4 to 5 drinks in one sitting? Sir HN Reliance Foundation Hospital cardiologist shares 5 rules to protect heart and liver

Saving up drinks for the weekend? Heavy binge drinking strains your heart and liver – follow these rules shared by a top cardiologist to protect your health.

Millions of social drinkers operate under a common illusion: abstaining from Monday through Thursday grants a license to indulge freely on Friday and Saturday. But a cardiologist has warned that 'saving up' your alcohol allowance for the end of the week carries severe, unexpected costs for your heart and liver.

Global toll of the unseen habit

According to the World Health Organisation (WHO), alcoholic beverages contain ethanol — a psychoactive and toxic substance capable of causing dependence. In 2019 alone, alcohol consumption was reportedly responsible for approximately 2.6 million deaths worldwide. Noncommunicable diseases accounted for 1.6 million of those deaths, while injuries claimed 700,000 lives, and communicable diseases accounted for another 300,000, per WHO.

While the WHO shared that alcohol consumption carries health risks even at low levels, the vast majority of alcohol-related harms stem from heavy episodic or continuous drinking. Effective public health policies exist to curb these numbers, but health experts stress that individual awareness remains the first line of defence.

The short-term consequences of a weekend blowout extend far beyond a standard hangover. (Unsplash)

What 4 drinks in one sitting actually does to the body

"Weekend drinking in moderation shouldn’t be a major health risk," Dr Ajit Menon, director of cardiology at Sir HN Reliance Foundation Hospital in Mumbai, told HT Lifestyle in an interview. "However, weekend binge drinking, which is 4-5 drinks in one sitting, can create issues affecting both the heart and the liver," he added.

That concentrated spike in consumption alters the body's internal chemistry far more dramatically than a single, mid-week glass of wine. Dr Menon pointed out that sharp spikes in blood alcohol levels trigger a cascade of systemic issues, including 'greater oxidative stress, increased inflammation, more liver toxicity, and greater cardiovascular strain'.

Moreover, the short-term consequences of a weekend blowout extend far beyond a standard hangover. Rapidly elevating your blood alcohol level can destabilise your heart’s natural rhythm and spike your blood pressure.

"Potentially, it can cause a rhythm disturbance called atrial fibrillation and sudden increases in blood pressure that can persist," Dr Menon explained, adding, "In addition, there is an increased risk of heart attacks, brain strokes, and heart failure."

Over time, heavy episodic drinking can permanently alter the physical structure of your organs. The heart muscle can weaken, diminishing its ability to pump efficiently throughout the body. "There is an increased risk of cardiomyopathy in these patients, where the heart's pumping becomes compromised," Dr Menon said. "It also affects the liver, causing a fatty liver and eventually cirrhosis. Binge drinking causes higher blood alcohol levels, which in turn have negative effects," he added.

Binge drinking 4-5 drinks in one sitting on weekends, even if you abstain on weekdays, puts major strain on both heart and liver, warns Dr Ajit Menon.

Dr Menon's 5 rules for safer drinking

For those who choose to consume alcohol, mitigating these risks required breaking the binge cycle and establishing intentional boundaries. If you drink, Dr Menon advised following the five essential practical rules:

⦿ Don’t 'save up' drinks for the weekend. Consuming your weekly total across one or two nights creates a spike in toxicity that your body cannot easily process.

⦿ Eat before and while drinking. Food in the stomach slows down the rate of alcohol absorption, preventing rapid surges in blood alcohol concentration.

⦿ Alternate alcoholic drinks with water. Hydration helps pace your consumption and reduces overall strain on your system.

⦿ Avoid combining alcohol with energy drinks. Mixing stimulants with depressants can mask intoxication levels, leading to higher intake and elevated cardiovascular strain.

⦿ Plan alcohol-free weekends periodically. Giving your body extended breaks allows the liver and cardiovascular system time to recover.

Moderate and deliberate choices make all the difference, as Dr Menon advised, "If you choose to drink, do so slowly and within recommended limits."

About the expert

Dr Ajit Menon, director of cardiology at Sir HN Reliance Foundation Hospital, Mumbai, is a heart specialist who has performed 10,000+ procedures. With over 30 years of experience, he is an expert in stents, TAVR and complex heart treatments.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.