Alcohol The Truth About...

In January, the Government released its new proposed guidelines for

alcohol, and for the UK's 40 million drinkers it was all pretty sobering.

There's no such thing as a safe level of alcohol...

That's according to new guidelines on alcohol

issued by the Government.

For men, the recommended weekly limit was slashed by a third,

to the equivalent of roughly seven pints of beer,

bringing it in line with the amount recommended for women.

Critics say the advice smacks of the nanny state.

But most significant was the publicised link between alcohol

and cancer.

..the increasing evidence strongly linking alcohol with cancer.

It's made a lot of us reassess how much how drink, myself included.

But if we're honest, did we ever think alcohol was really that

good for our health?

And for many of us, the new guidelines have made us realise

how little we understand alcohol and the way it reacts with our bodies.

Alcohol is a stimulant, true or false?

-Yes.

-For me, yeah.

Beer gets you less drunk?

-Yes.

-Yes.

Hangovers get worse as you get older?

-Maybe?

-Definitely.

Women get worse hangovers than men?

I would say so, but they disguise it very well.

Well, actually none of these myths are true.

-Oh.

-Really?

My name is Javid Abdelmoneim, and I am an A&E doctor.

In this programme, I want to discover

the latest science about alcohol

and with our own special pub lab, we'll be able to show you exactly

how alcohol affects your body, from the familiar to the unexpected.

We've teamed up with some of the country's leading scientists

and I'll be putting myself on the front line to tackle

questions about alcohol that are asked by everyone,

in homes and pubs and bars up and down the country.

Such as...

why do some people get drunk more quickly than others?

What is the best remedy for a hangover?

And why is red wine supposedly better for us than white?

And most important of all,

why has the weekly recommended limit changed so much for men

and just how worried should we be about alcohol and cancer?

Two questions I'll be putting to England's Chief Medical Officer.

It's not for me to say, "You must."

It's for me to share the science with the public.

I want to find out the truth about alcohol.

I am an A&E doctor, so I definitely see the worst sides of alcohol.

People who have drunk too much and people who are chronic alcoholics,

so you might think that I wouldn't drink, but I love drinking,

just not too much.

But the idea of drinking not too much has now fundamentally

changed with the Government's new recommended limits.

For both men and women it's now 14 units a week.

That's roughly equivalent to seven pints of beer, and I have no idea

whether I stick to the limit or not.

To discover if I drink within the weekly limits, there's only

one sure-fire way to find out.

So Matthew here is fitting me

with a device that's going to monitor how much I drink across

the week, by measuring precisely the amount of alcohol in my sweat.

I want to know if I drink within the recommended limits, so the bracelet

is going to monitor the alcohol in my system.

And alongside this I am

going to keep a video diary of what types of drink I've had and when.

OK, it's day one, and so today I am at my parents' house. Say hi

to my mum, who is just reading. No drinking today while I'm at home.

It's Wednesday, and I am off to Devon to give a rather informal

lecture, during which I have one can of lager. But it doesn't end there.

Two pints of cider at the pub, and a quick can to finish the night.

On my way to visit my friend in Honiton,

and she is the UK's number one tea drinker.

What have you got, Jo?

Big tea.

No wine at lunch?

No wine at lunch.

OK, it's Friday night, I've just got home, I have ended up

having two ciders and a pint of a lager in the pub with my friends.

I don't tend to drink at home, so, er, no-alcohol day.

OK, it's Sunday, I'm on my way to work.

I won't finish till 10pm tonight.

Today will be a non-alcohol day.

The last night.

It's Rosie's birthday, and she's in Lebanon.

-Say hi.

-Hello.

I've had a bottle-and-a-half of wine to drink

and you have just witnessed my...

..week of alcohol.

'So, did I drink within the 14-unit weekly limit?'

-Oh, gosh, that does feel good, you know.

-OK.

'Well, it's not looking promising.

'Matthew Mitchell is showing me the results.'

So, looking at the data here,

and we look at Wednesday

and that's probably close to ten, ten-plus units,

-possibly more.

-Gosh!

Probably a lesser amount on Friday, maybe four to six units.

-I drank three drinks!

-Three drinks.

Three pints in an hour!

And then we think again on Monday, definitely over ten,

probably closer to 12-15 units.

So, for the whole week, how much is it we're on now?

So, when you tally that up we're talking about more

than 25-28 units, just in three days that you've drank.

Does that come as a surprise?

Um!

It's surprising because if I sat down and had to tell someone

what I thought I drank this week,

I'd say, yes, I had a big night on Monday, with the wine.

The other two nights I would have thrown away mentally.

I would have just said, whatever, I had a couple of drinks in a pub.

I recognise I have an unhealthy pattern

but I never thought I drank more than the limit.

-Yeah.

-In fact, I'm well above the limit.

So that's...shocking to me.

So, across the week, I actually put away twice the recommended

limit of 14 units, and I'm not alone.

It's estimated that 13 million of

us Brits drink above the new weekly limit.

According to the NHS, drinking above the recommended weekly limits

automatically puts you at greater risk of developing

alcohol-related liver disease, so I am keen to find out what impact,

if any, my drinking has had on my liver.

'I've come to the Royal Free Hospital in London to meet

'liver specialist Dr Gautum Mehta.'

So, let's see how that liver is.

Right, this is it.

'Gautum is going to scan my liver to see

'if there are any signs of damage.'

OK, nice and relaxed.

-OK.

-Bit of cold jelly.

'The liver scan uses ultrasound to measure the stiffness of my liver.'

Here, what we want is not a stiff liver, a low number.

-What's a normal number?

-Most people who are normal would have a number under five.

-OK.

-OK, mine's about four-and-a-half, just so you know.

-Crossed fingers.

-All right, so let's see what we get.

-Let's have a look.

-Pop that it in.

'A reading of higher than 7.5 would be consistent with the early

'stages of liver disease.'

OK, well, that's given us just over ten valid measurements,

-which would be what we'd look for.

-OK.

And your score is within the normal range of 5.3, OK, so...

That's still a little bit high!

It is a little bit higher than I'd like to see for a young,

fit, healthy individual.

What we do know is that alcohol just can cause

inflammation of the liver as well, and small amounts

of inflammation can actually cause the Fibroscan to go up a bit.

-Right.

-That might well be what we're seeing here.

I mean, I've got away with it so far but am I...

am I guaranteed to stay healthy, with this level of drinking?

Well, gosh, there's a question.

So, look, with regards to your liver, I think

it's fair to say that most people who develop significant liver

disease, cirrhosis, drink at high levels.

You can be unlucky and we do see some people who

drink in the 30-40 bracket, who do develop liver disease.

-OK.

-Why that is we still don't know,

but there are genes that are involved.

The causes of alcohol-related liver disease are complex.

It's not just down to how much you drink.

Your genes, diet and weight are all factors as well.

The main message is that if you drink above

the recommended limit, the greater the risk to your health.

Now, of course, the best way of avoiding damage to your liver

is to not drink at all, but if you are going to drink

I suppose you should stick to the 14-unit limit.

To keep track of how much you're drinking across a week

it's best to use units,

which are a simple measure of how much alcohol is in a drink.

A single shot of whisky contains one unit.

A large glass of wine, around three units.

A standard glass, two units. And a pint of beer about the same.

And if you do drink your full 14-unit weekly limit,

then it's recommended that you spread your drinking over three days or more.

In other words, don't drink it all at once.

But besides keeping our liver busy, how else does alcohol affect us?

We've taken over this pub in north-east London to turn

it into a pub lab...

..a venue to host some special experiments to demonstrate

the science of alcohol.

And tonight we've invited the locals to take part.

You're actually doing quite well.

Remarkably, alcohol affects nearly every system of your body,

from your skin to your blood vessels,

from your gut to your heart.

But here in our pub lab we're going to

look at the effect of alcohol on your brain.

To drinkers, a lot of this will come as no surprise.

After a few pints, alcohol affects our sense of balance

and hand/eye co-ordination, generally making us more clumsy.

But Dr Tony Moss from London's South Bank University

is showing me some of alcohol's more subtle effects.

Firstly, how we begin to lose our self-control after we've had

a few too many.

So this is the Batak test.

The variation that we've put onto this is that we're also

asking people to listen out for a buzzer

and if they hear the buzzer to stop themselves pressing the button.

-BUZZER

-Nearly.

It sounds like an easy thing to do

but it's deceptively difficult once you've got used to

pressing the button and you're working, as you can see, so quickly.

-You're not supposed to press it if you hear the buzzer.

-Sorry.

So the alcohol actually sort of stops you stopping yourself?

Yes, alcohol has a particular effect on our ability to stop

ourselves from doing things that we feel that we need to do.

When people have had a few drinks they press the button when they shouldn't

because they can't override that response that they've learned.

BUZZER

'Time out.'

What's the cash prize?!

This next test shows why after a fair few drinks

although we may be able to do the job of walking home,

often we arrive to find that we've failed to remember our keys.

In other words, we can't multi-task.

997...

'To demonstrate this, our volunteer has been asked to

'do two jobs at the same time.'

993.

'Counting backwards in sevens...'

So she's actually almost totally failing at counting.

'..whilst at the same time

'rearranging the series of coloured rings on the wooden pegs.'

We call this a "divided attention task" because you're basically

trying to do two things at once, which is hard at the best of times.

Oh!

And one of the effects of alcohol is it limits

the amount of sort of mental energy that you've got to be able...

or mental resource you've got to do these things

and you'll notice as she's going through the task that one of

the strategies that she's using is to sort of stop one of the tasks

so that she can start doing the other one quite well.

-Very much in relay, not tandem.

-Yeah, absolutely.

-So sorry!

-Absolutely brilliant!

'And finally, this test is aimed at measuring the volunteers'

'tolerance of pain.

'In this case, having your hand in a bucket of freezing cold ice,

'shown here as purple and black on our thermal imaging camera.

'Sober people tend to give up by around the two-minute mark.'

How much have you had to drink tonight?

-Er, three pints.

-Three pints.

'But Stuart here has had his hand in the bucket for an impressive

'four minutes.'

I could stay here for quite some time.

'He can do this because the alcohol is numbing his pain.'

-Yeah, I think we call it time.

-Yeah?

Yeah. Well done, Stuart.

It's your call, it's not me.

Yeah, well, to be clear, it was me calling it time, not you.

Are your fingers still there?!

'And that's not all,

'when we drink, we often get the sensation of feeling warmer.

'That's because alcohol increases the flow of warm blood to the skin,

'but the overall effect is that your body actually loses more heat.'

So although alcohol may make you feel as though you're wearing

a beer coat, helping you keep warm as you walk home at night,

in reality it has the opposite effect.

But perhaps one of the most hotly debated topics in the pub is

why some people get tipsy very quickly, whilst others seem to

be able to drink a lot, apparently without feeling much effect.

So why is this?

At St Mary's University in Twickenham, I'm meeting five locals who have

very different experiences with alcohol.

So, who wants to put their hand up for saying that they can

drink the most in this group?

It looks like you got volunteered!

Yeah, pretty certainly at the heavyweight

-end of the spectrum, I think, yeah, yeah.

-OK.

'Our volunteers span the full range, from alcohol heavyweight Ian

'to Stacey and Andrea, who feel the effects of alcohol quickly.'

-I'd say I'm a lightweight.

-Yeah?

-Yeah.

Couple of glasses and I get a bit giggly...

'And as for our two students, Ian and Jacob...'

-Maybe somewhere in the middle.

-Yeah?

-Can hold a...hold a couple.

-And for you?

-Er, probably just about two pints and start feeling it.

Brilliant, well, thanks for coming.

'So, to put it crudely,

'why do some people get drunk quicker than others?'

OK, and if you'd just like to come and stand on this

platform for me with your heels touching the back.

With the help of sports scientist Dr Paul Huff

and alcohol researcher Professor Celia Morgan,

we're going to get to the bottom of this conundrum.

And it won't involve our volunteers touching a single drop.

Well, what we're essentially trying to do here, Javid,

is work out the total amount of water in someone's body.

Mm-hm. Now, why that's important with alcohol is that it's not just

the volume of alcohol that you drink that's important,

it's its concentration in your blood.

So what we call the blood-alcohol concentration.

So how drunk you feel is all down to the concentration of alcohol

in your blood, and one of the main factors that determines this

is the amount of water in your body.

If two people have different amounts of water in their body,

take the same amount of alcohol, the person with more

water in their body gets less drunk.

Exactly, it's almost you can think of the water in your body

diluting the effects of the alcohol.

And so that's why some people get more drunk than others?

That's exactly right, yes.

So let's see if the diluting effect of body water can

explain our volunteers' different experiences with drink.

Take a seat in the Bod Pod.

To work out precisely how much water is in our volunteers' bodies

involves measuring two things.

Firstly, Paul is using the Bod Pod machine to

measure our volunteers' body volume.

Next, Paul is passing a small electrical current

through our volunteers' bodies to analyse how

much of their bodies is fat and how much is muscle.

There's much more water in muscle than fat and so the more

muscle our volunteers have, the more diluting water their bodies contain.

So, what are the results?

In first and second place are the two Ians,

with 66 litres

and 51 litres of water in their body.

In third place is Jacob, with 46 litres.

And in fourth and fifth place

are our alcohol lightweights,

Andrea, with 34 litres,

and Stacey with 31 litres.

Celia has calculated what this means in terms of how our volunteers

handle their drink.

Laid out on each table are pints of beer that our volunteers

might drink on an evening out,

and their position on the track

represents how drunk the volunteer would feel after drinking them.

From sober to tipsy,

to more and more drunk.

Ian, if you drank one pint, your blood alcohol would rise to that

first table.

Stacey, yours would rise all the way to here.

'And this shows why alcohol lightweight Stacey gets drunk

'so much faster than heavyweight Ian.'

So your size and your body shape really makes a difference.

Alcohol dehydrates us,

so it's always a good idea to drink plenty of water on your night out

to ensure your body water is kept at its normal, healthy level.

But beyond this,

if you're really keen to handle your drink better, then whether

you're a man or a woman, the only option is to become more muscular.

Leave the pub and go visit the gym.

On drinks labels you'll always find the strength of alcohol,

or alcohol by volume, and often the number of units too.

But what's rare is to see the number of calories

and it's not surprising because the numbers are pretty horrifying.

A single shot of spirits contains 59 calories,

roughly the same as a bourbon biscuit.

A large glass of wine contains 180 calories,

the same as a teacake.

And a typical pint of beer has 215 calories,

the same as a jam doughnut.

And whilst it's true that our bodies process

the calories from alcohol differently to the calories

from fat or sugar, they're all potentially fattening.

But if you're worried about your waistline,

it isn't just alcohol's calories that you should be wary of.

Could alcohol actually make us eat more?

We've returned to the pub lab to do a special demonstration with

experimental psychologist Dr Sam Caton

from the University of Sheffield.

Her research suggests that alcohol might be able to trick us

into eating more, without us even noticing.

And taking part,

drinking beer in the name of science, are two sports teams

from Queen Mary University of London.

We're going to do an experiment today, so it may involve

drinking some beer. I think you might be OK with that.

Yeah!

Excellent, OK, let's have the hockey players here

and the footballers through the back in the snug.

'So that the students behave as normal, we've told them that

'the purpose of the experiment is to test

'how alcohol affects their memory.'

You've got the next five minutes to remember as many as you can.

'We haven't mentioned anything about food.'

Time's up.

Quite a lot there...

'And the other thing the students don't know...'

Here come the pints, guys.

'..is that whilst one table

'is being served with normal alcoholic beer...'

Cheers all.

'..the other will be given non-alcoholic beer.

'We're hoping they won't notice the difference.'

So here are your beers.

-Thank you very much.

-Enjoy.

-Cheers, guys.

You're such a stay of a human!

The calories in alcohol are often referred to as "empty calories"

because unlike most food they don't fill us up.

'In fact, according to Sam's research,

'alcohol has the opposite effect.

'It actually makes us eat more.'

We're ready, let's see how much they eat.

'So let's see if this is the case with our students.

'Both teams have been served with two pints of beer

'and then offered bowls of snacks.

'The question is, will the students that have drunk the alcoholic beer

'eat more than those that have had the non-alcoholic beer?'

..if they're real crisps.

These are nice crisps, actually.

'After 15 minutes, we clear away the leftovers.'

Hiya, Sam, these are the peanuts from the footballers.

Thank you.

'And Sam tots up what's been eaten.'

'It's time to fess up to our students.'

You guys actually had non-alcoholic beer, could you tell?

LAUGHTER

-So it tasted different?

-Not happy about that.

Not happy about that. I'm sorry, you got the dead end of the deal here.

Oh, well, OK, and you guys actually had proper beer,

but, actually, the real part of the experiment was about food intake.

And consistent with the results that we obtained in the laboratory,

the guys that consumed alcohol consumed much more food

compared to you guys.

So, on average, collectively you consumed 11% more calories

compared to the no-alcohol group.

So you guys were given the same amount of crisps

and peanuts for the same amount of time and the red bowls are

the people who had alcohol,

and the green bowls are the ones that didn't.

Overall, if we add together the energy from the alcoholic

beverages, you guys consumed 872 calories, whilst you guys

consumed 576, and that represents a 34% increase in total energy intake.

Each!

LAUGHTER

So it seems that alcohol does actually make us eat more.

The students who drank the two pints of real beer each consumed,

on average, a total of 300 extra calories.

The same as four-and-a-half bourbon biscuits.

And all of this without them noticing a thing.

The precise mechanism about how alcohol affects appetite is

still being researched by scientists.

At the end of the day, it's important for you to know, not only

does alcohol have a lot of calories, it also has the power to make

you eat more.

But is the relationship between alcohol and food always a bad one?

Could food before booze ever be a good thing?

Lining your stomach is the idea that if you have a big meal

before you drink, you'll be able to handle your booze better.

Lots of us do it before a big night out, but how exactly does it work?

It's Bonfire Night, and with the help of my friend Natalie,

I am going to put this to the test.

-Hi.

-Hey, Nat, come in, how you doing?

'Although not ideal from a scientific perspective -

'Natalie is a woman and I am man - we're roughly the same size

'and weight, and so reasonably matched.'

The plan is that we're both going to drink a single, large glass of wine.

Natalie is going to drink on an empty stomach.

I am going to line my stomach with food.

But first, it's time to eat a rather hi-tech hors d'oeuvre.

So, before I line my stomach with this lovely meal, I am going

to swallow this pill cam, so you can see the inside of my stomach.

Here goes.

'This has to be the best dinner-party trick ever.'

-There it is, you can see it in my stomach.

-Oh, gosh!

Wow. So, now you can see my stomach is empty.

It's time to eat.

The idea behind lining your stomach is to do with the fact that

alcohol is mostly absorbed not whilst in the stomach

but once it reaches the small intestine.

If your stomach is full of food then the alcohol is held up

and takes longer to get into your system.

You can see some green broccoli there.

Time for the vino.

Yes.

'Lined stomach versus empty stomach,

'let's see what difference the food makes.'

'Throughout the evening we are going to breathalyse

'ourselves to see how we compare

'and it's time for our first reading.'

Is yours ready? Go.

BOTH EXHALE

-Ah!

-44 for Nat.

-44.

23, yeah!

'So already there's a big difference.'

But will my readings catch up with Natalie's over the next few hours?

32.

15. The lining is working.

But, of course, there's a second character in the story,

and that's the liver.

For most people, the liver gets rid of about one unit,

or the equivalent of one single shot of spirits, every hour.

-Eight. 'And it's the same rate however much you drink.'

-21.

The enzyme in the liver that does the job of processing the alcohol

is actually present in small amounts in the lining of the stomach.

So when your stomach is full

and the alcohol is kept there for longer, this lining can do

some of the work that's normally just left to the liver.

Men tend to have more of this enzyme active in their stomach than women,

meaning that lining your stomach has an even bigger

effect if you're a man.

Zero!

12.

Argh!

So the results are in, and Natalie's alcohol level did this

and my alcohol level did this.

So lining your stomach works.

Scientific studies have shown that eating food before you drink

crucially means that your blood alcohol level peaks

at a lower value, meaning that you feel the effects less.

So lining your stomach is a good idea, however you plan to drink.

We've heard about the risks to our health of alcohol in general

but red wine in particular has had more than its fair share

of headlines, claiming that it's good for us.

So what's behind its healthy reputation?

It's good for the blood, is it, possibly? Maybe.

So it's quite good for your sort of thinning your blood out.

Doesn't it prolong your life, is that wrong?!

This popular notion that red wine is good for us

has its origins in what's become known as the "French paradox".

It's the fact that even though the French have a diet rich in

saturated fat, their incidence of

coronary heart disease is relatively low.

In the early 1990s, two wine-loving scientists proposed a solution.

Might all the red wine that the French drink somehow cancel out

the unhealthy aspects of their diet?

Or is that just wishful thinking?

'To get to the bottom of this, I've met up with researcher

'Dr Wendy Hall, and she is taking me to her labs

'at St Thomas's Hospital in London.'

-Right, if you'd like to come through, Javid.

-OK.

-This is our vascular lab.

-Cool.

And I'd like to introduce you to Benu, our vascular specialist.

-Benu, hello. Javid.

-Hi, nice to meet you.

-Nice to meet you, too. I've brought the red wine that you asked for.

-OK.

'Wendy and Benu are going to look at how my blood vessels dilate

'or expand before and after a single large glass of wine,

'because, according to research, if red wine is good for our heart,

'then one of the reasons might just be

'because it's good for our blood vessels, making them dilate

'better and having positive effects like reducing blood pressure.'

OK. So now you can get up now.

Guess, Wendy, now it's time for the wine?

Yes, let's go ahead.

# Red red wine... #

-Cheers.

-OK, cheers.

'The particular compounds in red wine thought to be

'good for our blood vessels are called polyphenols...

'..natural chemicals from grape pips

'and skin that give red wine its colour and taste.'

That was fast!

'After drinking the wine, I wait an hour to give it time to take

'effect, and then Benu repeats the measurement on my blood vessels.

'So, has the single,

'large glass of red wine made my blood vessels dilate more?'

Cool, we have results, what do they show?

They show that after you drank the wine there was a large

increase in the diameter of your artery in your arm,

so this would suggest that

if you've got a large vasodilation like that,

that it might decrease blood pressure

and have beneficial effects

on your cardiovascular system.

That's a good thing to happen.

Yes, you were fully dilated!

OK!

So, red wine in particular is potentially good for our heart

because of the effects from its polyphenols.

But which wines contain the most?

-Let's start with the rioja.

-Right.

'To find out, we're testing six classic wines from around the world,

'five red and, just to be sure, one white.'

-OK, that's ready now.

-Mm-hm.

'The darker the liquid turns when we add Wendy's special reagent,

'the more polyphenols the wine contains.'

That's definitely gone dark.

Yeah, it's a very dark colour.

'And to get a precise measurement,

'Wendy runs the samples through a spectrophotometer machine

'and ranks the wines according to how much polyphenols they contain.'

So the wine, as expected, with the lowest polyphenol content was

the white wine.

In this case it was a Sauvignon Blanc.

-Mmm, OK.

-So, a standard glass, 175mls, contains about 60 milligrams

of total polyphenols.

OK. And how much did our number one have?

The wine from Umbria in Italy, from the Sagrantino grape,

the final results show that it had a total polyphenol

content of 737 milligrams.

Wow, that's huge!

So it's about ten times the amount of polyphenols in this wine...

-Wow!

-..than this one.

-That one.

So there's some adage in the old saying that a glass of red wine

is good for your heart, at least when compared to a white?

Well, certainly, if you're going to choose to have a glass of wine

with your meal, there may be some added benefits to choosing

a red wine compared to the white wine.

As a rule of thumb, the darker the wine the more polyphenols it

contains, and this is what our tests showed.

A little known Italian grape scored the highest.

In second place, a popular Cabernet Sauvignon.

And in last place, the Sauvignon Blanc.

But the bad news is that

although it may be a good idea to choose wines that are high in

polyphenols, on its own this isn't justification for drinking more...

..because polyphenols are also found in lots of other drinks and foods.

So what we can see here, we've got a few examples of foods that

contain the same amount of total polyphenols as a standard

glass of wine, 175mls.

OK.

So, for example, we only need to eat

24g of walnuts to consume

the same amount of polyphenols that's in that glass of wine.

-That's not very much at all, actually.

-Yeah.

Not much dark chocolate, either.

-No, it's 70% cocoa solids dark chocolate.

-Ah.

And an apple and a half contains as many polyphenols as is in a glass of red wine.

You're giving me too many excuses not to have red wine here.

And what about this tea?

So, 360mls of tea will contain

the same amount of total polyphenols as wine

and we all drink, probably...

-most of us drink more than that every day.

-In a day.

So, in principle, you can get all the potential health benefits

of polyphenols without consuming alcohol.

So would you recommend that we all start drinking red wine?

No, what it tells us is that red wine is a good

example of a polyphenol-rich food, but if you eat a diet that's

varied in fruit and vegetables, and nuts and wholegrain cereals,

you'll be consuming a large variety of polyphenols

and this will be protective against heart disease and stroke.

But polyphenols aside, there is evidence that alcohol itself

may have a protective effect against heart disease.

However, that's only if you're drinking small amounts

and that protective effect is only marginal for most of us.

But the exception is for women aged over 55,

for whom drinking two glasses of wine a week, or roughly five units,

has actually proven an overall significant effect.

Still to come -

we're on the quest to find the ultimate hangover remedy...

I just need my bed.

..and why have the weekly recommended limits changed so much?

But first, is a nightcap good for your sleep?

Alcohol has a long history of being used as a sleep aid.

I always smile when I remember back to

when I was a medical student and nightcaps were prescribed

on the drug charts at night, so if you looked at the pharmacy

cupboard you could see a bottle of Bailey's, a bottle of whisky and

a bottle of gin, and if Ethel needed a gin at 10pm you'd prescribe it.

According to one survey, over five million Brits use alcohol to

help them get to sleep.

With men tending to opt for whisky, and women a glass of wine.

But is an alcoholic nightcap really such a good idea?

'To find out, I've come to

'the University of Surrey's Sleep Research Centre.'

Thank you.

'Here they research the science of the perfect night's sleep.

'And what I want to know is

'whether the alcoholic nightcap is friend or foe.'

-Derk-Jan.

-Javid, I assume.

Hello, how you doing?

'Sleep expert Professor Derk-Jan Dijk has agreed to host me

'at the Sleep Centre this evening.'

Well, this is our, er, sleep, it's not a comfortable,

cosy bedroom you will see.

It looks like a safe!

'He is going to measure my sleep patterns to see what effect

'alcohol has.'

OK, I have brought something to help me. Look at that.

Oh, wow, not...not bad for a... for a whisky.

OK, we'll put it there, then.

Great.

'Derk-Jan's colleague Giuseppe

'has the job of getting me ready for bed.'

Head down for me, thank you.

'He's fitting me with this colourful set of electrodes that will

'measure my brainwaves as I sleep.'

I feel like I'm having my head plaited or something.

'Research has shown that alcohol has a big effect on sleep,

'particularly as we get older, as our sleep generally becomes lighter

'and more fragile.'

You may have been able to drink and sleep well when you were young

but by the time you hit 40 or 50,

the disruptive effect of alcohol increases quite a bit.

Right.

And that disruptive effect of alcohol is much

stronger in older people than in young people.

-Ah.

-We are done.

-Oh, lovely.

I think you are good for the night.

-Great.

-So I am going to go home now.

-Thank you very much.

-And you're going to do some work for us.

-Yes, it's going to be hard work.

-And, er, and sleep, so, OK, guys.

-Bye-bye, see you tomorrow.

-Have a good night.

Thank you very much, Giuseppe, goodnight.

'But despite what Derk-Jan says,

'I am still holding out hope that five million of us aren't wrong.

'It's time for my double whisky.'

Let's see if this works.

# Sleeping

# I am the sleeper

# Sleeping

# I am the sleeper

# Sleeping... #

OK, Javid, time to get up now.

Oh.

Good morning.

Morning.

-How are you, then?

-I'm good, thank you.

Well, let's have a look at what the data show and then we can tell.

The squiggly lines show my brainwaves and from these

Derk-Jan has been able to work out my sleep patterns for the night.

Red blocks for when we do most of our dreaming,

yellow and green for light sleep, and blue for deep sleep,

and where it's blank, that's where I was awake.

So how well did I actually sleep?

So, if we start from the beginning when you are awake

and the lights go off, you know,

-it takes you approximately 10-15 minutes to fall asleep.

-Right.

So that's not bad, considering this is the first time, new environment.

Obviously here we see now a lot of deep sleep

but as the night progresses you can see that this deep sleep disappears

and what we are left with in the second part of the night,

you know, quite a period of wakefulness,

you again see this wake EEG.

And I don't remember them, but I must have, I must have been, yes.

So, when we look at it overall, not a brilliant night of sleep.

And my poor night's sleep is consistent with what's been

shown before in scientific studies that have compared sleep with

alcohol versus sleep without.

And scientists think that there is a connection between the extra

deep sleep that alcohol seems to cause when we first nod off,

and our lighter sleep later on.

Although alcohol gets you off to sleep faster,

and have a deeper sleep in the first half of the night,

in the second half of the night there's a rebound effect.

You have fragmented, lighter sleep.

So it seems that booze doesn't really help you snooze.

But if you've had a lot to drink, then bad night's sleep is

likely to be the least of your problems.

Search the internet for hangover cures

and there are literally hundreds of suggestions,

from the familiar, such as vitamin C, coffee, water, to other

things such as Marmite, sauerkraut and even charcoal tablets.

But despite the huge public interest there's actually been very

little research into hangover remedies,

which is why perhaps everyone has their own favourite.

When you get home at the end of the night, drink loads of water.

Cooked breakfast and fat Coke.

So what is the best remedy for a hangover?

Well, we're going to try and answer this question once and for all.

'I'm meeting hangover expert Dr Richard Stephens.'

Oh, right, what have we got here, then?

'He's selected two hangover remedies for us

'to test that apparently have more science to back them up than most.

'One over-the-counter supplement that can be taken before drinking,

'the other for the morning after.'

Richard, this I recognise, good old fry-up.

-That's right.

-What is this? Looks like it's got a hangover today?

So this is borage, so borage is a herb

and from these flowers come seeds.

Here's...we've got some seeds here, and we extract oil from the seeds,

-sometimes known as starflower oil.

-Right.

And that's what we've got in these capsules here.

You know there are a lot of people out there selling

-hangover remedies.

-Yeah.

-OK, mostly junk in my opinion.

However, there is some research behind taking one of these

capsules as a hangover remedy.

-Just the one?

-Just one capsule, that's the standard dose.

-Oh, right. Why does this work?

-OK, for the nation's favourite hangover remedy, probably,

a good old fry-up.

So there is some evidence that one of the biological

-underlyings of a hangover is a drop in glucose.

-Right.

So if you have one of these the next morning

when you've got a hangover, that's got a lot of sugars in it.

-Yes, it does.

-That will restore those sugars.

So, tonight, we're going to get some volunteers,

we're going to be dosing them up with alcohol to a set

blood-alcohol level, and then we're going to see what their hangover

is like in the morning and whether these have made any difference.

I know which group I'd like to be in.

I'd be with you!

To test these two hangover remedies is going to require

some serious drinking.

And I thought where better to organise a piss-up

than in a brewery.

This is Arkell's Brewery in Swindon.

And we've invited the workforce to take part in Richard's experiment.

Team Green, if you could put one of these armbands on, please,

thank you very much.

We're first splitting up the volunteers from the workforce

into three separate groups.

It's terribly big.

Blue Team, you are our breakfast group,

you will be having the fry-up in the morning, good?

Yes.

Yellows, you are our control group.

-I'm afraid you're not getting anything.

-Yay!

Yeah? And Greens, you've guessed it, you are going to be the borage

group, so you're going to get some borage before you start drinking.

Hurrah!

Great, let's go.

Whereas the fry-up is designed to replenish low glucose levels

and is eaten after we have felt the effects of alcohol,

borage is taken before drinking as a preventative measure.

Down the hatch.

And relies on the fact that its rich in a particular fatty acid

that's an anti-inflammatory.

-OK, drink away, enjoy.

-Wait a minute, wait a minute.

According to research, around one in five of us have hangover immunity.

We don't get hangovers at all, and scientists aren't sure why.

OK, time for your breathalysers.

'But the average man drinking nine-and-a-half units or shots of spirits...'

-96.

-96.

'..or the average woman drinking six units or six shots

'will probably achieve a blood alcohol level high enough

'to give them a hangover the next morning.'

-74.

-So it's hardly gone up?

-Hardly gone up.

-So I can have another double?!

104, 104.

Perfect. Right where we want you.

It's time for some taxis home.

Richard, it's the end of the night and I think we've achieved

some good high alcohol levels there, have we?

We have, so we were aiming to dose our volunteers to

0.10% blood alcohol, so we gave them specific amounts of alcohol

based on their body weight and if they're a man or a woman,

to achieve that and we adjust a little bit as we go along.

We give them a drink, we breathalyse,

I think we pretty much got there for everybody and got them

-pretty much where we wanted them to be.

-So we're set to have some hangovers in the morning?

We should see some hangovers in the morning.

It's 7.30am, our fry-up group have managed to make it to

the breakfast table, but, as Richard predicted, they're feeling

a bit worse for wear.

-I've got a bit of a headache.

-Same.

I just need my bed.

According to scientists, unless you're one of the lucky few,

the dreaded hangover affects men and women, old and young, the same.

So, has borage, with its alleged preventative qualities,

worked any magic?

-Good morning, how are you?

-A little bit of a headache.

-Yeah?

-Um, little bit, you know, just not quite right.

-Knock-knock, Alex.

-Morning.

-How are you?

-Not bad, thanks.

What group were you in last night?

I was on borage.

'There's no magic way of measuring someone's hangover.

'This questionnaire is the best that scientists have come up with.'

Headache, yes.

Thank you.

And after the fry-up group have had their breakfast

they fill in the hangover questionnaire as well.

'I'm catching up with our expert Richard Stephens to find out

'the results.'

So what did our demonstration show?

OK, so if we look at the control group,

all six of them had a hangover.

-Right.

-OK.

We look at the fry-up group, five of the six had a hangover,

one said they didn't.

In the borage group, three had a hangover and three didn't.

OK.

-Cheers.

-Cheers.

So, in the experiment, none of the volunteers in the control

group escaped the hangover.

In the fry-up group, after eating their breakfast,

just one reported not having a hangover.

And in the borage group,

three volunteers felt they had no hangover.

-A clear winner, then, surely?

-A clear winner.

Well, I'm a scientist so I am sceptical, but we were replicating a

previous study which showed similar, so that's positive, and we know

that borage is an anti-inflammatory and we know that one

of the ways that hangover affects us is by an inflammation response.

So, OK, borage may have an effect on that mechanism

but, you know, probably no different to if you felt bad in the morning

and popped an ibuprofen, it could have same effect.

-I see.

-So I don't think there's any earth-shattering effects here

but it's been an interesting demonstration.

So, if borage works in the way that Richard thinks it does,

then it's probably still no better than the ibuprofen you might

be taking anyway the next day.

And it's certainly not 100% effective.

So what is it, then, come on, what shall we do for our hangovers?

If you don't want a hangover, don't drink too much!

But apart from the obvious, not drinking,

is there anything else we can do to avoid a hangover?

Don't go out with a biker!

Some hot stuff called Lavronitza.

Oh, yeah.

From Czech Republic. You should never drink that.

Mixing drinks, definitely.

Contrary to popular belief, there's no evidence that

mixing your drinks leads to a worse hangover, but there is

scientific backing for the idea that some drinks might give worse

hangovers than others, and it all boils down to how drinks are made.

Back at the brewery, head brewer Alex Arkell is showing me

one of the key parts of the production process

for the nation's favourite drink - beer.

So we've got one of our beer tanks here.

Wow, look at that!

And in here we've got fermenting beer, and you can see the yeast,

so that white foam is pure yeast.

Wow, and to be clear, you cannot make alcohol without yeast?

-Yes, exactly, you need yeast.

-Wines, spirits.

You need to have a fermentation at some point to produce this

alcohol and then a couple of products down the line

-you might have your whisky or your vodka.

-Incredible.

But we're making a base drink here, which is beer,

and it's the best of the lot.

Into the lab.

But it turns out that the yeast cells produce other

things besides just alcohol.

-So, when they're splitting, when the mother and daughter here...

-Yeah.

..part of that process that's going on there is excreting congeners.

'Congeners are by-products of the fermentation process in which

'yeast converts the sugar into alcohol.'

We ferment it at a slightly warmer temperature.

That means the yeast not only ferments and obviously

creates alcohol, but it also gives it a fruity flavour as well.

'So, on the plus side,

'congeners are one of the things that give our booze its taste.'

It's not a flat flavour, that.

No, it's got a lovely... a lovely aroma on that one.

But the downside is that according to some research,

drinks with more congeners in them may make your hangovers worse,

and beer is by no means the worst culprit.

I've come to the labs of Kent Scientific Services

and, with the help of chemist John Griffin,

we're going to put ten of the UK's most popular drinks to the test.

We're going to analyse each drink for six typical congeners.

-This is acid aldehyde.

-Oh, crikey!

-I can imagine that would give you an hangover.

-You can smell it in the air,

-it lingers as well, doesn't it?

-Yeah!

And then at the end here we've got our amyl alcohols.

Oh, that smells like a really off cheese.

-Yeah, yeah, yeah, so it's very distinctive.

-OK.

Research suggests that

although the main cause of a hangover is the alcohol, drinks that

contain higher amounts of congeners may produce more severe hangovers.

So which drinks have the most congeners?

Some results, John. OK, show me what we have.

Yes, at the top end we have the red orange ones, where we

had the highest level of total congeners per unit of alcohol,

so per 10ml of pure alcohol.

Yeah, quite a lot, this is the winner or the loser.

Red wine actually came out top, yes, er, 53, yes.

I mean, we've almost got twice as much congeners in the red wine

than we have in the ambers.

Well, we've got white wine

and, er, whisky, as well as the lager, the stout and the cider.

This surprises me, certainly, because I always think about

white wine being sort of less toxic than whisky.

So in our tests, brandy

and red wine came out worst, with the highest amount of congeners per

unit of alcohol,

and in the mid-range were white wine, whisky and lager.

And the low-end ones, obviously, are the rums, gins and vodkas.

-Yeah.

-Vodkas and gins have got no congeners in there at all.

I knew there was a reason I drank vodka.

Well, if you're drinking white spirits there are no congeners.

It probably doesn't mean to say you won't get a hangover because you've still got alcohol

but there are no congeners in this to contribute to it.

It's incredible. Would it to be fair to say, then, as a rule of thumb,

-the darker the drink the more congeners?

-Yeah, I think the whisky

and the white wine were the slight anomalies in that, but on the whole

I think the darker the drink,

the higher level of the congeners present.

-So drink a lighter-coloured spirit like vodka.

-That seems to be what it suggests, yes.

-Cheers.

-Cheers.

The potential effect from congeners in making your hangover worse

is small compared to the alcohol itself.

That said, if you're going to drink, and you're particularly

susceptible to getting hangovers, then it may be a good idea to

opt for lighter-coloured, lower-congener drinks.

So far, we've found out lots about the science of drinking

but I want to investigate the new evidence for alcohol's health risks.

I think it's fair to say that the new alcohol guidelines mark

a big change in the traditional thinking, which is

drinking in moderation is completely safe.

Now the message is that even drinking

small amounts of alcohol isn't without risk.

So I'm on my way to meet the Chief Medical Officer of England,

who, along with her counterparts in Scotland, Wales

and Northern Ireland, has proposed the new guidelines.

The last time the alcohol guidelines were revised was in 1995.

'So I'm keen to find out from Professor Dame Sally Davies

'why have the recommended limits changed so much?'

Professor Dame Sally, the recommendations have

come down quite a lot for men, from 21 units to 14 in the week.

What's the reasoning behind that?

Well, this is the first review

that's really in-depth for over 20 years

in this country and what it shows is how cancer is related to alcohol.

Everyone knows about cirrhosis, stroke, high blood pressure,

but actually now we have to add to it the cancer risk, and by the time

you balance all of those out, if you want a low-risk guideline,

then for men it is 14 units in the week spread out over a few days.

It is quite a broad range of cancers that can be attributable to alcohol.

-Yes.

-So therefore you could say alcohol is a carcinogen?

It is.

Alcohol can damage cells and its breakdown products damage cells.

That can lead to cancer. Alcohol modulates hormone levels,

so, for instance, it changes oestrogen levels

and that's probably why it raises the risk of breast cancer.

-So, take women...

-Yes.

..for every 1,000 women, 110 of us will get breast cancer.

If you drink up to this guideline, which is a low-risk guideline,

then an extra 20 women will get breast cancer out of 1,000.

Double that, and an extra 50 women out of 1,000 will get breast cancer.

So it's very important that people know about the harms of alcohol

and take their decision how they want to handle it.

OK, and there is one small sub-group of the population

that could have some benefit from drinking, is that right?

Yes, it's women of 55 and older, my age group.

If you drink, as a woman, up to five units in the week,

as you go up to that five you protect your heart.

If you drink above that you begin to lose that protective

effect on your heart.

By the time you get to 14 units in the week,

you've lost the cardio protection. And the old wives' tale

was that that was the case for all of us, men as well, and, first

of all, the data isn't as robust as we all believed, now we've looked

at it, and the second thing is, that it is a marginal impact on men.

They'd have to drink less than half a glass on only a few days,

-of wine, and I don't think people usually do that.

-No!

Um, and the other harms come in,

that if you balance out a low-risk guideline, sorry, it's 14 units

spread over a few days in the week for both men and women.

Will you still be enjoying your glass of wine in the next five years?

I will, I am quite open about the fact I like a glass of wine.

I think for a lot of us

that explicit link between how much you drink and the risk

of developing certain kinds of cancer is actually quite shocking.

But if you stick to the new recommended guidelines

your actual risk of dying from any disease attributable

to alcohol is really quite low.

Just 1%.

But if you drink greater than the guidelines, your risk is greater.

It's as simple as that.

And the good news is that there is some evidence that the extra

risks of alcohol-related cancers can gradually go down again

if you decide to stop drinking altogether.

I've reached the end of a fascinating journey to uncover

the many truths about alcohol.

That's shocking to me.

Along the way, we've learnt that alcohol isn't actually

good for your sleep.

Deep sleep disappears.

And we've revealed its hidden appetising effects.

You consumed 11% more calories compared to the no-alcohol group.

And that lining your stomach is always a good idea,

however much you plan to drink.

-Eight.

-21.

In light of the health risks, some of us might decide to give up

booze altogether and, certainly, all 40 million of Britain's drinkers

should probably pause for thought before reaching for another glass.

But, personally, I don't think the British love affair with

alcohol is going to end any day soon.