Alcohol: what advice are you getting and how do you manage?

As posted before I had LAD NSTEMI thanks to ruptured plaque causing a clot. LDL was high (151 mg/dl) at time of admittance to hospital. Age 55, no other issues. Healthy and exercise, never smoked and just a few drinks at weekend - probably around 5-6 units. Japan is conservative and risk averse so kept me in hospital for 9 days. Upon release and for next couple weeks stayed close to the hospital diet and did not reintroduce alcohol until week 4 - actually same day of first tests that showed LDL down in low 50’s. And doctor also gave all clear but to follow their diet guide numbers. (Btw, my prescriptions are 5mg Rosuvastatin/10mg Ezetimibe, 3.75mg prasugrel anti platelet and a 100mg aspirin (with 15mg lansoprazole).

Guidance from hospital dietician in Japan was very focused on reduced salts (and sugars) - major concerns here with the diet containing lots of soy, miso, salted fish products etc. I have no BP issues (usually around 105/68). Alcohol limits of 25 grams per day were recommended - with couple days off per week. A handy formula of volume (ml) x alcohol amount x 0.789 was shared.

For example, for a moderate glass of wine:

120 x 0.135 x 0.789 = 12.782g

Or for a typical draft beer:

300 x 0.05 x 0.789 = 11.835g

Opinions here seem mixed, especially with some (seems mainly US doctors) pushing for zero alcohol. I’m lucky in that I have no addictive tendencies as can do dry January and can skip for weeks. I still only have a drink on weekends and now less than prior amounts for sure. I do however like some wine with dinner - or sake if appropriate here in Japan. And can manage within the 25g limits - I have been telling the servers to do tiny pours for example when doing a wine pairing.

What specific advice are you getting? Especially interested if drug interactions and subsequent liver impacts have been discussed with you

Posted Dec 7, 2025, 5:08 AM UTC

10
Loading comments…