House Call, MD: Health Carefully Explained

by Leah Frankel, MS, RD | frankel@myhousecallmd.com

It’s Friday afternoon and after a long week of work you head to the bar for happy hour and order a margarita, but did you ever stop to think about what’s really in that drink? Drinks can be filled with hidden calories, sugar and sometimes even fat. So does that mean you should cut out drinking all together? Not necessarily. With a little help you should be able to navigate your way through a bar menu and enjoy your drink as a cocktail connoisseur!

Before we understand the nutrition in our drinks it’s important to understand what constitutes a “drink”:

• 0.5 ounce of pure alcohol

• 12 oz of beer (5% w/v)

• 5 oz wine

• 1.5 oz whiskey, rum, vodka etc. (80-proof)

So when you’re out enjoying $1 pint night, after 3 pints (16 oz x 3 = 48 oz) you’ve actually had 4 drinks. Remember that moderate drinking is defined as one drink a day for women and two drinks a day for men, and no you can’t “save” up all your drinks for one night.  We appreciate your creative, “outside the box” thinking, however.

To better understand where the calories in your drink come from, it is essential to have some basic knowledge of where calories come from in general. In our diet there are three macronutrients that provide calories: carbohydrates, protein and fat. Both carbohydrates and protein provide 4 calories (kcal) per gram(g) (of carbohydrate or protein), but fat provides 9 calories per gram of fat. For instance if your cookie contained 10 grams of carbohydrates, 2 grams of protein and 5 grams of fat it would have a total of 93 calories.

Breaking that down:  (10 g carb x 4 kcal/g carb4) + (2 g protein x 4 kcal/g protein) + (5 g fat x 9 kcal/g fat)

Pure alcohol has 7 kcal per gram, which means it provides more calories per gram than protein or carbohydrates but less than fat.  However, most drinks, luckily, aren’t 100% alcohol (which would be 200 proof).

We know that alcohol has more calories that protein or carbs, but that’s not the only reason a few drinks can add up to a lot of calories. Mixers, whether it’s soda, juice, margarita mix or flavored liqueur, can add excess calories to a drink. It’s not uncommon to find martinis that look and sound more like desserts, consisting of creamy liqueurs and sugar-rimmed glasses. Many of these mixed drinks are also being supersized and can have up to 1,000 calories!

To play devil’s advocate, even though drinking can add inches to our waistline there are some benefits associated with moderate drinking. Moderate drinking (1 drink for women or 2 for men per day) has been linked with a reduced risk of heart disease and heart attacks in the elderly, if they are at increased risk for developing heart disease. Wine contains potassium which may help lower blood pressure, as well as flavonoids and resveratrol. Flavonoids have an antioxidant property which can help prevent blood clots and the formation of plaques in your arties. Resveratrol is found in grape skins and seeds and has been shown to increase HDL (“good”) cholesterol and prevent blood clots. Alcohol has been shown to improve appetite in the elderly or other populations with a poor appetite (enter drunk muchies).

Now to the magic numbers you’ve been waiting for…

Calories in common drinks (Note: Calories vary slightly depending on brand):

• 12 oz regular beer: 150 kcal

• 12 oz light beer: 100 kcal

• 5 oz wine: 100 kcal

• 12 oz wine cooler: 180 kcal

• 1.5 oz 80 proof spirit (not including mixers): 100 kcal

• 1.5 oz cordial or liqueur (not including mixers): 160 kcal

• 8 oz Margarita: 336 kcal

• 9 oz Pina Colada: 460 kcal

• 6 oz Long Island Ice Tea: 350 kcal

Is it possible to enjoy a drink and watch your waistline?  Of course it is!

Healthy Drinking Tips:

• Alternate your alcoholic drink with water or a low calorie non-alcoholic drink

• Use low calorie or diet mixers whenever possible

• Plan your alcohol consumption into your daily calorie intake like you would with food

• Stay away from “sweet” drinks, the added flavored liqueurs are primarily sugar

• Dilute your drink with club soda or sparkling water

It has been fabled since the days of Gladiators in Rome that drinking one’s own urine while training for battle  provided special nutritional value to the fighters in training. Fighters such as Lyoto Machida, who claims to swill his pee every morning, is one example.  These individuals profess that their urine is full of nutrients that their body could not absorb on the first pass. But is there any medical validity to this ancient practice?

Dr. Johnny Benjamin, sports columnist and renowned orthopedic surgeon shared the truth behind this myth with us, “Urine is 95 percent water, 2.5 percent urea, and a 2.5 percent mixture of minerals, salts, hormones, enzymes and non-toxic waste products.

“The practice of drinking urine is certainly not new or limited to a few modern practitioners of combat sports such as world champions Lyoto Machida in MMA and Juan Manuel Marquez in boxing. China, India, the Middle East and Rome all have ancient and modern writings that discuss the willful consumption of urine.

“I recently viewed an HBO 24/7 episode with Mr. Marquez sipping a steaming glass of his golden nectar in preparation for an upcoming fight with Floyd Mayweather Jr. I have the utmost respect for Marquez as a champion, but apparently the thought of a potential ass whipping will drive a man to consider a great many things.

“Although the potential benefits and healing capacities of drinking urine have been encouraged for centuries by many cultures, there is no credible medical literature or studies that support these beliefs.

“Urine has been consumed to combat dehydration in extreme survival situations for its 95-percent water content. Also, water is reclaimed from urine, purified and filtered for consumption on the International Space Station.

“Drinking your own urine may reclaim a small bit of water, but if the body didn’t want the other five percent (waste products and the like) during the first time, why would it want it the second time around?  Wouldn’t it be easier (and probably considerably tastier) to just sip a tall refreshing glass of H20 and take a multivitamin?”

In addition, proteins are not present in a healthy individual’s urine.  Loss of proteins in urine is a sign of kidney problems and necessitates further medical investigation.  If you’re looking for extra protein in your diet, we recommend a hearty chicken breast or protein shake after your workout.

As Juan Manuel Marquez says in his HBO clip, he drinks his urine because “that’s where a lot of proteins and vitamins are, part of your vitamin intake, and why not drink them again instead of wasting them?”  That’s an interesting question, Dr. Marquez.  Our thoughts are that 1) it’s pretty disgusting, and 2) you can consume infinitely superior “proteins and vitamins” from any number of other non-urine-based sources.  Are we supposed to believe that hot urine contains super-nutrients that you can’t find at the GNC, and the body is flushing them out of your system?  No disrespect to our beloved light-heavyweight champion, but is it possible that the athletes who swear by urine-drinking just enjoy drinking pee?  Maybe it simply serves as means of intimidation to the opponent.  After all, we wouldn’t fight him.