Yet more and more Americans don’t seem to share my admiration for a nip. We are living in skeptical times around alcohol. The International Wine and Spirits Record (IWSR) reports that the nonalcoholic industry grew in the United States by nearly 30 percent between 2022 and 2023, while sales of the real thing fell worldwide with the U.S. spirits market slumping by 2 percent. Perhaps counterintuitively, the trend is driven by younger consumers, who are drinking far less than my generation did when we were bingeing in the 1980s. Over half of drinking-age Gen Zers reported not drinking at all in the six months prior to being surveyed. 

The reason? Health, according to more than a third of Zoomers, which tracks for folks who came of age during a global pandemic. They might be onto something: In 2022, the World Health Organization stated, “When it comes to alcohol consumption, there is no safe amount that does not affect health.” The Surgeon General is recommending, controversially, that all types of booze bear a cancer warning. Canada changed its guidelines in 2023 to recommend no more than two drinks a week. Some of the researchers who developed Canada’s new standards have been working, controversially, on lowering the U.S. limit of two drinks a day for men and one a day for women, too. With all this neo-temperance in the air, what’s a girl gotta do to get a drink around here?

But seriously, folks, I’m a Boomer. And McKinsey & Company is correct in reporting that Boomers are confused as to why younger people are drinking so little. Me? I’m more curious than confused—not sober curious, mind you, but curious: What is alcohol really doing to my body? Specifically, given my interest in the microbiome, what are the ramifications for this bon vivant’s gut? Is pickling my insides a moderate amount going to ruin my gut health? Or is there a way to have my booze and drink it, too? I reached out to some experts to learn more.

To understand how the gut reacts to alcohol, we first need to know how it works on the brain. A two-carbon chain molecule, ethanol—the alcohol in booze—is small and simple enough to do its job fast. “It gets everywhere in the body quickly,” says Dr. David Nutt, a professor of neuropsychopharmacology at the Imperial College London and the author of Drink? The New Science of Alcohol and Your Health. “It interacts with proteins that sit on the connections between cells, including the neurons in the brain.”

After a drink or two, an inhibitory neurotransmitter called Gamma-aminobutyric acid, or GABA for short, kicks in and calms your nervous system, easing tension and reducing anxiety. The GABA effect, Nutt argues, is the evolutionary reason for drinking: “If alcohol didn’t serve a purpose, it would have disappeared a long time ago. It is the ultimate social drink.” He notes a theory by Edward Slingerland, author of Drunk: How We Sipped, Danced, and Stumbled Our Way to Civilization, that Homo sapiens settled into agriculture to grow the cereals for beer, which lubricated interactions among strangers. “That’s important,” Nutt observes, “because you want to spread the gene pool. Outbreeding makes a population more resilient.” 

So booze was the early hookup drug. But, like any drug, the more you consume, the more a potentially helpful substance turns bad. “When you go from one to two drinks, you interact with other neurotransmitters, which might bring more energy and euphoria, releasing dopamine and endorphins,” says Nutt, “and that comes at a cost.” Those happy-making chemicals can get addictive, he notes, “and someone who wanted a quick one ends up on a binge.”

The gut microbiome is implicated in this process. “Research shows a link with the gut microbiome, the gut-brain access, and craving for alcohol,” says Dr. Jennifer Barb, head of the Data Analytics and Translational Science Unit at the National Institute of Health Clinical Center. Addiction to booze, she says, is similar to addiction to highly processed food. Both can cause dysbiosis, or an imbalance in the microbiome, that can privilege bad bacteria over good. “Healthy gut bacteria is not used to metabolizing alcohol, so other bacteria may be sending signals to the brain”—telling you that you want more.

The brain and the gut are in a negative feedback loop over alcohol, goading each other into another drink. The effects of more and more alcohol in the gut can be profound, for the gut is the body’s carafe. “About 20 percent of alcohol consumed is absorbed in the stomach and 80 percent in the small intestine,” explains University of Texas MD Anderson Cancer Center’s Dr. Veronika Fedirko. But before all of that, it goes through your mouth, where it may disrupt your oral microbiome. “There’s work that shows a reduction in saliva production and an increase in acidity that can contribute to bacterial overgrowth and enamel erosion and increase in oral inflammation,” she says. 

Next, there’s the burn at the back of your throat. That’s the alcohol irritating nerve endings. “Alcohol is an astringent. You rub it on your skin to kill germs, so it is toxic to cells generally,” says Nutt. That explains alcohol’s “strong association with heartburn, which is inflammation at the junction of the stomach and esophagus.” 

If you drink too much over a prolonged period of time, eventually, alcohol starts to chew away at the gut itself, killing off good bacteria in the microbiome, eating the mucus that protects the tissues, and inflaming the cell lining. Many heavy drinkers—those who have five to seven drinks a day—get their calories from booze, not food, “so the gut bacteria don’t have anything [nutritious] to eat,” says Barb. Hungry, they start to gnaw on the intestinal walls, breaking them down and causing leaky gut. 

In an extreme situation like this one, the gut bacteria start to break down, and endotoxins—the toxins that come from inside bacterial cells—enter the bloodstream, leading to inflammation and other problems, explains Fedirko. A molecular cancer epidemiologist, she is concerned with alcohol as a carcinogen. In the liver, alcohol is metabolized into acetaldehyde, which can scramble our DNA and cause out-of-control cell growth, i.e., cancer. The International Agency on Cancer Research found causality between alcohol use and oral, esophageal, pharyngeal, laryngeal, liver, colorectal, and breast cancers. 

Add on immune system depression, vitamin deficiency–related neurological diseases, and other ailments from years of living with a dysbiotic gut, and booze starts to look like Drano, eating up everything (good and bad) on its way down the pipe.

All this might be enough to scare the average drinker off the hooch for good—until you realize the researchers are describing alcohol abuse, not average drinking. For most of us, alcohol hasn’t overtaken the system. It is a moderate part of a full lifestyle. “So then we bring it back to: How are you living? Is someone having a drink a day also having a nutrient-rich diet with more plant-based food, sleeping well, and exercising?” says Barb. Such a person generally doesn’t have to worry about the dire effects of booze on their microbiome.

Still, there are precautions to keep in mind that will help protect your gut when you’re drinking. First, not everyone can hold their liquor equally. Research has shown, for instance, that women’s bodies process alcohol less easily because we have less of the enzyme needed to metabolize acetaldehyde. This has also been shown to be true for many people of Asian descent, for whom rates of alcohol use and abuse are lower than in other demographics, in part, studies suggest, because drinking can be so unpleasant for them. Basically, given differential tolerance, you should know your limit and keep track of how much you drink. 

“Be mindful of alcohol content and try lower-alcohol beverages,” advises Fedirko. Spirits and sugary cocktails aren’t gut friendly, but beer and wine are lower in alcohol. They’re also fermented, and fermented foods and drinks can be healthful for the gut. Fiber and other nutrients in beer actually have been shown to benefit the microbiome. And though the jury is still out as to red wine’s effects on the heart, Barb cites a controlled crossover study suggesting that the polyphenols in red wine may benefit gut health.

No matter what you choose to drink, it’s a good idea to eat before imbibing. “Food slows down the absorption of alcohol, so your liver doesn’t get overwhelmed and can detoxify more efficiently,” says Fedirko. Then chase the booze with plenty of water. “Alcohol forces water out of your cells, so hydration is important.” One way to slow the absorption of alcohol is to do what Brits call “zebra striping”: Alternate between alcoholic and nonalcoholic drinks. And if you’re thinking of skipping the booze altogether but still want that relaxation, Nutt has invented Sentia, a nonalcoholic botanical drink designed to induce the GABA effect. It’s on my list to try. 

To understand the gut the day after you indulge, we need to go back to the brain. The more you drink, the more you interfere with a neurotransmitter called glutamate, which regulates learning and memory, notes Nutt. But your brain doesn’t give up without a fight, so it increases the functioning of the glutamate system. Then, more often than not, you fall asleep or pass out and go into alcohol withdrawal. But your glutamate is still turned on, and that’s what gives you a hangover.

There’s no agreed-upon clinical definition of a hangover; it’s just a set of misery-making symptoms as your blood alcohol level declines. Even so, notes William Royle, a lecturer on hangovers at the UK’s University of Salford, it has been suggested that “changes to the gut microbiome caused by alcohol consumption contribute to the experience of hangover.” 

Compounding the lousy feeling in your brain, the inflammation that alcohol causes can be tough on the gut the day after a bender, says Dr. Sally Adams, an associate professor of psychology at the University of Birmingham. Diarrhea, bloating, gas, cramps—they’re all part of the woe.

Alcohol also disrupts sleep. “There’s a part of your brain that does not rest when you have alcohol in your system,” says Barb. Neurotransmitters involved in wake-sleep regulation are affected. “And when you don’t get healthy sleep, your body looks for energy-dense foods to replenish it, with high sugar and high fat, so there’s a lot of things at play: the sugar, the ethanol, what you ate, the poor sleep.” All of them contribute to gut distress. 

So what to do to heal the wounds the morning after? Hair of the dog just spikes your blood alcohol level, suppressing the glutamate system again, so it might make you feel temporarily better, but it’s just staving off the inevitable. You’re better off drinking water: It won’t disrupt the hangover but will alleviate symptoms of dehydration, which can include nausea, vomiting, and constipation. If you’re not constipated and you can go, a healthy sit on the throne can expel the ethanol your hungover intestine is still absorbing. 

A recent review of the medical literature suggests that probiotic supplements can also reduce gut inflammation during a hangover, notes Adams. But like other solutions—exercise, eating, carb loading, Korean pear juice—there’s no silver bullet because a hangover is a “complex phenomenon with a multitude of physical and psychological symptoms.”  

Royle’s best advice? “Plan to be hungover. That means putting the time aside to recover from the symptoms, the worst of which should have passed after about 12 hours from stopping drinking and are likely to be unnoticeable within 24 hours.” If you don’t like the idea of suffering through it, moderation is the only solution, he says. 

Moderation, in the end, is my big takeaway. It seems obvious, but in the thick of the party, it’s easy to forget that “it’s all about balance and choices,” as Fedirko puts it. Next time I’m checking out a new bar for work, I’ll order plenty of snacks to go with the drinks. I’ll do the zebra thing, switching off with big glasses of water, and I’ll stop before I get wobbly. At home, I intend to follow Nutt’s advice, sipping better, not bigger. “If you want to constrain your drinking,” he says, “the best way is to always buy the most expensive booze you can afford,” if only because its prohibitive cost minimizes dosage. At the risk of sounding like a Boomer drinks snob—which I am—I am pleased to know that one glass of grand cru white burgundy, savored slowly, is a gut-healthier choice than a bottle of cheap vodka any day.