Holidays without alcohol: celebrate without regrets

• U.S. cardiac deaths are highest on December 25 and 26 and January 1.
• In a Swedish study, heart attack risk on Christmas Eve was 37% higher than usual.
• Large amounts of alcohol can trigger atrial fibrillation, "holiday heart syndrome".
• Quitting alcohol reduced atrial fibrillation recurrences in a randomized trial.
• Prepare a short reply to pressure and appealing nonalcoholic drinks.

What happens to the heart over the holidays

An analysis of U.S. death certificates over several decades found that cardiac deaths peak on December 25 and 26 and January 1, more than on any other days of the year (Phillips et al., 2004).

The Swedish SWEDEHEART registry, covering more than 280,000 heart attacks, found that the risk of heart attack on Christmas Eve was 37% higher than on control days, peaking around 10 p.m. (Mohammad et al., 2018). Likely contributors include emotional stress, overeating, alcohol and delaying care.

Alcohol and heart rhythm

Heavy drinking over a short time can trigger atrial fibrillation. In a randomized trial of regular drinkers with this rhythm disorder, abstaining for 6 months reduced recurrences and lengthened the time until they occurred (Voskoboinik et al., 2020).

A global analysis concluded that the level of drinking that minimizes health harm is zero (GBD 2016 Alcohol Collaborators, 2018). Holidays are also a time of more drunk-driving crashes on U.S. roads.

How to celebrate without alcohol

Have a reply ready

• “Thanks, I’m not drinking tonight.”
• “I’m driving.”
• “I want to feel good tomorrow.” You do not need to explain more than you want.

Keep a drink in your hand

• sparkling water with lime and mint;
• cranberry spritzer or apple cider;
• hot spiced tea or nonalcoholic mulled cider;
• nonalcoholic sparkling wine or mocktails.

Shift the focus from drinking

• a walk after dinner, ice skating, board games, caroling;
• cooking together instead of toasting;
• plans for the next morning, a good reason not to drink.

If you do drink

• alternate each drink with a glass of water;
• eat before and while drinking;
• never drive after drinking, even a small amount;
• do not mix alcohol with sleeping pills or painkillers.

See also: A month without alcohol and the AUDIT-C quiz.