Ep. 322 Impact of Alcohol and Our Health with Dr. Brooke Scheller

Today, I am honored to be in conversation with Dr. Brooke Scheller. She is a doctor of Clinical Nutrition, a nationally recognized health expert, and the founder of Functional Sobriety, a nutrition-based program for alcohol reduction. She also wrote How to Eat to Change How You Drink. 

In our conversation today, we discuss the stigmatization of alcohol use and explore the nuances of curiosity and sobriety. We dispel common misconceptions, examine the research on alcohol consumption, tackle the definition of moderation, scrutinize the influence of industry ties, and unravel the issues linked to excessive alcohol consumption. Dr. Scheller also sheds light on how poor absorption impacts the gut microbiome and causes a leaky gut, offering insightful nutritional strategies to address those concerns. Our conversation also extends to fertility, blood sugar, and the challenges posed by initiatives like Dry January and sober challenges.  

Stay tuned for today’s comprehensive exploration of the relationship between nutrition and alcohol use.

“My number one recommendation for people looking to change their relationship with alcohol or quit drinking is increasing protein intake.”

– Dr. Brooke Scheller

IN THIS EPISODE YOU WILL LEARN:

• How the stigma surrounding alcohol use is changing
• How does alcohol affect the brain and body?
• How alcohol impacts the gut microbiome, intestinal permeability, and nutrient absorption
• Dr. Scheller shares her personal experience with alcohol 
• How alcohol consumption in middle-aged women could increase inflammation and oxidative stress
• How alcohol impacts blood sugar
• The link between alcohol consumption and male infertility 
• Some suggestions for navigating a Dry January
• How alcohol use impacts mental health
• Overcoming alcohol addiction through self-awareness and wellness

Bio: Dr. Brooke Scheller DCN, CNS

Dr. Brooke Scheller is a Doctor of Clinical Nutrition, the founder of Functional Sobriety, and the author of How to Eat to Change How You Drink.

After finding freedom from alcohol in 2021, Dr. Brooke took her experience in sobriety and applied her expertise in nutrition and functional medicine to help others change their relationship with alcohol. Her approach results in improved brain health, mood, energy, focus, gut health, and hormone balance. 

Her launch of Functional Sobriety led to the development of her online community, the Functional Sobriety Network, and several online programs with members across the globe. Functional Sobriety offers the first-ever custom supplement program for the sober and sober-curious. As a motivational speaker, Dr. Brooke helps to spread the word about functional nutrition, alcohol-free wellness, and the power of sobriety. 

She currently resides in NYC. 

Follow Dr. Brooke on Instagram @drbrookescheller. Learn more at www.brookescheller.com  or www.functionalsobriety.com

Connect with Cynthia Thurlow

• Follow on Twitter, Instagram & LinkedIn
• Check out Cynthia’s website
• Submit your questions to support@cynthiathurlow.com

Connect with Dr. Brooke Scheller

• On her website
• On Instagram (@drbrookescheller)
• Functional Sobriety

How to Eat to Change How You Drink will be available in US bookstores on December 26th. It will be available around the world from January 4th.

Transcript:

Cynthia Thurlow: [00:00:02] Welcome to Everyday Wellness podcast. I’m your host, Nurse Practitioner, Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent, is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.

[00:00:29] Today, I had the honor of connecting with Dr. Brooke Scheller. She is a doctor of Clinical Nutrition, a nationally recognized health expert, and the founder of Functional Sobriety, a nutrition-based program for alcohol reduction. She is also the author of How to Eat to Change How You Drink. 

[00:00:47] Today, we dove into stigmatization around alcohol use as well as sober curious and sobriety, common misconceptions and research surrounding alcohol use, definition of moderation and also the influence of industry ties, the issues related to excessive consumption, the role of poor absorption, impact on the gut microbiome and leaky gut related to alcohol intake, nutritional strategies to help address the use of alcohol including higher protein meals and meal timing, the impact on fertility, blood sugar and Dry January and sober challenges. I hope you will enjoy this conversation as much as I did recording it. 

[00:01:34] Well, welcome, Dr. Brooke. It’s a pleasure to have you on the podcast today. And it was so serendipitous that your work was introduced to me right at the time that I was looking to bring on an expert to talk about alcohol on the podcast. And now you have a new book, which I enjoyed reading thoroughly. 

Dr. Brooke Scheller: [00:01:48] Yeah. Thank you so much for having me. And it’s funny that you mentioned that because when I first started writing the book about two years ago, and during that time, there was a lot of discussion in the sober, sober-curious community. But I remember thinking, “Oh, this conversation is going to be over by the time this book comes out in two years.” And it’s more ripe than ever the space for this conversation. And so, I’m just so excited to be a little teensy part of this conversation around exploring a life with less or no alcohol and bringing in my story personally, but also my experience as a doctor of nutrition. So, I’m thrilled to have this conversation today and I love that we have a similar backstory too, which is lots of fun. 

Cynthia Thurlow: [00:02:35] Yeah. So, for listeners, Brooke and I both grew up in the same area of New Jersey, in a town that most people have never heard of. And so, when I was reading your book, I chuckled to myself. I actually reached out to you on Instagram and said, “You’re not going to believe this.” We’re from the same part of New Jersey. No one ever knows where it is I usually have to just mention the county or counties that I grew up in. And so, I felt a little kindred spirit to you with a lot of similarities in terms of thought process of your evolution and your thought process around alcohol. So, let’s really start the conversation around the stigma around alcohol use, sober living, whether it’s someone who has never had an unhealthy relationship with alcohol, but has just decided to stop drinking, all the way to the individuals that maybe had an unhealthy relationship and are now no longer drinking. Why is there so much stigma around alcohol? I suspect largely because it is such a socially permissible drug that people can use that’s encouraged, and there’s a lot of marketing and publicity around making alcohol as enticing as possible. 

Dr. Brooke Scheller: [00:03:42] Yeah. The conversation on this one is complex, because I think there’re a lot of pieces that play into the current stigma that we have around alcohol, and that stigma is definitely changing. We’re in this era of people being more sober curious or really just being more thoughtful about their decisions around alcohol use. And that stigma is lifting, which is making it easier for people to move forward and come out and say, “I’m not drinking because of XYZ reasons.” But I believe that some of the stigma today exists around for a long time, it was such a negative thing to have an alcohol problem or to be an addict of any kind, or to join a group like Alcoholics Anonymous, which is anonymous for several reasons. 

[00:04:29] But part of that also adds to that stigma and that shame of people not being more forthcoming, maybe about their experiences with alcohol. And what’s really shifting in this era of sober and sober curious is that more people are coming forward to say, “I might not identify as an alcoholic or as someone who maybe has an addiction to alcohol, but I recognize that it has negative effects on my life.” And that’s where we get to have the choice. This isn’t necessarily about you having to identify as having a problem or not having a problem. It’s about, is this substance having a negative effect on my life? And if so, I get to make that choice to decide if I want that to be part of my lifestyle or not. 

[00:05:16] And that’s where the wellness and the nutrition angle is really interesting, because it is a toxin, it is a toxic substance that we are selectively choosing to put into our body. And by doing so, we’re having effects on our health. So that is a big part of what I talk about in the book, as you know, Cynthia, how it affects our gut, our hormones, our blood sugar, how it contributes to changes in our metabolism, changes to our brain’s neurotransmitters. And so, this isn’t just about you feeling like maybe you’re drinking too often, but if you’re feeling like your alcohol use is having effects on your mental health, it’s contributing to anxiety or low mood, it’s maybe contributing to difficulties with weight management or your gut health or your hormone balance, that you can decide to change that relationship with alcohol. And it doesn’t necessarily need to mean that you have a problem with it.

Cynthia Thurlow: [00:06:18] Yeah. And I think it’s such an important distinction. And the message today is not to shame anyone who does drink. That is certainly not the message. I think growing awareness around what drives people’s decisions to drink can be illuminating. I know uncomfortable feelings. My listeners know this, I have a family member who’s an alcoholic that has heavily influenced my drinking behaviors throughout my lifetime. And it’s interesting, in your book you were talking about the National Institute of Alcohol Abuse and Alcoholism. Children of alcoholics may be four times as likely to engage in inappropriate drinking behavior. And more than 10% of children in the US ages less than 17 live with an adult with an alcohol use disorder. So certainly, genes are not our destiny.

[00:07:08] Even if you grew up in an environment where a parent might have had an addiction, that does not mean that you will definitely go on. You might be more susceptible, but that doesn’t mean or equate to you will be dealing with a chronic or acute related concern specific to alcohol. And I think for a lot of individuals, myself included as a clinician, we were always told that alcohol has all these health benefits. Resveratrol, you have two glasses of red wine. It’s going to be super beneficial and yet we’re starting to see the research that’s coming out that’s contrary to that. Can we talk a little bit about that? What is the research telling us about alcohol use right now? What is it doing to our health, both on an acute and a chronic level?

Dr. Brooke Scheller: [00:07:54] Yeah. Well, great question. And I’ll start by just pointing out too that the statistics around alcohol use behaviors and our kind of familial history is still up for debate in a lot of ways. I talk in the book about some of the genetics that are associated with increased susceptibility for alcohol use disorder. But I think there’s a lot of misconception on what that really means, that when we hear that there’s maybe genetic susceptibility or that we have an increased risk because a family member might. It’s not that there is this one gene that says you, “Yes or no.” The research actually shows there’re all different kinds of genes that can be associated with it. Things like how our liver metabolizes alcohol, like how our dopamine is metabolized in our brain, but also things that are seemingly unrelated, like our hunger and satiety hormones leptin and ghrelin, are also have affiliations or associations with development of alcohol use disorder.

[00:08:57] So that’s where the nutrition piece gets really interesting for me. But I think it’s an important distinction to point out that as it relates to genetics, it’s not like it’s in your genes, so yes/no, there’s a lot of complexity to that. And for many people, it’s that question of nature versus nurture, of being in that environment and growing up with a family member that has not even necessarily a diagnosed alcohol use disorder, but maybe heavy alcohol use or frequent alcohol use, that has an impact, either positive or negative, on the child. Either that the child looks at that maybe and says, “I don’t want to continue that pattern,” or it’s so normalized in the home that it’s not necessarily something that is ever looked at as a negative or an unhealthy behavior, and therefore that behavior is continued. But to shift and answer your question about the health effects of alcohol, they’re far and wide and you know I think we hear certain things, like alcohol increases risk for cancer.

[00:10:01] And that’s one of the things that is a little bit more widely known. But the statistics are even quite low of how many people are aware of that and how impactful it is. In fact, I was just on a recent session through the World Health Organization out of Europe, talking about and making the comparison of alcohol and tobacco and how we know that alcohol causes cancer. But we don’t have warning labels on alcohol bottles like we do on tobacco. And that is something that is potentially in the future for something like alcohol as we continue to understand more about its negative effects. And in the early 2000s, there was much more of that research that came out around the Mediterranean diet that said, exactly like you mentioned, “One glass or two glasses of red wine may have benefits.” But what we’re actually seeing now in the research, 2022 was a pretty pivotal year in terms of research studies around alcohol and really finding that there is no cardiovascular benefit at any level, that those previous studies are now being refuted, that we are seeing major impacts on the brain, both in its structure and function. 

[00:11:14] So, we’re seeing decreases in gray matter volume, white matter volume within the brain. And a lot of the research that I find really interesting isn’t what gets us popularized just yet, but things that I cover in the book where we’re seeing the impacts that alcohol has on the gut microbiome, and the impacts that it has on intestinal permeability or the lining of the gut, and how that can contribute to things like autoimmune disease. Also, things like cortisol and hormones and blood sugar and all of these other kinds of smaller, like, not as sexy topics that I really think we’re going to continue to see more of. And this book, for me, has just been an amazing way to pull together all of this misunderstood research around how alcohol is actually affecting our bodies negatively. And those risks really outweighing the benefits that we seemingly have thought were there previously. 

Cynthia Thurlow: [00:12:12] Yeah. And all those topics on this podcast we love. So, the blood sugar dysregulation, the impact on hormones, satiety, leaky gut, autoimmune conditions, that’s absolutely up our alley. So, I’m so grateful that you wrote this book and it allows us to have this opportunity to tie all these things together. Now, you mentioned that there is this net impact, this emerging research. I think the gut microbiome is certainly something that has gotten a lot more attention in the last several years. Let’s talk about what’s going on physiologically in the gut when we are consuming alcohol. And let’s be really clear, like having one glass of wine once a month is very different than I do know many people that are having two or three glasses of wine every night.

[00:12:56] And maybe before we even have that conversation, let’s talk about this concept of moderation, because I think that’s so important. I used to say for a long time, as it pertains to a lot of lifesatyles of moderate, don’t eliminate. But there are definitely people who can’t moderate, and therefore, they do need to genuinely eliminate some of these things. So how does the USDA define, there’s the 2020 to 2025 dietary guidelines. How did they define what is moderation? Because I think it’s very interesting that there are these little nuances depending on which organization is talking about alcohol consumption.

Dr. Brooke Scheller: [00:13:33] Yeah. And you know unfortunately, there’s industry ties in there too. And so even if we think of things like the recommendations for dairy and milk and how questionable that is based upon the dairy council and their kind of stake in the conversation. And so, as it relates to the most recent dietary guidelines that I write about in the book, they’re written every five years, so our most recent is 2020 through 2025, which is a body of research that’s pulled together every five years through the USDA to give general recommendations to Americans on what to eat to follow a healthy lifestyle. And so that recommendation is this the typical what we know of the one glass or less for women per day, two or less per day for men, and that is what we call “moderation,” or that is what we kind of consider or recommend to be what we should be following on a regular basis. Very little kind of insight into the fact that it’s actually better for you if you don’t drink at all. We rarely talk about that being a part of the conversation, but as we’re talking about here, the research changes and can change quite quickly. 

[00:14:50] So, actually, in 2022, mid-year, Canada released new guidance that said that anything over two drinks per week will begin to increase risk for different types of health effects. Anything over six or seven glasses per week is going to hop you into another, an increased risk category, where now we’re seeing closer associations with things like cancer, for example. And so, you can see that two drinks per week is very different than the two drinks per day that is currently in the recommendations. And actually, there was an article that came out not long ago starting to kind of create this controversy over is, is America going to follow these Canadian guidelines? Because it’s a pretty stark contrast compared to what we’re kind of currently saying today. 

[00:15:39] But in general, moderation, like you’re saying, Cynthia, is this term that we kind of just, like, blanket statement. If you were to ask anyone on the street what moderation means when it comes to alcohol, they’ll probably have a different answer. And that’s based on their own life experiences and their own perceptions and beliefs around alcohol. Someone who doesn’t drink often might say moderation is having one drink a couple of times a month or a couple times a year. Where you might ask someone here in New York City what their idea of moderation is and it might be a couple drinks a day. And so, it’s not necessarily something that we have well-informed people about what that means. And I also think that that gives many of us the opportunity to kind of take that and run with it and make it mean for us what we feel like it means for us. But what I can tell you as someone who identifies as having a very dysfunctional relationship with alcohol in the past is that my belief around moderation was very skewed by my dysfunctional behaviors with alcohol. And so that doesn’t necessarily mean that my perception of moderation was correct either. And so, it’s a really tricky topic. 

[00:16:59] The one thing that I share with people often and often share on podcasts, is that if you have a health concern, if you have something that you are working toward improving, or if you have a condition that you have symptoms for that you are looking to minimize or you’re really looking to amplify and improve your health, the best thing that you can do is limit your consumption to close to nothing or nothing. That if you have a health goal, let’s say you have an autoimmune condition, a thyroid condition, you’re struggling with weight management, etc. Alcohol is absolutely having an effect on that. It’s just a matter of how much of an impact that that might be having. 

Cynthia Thurlow: [00:17:42] Yeah. I think especially as we’re kind of entering 2024 and this would be four years into the pandemic and the social isolationism and the ongoing joke that a lot of colleagues would say is, “You either became a hunk, a drunk, or a chunk.” Meaning people either took that time where we were all in suspended animation-

Dr. Brooke Scheller: [00:18:02] I love that.

Cynthia Thurlow: [00:18:03] -and either leaned into good habits or leaned into habits that then became problematic. And so, I love that you’re inviting us to have this conversation in a way that makes it very non-judgmental and makes it more supportive. Like, let’s closely examine our behaviors and figure out if they’re working well for us. We were pivoting a little bit to talk about gut health and I think that this is certainly an area for my population, certainly my listeners, most of whom are 35 and up, they are definitely impacted by the changes going on in their bodies with perimenopause and then menopause, gut health becomes paramount, especially as we have all these hormonal fluctuations. But let’s talk about what alcohol actually does to the gut microbiome, what it does to small intestinal lining integrity, leading to leaky gut and all sorts of unpleasantries, that if we aren’t navigating this in a proactive way can become problematic. 

Dr. Brooke Scheller: [00:18:57] Yeah. And this is a topic I love talking about, because it really does not get enough attention as it relates to the discussion around alcohol and the impacts of alcohol. And one of the really well-known things that we know about alcohol is that it affects nutrient absorption and it will cause deficiencies in many of our nutrients, which is a big part of the book and a big part of my work around nutrition is that the very nutrients that we need to have energy and healthy mood and not have anxiety, for example, are the ones that alcohol depletes. So, we kind of get caught in this vicious cycle. So, we know pretty well that alcohol affects nutrient absorption, but also digestion because it’s very irritating to the stomach lining, it’s very irritating to the small intestine and the bowels. That burning sensation that we feel if we were to take a shot of liquor, for example, that continues on through our system and is very irritating to the lining of the digestive system. 

[00:19:57] So there’re three ways that I look at the effects that alcohol has on the gut. The first is digestion and absorption, and what’s happening maybe in the upper half of the stomach and small intestine, and how we’re kind of breaking down the food that we’re consuming. The second is the impacts on the gut microbiome. So, what we are seeing in the research is that alcohol does decrease bacterial diversity. It does negatively impact probiotics. So, our good bacteria, it’s lowering our bifido, our lactobacillus, and it’s causing, or allowing our body to increase levels of more harmful microbes that are maybe there naturally, like E. coli, for example, or Streptococcus, which is a normal part of our digestive or gut microbiome. But when we don’t have as much protective action from our probiotics, they can start to overgrow. So, we’re seeing that there’s this skewing toward more overgrowth or dysbiosis, overgrowth of that harmful bacteria, and a lowering of our probiotic bacteria that is going to create many effects, as we know, throughout the body. I’m sure your audience, you’ve spoken about this on the podcast before, all of the health effects that can come with dysbiosis or an imbalanced gut microbiome, it’s also going to contribute to Candida or yeast overgrowth because yeasts feed off of sugar, carbohydrates, and many of these harmful microbes can actually feed off of alcohol too. 

[00:21:24] So there’s this really interesting research that shows that these imbalances in the gut microbiome can also contribute to cravings that we have for alcohol. That is a piece of kind of the cravings, which we can talk a little bit more about, but there’s a big association as well with blood sugar. The third piece that is also important is what we were discussing about leaky gut and intestinal permeability. And so, there’s actually really interesting research around alcohol being one of the most disruptive things to the intestinal tract. So, we know that there are other things that will break down the digestive lining, like certain types of medications, high-sugar, high-carbohydrate diet, toxins from our food, from our environment can all be disruptive to the gut lining. Some of those things are a little bit more difficult to avoid. So, if we have toxins in the air that we’re breathing, yes, we can move, we can filter our air, etc. But alcohol is something that, by choice, is going to have a negative impact on our gut lining. And so, as we kind of briefly touched on earlier in the discussion, intestinal permeability or that leaky gut can be really closely associated with things like food sensitivities, especially adult-onset food allergies, autoimmune disease.

[00:22:42] So, especially if you have an autoimmune disease and you’re drinking alcohol regularly, that is definitely going to be making things maybe a little bit more difficult to manage that autoimmune disease and keep you from getting a little bit more control over that via the gut, but also things like systemic inflammation. We’re having a crisis, an epidemic of inflammation in our society. And alcohol is a huge contributor to this. And unfortunately, it’s been something that I really believe we’ve done a disservice to our society and not really providing enough information on how harmful that it really truly is. And now we’re having to kind of backpedal a little bit. And part of my goal with this book is educating people on knowing, like, this is something that is truly having a negative effect on you. Those slight benefits that maybe you’ve been told were there are actually not being outweighed by the risks of what’s really, truly going on an internal systemic level. 

Cynthia Thurlow: [00:23:47] Yeah. And it’s interesting because you bring up the nutrient malabsorption or the poor absorption of nutrients. And this may seem intangible to some, but for those of us that are licensed healthcare providers, my alcoholic patients always had, we used to call it a banana bag, but it was a bag full of IV fluids that was colored yellow because it had B vitamins in it. And one of the significant and severe side effects of long-term drinking, heavy drinking is you can have kind of like the worst-case scenario, Wernicke’s encephalopathy, which is a fancy way of saying you get some brain-related effects due to the chronic drinking that are impacted by this low absorbability, specifically of B vitamins. And there are key nutrients like thiamine that our body needs. And if it’s not getting, it can become problematic. 

[00:24:36] So I know that you talk about specifically some of these B vitamins and how important it is, understanding that alcohol increases our needs for antioxidants, that’s number one. Like vitamin C, which is something we should be getting, you know ascorbic acid, we should be getting that from citrus fruits and other things. But also, it can actually block the absorption, as you mentioned, in the gut. And that in and of itself can be problematic. So, I know lots of people that enjoy taking supplements, but the supplements they’re taking, you may not even get the benefits if you are using alcohol excessively or frequently or habitually, that can actually impact what’s going on in the gut, what’s being absorbed, what your body can readily use. And I love that you brought up the gut microbiome. We’ve had so many physicians coming on and talking about this. The research continues to emerge. And finding balance in the gut microbiome is really key. 

[00:25:32] As you mentioned, certain medications, things like whether it’s proton pump inhibitors, H1 blockers, whether it is antibiotics, all of these can have a negative net impact on the gut microbiome. But then thinking about these seemingly benign things like alcohol, can also kind of light a match. And then you add into that, as women are navigating middle age, they’re already a little bit more inflammatory. There’s already an upregulation in oxidative stress. And so many women will say to me, “I used to be able to drink in my 20s and 30s. I no longer can because it disrupts my sleep, or it gives me hot flashes, or it makes me crave food that I should not be eating.” 

[00:26:12] So let’s kind of pivot and talk about some of the choices that we make with regard to food. You were alluding to this, some of the craving’s piece, but some of the food things that we will lean into if we are drinking excessively. I think about the family member that I’ve alluded to. He is a carbaholic, he’s very thin, but all he eats is like fruit and granola bars and cereal and bread. And that is like the mainstay of his diet other than alcohol. And it’s very likely he’s feeding exactly the gut imbalances that are ongoing, the yeasty beasties. What’s going on with yeast and Candida is very likely being fueled. That is their fuel source. That is what they are looking for. So those cravings can be for a variety of reasons, but more often than not, are a sign that something is remiss in the gut microbiome. 

Dr. Brooke Scheller: [00:26:59] Absolutely. Yeah. And this is where food and nutrition is, is a really critical piece of this discussion and has not been until I started working on this book. And I think that there’s so much conversation in today’s day and age around alcohol and the mental health effects and the ways that we can manage alcohol use via support groups, via therapy, via addressing traumas, and all of these really, really, really dire and important things to address. But we’re forgetting that there’s this physiological side of things, that when we put alcohol into our system, it is having an effect on our physiology, whether we want to believe it or not. And so, again, some of these ways that it’s affecting the gut and our actions and our choices of the foods that we eat are going to be affected by that. 

[00:27:49] It’s really interesting, because when I started doing this work, one of the core areas that came up for me was around blood sugar. And as you know from reading the book, there’s an entire section on, really the hormonal system, the endocrine system, and also blood sugar. And so, this is an important area because a lot of people, when they quit drinking, and depending on how heavy their drinking was, they may experience cravings for alcohol. But when they take away the alcohol, they typically experience cravings for sugar. And a lot of that discussion previously has been around dopamine and how alcohol increases dopamine levels. So, when we take it away, what also increases dopamine levels is sugar. And yes, that is true. There is a piece of this discussion around dopamine. But there’s also a very close link with blood sugar. 

[00:28:42] And there’s research that shows that alcohol can contribute to irregularities in blood sugar levels even when we are not drinking. So, a lot of people who have a heavier history of drinking or a more regular history of drinking, they can have tendency toward hypoglycemia. And because of that, they’re going to have these chronic decreases in blood sugar, these points of low blood sugar that manifest as cravings for sugar, carbohydrates, but also alcohol. And so, when we take away the alcohol, what exists there? Well, we have sugar and we have carbs, and alcohol is different than sugar and carbs because we don’t need alcohol to survive. Our body is not necessarily fueled by alcohol, but our body is fueled by glucose. So, we can’t take away sugar completely, we can’t take away carbohydrates completely because they are still part of the fuel for our body, unless we’re in ketosis for example. 

[00:29:45] And so, food can be such a critical part of this journey. And one of the simple recommendations that I give, and it’s kind of my number one recommendation for people who are looking to change their relationship with alcohol, looking to quit drinking, is increasing protein intake. And that’s going to support in a couple of different ways. One is that it’s going to help balance and stabilize that blood sugar. It’s going to help us avoid getting into these pitfalls with cravings. Again, not only for sugar, but also for alcohol. It’s also going to help with those hunger and satiety hormones. So, it’s going to keep us in this more regulated state. 

[00:30:23] I always recommend having something to eat every 3 to 4 hours so that, again, we’re keeping blood sugar fairly stable and regular. And another thing that and I know that you talk a lot about intermittent fasting and the benefits of intermittent fasting, but I actually find for those who are early in this journey, especially if they have heavier alcohol use, that they may struggle to manage cravings for alcohol and sugar if they are in a fasted state. And so, I’m actually more of a proponent during this time of having breakfast, having high-protein breakfast, because that is going to stabilize you throughout the latter part of the day as well. 

[00:31:02] And one thing that I’ll also just point out in relation to that and kind of this meal timing or structuring these protein meals throughout the day is what time of the day is it that most people struggle? It’s the 04:00 or 05:00 PM time slot. You’re coming home from work, you’ve had a really stressful day, and the craving is really strong and overwhelming, and it’s hard to say no to a drink at that time. And my first question is, “Well, when was the last time you had something to eat?” Because most people had maybe lunch many, many hours ago. Maybe it was a quick lunch, maybe it was a high-carb lunch. And that can be influencing these cravings later on in the day. So, there’re a lot of ways that we can use food to strategize in getting through, especially these early times. If you’re someone who does feel like you have maybe a little bit more of that physical craving for alcohol or find it really hard to say no when that craving starts to hit. 

Cynthia Thurlow: [00:31:56] I think those are such important points, and certainly with my background, I always say intermittent fasting is one of many strategies, but it may not be the right strategy for you at this time. So, if there are people listening who are interested in fasting and they do have a disordered or dysfunctional relationship with alcohol, it’s probably not the time. You may need to have three solid protein-centric meals a day, get your blood sugar stabilized, keep that satiety up, because to your point each one of us has a vulnerable time of the day where we are more prone to eating foods we probably shouldn’t ideally eat or consuming things that we shouldn’t ideally be doing. And I think setting up, having stable blood sugar is one of the most impactful and important things that we can do. Talk to me about women and fertility and alcohol, because you bring up some interesting points in the book speaking specifically to fertility, which I think is really relevant, again in the context of understanding that alcohol is not this benign entity. 

Dr. Brooke Scheller: [00:33:03] Yeah. I think fertility is such an interesting topic and it’s really eye opening for women when they hear this kind of different perspective. Because for the most part, we hear that you shouldn’t drink while you’re pregnant. And that’s kind of what we hear is once you’re pregnant, then you stop drinking because it can be harmful for the fetus and the development of the baby. But we aren’t discussing the impacts that alcohol is having during conception or during that period of fertility. There was an amazing study that was done in 2021 and this is the one that I reference in the book around, that looked at fecundability, which is essentially the egg implanting for a successful conception. And it looked at the impacts of alcohol on fecundability at different levels of different points of the women’s cycle. So, during ovulation, during the luteal phase, across the board. And what they found is that at all points in a woman’s cycle, alcohol intake was associated with a lower fecundability score. So, a decreased risk for conception, that was strongest if women were drinking during the ovulation phase. 

[00:34:16] So, yes, during ovulation, if you are strategically working to have a successful pregnancy and you are consuming alcohol during that ovulation period, it may be having an effect on a successful conception. But that is also to say that during this time, even during your period, if you’re drinking alcohol, that can still have an impact on your success of conception during your ovulation phase a few weeks later. And so this is, again, to your point, it is not a benign substance. It is not just something that we need to consider when we put it in. And I think many people associate, like, “Well, when I drink, I get a hangover and that’s the effect that I have of alcohol.” And we don’t necessarily think of these longer-term effects that really do have an impact on all of these health effects for ourselves, for our families, etc. And this isn’t just for women, there’s research that also shows how alcohol affects male fertility and sperm motility, sperm count, and sperm quality. And so, this isn’t just for women. This is for men and women to consider if fertility and conception is a goal for you. 

Cynthia Thurlow: [00:35:33] Yeah. I think it’s such an important point because there’s now greater awareness around this. I am friends with a lot of urologists, male hormone specialists, and they’ll talk about the fact that we now have this epidemic of infertility in men largely because of insulin resistance, secondarily to that exposure to estrogen-mimicking chemicals in the environment. And I would imagine, again, if we reflect back on the past nearly four years, probably a bit more alcohol consumption for most people overall, given the stress, the strain of the pandemic, social isolation, etc. And I find it’s really interesting if men are consuming a great deal of, let’s say, beer as an example, beer is a good indicator, you can get something called aromatization. So, the men’s testosterone that their body is making endogenously inside the body can aromatize, can be made into estrogen. So not only is this another component to why we’re dealing with infertility issues in men, but it can be exacerbated by something as seemingly benign as beer. I’m using beer as the example because that was the research I was looking at. 

[00:36:47] And oftentimes there are physical signs that are a key to this. Feminization is sometimes the word that people will use in terms of men that are dealing with maybe they’ve got abdominal obesity, they’ve got a little bit of a belly, maybe they have gynecomastia, which means they have some enlargement of their breast tissue, unfortunately, which is also a permanent thing unless you deal with it surgically. But understanding, like, we’ll start seeing some changes in the male body habitus in relationship to overconsumption of alcohol. And for some people, they think they’re like, “Oh, it’s cute, he’s got a beer belly.” No, it’s actually a sign of this aromatization of testosterone to estrogen, very likely some degree of insulin resistance, lowered testosterone. And we’re seeing more and more of this, which I think clinically is a huge concern for a variety of different reasons. 

Dr. Brooke Scheller: [00:37:38] Yeah. I think we have for a long time as a society, put this very positive spin on alcohol, that it is beneficial for your social life, it’s beneficial for your relationships. It’s part of our work life. I know even as someone in the wellness space and you read this in my book, that I was still surrounded by people who were drinking heavily, that I’m sure you’ve gone to conferences that are health oriented, that are still pouring lots of alcohol. And it is very ingrained in our society in every which way, including the health sector. And we actually see some really high levels of alcohol use disorder in doctors because of their stress. And it’s kind of, again, to compare alcohol and tobacco, we used to advertise that doctor’s smoked Camels. Because Camels were the doctor’s choice. We were actually marketing that. 

[00:38:37] And in a way, we’re doing that today, maybe not as directly through magazine advertisements previously, but by showcasing on television or in movies. These professionals are imbibing and still having a successful life or a happy life. And something like beer and sports, it carries this American concept of the American dream and this is what we do on Sundays and how we connect with our friends and family members, etc. And it’s really, really sabotaging our health in so many ways. And the research that had come out earlier this year and maybe it was toward the end of last year, but around how one in five adult deaths are the result of alcohol-related effects and actually one in four deaths of those between the ages of, I believe it was 18 to 35, one in four is actually alcohol related. And that’s only looking at things like accidents, things like liver disease and things that are very specifically alcohol related. But let’s not forget that alcohol is a huge risk factor for cardiovascular disease, which is the number one cause of death.

[00:39:55] And so we can’t necessarily splice out that data or we haven’t necessarily spliced out that data to say how much alcohol is contributing to the overall epidemic of cardiovascular disease. But it is having a major, major impact. And I know that, I don’t want to be like scare tactic-y in the way that we’re talking about this. And I don’t want you to feel bad if you do drink or have had maybe a history of heavy alcohol use. This is simply just to inform you that you have the choice moving forward of how you want alcohol to be a part of your life. And for so long, this goes into the stigma, like, to bring it full circle. It’s been, you’re not cool if you don’t drink alcohol, that there’s something wrong with you if you don’t drink alcohol, that there’s this negative association if you’re someone who doesn’t drink. And now it’s cool not to drink. I mean, we’re seeing celebrities not drinking. We’re seeing a huge rise in nonalcoholic beverages. It’s not as stigmatized as it once was.

[00:40:53] And so, I really believe there’s a major shift happening in our society around alcohol. And if you are making this decision now to change your relationship with it, you’re on the forefront of, I think, a really exciting new venture in the health and wellness world. And so, it’s a really exciting time. I’m really nerdy about it, but I also really believe that and I know that alcohol elimination has completely changed and transformed my life and I truly believe that it will do that for every single person who’s listening.

Cynthia Thurlow: [00:41:23] Yeah. And I think you bring up so many good points. I mean, the stigmatization of whether you do or don’t drink, I know within my health and wellness community, certainly events I’ve gone to over the last four years, more often than not people don’t drink. And it’s been nice to be surrounded by other people who are not drinking, because in a lot of social settings, when I tell individuals that I don’t drink alcohol, and for full disclosure, I’ve never had a problem. But as I was navigating my 40s, it was the one thing that gave me hot flashes. And so that was the sign of– my sleep is too important, I don’t want hot flashes; therefore, I’m not going to drink. And I’m just that discipline, that’s how important my sleep is. The conversations I have socially, people, it makes them uncomfortable. 

[00:42:06] In many instances, they get very triggered. I’m like, listen, “I am good with a glass of sparkling water and a lime. No one knows the difference. It’s totally fine.” But I find many people are just so uncomfortable. Like, “What do you mean, you don’t drink?” And so, I love that there are more and more individuals that are choosing not to drink. And if you do choose to drink, do so with some degree of responsibility and understanding of what is going on with your body. And I think that allows people to make good decisions for themselves. I would love to kind of touch on, we’re heading into the end of 2023. I know for a lot of people, they subscribe to the philosophy of Dry January or having sober challenges. What is your prevailing philosophy around this? Like, do you have recommendations, suggestions, or ways to navigate this? 

[00:42:58] And for full disclosure, my husband and all of his childhood friends, every January, they do a Dry January to support one another. And so, for the entire month of January, my husband doesn’t drink any alcohol. He usually only drinks on Friday and Saturday night. But it becomes this, he’ll say to me, “It’s like a reset.” Because it’s such a part of what he does on Friday nights, unwind or have a glass of wine on Saturday. And then all of a sudden, he’s like, “I need to find something else to fill that space.” So, when people are navigating the beginning of 2024, what are some of the suggestions and recommendations you may have for them? 

Dr. Brooke Scheller: [00:43:33] Yeah. So, I think that these challenges are great. I think that it’s a great way to explore alcohol elimination. It’s a great way to kind of set a goal around it, because for most people, we need a little bit of, like, an endpoint, maybe, to help us kind of understand or just make that decision to make the change. And many people who do eventually go more sober curious or eventually eliminate oftentimes start with these challenges because they give themselves a little bit of space and opportunity away from alcohol to start feeling the benefits of alcohol elimination. Unfortunately, alcohol can take at least a week to regulate or our body will take at least a week to regulate cortisol levels after alcohol use. It will take a couple of weeks to start to reregulate some of these areas, like the gut microbiome and brain neurotransmitters, etc. So even if we’re drinking once a week or a couple of times a month, we still don’t really have full clarity in our brain and our body of how we feel without alcohol. So just something to keep in mind if you’re considering something like a Dry January. 

[00:44:42] And the biggest thing to do during this time is use it as an opportunity to learn and understand more about your relationship and your behaviors around alcohol. And so books like mine, like How to Eat to Change How You Drink or many of the other kind of what we call quit lit books are great resources during this time, while you’re taking a break, to start to understand a little bit more about what’s going on in your body when we consume alcohol, what is underlying maybe some of these behaviors, but also there’s a huge community of sober-curious people on social media, in different podcasts on sober curiosity. 

[00:45:27] So if you’re exploring a month like Dry January, surround yourself with some of these resources, because it’s not only going to help you make it through a month fully alcohol free, but it’s also going to help strengthen your understanding of your behaviors with alcohol during that time, so that when you get to the end of the month, you can make a more informed decision around if it’s something that you want to continue further or how you’re kind of going to use that information moving forward. Because my concern around Dry January is that on February 1st, you go right back out like guns blazing and right back to the bar. And we really want to use this as an opportunity to help influence your behaviors moving forward, rather than kind of a short-term reset for lack of a better word. That is not necessarily going to have an impact on your health and longevity.

Cynthia Thurlow: [00:46:20] Yeah. And it’s interesting, years ago, when I was still seeing patients clinically in this cardiology practice that I work for, we used to use a CAGE questionnaire. So, there were specific questions we would ask patients to get a sense for how much alcohol they drank. And inevitably, if someone told me they had four drinks a night, I would double it. That was the prevailing philosophy, that a lot of people felt uncomfortable. They felt like they were perhaps being judged, although that was certainly never what I intended anyone to feel. It was really to get a sense for how much alcohol, like, do I need to give you certain medications in the hospital to make sure you don’t have a seizure because you drink quite a bit? You mentioned in the book looking at root causes, looking at stress. You used the halt kind of acronym. Let’s talk a little bit about that, because there may be someone listening that is interested in being more sober conscious. They’re interested in perhaps a Dry January. But how do they help differentiate if they just drink a little too much or if they, in fact, actually have a problem with alcohol in and of itself? 

Dr. Brooke Scheller: [00:47:21] Yeah. And it’s a great question because to so many people, alcohol dysfunction or deciding that you have a dysfunctional relationship with alcohol is self-determined. That I could say I have two drinks per day and that feels unhealthy for me or is having a negative impact where someone else might be having five drinks, six drinks, eight drinks a day, and still not feel necessarily like that they are out of control. And so, it’s really, in many ways, unless you’re working with a practitioner, a mental health practitioner, a psychiatrist who is going to diagnose that. Most of the time when we go to our practitioners, we’re not fully transparent or honest about that. And I write about that in the book because it was an interesting thing for me to experience as a healthcare practitioner, but also someone who goes to healthcare practitioners how to balance that discussion and that conversation to my own benefit, of course, during those times. And, you know, I think innately, if you feel uncomfortable with your relationship with alcohol. There are so many people who I know in sobriety that admit that at one point they had googled do I have an alcohol problem or not? 

[00:48:38] And I’ve heard in some conversations that people who don’t have a problem don’t wonder if they have a problem or not. That there is this kind of inner knowing that we know in our own selves if we’re choosing this as something that is out of our own desire. If you are someone who has said, “I’m only going to have one drink and then you wake up the next day hungover and had kind of lost control of those choices. It’s not to say that you have a problem.” I hate that word problem because it’s just like it’s such a negative thing. And it’s not really about that. One of the things I talk about in the beginning of the book is that we’re not going to use the word alcoholic. We’re not going to talk about if you have a problem or not. This is going to be a way for you to just explore where there’s opportunity for you to change and if this is a lifestyle that you want to pursue. Because I really believe, again, it goes back into the stigma. No one wants to have a problem with anything.

[00:49:39] It’s such a negative connotation and there’s such an opportunity for us to use this as a means of self-improvement that it’s not about beating ourselves up for the choices that we made before. It is not about placing a negative association on this. This is simply you saying I get to have a choice. Am I going to be present in my life or am I going to numb out my feelings or emotions? Am I going to have the strength to kind of overcome these things or am I going to continue down this path of maybe holding myself back in a lot of ways? And so, I really think that we get to decide if we feel like we want to identify as alcoholic, problem drinker, whatever that might be. If you feel good doing that, do it. But that also doesn’t mean that you can’t just stand up today and say, “I don’t like how alcohol makes me feel and I’m going to do something about that.” 

Cynthia Thurlow: [00:50:37] I think it’s such an important message and I’m so very grateful that you helped me reframe some of the terminology, not that I’ve purposely been pejorative, but helping me understand, to speak in a way that allows people to feel comfortable kind of exploring what it is that they’re going through. Now, obviously, individuals that are listening to the podcast can certainly purchase your book, but I’d love to round out the conversation with you sharing a little bit about your story, because it was incredibly inspiring and you were very transparent. When was the point at which you acknowledged you were ready to make a change in your relationship with alcohol? 

Dr. Brooke Scheller: [00:51:16] Yeah. And it’s always such a personal thing. Thank you for asking me to share my story. It’s a personal thing for all of us when we get to that point of making that decision. And part of the stigma and the history around alcohol use has been you have to hit rock bottom to decide that you’re going to stop. And that’s kind of the mentality of Alcoholics Anonymous. That you come in when you don’t really have any other choice. And the beauty today is that there are so many resources around sober curious, around exploring this idea of becoming sober, that you don’t have to be at a rock bottom to decide that you want to change your relationship with alcohol. And for me, my kind of “rock bottom” was not traditional in the sense of I didn’t have a DUI, I lived in New York City, I didn’t have a car. So that was [crosstalk] [Cynthia laughs] But I didn’t lose a job. I didn’t have any kind of monumental things happen to me. But my rock bottom was the culmination of many, many years of self-imposed anxiety and depression and many years of using alcohol as a coping tool and really struggling with the effects that it was having on me, but also feeling very out of control.

[00:52:36] I didn’t know any other way of living. I had no other coping skills and I had started drinking as a young teenager. So it kind of just pervaded my lifestyle in its entirety. And it really wasn’t until the pandemic that I felt that I had lost more control than I had previous to the pandemic. And this is kind of a typical story that the pandemic increased drinking for a lot of people, a lot of isolation. For me, I was working from home. So that really changed my ability to start drinking earlier in the day on some days. And I ended up being someone who probably prior to the pandemic, was drinking four or five days a week. And during the pandemic, by the time I quit drinking, I was drinking six or seven days a week, more like seven. And several of those days starting earlier in the day. And I didn’t last very long doing that because I caught myself in this really, really unhealthy cycle that some people get stuck in for many years.

[00:53:40] And for me, I felt like I was kind of built up with pressure all the way to the scenes. I always make this reference and if anyone’s a Titanic fan, like, Titanic has always been one of my favorite movies. But there’s the scene where the water is about to burst through the doors, and it’s, like, exploding through the cracks. And that’s how I felt like my life was that I had this kind of constant pressure and alcohol was contributing to that. And I had an experience where someone I was dating at the time brought up that I had drank all weekend, and I had been hiding a lot of my drinking as this was someone that I didn’t see very often. And as soon as they brought it up and they didn’t say, “Hey, you have a problem. You need to go to rehab. You need to get some help with this.” They simply brought my attention to it. And the pressure at that point was so intense that as soon as this person saw it, it allowed the pressure to, like, the pressure valve to open and I knew. I just knew. 

[00:54:38] I had known for years that I needed to do something about this problem. I was a doctor of nutrition, feeling like I was living a total double life. And as soon as that seemingly kind of unimportant conversation happened, it was just like, the switch that needed to flip for me. And that’s the thing, is that it doesn’t have to be this major change in your life. It doesn’t have to be this major thing. It can simply be you listening to this conversation that says, “I feel in my gut like this is something I want to try and explore.” And all your job is to do is to follow those breadcrumbs and start seeing how you feel. Because I know in my life that my life completely changed. All of the doors opened for me. I got a book deal, something I had been wanting for many, many years. And sobriety really brought me to all of these things with grace and dignity and I’m so grateful for that. 

Cynthia Thurlow: [00:55:33] Yeah. I mean I think in many ways, when we’re ready for the work, it brings us into full alignment, and then we’re able to actualize our full potential. Well, thank you so much for this discussion today. Please let listeners know how to purchase your new book, how to connect with you on social media. If they want to work with you, how to connect with you. I don’t know if you probably, like the rest of the world, do things virtually, but if they want to connect with you and work with you, how would they go about doing that? 

Dr. Brooke Scheller: [00:55:59] Yeah. So, thank you so much again for having me, Cynthia. The book is available wherever books are sold, How to Eat to Change How You Drink, and it is available or on shelves as of December 26th here in the US and then around the world on January 4th. So perfect for your Dry January, but also just exploring your sober-curious journey or just exploring a life with less alcohol. I’m most active on social media, on Instagram @drbrookescheller and also you can learn more about me and my programs. My online programs. I work with clients around the world. I also have an online community that is a wellness-focused approach to a sober-curious lifestyle. And I also see some clients one on one. And you can learn more about that at functionalsobriety.com. 

Cynthia Thurlow: [00:56:46] Awesome. Thank you so much for your time today. 

Dr. Brooke Scheller: [00:56:48] Thank you, Cynthia. 

Cynthia Thurlow: [00:56:51] If you love this podcast episode, please leave a rating and review, subscribe and tell a friend.