sit there waiting as a supply of cells to be able to repair and regenerate and

renew and heal us when we need it. Stem cells grow our hair back, stem cells will grow our tissue back, cell cells grow our liver back. You ever eat something really hot or really sharp and you scrape the top of your mouth and you've got this little piece that's hanging? It's happened to all of us, right? Okay. So man, is that annoying? And it's not comfortable. And it kind of screws up your eating and drinking for the rest of the day. Well, when you go to sleep and you wake up the next day or the next day after that, it's gone. It's healed. It's because your body's regenerated it. And your stem cells took part in that. If I took your liver and I cut off two thirds of your liver,

that one third that's left will regenerate the entire liver. If I clip the top of your lung, it'll regenerate. We used to be taught that only starfish and salamanders and lizards can regenerate. Humans regenerate all the time. Really important for our health because we need to regenerate our gut lining. We need to regenerate our blood vessels. We need to regenerate our glands. And we need to regenerate our skin, too.

It's very, very important. So what happens with alcohol? Alcohol stuns your stem cells. Alcohol stuns them and makes it less likely they'll do the right thing that they'll actually participate in regeneration. So people who drink a lot of alcohol who stem cells are stunned don't repair themselves, don't heal themselves, don't renew themselves. And by the way, somebody who drinks a lot, their skin doesn't look that great, their hair doesn't look that great. Now you know why. With that in mind, do you know if alcohol has an epigenetic impact?

that you would see generationally in any way? Oh, yeah, absolutely. We do know that alcohol can change epigenetics and alter certain genes. I mean, I think that we're still, again, at the very beginning of studying the sort of multi-generational effects, but some of the changes in the genes can get passed onto the children. And just like children of alcoholic parents are much more likely to actually have alcohol abuse themselves and the next generation and the next generation, I think it's complex.

small typefactoria, but definitely the alcohol in the environment that can alter your genes and cause these negative epigenetic changes can get passed on to the next generation in animal studies. We do know that that can occur. And one of the interesting things that researchers are interested in, like how many generations do that occur in? And does it become permanent or does it fix itself eventually? We don't really know the answers to that. But I would say when one drinks too much, if you are of reproductive age and you're

pretending to have children. Just remember, later on in life, you might actually be passing some of these things on, especially if the habit is longstanding and chronic and intense. You may be passing on some things unknowingly to your next generation. And then those stunned stem cells, if you stop drinking, how quickly do they become unstunned and active again? The good news is pretty quickly because the stem cells are reacting to the alcohol in the bloodstream. And it takes time to clear up the bloodstream to purify the blood from the alcohol. But anytime the stem cells out there trying to fix itself, the moment it encounters alcohol, it gets drunk too. So that's why I call it tipsy stem cells. Normally, a stem cell will be like a homing missile to go exactly where it needs to go. But just like

somebody who's drunk, they may not find their way home. They may even wander into a different path. When the alcohol burns off, you kind of sober up, the stem cell can sober up and I can do a thing again. I'm really curious how you approach drinking in your life. Like, how often do you drink? What are you drinking when you do drink? Is there anything that you eat or make sure you consume or do from a lifestyle perspective to mitigate the impact of alcohol? How are you approaching it? My background is Asian.

So I have, like many Asians, sort of this sensitivity to alcohol. Many Asians don't have the same levels of a gene that can detoxify alcohol as quickly. So like an Irishman could drink me out of the table in two seconds, okay? But what I will tell you is that I do drink occasionally, but it doesn't feel that great. Like I feel the toxic effect, so I'm very, very careful. However, with a kind of a time-honored ritual that happens, like a Christmas meal or at a wedding or a celebration, I'll tip a glass. I might have a glass of wine, but I never really honestly, just because I don't feel good,

myself after if I drink more than a glass or so, I won't drink more than a glass or so, and also very infrequently. And by the way, I do enjoy a really fine quality wine. I enjoy food. I enjoy beverages. I enjoy the experience of something that's time-honored, part of culture. But I look at it in sort of the bigger context. I'm not drinking wine because I want to get drunk. Well, thank you so much, Dr. Lee, for taking the time to share all of this with us. It was absolutely fascinating. My pleasure. Thanks for having me. This episode blew my mind. I think I've told like 50 people about the alcohol stain and saliva and causing mouth and throat cancer's thing since recording and then the stem cell thing. Oh my gosh. I also love that Dr. Chuckin and Dr. Lee were both realistic about the fact that many people want to drink alcohol, especially for celebrations and special occasions. And that's okay, but there are a lot of ways to better support your health while doing so. If you're new here, make sure that you're following the podcast so you don't miss out on any few. future episodes, including the next two parts of this series, we're going to do a deep dive into

all of your questions about things like, what do I do if my partner loves to drink and I don't? Or what do I order at bars? Or how do I relax after work if I'm not drinking? So hit that follow or plus button so you can get all of those answers and so much more. Okay, I love you and I will see you next week on the next episode of the Healthier Together podcast. I very rarely get genuinely excited about skincare, but this is one of the most innovative products that I have come across in years, and I am so obsessed with it. I've been telling all of my friends to get it, so now I need to tell you guys.

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