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The Diary Of A CEO with Steven Bartlett

Most Replayed Moment: Is There A Safe Amount Of Alcohol? What Happens To The Body When You Drink!

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PodcastThe Diary Of A CEO with Steven Bartlett
Publisher/creatorDOAC
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About this episode

Sarah Wakeman is a physician and Medical Director specialising in substance use and addiction treatment, working on the front lines of alcohol-related harm. In this Moment, she breaks down what the science actually says about having just one drink, debunks old narratives and reveals what alcohol is really doing to the body. Listen to the full episode here! Spotify: https://g2ul0.app.link/BVLeOxhOTZb Apple: https://g2ul0.app.link/vw2IpvzOTZb Watch the Episodes On YouTube: ⁠⁠https://www.youtube.com/c/%20TheDiaryOfACEO/videos Sarah Wakeman: https://www.massgeneral.org/doctors/19383/sarah-wakeman

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Episode summary

Alcohol’s been on a journey in public opinion. Walk me through how we got here on its supposed health benefits, what the evidence really says now, and what we’re still getting wrong.

People have brewed for thousands of years, mostly for social and spiritual reasons, not health. Modern claims of benefits came from flawed population studies that grouped lifelong abstainers—often sicker or former heavy drinkers—against moderate drinkers, creating that famous J-shaped curve; when you compare to very light drinkers instead, the “benefit” largely disappears across conditions.

So there’s no healthy level of alcohol?

I wouldn’t call alcohol health-promoting. Low-risk drinking can fit a healthy life, but it’s more like dessert or sun exposure—you weigh the risks and choose.

If I have one glass a day, doesn’t my body just clear it with no downside?

“One drink” is slippery. In the UK, low-risk means under fourteen units a week, and a large glass of wine can be roughly three units, so a daily large pour puts you at the limit and real life often pushes you over it.

So that puts me in moderate risk?

Yes—once you’re into moderate territory, the risk rises for most cancers.

Cancer rates seem to be climbing. What does the data say at low and moderate levels?

Breast and esophageal cancers show increases even below low-risk limits; breast cancer risk nudges up about 5 percent, on top of a baseline near 13 percent over a lifetime. Rising cancers also reflect environment and behavior—alcohol, obesity, reproductive timing, processed meats—and likely other exposures we’re still uncovering, with colon cancer increasingly hitting younger people.

What about cancers that affect men?

Colon and liver are big concerns, and while prostate isn’t classically alcohol-sensitive, alcohol raises risk broadly by driving cellular damage rather than targeting just one organ.

If I drink two glasses every day, what happens to my risk profile?

That’s considered heavy; roughly a 40 percent higher cancer risk depending on type, and it climbs with intake. Smoking and obesity amplify harm—drinking makes tobacco’s carcinogens hit harder, so risks multiply, not just add.

What’s actually happening in the body to cause this?

Alcohol absorbs quickly, spreads through body water, and crosses into the brain—at first relaxing you, then impairing judgment and coordination. The liver breaks it down, generating a toxic intermediate and inflammation that injure cells and DNA, which over time raises cancer risk.

Show me the liver and explain the liver story.

The liver sits under the right ribs, is large, and handles most alcohol metabolism; it can regrow, but not once scarring sets in. Today, alcohol and obesity drive rising liver failure and transplants, and we’re seeing younger patients crash late without realizing the damage until it’s irreversible.

Could I do a blowout weekend and bounce back?

One big weekend is usually recoverable, but repeated binges speed up injury and push you toward trouble.

But the liver regenerates, right?

Only before fibrosis; once there’s real scarring, it can’t return to normal. People vary widely, so catch problems early with bloodwork and imaging—the path goes from fatty liver to inflammation to fibrosis to cirrhosis.

What else stresses the liver that we overlook?

Excess weight and high-sugar eating strain it, and medications like acetaminophen can damage it, especially when stacked with alcohol or mixed unintentionally with cold remedies.

How much alcohol actually causes liver damage?

It differs by person, but moderate to high intake and big spikes are most harmful; stay within low-risk limits and avoid binges. Heavy use also shrinks brain tissue and can lead to alcohol-related dementia, worsened by poor nutrition; it irritates the gut causing reflux; and it can trigger atrial fibrillation—sometimes called holiday heart—and, over years, a weakened, failing heart.

What you just heard was one of our most replayed moments; the full episode is linked below in the description.

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