Water, Coffee and Alcohol: A look at vocal fold viscosity

In the 1990s Castrol Oil published a very effective commercial in the United States cautioning the consumer about “viscosity breakdown” of their motor oil. That may have been the first time I learned about the term viscosity and I thought of the term as a positive one.

In short, motor oil needs to be viscous–thick and difficult to break down.

For the mucous cover of the vocal folds, it is the opposite. We want our vocal folds to be flexible, therefore less viscous and

“the oil in our vocal machine” is water.

Proper hydration keeps our skin from getting dry, keeps our muscles working efficiently, facilitating motion in our joints, and keeps the mucous system throughout our body from becoming too viscous. This excellent, short article from SportsCardiologyBC gives a good outline of the issues of performance relative to hydration.

The linked article recommends 4 liters of water intake for the average male athlete and 3 liters for female athletes. That recommendation is obviously relative to many factors, including: body size, level of physical activity (including singing, especially operatic singing, which is very athletic) and the consumption of diuretics (eliminating water from our body) like caffeinated and alcoholic beverages.

For athletic singers, particularly operatic singers who must produce powerful sounds without the usage of microphones, proper hydration is vital. And for many singers, a great danger is lifestyle and the unconscious choices we make in a social environment saturated with incentives to drink caffeinated drinks and alcohol.

“I grew up drinking caffeine and alcohol very early in life and felt relatively immune to the negative effects because of “higher tolerance.” Until I wasn’t.”

My recent years in Sweden exacerbated my use/abuse of alcohol, where the control of alcohol access represents an underlying widespread abuse and I believe encourages a tendency to hoard alcohol since it is only available in state-controlled stores. I experienced this also 25 years ago when I lived in Utah for a year. The Mormon religion forbids alcohol but whenever I visited the only liquor store in my town back then, I was shocked to see people purchasing shopping carts full of alcohol beverages (just like in Sweden) when I bought my couple of bottles of wine, vodka and amaretto once a week. In a town that was nearly 100% Mormon (I knew pretty much all the non-Mormons in town. We were very few) how was it that the store was full of people buying cartloads? I drink considerably less since I decided to spend the majority of my time outside of Sweden. There are many reasons why alcohol is routinely abused in Sweden and I experienced them firsthand. But that is for another article.

After a few unusual alcohol-related incidents which gave me pause, I begin reducing my alcohol intake as a whole, including several times stopping altogether.

I expected to see a considerable improvement in my singing. But surprise! I did not! Why?

I am also a coffee drinker but I don’t drink more than one cup of coffee or tea a day. That should not make that much of a difference. What makes the biggest difference is that for years, I have not been drinking enough water. If 4 liters is the recommended norm for an athlete, I have been drinking less than half of that for a long time.

In other words, I have been in a state of near dehydration constantly and have been used to it as normal.

This is were lifestyle choices matter! Coffee, tea, and alcohol have been uplifted socially to the point that those that do not partake are considered “not normal.” Coffee and alcohol have become synonymous with meetings and social encounters of all kinds. This was different a generation ago when I first began drinking alcohol more regularly. This was when I worked as a chorus member at the Spoleto Festival of Two Worlds beginning in the summer of 1986.

A few practices in Italy came with the flow of life. In Italy, the glass of wine with meals was accompanied with carafes of water. The chorus master and managers required that we all have 2-liter bottles of water with us at all times because Spoleto in the summer is hot and we needed to stay hydrated to perform properly. Coffee in Italy came in the form of espressos and cappuccinos, which were less caffeinated than long coffees and were imbibed, as with everything in Italy at the time, in moderation.

In recent times, with coffee shops like ‎Starbucks® and Coffee Fellows, and others, in every corner, and alcohol becoming normalized socially, alcohol and coffee have become substitutes for water in our lives. This happens unconsciously to many singers, who are not aware that many of their vocal technique woes are due to vocal fold viscosity due to unperceived dehydration.

I have not given up coffee and alcohol entirely, but once in a while I will stop both for a week, while being religious about water intake. This is a way of becoming clear about “my healthy baseline!” For myself, I find that one caffeinated drink and one alcoholic drink a day does not impact my singing noticeably, as long as I have my 4 liters of water a day and even an extra liter to be certain I compensate for alcohol and coffee.

More than one caffeinated drink and more than one alcoholic drink will have a noticeably detrimental effect on “my voice”, including longer warmup time, the voice feeling lower than normal, certain vowels becoming dull and unclear (particularly [a]), and short-term difficulty accessing the passaggio and high range easily–All signs of overly viscous vocal fold mucosa.

The change in my vocal flexibility including a feeling of consistency in my highest range has been life-changing in recent months, since my departure from Sweden. I find myself enjoying Bel Canto repertoire including the highest Rossini challenges with a voice I always assumed was more Wagnerian in nature, particularly since I began my career as a baritone. In that regard, I am forced to consider the difference between the Italian Tenore Eroico (heroic tenor) and the German Heldentenor (also heroic tenor). I will address this in my next blogpost.

The operatic business environment was depressing for many aspiring professionals before Covid-19. Just as one needs to live in Sweden to be aware of the widespread levels of clinical depression, one also must be in the operatic world to be aware of the high levels of clinical depression among opera singers. Meanwhile, the world does its absolute best to promote alcohol as socially required. The combination of widespread depression and alcohol naturally leads to self-medication at different levels. I think we need a research project with respect to alcohol abuse in the operatic milieu. Coffee may be less hurtful but caffeine is also a drug and caffeine abuse is also a problem. The two influences relative to the kind of athletic physical conditioning needed for operatic singing are obviously anathema.

Alcohol and caffeine do not affect everyone equally even if appropriate daily hydration was not a factor. But the combination of alcohol, caffeine and inadequate hydration is a perfect storm for vocal fold viscosity and could in many situations be the first issue to address in terms of vocal technique. I should add that both coffee and alcohol consumption contribute to GERD (Gastro-Esophagial Reflux Disease), more commonly called Acid Reflux, and one of the diseases most reported by opera singers.

My recommendation to professional singers relative to proper hydration relative to vocal fold viscosity: avoid or reduce alcohol and caffeinated beverages and increase water intake to at least 4 liters a day. Naturally proper sleep, healthy nutrition and exercise are also necessary, but those things are obvious. The fact that caffeine and alcohol have been elevated to almost necessary food groups (due to great advertisement efforts by those industries), we singers have to be conscious of our use of these beverages and be personally responsible about how they effect us individually.

No blanket statements can be made about how much caffeine and/or alcohol is harmful to our vocal health at the professional level.

There are people who are even genetically predisposed such that they are less effected by alcohol and caffeine relative to vocal health. Nevertheless, the effects of caffeine and alcohol should be of personal responsibility to every singer who aims to produce operatically viable vocalism. I have met singers who do not drink coffee and alcohol at all and suffer from allergies and have different problems with vocal fold viscosity. I have met singers who live like monks and still have stiff vocal production from pressed phonation. I have also known singers who drink a great deal of coffee and alcohol and sing at a very constantly high level. But the question should be asked:

Are you one who suffers vocally from caffeine and/or alcohol consumption? I know I am! Are you?

Operatic vocal production is difficult enough without exacerbating factors. If you are serious about your singing, eliminating every negative influence to vocal health should be part of your conscious efforts.

© 22 April 2020

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