You May Be Drinking More Alcohol Than You Realize | Everyday Health
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 Diet & NutritionYou May Be Drinking More Alcohol Than You RealizeCraft beers are tasty, but they can be a shortcut to a hangover or worse if you’re not careful. Here’s why experts urge caution with local brews.By Leah GrothMedically Reviewed by Lynn Grieger, RDN, CDCESReviewed: September 21, 2021Medically ReviewedNot all beer is created equal, and artisanal brews especially vary widely in alcohol content.Gabriel Bucataru/StocksyOver the last decade, craft beer has become wildly popular. Since 2015, the number of breweries in the United States has nearly doubled, according to the Brewers Association. While many people think of locally brewed beverages as being on par with other small-batch, farm-to-table products, like produce and meat, with a similar reputation as fresh, organic or sustainable, and better for you overall, that isn’t necessarily true. In fact, many craft beers have a hidden risk their mass-produced counterparts don’t, and it could be causing you to drink more than you realize.What Is Craft Beer?Beer is considered "craft" if it is produced by a small, independent brewer. The Brewers Association defines “small” as an annual production of six million barrels of beer or less, and "independent" as a business in which less than 25 percent of the brewery is owned or controlled by an alcohol-beverage industry member that is not itself a craft brewer. Craft brewers, like all commercial beer makers, must be registered with the Alcohol and Tobacco Tax and Trade Bureau.In terms of ingredients, craft beer is generally made with malted barley, although some brewers add unconventional ingredients for flavor or to make their product stand out.RELATED: 6 Tips for Drinking Responsibly During the COVID-19 PandemicDoes Craft Beer Have Any Health Benefits?There are a few health benefits to drinking beer, says Jackie Newgent, RDN, a plant-forward culinary nutritionist and the author of The Clean & Simple Diabetes Cookbook, but she emphasizes that they are associated with “moderate intake — not weekend binges.” The 2020–2025 Dietary Guidelines for Americans defines “moderation” as two drinks or less a day for men and one drink or less a day for women, on days when alcohol is consumed.Because beer is derived from plants, especially fermented cereal grains, it contains some health-promoting polyphenols (plant compounds), and has potential anti-inflammatory properties, according to a study published in November 2016 in the journal Age and Aging. Additionally, a meta-analysis published in PLoS One in June 2020 found that beer may offer protection against cardiovascular disease by improving the elasticity of blood vessels and increasing HDL (“good”) cholesterol levels. In March 2021 the journal Nutrients published a study that found moderate amounts of beer may boost bone mineral density, which means that drinking beer in moderation may be helpful for the prevention of osteoporosis.Previous studies found that moderate beer intake was associated with a lower overall mortality risk and also linked to a decreased risk of type 2 diabetes in men. There is evidence that beer is a source of prebiotics, a nondigestible ingredient that helps “feed” beneficial probiotics (“good bacteria”) in the gut, according to a study published June 2017 in the Journal of the Institute of Brewing. These bacteria, collectively known as the microbiome, are being researched for their role in a variety of health processes, from digestion to immunity.Newgent adds that craft beers may have slight added benefits, as some are not pasteurized or filtered, which she says means they can be richer in naturally occurring plant-based compounds and antioxidant activity. A study in the April 2020 issue of Food Chemistry found “significantly higher values” for several health-related compounds in small-scale beers.Other things to take into consideration? Color and calories. Newgent notes that dark beer may actually be healthier than light beer because it may have higher antioxidant content. This observation is in line with findings from a study published in the journal Biomolecules in March 2020.RELATED: Expert Hacks for Preventing a HangoverThe Potential Dangers of Craft BeerWhatever benefits it may have, craft beer is still alcohol. Like the Dietary Guidelines for Americans, the Centers for Disease Control and Prevention (CDC) recommends that adults limit alcohol consumption to one drink per day for women or two drinks per day for men, and defines a drink as one 12-ounce serving of beer with 5 percent alcohol by volume (ABV).While every craft brew is unique, the majority of them boast higher alcohol by volume than the average beer made by a larger producer. Per the National Consumers League, beer contains between 4 and 7 percent alcohol by volume, with the average being 5 percent ABV. But craft beer can contain four times that. For example, according to Dogfish Head’s website, their 120 Minute IPA contains 15 to 20 percent ABV.Additionally, craft beers are often packaged in larger bottles and cans. In 2013, The New York Times dubbed the increasing size of craft beers the “wine-ification” of beer, claiming that more people wanted to drink beer with dinner as if it were wine; and noted that it is more cost effective to package a beverage in one rather than several bottles.Because of both size and alcohol content, a bottle of craft beer can easily exceed the recommended daily amount of alcohol, explains Stephen Holt, MD, an addiction medicine physician at Yale Medicine in New Haven, Connecticut. “A traditional microbrew, with an ABV of 5 percent in a 12-ounce can, provides about 14 grams of pure alcohol,” he says. “A lot of craft beers come in 16-ounce cans, with a 6 to 7 percent ABV, which is going to translate to nearly 26 grams of pure alcohol.”If, for example, you drink two of those cans, you’re consuming the equivalent of nearly four beers’ worth of alcohol, “which undeniably has the potential to negatively impact your health, especially if you’re doing this on a regular basis,” Dr. Holt says.All that alcohol also contains calories that add up. Per Newgent, one gram of alcohol translates to 7 calories. In Holt’s example above, that’s a difference of 98 calories per can compared with 182 calories.The psychotherapist Paul Hokemeyer, PhD, author of Fragile Power, says that if an individual prone to addiction believes that craft beer is a healthier alternative to other beers, he or she is more likely to abuse it. “The notion of a healthy alternative has great appeal to people who are in denial about their substance abuse,” he says. “These individuals are under the pernicious grip of the disease of addiction, which tells them they don’t have a problem and comes up with all sorts of clever ways to rationalize and justify their alcohol consumption.”Newgent also notes that toxic compounds called mycotoxins are found in a small percentage of craft beers. This contamination can be caused by improperly stored barley. A study published October 2017 in PLoS One found that 27 craft beers tested at or above the Tolerable Daily Intake for two major mycotoxins, with popular imperial-stout-style beers having the highest percentage of samples suspected positive. Per the World Health Organization, adverse health effects of mycotoxins range from acute poisoning to long-term problems such as immune deficiency and cancer.RELATED: The Best and Worst Types of Alcohol for Weight LossHow to Enjoy Craft Beer ResponsiblyWhile craft beers do carry some risks, simply being aware of those risks can help. A beer’s ABV is typically very prominently displayed not only on the can or bottle, but also on beer lists, menus, and on boards listing selections above a bar, Holt points out.“I find that when it comes to craft beer, people tend to reach for it due to taste and unique style or characteristics,” adds Newgent. “When craft beers are selected because of their uniqueness, people may sip them more slowly to enjoy their special characteristics — and ultimately drink less.”It is important to remember that like any alcoholic beverage, beer does carry certain risks. “It doesn’t matter whether you're drinking a pint of cheap vodka out of a paper bag, or three pints of delectable, artisanal IPAs from your favorite brewery,” Holt says. “Consuming too much can acutely and chronically wreak havoc on nearly every organ system in the body.”Holt offers the following recommendations if you'd like to drink craft beer responsibly.Stick to the guidelines. Try to use the CDC guidelines to form healthy drinking habits, “and keep in mind that some of the latest data suggests that no amount of alcohol is perfectly  safe, so the guidelines may already be inadequate,” he says.Do the math. Pay very close attention to the ABV and the serving size of your beer, Holt says. “When you drink that 12-ounce can of Kentucky bourbon barrel-aged stout with an ABV of 11 percent, that one beer counts twice.”Consider alternating with nonalcoholic beers. The craft-brew craze has led to an explosion of tasty nonalcoholic beers, too, and they “do a pretty good job of replicating the taste of an IPA, a stout, et cetera,” he notes. “Athletic Brewing, in particular, has a number of well-liked ‘near-beer’ options.”Don't drink and drive. 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