What Alcohol Actually Does to Your Gut Lining | Dr Wil Bulsiewicz

0:02This is a Be Well Moment, the most replayed moments from my latest conversation. It's a glimpse into the wider episode, which you can find linked in the show notes below. Because sometimes one small moment is enough to reconnect to living well and being well.

0:22There's been many experts over the last five years that have come onto the show and also when I've gone to the Royal College of Physicians and listened to different conversations. people have cited that you know one glass of red wine a day is fine for your gut microbiome it's got you know polyphenols in it so it's not actually that bad and there's always been you know a bit of indiscrepancy on whether people believe that or they don't I think one thing that we can all agree on is that social drinking if it brings you a little bit of joint connection that's undeniable but when we're actually just isolating it now taking all of that part out which is isolating it to like the gut lining and inflammation and exactly what's going on in the body it was really interesting to hear that your own views have kind of changed a lot as well understanding on alcohol and you kind of mentioned that you don't believe alcohol to actually have any health benefit from a recent study that you that you looked at whilst you were writing this book can you explain a little bit about how the conversation has shifted from the original 2011 systematic review, which is where this will really stand from showing that moderate drinkers had a lower risk of cardiovascular disease, which is why I think this whole conversation started, to now to what you've recently discovered and why your views on this are quite strong when it literally just comes directly to the gut microbiome.

1:39First of all, let me say I totally agree with you that when you are making the choice to go out and be social, if you choose to consume alcohol, I don't think you should feel horribly bad about that. I also don't think that you should make it a weekly pattern that every Friday and Saturday night, you're going to go and get smashed. Have you met anyone British? Yeah, I have. I know how y 'all like to enjoy your pub on a Friday after work. Do you know the pub is busy at 11 a.m.? Yeah. Yes. No, I understand. I understand. So, I mean, look, the social aspect, I think, is relevant because we do have a loneliness issue at the same time.

2:18So we need to find ways to be connected with one another. So that being said, really what we're discussing here is like, if this was not for social purposes, if you were sitting at home by yourself, should you be consuming alcohol on a regular basis? And this original study, these are population-based studies, they're epidemiology studies, where you're trying to understand a risk factor for a specific condition. and when they examine alcohol what they discover is that actually the people who consumed a moderate amount of alcohol so like one to two drinks per day they actually had lower risk than the people who were zero drinks and they had lower risk than the people who were excessively consuming alcohol so it sort of led to this idea that there's this sweet spot where you should be one to two drinks per day and that's what you should target and that was just for cardiovascular disease right nothing else it was just cardiovascular disease that study was showing from my room i believe it was for cardiovascular disease but i i um i have it here i have to dig into more detail you do underlined perfect thank you thank you so anyway the the issue with this and i just to be clear i'm actually a big believer in epidemiology studies i i studied at the university of north carolina which is the number two school of public health in america on this particular topic i have a master's of clinical investigation.

3:47But the problem that exists is that you can have confounding, which basically means that there's stuff that's impacting the result that has nothing to do with alcohol and heart disease. There's other factors. So do people who drink wine, do they tend to be more affluent? Yes. Do people who drink wine, do they tend to be people who live a healthier lifestyle and have a healthier diet? Yes. Do they also tend to be people who exercise more often? Yes. Could those things impact heart disease? A hundred percent. And can we account for all of that in a study? No, you can't. That's the problem. You can have this like leftover element that you haven't fully addressed.

4:25And so there've been more recent studies in the last five years that have called this entire discovery into question because when they do more thorough analysis of these confounding factors, they actually discover that there is no advantage relative to zero. So then it leads me to, okay, well, what is the impact on the gut microbiome? And what we know with 100 % total clarity is that heavy drinkers definitely don't have a healthy gut microbiome. In fact, what I've found is that in order to develop alcoholic liver disease, things like cirrhosis or alcoholic hepatitis, it's actually a required step that the microbiome basically collapses.

5:13So in order to get to the disease, you actually need to ruin your gut and then you will develop these alcoholic liver diseases. Okay. So, but what about like this idea of one to two drinks? What does that mean in the gut microbiome? Well, there was this study that sort of changed my perspective on it, where they took a group of people and they, they had them consume alcohol consumption to like the point of intoxication, where if they had a, in the States, at least if they had a sobriety test, they would fail. And like, you couldn't drive, you would, you would get pulled over and get a ticket. it.

5:54So, and they measured two things. Every 30 minutes, they would measure their blood alcohol level and they would measure what's called their lipopolysaccharide level. What's that? Now, lipopolysaccharide is a toxin that lives on the surface of bacteria like E. coli. And these are bacteria that are inside your intestines. They're in your gut. and the purpose of your gut barrier is to keep them in your gut. And when the gut barrier gets weak, we call that increased intestinal permeability, but many people call it leaky gut. I don't have a problem with that because the leaky gut allows these bacteria to sneak across, and then you can actually detect them in the blood.

6:46So these inflammatory bacteria are now present in your bloodstream. They weren't supposed to be there. And so what they discovered was that the, and for people who are not watching on YouTube, you may want to flip over because basically I'm going to show with my hands that they had this graph of like how the blood alcohol level went up after they started drinking. and you could have superimposed the lipopolysaccharide level because it was a mirror image. Like it was basically like you could just carbon copy it right over the top of it. Basically, the lipopolysaccharide levels matched what was happening with the blood alcohol.

7:35There was this weird moment and I can't explain why this happened, but the blood alcohol level went down and then it kind of blipped up a little bit. It kind of went back up. guess what the lipopolysaccharide did? It went down and then it blipped up, it copied. And then the last thing is that the lipopolysaccharide level didn't get back to zero, not zero, but it didn't get back to normal until the alcohol level was literally zero. Wow. So to be clear, the study wasn't on one or two drinks, but I think that the takeaway from the study for me, the fact that there was such one-to-one matching of alcohol level in the blood and lipopolysaccharide and that the lipopolysaccharide needed a zero alcohol level to get back to normal, that to me was sufficient evidence for me to say, I don't think there's any advantage to one to two drinks because even that small amount is enough to impact your blood alcohol level and potentially cause leaky gut.

8:40And that creates inflammation. Wow. How many people do you think are walking around with leaky gut that have no idea? Because I think we hear this terminology a lot. And I'm guessing if we are a nation full of drinkers, I think, you know, we probably drink more than anyone else. When I'm in America, I don't tend to drink as much, but that might be in certain places. What do you think kind of the relationship is between leaky gut and alcohol consumption? The relationship between leaky gut and alcohol consumption, you know, based upon what I'm seeing, It's leading me to believe that alcohol is directly responsible for creating leaky gut.

9:14And so, you know, if you have half of a drink and you feel nothing, then I don't, it's hard for me to argue that that's a disastrous thing. But when you drink and then you feel it, and I would argue that most people, even one drink, you feel something. That's why you're having it. There's also a big connection to alcohol in the liver, obviously, as well. And that is a big connection with the liver and the microbiome. 100%. These things are completely interconnected. And even the ways in which we manifest a hangover, we have blamed this one particular molecule called acid aldehyde. but actually if you dig into this in more detail i'm totally convinced that hangovers are related to basically the damage that we have caused to our microbiome with alcohol thank you for listening to this be well moment if it resonated the full conversation is linked in the show notes and i hope it gave you a small pause to take a moment for you and to reconnect to living well and being well.

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