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An MD On How Much Sugar, Caffeine & Alcohol You Can Get Away With

Vincent M. Pedre, M.D.
Updated on August 26, 2020
Vincent M. Pedre, M.D.
Board-Certified Internist
By Vincent M. Pedre, M.D.
Board-Certified Internist
Dr. Vincent M. Pedre is a board-certified internist in private practice in New York City since 2004. He serves as medical director of Pedre Integrative Health, president of Dr. Pedre Wellness, and is the author of Happy Gut.
Last updated on August 26, 2020

As a medical doctor who specializes in functional medicine and gut health, I see how chronic inflammation affects the gut but eventually becomes systemic, affecting nearly every organ in the body. While numerous factors drive inflammation, some of the biggest culprits are the foods and drinks we consume every day.

Some of my patients start their day with stimulants (caffeine) and end with relaxants (the foods they’re addicted to or glass of wine or beer every night).

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They repeat this cycle because it gets them through the day, and they believe it helps them cope with stress. They also consume more sugar than they realize, often in sneaky sources like sweetened almond milk in their dairy-free lattes or store-bought tomato sauce.

All of these things have a cumulative effect on chronic inflammatory conditions. But how much of an effect? Let’s look at how three major players affect inflammation: sugar, caffeine, and alcohol.

How sugar can affect inflammation.

Let's start with the big one. Sugar is the king of inflammation1, inflicting a massive blow to your gut and overall health.

This low-grade inflammation contributes to the development of numerous age-related chronic conditions1 including nonalcoholic fatty liver disease (NAFLD), type 2 diabetes, and cardiovascular disease that may lead to a heart attack.

Sugar also contributes to obesity, characterized by a chronic low-grade inflammation2 in fatty tissues as well as systemically. With obese people, we see an increased immune response within fat tissue that researchers call metabolic inflammation2.

Sugar, especially added sugar in processed food, can also result in insulin resistance3. In this condition, your pancreas works on overdrive, secreting ever higher amounts of insulin because your cells have become resistant to "hearing" this hormone signal.

Insulin resistance can lead to metabolic syndrome, a major cause of heart and vascular disease, and diabetes—all major causes of health problems that can destroy your quality of life. Insulin resistance also perpetuates the vicious cycle of inflammation. Chronic inflammation, in turn, fuels insulin resistance4. Once it gets kicked off by excess sugar and processed carbs in the diet, it's hard to shut off.

Be mindful of "healthy" sugars & hidden sugars

Many of my patients know the usual suspects for sugar. That piece of birthday cake isn't going to do their gut or their overall health any favors, and they know to keep it to the occasional indulgence (if at all).

More problematic are the so-called healthy sugars in foods like agave-sweetened cookies, almond and other nut milks, and even fruit. Large amounts of fructose3, even from healthy foods like fruit, can create or exacerbate insulin resistance and inflammation.

Insulin resistance doesn't exist in a vacuum; it also leads to other imbalances that fuel the inflammatory fires. Take leptin, a very important hormone that regulates your feeling of fullness. The more leptin in circulation, the less hungry you should be.

However, the brains of people who are obese do not respond to the leptin signal. Their levels are high, but these levels are not sensed by their brain to signal that they are full and they should stop eating. That leads to another problem—leptin resistance—leaving you hungry when you've already had all the food you need for fuel.

Too much sugar leads to insulin resistance, which leads to leptin resistance, resulting in weight gain—all of which increase inflammation.

All carbohydrates convert to sugar in your body. Some convert more quickly than others. If you eat a food containing gluten (such as pasta) and you have a sensitivity to that food, that will only add more fuel to your inflammatory levels.

Want to dial down inflammation? Start with sugar, in all its many forms.


So how much sugar can you get away with and stay low in inflammation? Aim for a max daily intake of refined sugar of 25 grams or less.
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How caffeine can affect inflammation.

Research shows coffee can have pro- or anti-inflammatory effects5, depending on the individual.

I see this in my own practice: Some patients do fine on three or four cups of black coffee in the morning, while others get jittery on even a few cups of green tea. Everyone responds to caffeine differently. Knowing your body means tuning in to the signals it gives you. If you feel jittery after two cups of coffee, then dial back down to one cup once daily. It all depends on whether you are a slow metabolizer or fast metabolizer.

For myself, I'm a slow metabolizer, so one cup of coffee will leave me feeling jittery for hours. As a result, I decided to give up coffee altogether and instead drink tea for caffeine because of its more measured, tempered effect. Now don't get me wrong, I did love the taste of coffee, but I value an internal sense of calm more than the accelerated fuel coffee can offer.

Your go-to caffeine source matters

How you drink caffeine matters, too. If you're pouring sugar or sugar-laden nondairy creamers into a hulking cup of coffee every morning, your body is going to respond much differently than someone having a cup of black organic coffee with MCT oil. It's what you add to your cup of coffee that can fuel the fires of inflammation.

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Why you need or want caffeine is also important

If getting moving in the morning requires multiple cups of something caffeinated (coffee, tea, or anything caffeinated), I would encourage you to look at your sleep habits, stress management, and how you're expending your energy levels. If your caffeine habit is excessive, it's time to look at your lifestyle habits and move toward greater balance between activity and rest.

Caffeine can also be dehydrating, so I encourage patients to stay ahead of their hydration. Drink at least 64 fluid ounces of clean, filtered water daily, or even more depending on your caffeine habit.


So, how much caffeine is too much? It's safe to say that less than 50 grams of caffeine, found in a typical 12-ounce cup of coffee or green tea, is a safe bet. More than 150 grams (easily seen in a 20-ounce cup of coffee) will push your insulin secretion, leading to all the problems we talked about before, including increasing your cravings for sugar and refined carbohydrates. Yes, drinking too much coffee can actually lead to weight gain!
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How alcohol can affect inflammation.

According to the Dietary Guidelines for Americans, moderate alcohol consumption is up to one drink per day for women and up to two drinks per day for men. However, even this is too high when we look at the research, and many people are drinking more than that.

Check in on your serving size

A serving size6 is a 12-ounce beer, 5-ounce glass of wine, or a 1.5-ounce shot of liquor. Some people generously fill their wineglass (16 to 18 ounces) and consider it one glass. Some research shows that light to moderate alcohol consumption can have anti-inflammatory benefits7.

However, large amounts of alcohol can create intestinal inflammation8 through multiple pathways. A vicious cycle ensues as the inflammatory response exacerbates alcohol-induced organ damage, affecting your gut but also other organs, like the liver.

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Think about your drink of choice

How your body responds to alcohol depends on several factors. Enjoying a glass of organic red wine will have a completely different impact than drinking a margarita or other sugary alcohol concoctions (a surefire way to rev up inflammation, by the way, based on everything I noted in the above section about sugar).

Some people also enjoy a glass of dry red wine as their dessert. For others, a glass becomes two, and before they know it, they're devouring a second piece of pie. In other words, know how alcohol makes you behave, as it disinhibits your brain control centers and will lead you to overindulge in the other contributors to inflammation.

Like caffeine, alcohol can be dehydrating. Be especially mindful to drink sufficient water when you're drinking. Certain situations like drinking while flying can be even more dehydrating, potentially exacerbating inflammation.


So, how much alcohol can you get away with without causing too much inflammation? Stick to one drink three times a week or less to enjoy your cup while keeping the tides of inflammation low. And for your long-term health, it's better to be an intermittent non-binge-drinker than a regular drinker.

The bottom line

Let's face it—a warm brew, a glass of red wine, and an occasional pastry are all life's little pleasures. Consumed mindfully and in a low-stress environment, they will minimally affect inflammation and can even be anti-inflammatory. Treating these as luxuries to enjoy in moderation allows you to indulge, while managing inflammation and keeping your cells young.

Vincent M. Pedre, M.D.
Vincent M. Pedre, M.D.

Vincent M. Pedre, M.D., medical director of Pedre Integrative Health and president of Dr. Pedre Wellness, is a board-certified internist in private practice in New York City since 2004. He completed his bachelor’s degree in Biology at Cornell University before attending the University of Miami School of Medicine and completed his residency in Internal Medicine at the Mount Sinai School of Medicine. He has appeared on the Martha Stewart Show and ABC and is the author of Happy Gut: The Cleansing Program to Help You Lose Weight, Gain Energy, and Eliminate Pain. Dr. Pedre is a clinical instructor in medicine at the Mount Sinai School of Medicine and is certified in yoga and medical acupuncture.

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