Drinking Alcohol Responsibly on a Renal Diet

By Maria Karalis, MBA, RD, LDN

Drinking Alcohol Responsibly on a Renal Diet

Over 50% of American adults drink alcohol. Alcohol may have beneficial effects when consumed in moderation. This article will review what moderate drinking is, what is a serving size, and the health benefits of drinking.

Check With Your Doctor
Some people should not drink alcohol beverages at all because they may be more susceptible to its harmful effects. Some prescription or over-the-counter medications can interact with alcohol. Alcohol alters the effectiveness or toxicity of many medications, and some medications may increase blood alcohol levels.

Always check with your doctor for advice about alcohol intake.

What is Moderate Drinking?
Moderate drinking is defined by the federal government’s Dietary Guidelines for Americans as consuming no more than one drink per day for women and no more than two drinks per day for men. The difference in limits for men and women is based on how differently men and women weigh and how differently their bodies process alcohol.

A standard serving of beer, distilled spirits, and wine each contains the same amount of alcohol. Distilled spirits are alcohol beverages that are first fermented and then distilled. There are many types of distilled spirits, including whisky, vodka, rum, bourbon, gin, brandy, and liqueurs. Regardless of how they are made, distilled spirits, beer, and wine all contain alcohol.

How Much Alcohol is in a Serving?
A standard serving of beer, distilled spirits, or wine each contains the same amount of alcohol. It is important to know this so you can plan to drink responsibly.

The following amounts count as one drink:

  •     12 ounces of regular beer (150 calories);
  •     5 ounces of wine (100 calories); and
  •     1.5 ounces of 80-proof distilled spirits (100 calories).


How Do Alcoholic Beverages Compare?


Sodium (mg)

Potassium (mg)

Phosphorus (mg)


1.5 ounce jigger




Wine, table, red

3.5 fl oz




Wine, table, white

3.5 fl oz




Beers, all varieties

12 fl oz


60-100 (average)

150 (average)

Martini (gin & vermouth)

2 fl oz cocktail




Manhattan (whiskey & vermouth)

2 fl oz cocktail




Gin and tonic

7.5 fl oz cocktail




Pina colada

4.5 fl oz cocktail





2 fl oz cocktail





Watch the Calories
There are no nutrition benefits from drinking alcohol. It provides energy, but no other essential nutrients. Alcohol provides seven calories per gram compared with four calories per gram for carbohydrate and protein, and nine calories per gram for fat. For example, a one-ounce jigger or shot of vodka may be 40%-50% alcohol or up to ½-ounce alcohol. This is about 14 grams and will add about 100 calories.

If you are trying to watch your weight, calories from alcoholic beverages can add up quickly. For example, if you drink a five-ounce glass of wine before dinner every day, this will give you 100 calories per drink or 700 calories for the entire week. Within five weeks, that adds up to one pound of body fat.

Is Red Wine Heart Healthy?
You may have read that moderate consumption of wine may reduce the risk of heart disease. Research findings, however, report that this potential benefit is linked with the alcohol in all beverage alcohol — distilled spirits, beer, or wine. Possibly a small amount may increase the “good” cholesterol or HDL cholesterol and help keep the “bad” cholesterol or LDL cholesterol from forming. Research is not conclusive, so don’t start drinking thinking that you are protecting your heart. There are other things you can do that will offer protection against heart disease:

  •     Following your renal diet;
  •     Sticking to your dialysis regimen and prescribed medications;
  •     Exercising; and
  •     Not smoking.

Diabetes and Alcohol
If you are diabetic and have good blood sugar control, your blood glucose levels will not be affected by the moderate use of alcohol if taken with meals. If taken on an empty stomach, alcohol can cause your blood sugar levels to become too low. Low blood sugar levels can occur before you are aware of being mildly intoxicated. It only takes two ounces of alcohol or 1-2 drinks to produce low blood sugar levels.

So, the bottom line is: check with you doctor and/or dietitian about drinking alcohol. If you get the OK, always drink with meals, and the amount must be counted in your meal plan.

Dispelling Alcohol Myths

  •     A little “nip” of brandy will not help fight a cold. Alcohol can affect the body’s ability to fight infectious bacteria. Keep in mind, that it may also interfere with the your medication.
  •     Alcohol will not warm you up in cold weather. Alcohol tends to increase the body’s heat loss, making people more susceptible to cold.

Drink Responsibly
People should not choose to drink alcohol for health reasons. For those adults who choose to drink, they should do so responsibly at all times. Alcohol abuse can cause serious health and other problems. Excessive drinking can lead to damage to the heart and brain, increased risk for some cancers, permanent liver damage, and an inflamed pancreas. There is also a body of scientific literature regarding the reported health risks of alcohol consumption generally. And, there are warning labels on all alcohol beverage containers sold in the US.

The advice is: if you do drink, do it in moderation, and make sure you know the potential risks for you. Discuss this with your doctor or registered dietitian.


  •     The American Dietetic Association’s Complete Food & Nutrition Guide, by Roberta Larson Duyff, MS, RD, CFCS, 1998.
  •     Bowes and Church Food Values of Portions Commonly Used. Sixteenth Edition revised by Jean A.T. Pennington, PhD, RD. JB Lippincott Company, 1994.

Drinking Alcohol Responsibly on a Renal Diet - Maria Karalis, MBA, RD, LDN - About the Author
Maria Karalis, MBA, RD, LDN, is a Nutrition Consultant and Writer and has worked in the nephrology field for over 17 years. She enjoys writing for healthcare professionals and people with chronic kidney disease (CKD) with one goal in mind:  helping CKD patients live their life to the fullest. This article was originally published on the iKidney.com website, supported by Watson Pharma, Inc.

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