A Nutritionist’s Guide to Drinking Alcohol Smarter

Written By Jessica Coghill

Life isn’t about being perfect — it’s meant to be enjoyed. And for me, that sometimes includes a drink. I’m not here to guilt anyone or tell you what to do — just to share some helpful info so you can make choices that actually feel good.

Understanding how alcohol is processed in the body, and the risks that come with it (like its link to cancer), gives you the tools to be more intentional. Tuning into when, why, and how much you drink can go a long way in supporting your long-term health. Even small shifts — like drinking less often, or opting for an alcohol-free option when you’re not super excited about the drink — can make a real difference.

Because honestly, it’s just more fun to enjoy life when you feel good in your body — clear-headed, energized, and able to show up fully for the things and people that matter.

These suggestions are not about rules or restrictions. It’s not here to push drinking, either. It’s here to help you understand what’s happening in your body when alcohol’s in the mix — and how to care for yourself before, during, and after, so you can feel like yourself both the next morning and long-term.

Interesting Fact: Alcohol Is Actually a Macronutrient (But Not Like the Others)

Most people know alcohol has calories, but what’s less known is that it’s technically a fourth macronutrient. It provides 7 calories per gram—more than carbs or protein (4 cal/g) and just under fat (9 cal/g). Unlike the others, though, alcohol offers no nutritional benefit and is treated by the body more like a toxin than a fuel.

But unlike the other macronutrients, alcohol doesn’t provide nutrients or building blocks. It’s not something your body needs, and it’s processed very differently.

Historically, alcohol played a role in survival. In times of food scarcity, people used alcohol — often in the form of beer or fermented grain drinks — as a source of calories when food was limited. It was never ideal, but it provided quick energy in hard times.

That said, alcohol is not a carb or sugar, though it’s often lumped in with them. The fermentation process that creates alcohol starts with sugars or starches (like grapes or grains), but the final product — ethanol — is its own compound. Where things get confusing is in mixed drinks, which can combine alcohol with sugary mixers or juice, leading to higher blood sugar spikes and inflammation.

What Happens When You Drink: Liver Detox in Two Phases

Your body has no way to store alcohol, so it prioritizes processing it right away. About 20% is absorbed in the stomach, the rest in the small intestine — and it quickly heads to your liver.

Liver detox happens in two phases:

Phase One (Activation)
The liver uses enzymes — mainly alcohol dehydrogenase (ADH) — to convert alcohol into acetaldehyde, a compound that’s even more toxic than alcohol itself. Think of this phase like unwrapping a package and exposing something sharp and reactive.

Phase Two (Neutralization)
Your body then uses aldehyde dehydrogenase (ALDH) and a host of nutrients to convert acetaldehyde into acetate, a relatively harmless substance your body can use for energy or convert to fat.

The problem? If phase two is sluggish — because of nutrient depletion, genetics, or drinking too much too quickly — that toxic intermediate (acetaldehyde) lingers, making you feel worse.

Nutrients Your Liver Needs to Detox Alcohol

This two-phase process requires a steady supply of nutrients. When you drink often, these stores can run low, making detox slower and recovery harder. Here’s what your body burns through:

How to Support Your Body When You Drink

A few strategies to reduce the toll on your system and feel better the next day:

  • Be VERY hydrated the day prior to your first drink. Shoot for half your body weight in ounces plus ~30 oz. Ideally, adding 1- 3 packs of electrolytes throughout the day.

  • Have one (or even two) glasses of water between each drink

  • Eat a balanced meal beforehand – include protein, fat, and complex carbs to slow alcohol absorption

  • Skip sugary mixers – they increase inflammation and intensify blood sugar crashes

Supplement Support for Drinking Days

You don’t need a pharmacy, just a few well-timed additions:

Before drinking:

During drinking:

  • Water before and between each drink. If you forgot electrolytes before hand, you can use them here :)

After drinking:

My Go-To Mocktail (for Nights Out or Between Drinks)

If you want to pace yourself or skip alcohol entirely — without fielding questions all night — try this:
Soda water + bitters + lime.
It looks like a cocktail, tastes refreshing, and gives your liver a break without drawing attention. You can sip one between drinks or use it as your drink for the night. Bonus: Bitters help with digestion. This is not recommended for those 100% sober as it contains very small amounts of trace alcohol.

Challenge: Try a Sober Night Out

If you usually have a drink every time you go out, try switching it up. Challenge yourself to a night out without alcohol — even just once. You might be surprised by how present, energized, and genuinely connected you feel. It’s a great way to check in with your habits, enjoy the moment fully, and wake up clear-headed the next day.

Why Some Drinks Hit Harder Than Others

While all alcohol contains ethanol, which your liver processes the same way, different drinks come with different add-ons that may make them harder to tolerate:

  • Beer often contains gluten, which can trigger inflammation or immune reactions in sensitive people

  • Wine contains histamines and sulfites, which can lead to headaches, flushing, or sinus issues — especially if you’re low in the DAO enzyme that breaks down histamine

  • Sweet cocktails combine sugar, alcohol, and additives, creating a triple hit for your liver and blood sugar

If you’re sensitive, consider sticking with clean spirits like tequila, mezcal, or vodka with soda water and lime — no added sugars, gluten, or histamines.

Sleep & Alcohol: The Hidden Cost

Even one or two drinks can reduce REM sleep, suppress melatonin, and lead to more fragmented, shallow sleep. That’s why you might wake up groggy, irritable, or wide awake in the middle of the night after drinking.

Tips:

  • Stop drinking at least 4-5 hours before bed

  • Avoid back-to-back drinking nights

  • Stay hydrated throughout and after

Drinking earlier in the day — at brunch, a late lunch, or happy hour — is easier on your sleep cycle than late-night drinking.

Women & Alcohol: Why It Hits Differently

Women often feel the effects of alcohol faster and more intensely. Here’s why:

  • They naturally produce less ADH, the enzyme that breaks alcohol down

  • They tend to have more body fat, which holds less alcohol than lean tissue

  • Hormonal shifts throughout the cycle can affect alcohol metabolism

Translation: the same drink can lead to a higher blood alcohol concentration in women, and the liver may need more time to process it.

The Link Between Alcohol Consumption and Cancer Risk

While enjoying a glass of wine or a cocktail is a common way to celebrate or unwind, it's important to be aware of the associated health risks, particularly concerning cancer. Extensive research has established a clear connection between alcohol consumption and an increased risk of several types of cancer.​

Key Findings from Recent Research:

  • Types of Cancer Associated with Alcohol: Alcohol consumption has been causally linked to at least seven types of cancer, including breast (in women), colorectal, esophageal, liver, mouth, throat, and voice box cancers. ​HHS.gov

  • Impact of Light to Moderate Drinking: Even light alcohol consumption (defined as one drink per day) has been associated with increased risks of certain cancers. For instance, a meta-analysis reported that such consumption is linked to a 30% increased risk of esophageal cancer, 17% for oropharyngeal cancer, 8% for liver cancer, 7% for colon cancer, and 5% for breast cancer. ​PMC

  • No Safe Level of Alcohol Consumption: The World Health Organization has stated that no level of alcohol consumption is safe for health, emphasizing that the risk of developing cancer increases substantially with the amount of alcohol consumed. ​Food & Wine+2World Health Organization (WHO)+2Wikipedia+2

Biological Mechanisms:

Alcohol can contribute to cancer development through several biological mechanisms:​ Wiley Online Library+9HHS.gov+9aicr.org+9

  • Conversion to Acetaldehyde: Alcohol is metabolized into acetaldehyde, a toxic chemical that can damage DNA and proteins. ​HHS.gov

  • Oxidative Stress: The metabolism of alcohol can generate reactive oxygen species, leading to oxidative stress and further DNA damage.​

  • Hormonal Changes: Alcohol consumption can increase levels of certain hormones, such as estrogen, which are linked to hormone-sensitive cancers like breast cancer.​

How Much Is “Okay”?

Abstaining completely is the most protective choice for health — especially when it comes to cancer risk. But for many people, a more realistic middle ground can still support long-term well-being.

General guidelines:

  • No more than 4 drinks per week (not every week)

  • Most weeks, try to abstain, giving your liver a break

  • No more than 2 drinks in a day

  • Space out drinking days to give your body time to recover

  • Stay hydrated and nourished, before, during, and after

Bottom Line

There’s nothing wrong with enjoying a drink now and then. But knowing what alcohol does — and how to support your body — helps you make informed choices and show up with more energy, clearer focus, and fewer “what was I thinking” mornings.

If you’re working on reducing inflammation, improving digestion, balancing hormones, or just building more sustainable habits — working with a nutritionist can help you develop the skills, structure, and support you need to heal, thrive, and reach your specific health goals.

If you try these tips on your next night out- I’d love to hear how they worked for you!

Jessica Coghill
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