Pillar 6 🍷: What we put in our bodies matters more than we think

By Ashlyn Smith, MMS, PA-C, DipACLM, BC-ADM, DFAAPA, LSC

ELM Endocrinology & Lifestyle Medicine

So far in our series, we’ve talked about food, movement, sleep, stress, and connection.

Now we come to the final pillar that has some of the most powerful health effects: Avoidance of risky substances.

Because everything we put into our body has an effect.

Some are subtle. Some are profound. Some are life-changing.

Let’s break it down.

Health isn’t built by one choice. It’s shaped by what becomes normal. Enjoy the moment. Stay curious about the impact.

Alcohol: not as “neutral” as it seems

Alcohol is widely used (and often socially normalized) but it is not risk-free.

Research shows alcohol use is associated with increased risk of several cancers, including:

• Head and neck cancers

• Esophageal cancer

• Liver cancer

• Breast cancer

• Colorectal cancer

But the impact goes beyond cancer risk.

Alcohol can also affect daily health in ways people don’t always connect:

• Disrupted sleep leading to less restorative sleep

• Increased symptoms of anxiety and depression

• Accelerated bone density loss

• Worsened hot flashes in menopause

Notice how your own body is talking to you the day of alcohol intake and the next day.

👉  Did you fall asleep at night only to wake up a few hours later? 

👉 How is your mood? Is agitation increased? 

👉 How about mental clarity, motivation, and productivity? 

👉 You might notice changes to your energy, endurance, or focus. 

👉 Food, snack, or beverage cravings might be heightened or different versus your usual. 

So how much is “safe”?

The honest answer: it depends who you ask.

• The American College of Lifestyle Medicine (ACLM): no amount of alcohol is considered safe

• The Mediterranean dietary pattern: allows moderate red wine as part of a cardiometabolic eating pattern

• Some health organizations advising on preserving bone density:

  • Women: ≤1 drink/day 

  • Men: ≤2 drinks/day 

But a more useful clinical question may be  Is this use, overuse, or abuse?

Alcohol use disorder: when it becomes more than habit

Alcohol dependence is characterized by:

• Tolerance (needing more for the same effect)

• Withdrawal symptoms when stopping

But alcohol abuse/misuse may also be present even without dependence.

A helpful framework to identify misuse is the “4 C’s”:

• Consequences despite use

• Compulsiveness

• Cravings

• Loss of Control

The good news: treatment options exist, including medications that can significantly reduce cravings and support recovery.

Tobacco: the most preventable cause of death

Tobacco use remains the leading cause of preventable disease and death.

Smoking is associated with:

• Lung cancer (well known)

• Head, neck, mouth, throat cancers

• Esophageal, bladder, kidney, pancreas, liver, stomach, cervical, prostate, and colorectal cancers

• Heart disease

• Reduced overall life expectancy

On average, smoking is associated with ~10 years of life lost.

The risk of years lost is highest in those with:

• Co-occurring mental health conditions

• Lower access to education and resources

But here’s the hopeful part

The body begins healing surprisingly fast after quitting:

• Immediately: risk of sudden cardiac death drops significantly

• 1 year later: heart disease risk decreases by ~50%

• 2–5 years later: stroke risk approaches that of a non-smoker

• 10 years later: lung cancer risk decreases by ~50%

Healing is not only possible...it’s measurable.

What actually helps people quit

The most effective approach is: Medication + behavioral support

Quitting is not just willpower: it is biology + environment + support.

And this is where lifestyle medicine matters most: Social connection plays a powerful role in behavior change. Remember that health behaviors, emotions, and habits like smoking or drinking can spread through social networks up to three degrees of separation.

You are not doing this alone. And neither is your body.

Other substances matter too

This pillar also includes:

• Illicit substance use

• Prescription misuse

• Co-occurring substance use disorders

When present, the most effective approach is complete cessation with medical support, not “cutting back” alone.

Your next step this week

Pick one:

• Reflect on your current relationship with alcohol or tobacco without judgment

• Identify one trigger or situation where use is most likely

• Reach out for support or explore resources below

Support resources (you are not alone in this)

Tobacco cessation:

• 1-800-QUIT-NOW (U.S. quitline)

• smokefree.gov

Alcohol support:

• SAMHSA National Helpline: 1-800-662-HELP (4357)

• https://www.samhsa.gov/find-help/national-helpline

• Alcoholics Anonymous: https://www.aa.org

General substance use support:

• https://www.samhsa.gov/find-help

Next week, we bring everything together. Because health isn’t just about what you avoid...it’s about what you build

👉  If you’re looking for support with reducing or quitting alcohol or tobacco without doing it alone, let’s connect on a free consultation to discuss further!

Disclaimer:

The content on this blog is for informational purposes only and is not intended to provide medical diagnosis, treatment, or replace professional medical advice, diagnosis, or care. Always consult a qualified healthcare provider with any questions regarding a medical condition or treatment.