Rethinking Alcohol’s Role: A Longevity Expert’s Perspective
For 15 years, Dr. Simon Feldhaus, chief medical officer at The Balance Rehab Clinic’s Swiss hub and president of the Swiss Society for Anti-Ageing Medicine and Prevention (SSAAMP), has dedicated his career to the science of longevity. At 58, he challenges the prevailing modern narrative that strict abstinence is the sole path to good health. Dr. Feldhaus, who lives in Brunnen with his wife and four children aged 8 to 22, believes that a life devoid of simple pleasures, like sharing a beer or wine with friends, misses the point of living well for as long as possible.
“Doing all that we can to achieve good health is sensible – who doesn’t want to enjoy life for as long as possible?” Dr. Feldhaus muses. “Yet what is the point of living a long life if it is one of restriction and abstinence, not joy? At the age of 58, some of my fondest times with friends have certainly included wine or beer. Spending time eating, drinking, laughing and swapping stories has brought me much pleasure over the years, so I have no plans to stop.”
While acknowledging that alcohol is not without its risks, Dr. Feldhaus argues that our relationship with it is far more complex than the current fear-driven discourse suggests. He observes that much of modern medicine is propelled by fear – fear of food, fear of alcohol, even fear of life itself. However, his three decades as a doctor have taught him that fear, of all human emotions, is perhaps the most toxic to the body.
The Nuances of Alcohol: A Toxin with Context
It’s undeniable that alcohol is a toxin, and it plays no essential biological role in the human body. The World Health Organisation has stated there is no safe amount to drink. However, Dr. Feldhaus points out that we often overlook alcohol’s natural presence and our evolutionary relationship with it. Fermentation is a natural process; fruit left to ripen will eventually produce alcohol. Even our own gut bacteria can generate small amounts of alcohol during the digestion of certain foods, like freshly pressed apple juice. Animals, too, encounter alcohol, with documented cases of primates becoming intoxicated from fermented fruit. Humans have evolved in an environment where alcohol was present, meaning our bodies possess mechanisms to recognise and process it.
Furthermore, toxicity in biology is rarely a simple binary. It’s almost always a question of dose. As Dr. Feldhaus highlights, even water can be lethal in excessive quantities, and oxygen becomes toxic at high concentrations. “Almost nothing in nature is harmless in unlimited quantities, and alcohol is no different,” he states.
Dr. Feldhaus himself drinks moderately, typically one or two bottles of beer or two glasses of wine, perhaps six to eight times a month. His aim is enjoyment, not intoxication, a practice he views as “enjoyment with boundaries” rather than mere discipline.
From a toxicological standpoint, alcohol is not the most demanding substance for the liver to process. Many commonly prescribed medications, including statins, blood pressure drugs, anticoagulants, and sleeping pills, place a far greater burden on liver enzymes. These foreign chemicals require complex detoxification pathways, often competing for the same enzymes. The situation can be further complicated by interactions with grapefruit juice, supplements, or multiple prescriptions, which can inhibit these crucial detox pathways. Yet, warnings about these complexities are often absent, with patients instead being told, “Never drink a glass of wine.”
Dr. Feldhaus provides a compelling example: “The liver of a person who drinks one glass of wine per month but takes three medications every day may be under far more strain than someone who drinks moderately (as I do) and who (like me) isn’t on medication. This is not an argument for drinking, but just offering some perspective.”
Your Genes and Alcohol Tolerance
The capacity to metabolise alcohol is highly individual, largely dictated by our genetic makeup. The liver relies on enzymes, particularly the cytochrome system, to process chemicals, and the blueprints for these enzymes are encoded in our DNA. Genetic polymorphism means some individuals produce these enzymes efficiently and can tolerate moderate alcohol intake well, while others produce them poorly or lack them entirely. This genetic variation explains why individuals with identical lifestyles can react very differently to alcohol, medications, or supplements.
A key enzyme in alcohol detoxification is alcohol dehydrogenase. In individuals of East Asian descent, this enzyme is often less active or present in lower quantities. This can lead to a build-up of acetaldehyde, a highly toxic byproduct of alcohol metabolism, triggering symptoms like flushing, headaches, palpitations, nausea, and fatigue. For these individuals, a lower alcohol dosage is strongly advised, as the negative effects will be more pronounced compared to those without this genetic variation, especially with prolonged heavy drinking.
While many people have an intuitive understanding of how they process alcohol, a genetic test for detoxification can provide more precise information. Individuals with the ALDH2*2 gene variation, for instance, may have a reduced capacity to metabolise acetaldehyde, increasing their risk of oxidative stress and the build-up of damaging free radicals.
It’s important to note that while oxidative stress is linked to cardiovascular disease and certain cancers, it’s rarely the sole cause. An individual’s overall nutritional intake, physical activity, and lifestyle patterns play a significant role. The most well-established risk of heavy drinking remains liver damage, including conditions like fatty liver, alcoholic hepatitis, and cirrhosis. The development of cancer or cardiovascular disease, however, is typically a result of multiple high-risk factors. Dr. Feldhaus points out that many individuals in their late 70s or 80s who drink heavily do not develop these conditions.
As a physician focused on longevity and preventive medicine, Dr. Feldhaus advocates for avoiding fear. Genetic testing, in his view, serves as a roadmap for preventative focus. However, he stresses that understanding how to mitigate the negative effects of alcohol, even with genetic predispositions, is paramount.
Protecting Yourself from Alcohol’s Impact
While genes cannot be altered, the field of epigenetics is revealing how lifestyle and environmental changes can influence gene expression. It is sometimes possible to improve a reduced alcohol tolerance. For example, if an enzyme is inefficient but present, it can often be supported by specific micronutrients like vitamins B2 and B3, zinc, magnesium, and molybdenum.
At a minimum, Dr. Feldhaus recommends vitamin D and omega-3 supplements, which are crucial for reducing inflammation and aiding alcohol processing. Certain foods, including broccoli, Brussels sprouts, watercress, and radish, can also support liver pathways. However, if a key enzyme is entirely absent, alcohol will likely never feel good, serving as a clear biological signal that it is not suited for that individual.
The Social and Environmental Context of Drinking
The way we consume alcohol – how, where, and with whom – can significantly impact longevity. France, renowned for its wine culture, offers an interesting case study. The French enjoy their wine, often paired with food and typically at a lower alcohol percentage than many New World wines. This is a mindful activity, not one of bingeing. Dr. Feldhaus contrasts this with the British approach, where drinking can become the primary focus of an evening, sometimes used as an emotional coping mechanism or to mask social awkwardness, rather than a genuine form of connection.
Alcohol does not exist in a vacuum. The physiological impact of a glass of wine consumed anxiously and alone, as self-medication, differs greatly from the same glass shared over a meal with friends. The context of consumption can, in fact, alter biology.
Dr. Feldhaus describes his own drinking as “deliberate” – he drinks intentionally, never in front of the television, never to escape stress or simply relax. Research consistently shows that social connection supports health and longevity, while isolation increases inflammation. Within reason, he believes intention matters as much as the quantity consumed.
His personal habit involves drinking only beer or wine, almost always with food, integrating alcohol as part of a meal. He does, however, make an annual exception: “During the annual German beer festival Oktoberfest, I enthusiastically – and unashamedly – enjoy drinking beer by the litre. Because life is too short not to have fun.”
