Beer School: Head and heart

Beer was once brewed with medicinal herbs, but these days it’s viewed as a scourge on public health. Louise Crane breaks down your pint and asks whether it’s kill or cure…
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Sometimes, beer makes you fat, and Guinness is good for you. On the flipside, beer can pad your belly and Guinness is not a health food. Puzzled? The simple fact is that beer contains ethanol, a poison in large amounts, but it also contains carbohydrates, amino acids, polyphenols, vitamins and minerals that are really useful to our bodies. That’s why on one day, you’ll read a headline that says: “Dementia risk for binge-drinkers” and the next “Beer: the cancer killer”. Before we delve into the consequences of drinking beer, let’s find out what makes up our favourite drink.

First off, it’s 90% water. Whether it’s from an underground well, a spring or the tap, this is the biggest ingredient. Don’t let that fool you into thinking beer will hydrate you, though - since alcohol has a ‘diuretic’ effect on you - it makes your bladder fill up with urine quicker. What goes in must come out, plus a little extra. The amount of alcohol is stated as an abv% - alcohol by volume. When this is 5%, and you’re drinking a pint, that’s 28.4ml of pure alcohol, or 22.4 grams. In the UK, 10ml of pure alcohol is a single unit, so that’s 2.84 units.

Alcohol is a source of fuel - you can see this by setting it on fire, though we don’t recommend it (honest). It also fuels the human body, to the tune of seven kilocalories per one single gram. In our hypothetical 5% abv pint, you’re looking at 156.8kcal. But that’s not all! There’s energy in beer in the form of lovely carbs, the complex sugars that lend a subtle sweetness to your ale, left behind by fermentation. What the yeast couldn’t turn into energy, we do. An average 330ml bottle of American beer has 12g of carbohydrates, which gives us another 48kcal. The equivalent amount in a whole pint is 20.65g, or 82.6kcal. Add that to the calories from alcohol, and you’ve got 239.4kcal in a pint - over 10% of the recommended daily allowance (RDA) of calories per day for the average person.


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Moving away from hidden calories, we’re also got secret minerals. Beer contains trace amounts of minerals such as calcium, iron, magnesium, phosphorus, potassium, sodium, zinc, copper, manganese and selenium, fluoride and silicon. Worried about your teeth? Drink two 330ml cans of beer and you’ll ingest almost 300mg of fluoride, which covers 10% of the RDA for adults. Silicon, a mineral important for bones and connective tissues, is hard to come by in foods, but drinks are a rich source - 55% of the average American person’s daily intake comes from beverages such as red wine, beer, coffee and water.

Vitamins also lurk in your glass, bottle, or flagon of beer. B vitamins are produced during fermentation, mostly in small amounts, except for folate and choline. Two cans of regular US beer contains almost 10% of the RDA of both vitamins. Folate is crucial to developing babies in the womb, and many pregnant women take it as a supplement. Without choline in your diet, you risk liver damage. Other useful ‘macronutrients’ include polyphenols such as flavonoids and phenolic acids, which contribute flavour, haze, body and fullness. They are much touted as powerful anti-inflammatories and have even been linked, in some tabloid newspapers, to the treatment of depression.

A group of scientists, led by Dr Giovanni de Gaetano and Dr Simona Costanzo at the IRCCS Istituto Neurologico Mediterraneo Neuromed in Pozzilli, Italy, looked at a tonne of research into beer’s impact on health, and in 2016 wrote up a broad review. “A large body of evidence from observational studies supports beneficial health effects of moderate alcohol consumption,” says Dr Simona Constanzo, with one important warning: “We should underline that heavy alcohol drinking can cause damage in the short and long term.” Dr Costanzo also makes clear that beer should be consumed as part of a balanced, healthy diet. She recommends high consumption of vegetables, fruits, legumes, nuts, whole grain cereals, extra virgin olive oil, fish and low-fat dairy products. Alongside this good diet, “regular consumption of alcoholic beverages like beer, up to two glasses a day for men and up to one glass a day for women, has beneficial effects on health,” concludes Dr Costanzo.

The main message is that the amount of alcohol, rather than the content of the drink, is the most important factor when considering health aspects, at least with wine and beer. It’s hard to pull out exactly what is in beer that causes effects that benefit the human body; is it the high silicon, the B vitamins or the polyphenols? Research to date cannot rule out that the protective effect against cardiovascular ‘events’ is (mainly) down to the ethanol itself, but research is always ongoing, and different diseases work in different ways.

Beer, and wine (but not spirits), can protect against cardiovascular risk in healthy adults. This has been attributed to the antioxidant and anti-inflammatory effects of polyphenols, as well as the impact of ethanol in the blood, where it increases levels of good cholesterol, reduces bad, preventing clotting and increases sensitivity to insulin. Looking at atherosclerosis, where fatty deposits harden the arteries of the heart, it’s polyphenols that stop white blood cells sticking, and reduces inflammatory markers. Alcohol’s effect on the fat profile of the blood also plays a role in preventing this disease.

There is some evidence, though not conclusive, that drinking beer in moderation (so about one beer a day) protects against ischemic stroke - where the arteries supplying oxygen to the brain are blocked by a clot. There are also conflicting results regarding alcohol consumption and the risk of dementia. Some say that alcohol can have a ‘neuroprotective’ factor and improve memory performance. It could also protect the brain by enabling changes in its blood vessels. But recent reports suggest that alcohol increases dementia risk, so the jury’s still out on that one.

“The relationship between beer intake and cancer is more controversial,” says Dr Costanzo. “Several studies have concluded that alcoholic beverages may contribute to the risk of breast cancer, esophageal cancer, and oral and pharyngeal cancers, among others. It is difficult to disentangle the possible role of beer drinking separately or in combination with other alcoholic beverages. This is essentially due to the fact that, in several populations, heavy drinkers tend to use more than one type of alcoholic beverage. However, other studies have reported that the effects of fermented beverages such as beer and wine consumed with moderation are absolutely different than the effects of liquors and spirits.”

Moving from one controversy to the next, Dr Costanzo tackles the myth of the beer belly: “Many people are worried about the effects of beer on body weight and waist circumference. However, scientific evidence is not clear. Without doubt, consumption of large amounts of beer may cause overall obesity (from excessive calories) and increased abdomen circumference, but moderate alcohol consumption in a healthy diet seems to protect against weight gain.” In fact, some theorize that it is our drunken snack choices that contribute to the beer belly more than beer itself, as well as the lethargy of a lazy Sunday afternoon with a few pints, or a Monday morning hangover.

If we look at beer as a source of nutrients rather than just tasty, liquid fun, we can appreciate another facet of its multi-textured personality. The next time you take a sip, imagine, if you will, an army of tiny soldiers rushing to your blood. Granted some will make you courageous and loud, but some will get to work on your cholesterol, or your platelets, or your brain, changing the way your body works for the better. Some will lie around and make you fat. Others will improve your memory, though it might not seem like it at the time. But don’t up your beer intake thinking it will make you healthier, or wiser. The message is, as always, everything in moderation - and if we take Dr Costanzo’s advice, with heaps of tomatoes and lashings of (extra virgin) olive oil. Or perhaps an apple. Trust her, she’s a doctor.

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