The Diary Of A CEO with Steven Bartlett
Most Replayed Moment: Is There A Safe Amount Of Alcohol? What Happens To The Body When You Drink!
06 Feb 2026
Chapter 1: What is the societal perception of alcohol and its health benefits?
Yes. I mean, alcohol's been on a journey.
Yes.
It's been on a journey in terms of society's opinion about it. Can you take me on that journey and tell me where we are now? And when I'm saying that, I'm talking about society's opinion on its health benefits and what it is. And then also what we're getting wrong now about alcohol.
Yeah, yeah. So, I mean, the journey of alcohol is fascinating. So first, I think we think of this as a relatively modern thing, but, you know, archaeologists have discovered, like, beer-making equipment in hunter-gatherers' cave dwellings from 13,000 years ago. That's wild. Wow. Like, 13,000 years of people figuring out how to make beer. Yeah. You know, you look at China 9,000 years ago.
Chapter 2: How has the understanding of alcohol's impact on health evolved?
It was really about like a spiritual journey or a social thing. It was never really about health. At some point, we started talking about this as something that is good for your health. Like drink red wine. It's going to improve your health. And that's where I think we got wrong. And the reason why was actually from how we were looking at the data.
So first, if you look at only one health condition, there are some health conditions where a moderate amount of alcohol actually improves your health. But it was also how people were conducting the studies. So in most of the studies, what people do is they take like a massive population, tens of thousands of people, where we have some data where they're reporting how much alcohol they used.
And then we look at health risks over time. And scientists would lump people into sort of non-drinkers versus light drinkers, moderate drinkers, or heavy drinkers. And what they were finding is that people who were drinking even up to the moderate level were actually doing better than the people who weren't drinking at all.
And so that was where that concept that drinking is good for your health came from. And so people talk about this like J-shaped curve, meaning that moderate drinkers actually have lower risks of health problems. And then it's really only when you start drinking very high levels that you start having more risk of health problems than people who don't drink at all.
What they realize is wrong with that is that in the people who don't drink at all, many of those people are not drinking because they're actually really unhealthy for another reason. Like they might have heart failure and they like don't want to drink because they don't want it to mix with their medication. Or they might have had a history of alcohol use disorder and they're actually in recovery.
So they've already had some damage from alcohol and they are not drinking because of that. And so when you change the reference group, you actually make the sort of group that you compare people to, to people who very rarely drink. So it's not that they're not drinkers at all, but they drink, you know, very, very light levels.
Then you start to see that those like health benefits of alcohol go away, especially if you look across all conditions.
Are you telling me that there's no healthy level of alcohol consumption?
Yes. I would never say drinking alcohol is good for your health. That doesn't mean that drinking at what we call low-risk levels can't be a part of a healthy lifestyle. So it's a slight shift that like don't fool yourself into thinking that drinking that glass of wine is like going to exercise for 30 minutes. Like it's not something that's going to promote your health.
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Chapter 3: Is there a safe level of alcohol consumption?
So it's about inflammation and what are called reactive oxygen species that sort of change our cells and increase the risk over time of the mutations that lead to cancer.
So yeah, can you drill down on that? So if I'm a heavy drinker, so say that I'm drinking, let's say I'm drinking two glasses of wine a day consistently, which I guess would, like if I was drinking two of those a day.
If you're drinking two of those glasses, yeah, you'd be in the heavy category. Okay.
So two of those a day puts me in a heavy drinker category.
Which would surprise most people, right? Like that for many people is very normal.
Yeah.
It is very normal. I think it's somewhat more difficult for younger people to understand because younger people drink less. But if I think about the generation above me, having two glasses of wine a day is quite normal. After work, on the weekends, with every meal that you have. So that would make me a heavy drinker. And then what are the stats saying in terms of my cancer risk profile?
Yeah, so it varies by cancer, but roughly we're talking like a 40% increase in cancer depending on the cancer type. And the more you drink, the more that's going to go up. So, you know, these are scientific studies where it's not precise to you as an individual. They're based on large populations, but definitely the more you drink, the greater the risk.
And then if I have other sort of, do they call them comorbidities?
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Chapter 4: What happens to the body when alcohol is consumed?
Many people have probably experienced it. You know, you may be stumbling, not able to drive safely. You're not going to make the same decisions you would make if you weren't drinking. And then if you keep drinking, then you get, you can actually lose consciousness. So pass out. And people have experienced that. Your body is going to try to break down alcohol as quickly as it's able to.
Like anything, we want to kind of excrete any abnormality and get back to our normal functioning. And so that process happens mostly in your liver, which is why the liver is so sensitive to alcohol.
Because your body sees ethanol as poison.
Yes. I mean, you know, I know you talked about this, Dr. Lemke, but your body always wants to restore what's called homeostasis. Your body's always going to fight to get back to what it feels its normal is. And so ethanol is not something that belongs in your bloodstream. Your body's going to try to excrete it as fast as it can.
And then it converts it into something called acetate, and then you can pee that out and breathe that out and get rid of it. So to eliminate the alcohol in your body, you have to go through this process. And part of that process includes this toxic molecule that's going to be floating around and causing damage to your cells. So that's one way that alcohol can cause cancer.
The other is just general sort of inflammation. People have probably heard that inflammation is just not good for the body and increases the risk of cancer. And alcohol generates a lot of that inflammation in the process of getting eliminated. And so it can actually change your cells that over time that can lead to cancer.
So I also found this graph, which shows for anyone that can't see what we're describing at the moment, it shows the acceleration in liver disease, death rates and general liver disease compared to other parts of the body. Other organs in the body, I believe it shows. What impact does alcohol have on the liver? And we have our little mannequin here of the human body. Where is the liver?
Yeah, great question. So here's our little mannequin. So just to orient people to the body. So we're looking at the inside of the body. So like the ribs are gone. The outside of the skin is gone. These two pink things are the lungs. They kind of encase the heart. You can see the hearts behind the lungs pumping your blood. The liver is this brownish organ.
It's on the right side of your body, right under your ribs. It's quite large.
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Chapter 5: How does alcohol consumption affect cancer risk?
So I'm thinking this thing will just pop back to normal again.
as long as you haven't gotten to that scarring phase. So once you get too far down that path, even if you were to stop drinking, your liver won't recover. The hard thing is that we don't totally understand who and why that happened so young to. So this is an active area investigation because there are people who've been drinking for 60 years and their livers don't show signs of scarring.
And then we're seeing these young people at 25 who come in and die in the hospital. And so there are individual factors that you don't have any way of knowing that are going to impact your risk of developing liver inflammation and scar tissue. And so the safest way to prevent that is to not drink in these really high ways that we know are going to lead to harm.
The other way is to get medical care because often we do detect these things through blood tests and we can do ultrasounds. And when we see those early phases, so what happens first is you actually get fat deposition in your liver. That's the first step. And then we see inflammation in fatty liver.
And if you don't stop the thing that's driving those changes, over time we see the development of what's called fibrosis, which is like scar tissue. And then that scar tissue gets more and more advanced to the point that your liver stops functioning and you either die or you need a liver transplant.
What activities outside of alcohol cause great stress on our liver that we might not see as obvious?
Yeah. So obesity. Food does. Yeah, food. So your liver is very involved in glucose metabolism. So our diet and our body weight impact our liver health. And the other medications, so acetaminophen or Tylenol, which is a very common over-the-counter pain reliever, above a certain threshold can cause... serious liver damage.
So sometimes we'll see cases where someone didn't realize that like their cold medicine plus the Tylenol they were taking both had that ingredient and then they go out and drink heavily and that kind of combination effect can cause liver damage.
How much do you think, this might be a bit of a strange, a bit of an unclear question, but how much alcohol is going to cause liver damage?
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