Alcohol, an irritant to the liver and other parts of the digestive tract, may be used by the body for immediate energy, or stored in the liver or in the rest of the body as fat. Unfortunately, the liver cannot convert alcohol to a storage form of glucose. As a result, the amount of fat stored in the liver increases with excessive alcohol use. Alcohol raises the liver enzyme level, leading to liver inflammation (or hepatitis). Eventually the chemical byproducts of alcohol and the fat derived from alcohol can cause scarring and shrinkage of the liver, leading to its functional impairment and cirrhosis. In addition, alcohol irritates the lining of the upper digestive tract, including the esophagus, stomach, and upper part of the small intestine. It also causes irritation and inflammation of the pancreas. Over time, this can result in worsening of hypoglycemia and diabetes, as well as impaired absorption and assimilation of essential nutrients from the small intestine. Some of these nutrients, such as B vitamins, are necessary to stabilize these conditions.

The nervous system is particularly susceptible to the deleterious effects of alcohol, which readily crosses the blood-brain barrier and actually destroys brain cells. Alcohol can cause profound behavioral and psychological changes in women who drink it excessively. Symptoms include emotional upset, irrational anger, emotional outbursts, poor judgment, loss of memory, mental impairment, dizziness, poor coordination, and difficulty in walking.

Symptoms of emotional upset triggered by alcohol can also be due to candida overgrowth, since candida thrive on the sugar in alcohol. Alcohol can, thus, promote a tendency toward chronic candida infections. Women with candida-related mood upset and fatigue should avoid alcohol entirely. Furthermore, many women with allergies are sensitive to the yeast in alcohol, which worsens their allergic symptoms.

Fermented Alcoholic Beverages

• Ale
  
• Beer
  
• Port
  
• Sherry
  
• Stout
  
• Wine
  
• Bourbon
  
• Gin

• Rum
  
• Rye
  
• Scotch
  
• Vodka
  
• Whiskey

When taken carefully, not exceeding 4 ounces of wine per day, 12 ounces of beer, or 1 ounce of hard liquor—alcohol can have a delightfully relaxing effect in women who are healthy. As mentioned earlier, it can make us more sociable and enhance the taste of food. For optimal health, however, I recommend drinking alcohol no more than once or twice a week. Women with preexisting health problems, particularly estrogen related problems like PMS or fibroid tumors of the uterus, should avoid drinking alcohol entirely when they are symptomatic. Fortunately, there are many good alcohol substitutes. If you entertain a great deal and enjoy social drinking, try nonalcoholic beverages. A nonalcoholic cocktail, such as mineral water with a twist of lime, lemon, or a dash of bitters, is a good substitute. Near Beer is a nonalcoholic beer substitute that tastes almost like the real thing. Light wine and beer have a lower alcohol content than hard liquor, liqueurs, and regular wine. They can be mixed with mineral waters, crushed ice, or fresh fruit for a variety of delicious low-alcohol drinks.

Sugar and Artificial Sweeteners
Sugar is primarily used as a sweetening agent in the form of sucrose, which most of us know as white, granular "table sugar." It is one of the most overused foods in the Western world. Refined white sugar and brown sugar are the primary ingredients of cookies, cakes, soft drinks, candies, ice cream, cereals, and other sweet foods. In addition, foods such as pasta and bread made out of white flour with the bran, essential fatty acids, and nutrients removed act as simple sugars and also make up a significant part of the diet of many women in Western societies. Many convenience foods (salad dressings, catsup, and relish, to name a few) also contain high levels of both sugar and salt. Some prepackaged desserts and even main courses sold in natural food stores are highly sugared, too, although they are sweetened with fructose, maple syrup, and honey. With sugar so predominant in many foods, it is no wonder sugar addiction is so common in our society among people of all ages. Many people eat sweets as a way to cope with their frustrations and upsets. Statistically, the average American eats more than 120 pounds of sugar per year.

This dietary sugar is eventually metabolized to its simplest form in the body, glucose. Glucose is essential for all cellular processes, since it is the major source of fuel that our cells use to generate energy. However, when we flood our body with too much sugar, it is overwhelmed and cannot process the sugar effectively. This excessive intake can be a major trigger for blood sugar imbalances, food cravings, PMS symptoms, and anxiety symptoms.

It happens like this: unlike simple carbohydrates such as whole grains, beans, and peas, which digest and release sugar slowly, food based on sugar and white flour break down quickly in the digestive tract. Glucose is released rapidly into the blood, and from there is absorbed by the cells of the body to satisfy their energy needs. To handle this overload, the pancreas must release large amounts of insulin. This is the hormone that helps drive glucose into the cells where it can be used as energy.

Often the pancreas releases a flood of insulin, more than the body requires. As a result, the blood sugar level goes from too high to too low, resulting in the "roller coaster" of energy you typically see in hypoglycemia or PMS. You initially feel "high" after eating sugar, followed by a rapid crash. (Excessive amounts of stress also use up glucose rapidly and can cause similar symptoms.) When your blood sugar level falls too low, you begin to feel anxious, jittery, "spacey," and confused because your brain is deprived of its necessary fuel. To remedy this situation, the adrenal glands release hormones which cause your liver to pump stored sugar into your blood stream. While the adrenal hormones boost the blood sugar level, they unfortunately also increase arousal symptoms and anxiety. Thus, both the initial brain deprivation of glucose and the adrenal gland's response to restore the glucose levels can intensify symptoms of anxiety and panic in susceptible women.

Several studies have shown the relationship between the overindulgence of simple sugars and resulting PMS symptoms. One study published in the Journal of Applied Nutrition found that women with PMS symptoms had a 50 percent higher sugar intake than normal volunteers. Another study published in the American Journal of Psychiatry found that women with PMS were more likely than others to crave sweets and experience emotional symptoms premenstrually.

With continued overuse of sugar, the pancreas eventually wears out and is no longer able to clear sugar from the blood efficiently. The blood sugar level rises and diabetes mellitus is the result. This tendency towards diabetes or high blood sugar levels increases dramatically after menopause. Studies show that more than 50 percent of Americans have blood sugar imbalances by the age of sixty-five.

Excess sugar can worsen the anxiety, irritability, and nervous tension that many women feel as they transition into menopause. One study even suggests that a diet high in sugar can impair liver function and affect the liver's ability to metabolize estrogen. Highly sugared foods also promote tooth decay and gum disease. Many women, however, are addicted to sugar and have a difficult time controlling their intake once they start eating sugary foods like cookies and candy.

The excessive use of sugar has further detrimental effects on the body. Like caffeine, sugar depletes the body's B-complex vitamins and minerals, thereby increasing nervous tension, anxiety, and irritability. Too much sugar also intensifies tiredness by causing vasoconstriction (the narrowing of the diameter of blood vessels) and putting stress on the nervous system in women with chronic fatigue. Candida feeds on sugar, so overindulging in this high-stress food aggravates chronic candida infections. Many women with chronic candida overgrowth notice a worsening of emotional symptoms like depression and nervous tension. Sugar (as well as caffeine, alcohol, flavor enhancers, and white flour) also appears to be a trigger for binge eating and even bulimia. In fact, research has shown that when women switch from a diet high in sugar to a sugarfree, high nutrient diet, their food addictive behavior tends to cease. After making the switch from a high-sugar diet, women tend to lose or maintain weight more easily and gain relief from the pattern of craving and bingeing. In one small study of 20 women, the women on a nutrient-rich diet (free of sugar and other high-stress foods) were able to remain bingefree for two and a half years.

Because sugar is so deleterious to good health, it is best for menopausal women to avoid sugar entirely or limit its use to small amounts on occasion. It is easy to substitute for sugar in recipes by using fruit, sugar substitutes like aspartame (if you can tolerate them without side effects), or smaller amounts of more concentrated sweeteners. Also, become a label reader. When canned and bottled foods like salad dressings, soft drinks, and baked beans have sugar near the top of the list of ingredients, the product probably contains too much sugar. If so, find alternatives that don't use sugar or only in very small amounts. If you crave sweets, keep fresh or dried fruits in the house like apples, bananas, or dried figs. Whole grain snacks can be a more healthful choice, too. A good example is an oatmeal cookie or a bran muffin sweetened with fruit juice. You can use whole fruit and whole grain products in small amounts to satisfy your craving for sweets; as an added benefit, they provide many essential nutrients. Instead of disrupting your mood and energy levels, these foods may actually have a healthful effect on the body. If you have hypoglycemia or PMS related blood sugar imbalances, you should avoid simple sugar entirely. Instead, eat a good amount of complex carbohydrates such as whole grains, potatoes, fruits, and vegetables. The sugar in these foods is digested slowly and released gradually into the blood circulation. Thus, the amount of sugar released never overwhelms the body's ability to process it. For even more blood sugar control, combine complex carbohydrates with protein and essential fatty acids. I usually recommend that patients eat foods like tuna fish on toast, and sesame or almond butter on rice cakes.

In an attempt to reduce table sugar intake and other sweeteners, many women will resort to using artificial sweeteners. Unlike natural sweeteners, which are extracted from real food and do have nutritive value as sources of energy, artificial sweeteners are strictly products of the laboratory. They have a sweet taste but no inherent nutrient value.