Alcohol: The Forgotten Macronutrient

When we think about macronutrients, most of us list the big three: carbohydrates, protein, and fat. But did you know there’s technically a fourth? Alcohol often gets left out of the conversation, yet it contributes calories and energy just like the others.

Why Alcohol Is Considered a Macronutrient

A macronutrient is any substance that provides energy (calories) for the body. Like carbs, protein, and fat, ethyl alcohol (ETOH) provides calories:

• Carbohydrates: 4 calories per gram

• Protein: 4 calories per gram

• Fat: 9 calories per gram

• Alcohol: 7 calories per gram

The big difference? Unlike carbs, protein, and fat, the calories from alcohol are NOT essential for survival.

How the Body Processes Alcohol

1. Absorption: About 20% of alcohol is absorbed quickly through the stomach lining into the bloodstream, with the remaining 80% absorbed through the small intestine.

2. Transport: Once in your bloodstream, alcohol circulates throughout the body, affecting the brain, liver, stomach, pancreas, and other organs.

3. Metabolism:

   • The liver does most of the heavy lifting...

   • First, the enzyme alcohol dehydrogenase (ADH) converts alcohol into acetaldehyde (a toxic byproduct)

   • Acetaldehyde gets broken down into acetate, which is less toxic

   • Finally, acetate is converted into water and carbon dioxide, which the body can eliminate.

4. Elimination:

   • A small percentage (~2-5%) of alcohol is excreted unchanged in breath, sweat, and urine. This is how breathalyzer tests work.

   • The rest is metabolized in the liver at a fairly constant rate (about one standard drink per hour)

Your body treats alcohol like a toxin to get rid of first, leaving everything else on hold. It will prioritize metabolizing alcohol above all other nutrients, medications, supplements, etc.

How Many Calories Are in a Drink?

On average, one standard drink contains about 15 grams of alcohol, which equals roughly 105 calories. That’s before you add mixers, sugar, or cream.

Downsides of Alcohol

• Nutrient absorption: Alcohol interferes with the absorption of not only macronutrients, but important vitamins and minerals, especially B vitamins, zinc, magnesium, and folate.

• Muscle recovery and growth: It reduces protein synthesis and can hinder recovery, leading to loss of lean muscle mass over time, as well as slow fat loss and/or increase likelihood of gaining fat mass.

• Hydration: Alcohol acts as a diuretic, increasing fluid loss and contributing to dehydration.

• Gut lining damage: It irritates and inflames the intestinal barrier, which can lead to intestinal permeability or “leaky gut” and worsen digestive symptoms.

• Microbiome imbalance: Alcohol disrupts the balance of healthy gut bacteria, making it easier for harmful microbes to thrive.

• Altered Motility: Depending on the type and amount, alcohol may slow digestion (causing constipation) or speed it up (leading to diarrhea).

• Reflux and heartburn: Alcohol relaxes the lower esophageal sphincter, increasing the likelihood of acid reflux.

• Liver strain: The liver must prioritize metabolizing alcohol before anything else, which can increase long-term risk of liver disease.

How to Minimize Negative Effects:

• Stay HYDRATED with both water and electrolytes to combat dehydration

• Eat a well balanced meal BEFORE drinking to help slow absorption, reduce impacts on blood sugar, and maximize nutrient absorption

• Nourish your liver with plenty of nutrients like colorful produce for antioxidants, and get a variety of foods like leafy greens, nuts, seeds, fruits, and vegetables

• Mind the timing... Give your body time to process (remember it takes about one hour to clear a standard drink)

• Limit frequency and amount - The fewer and smaller the doses, the less cumulative strain