Part of the challenge in trying to find clear answers about the benefits and risks of moderate alcohol consumption is that there’s no standard definition of the term “moderate drinking.” In some studies it means less than one drink per day, while in others it means three or four drinks per day. In addition, there’s no standard agreement about what constitutes a “drink.” In the U.S., this is generally defined as 14 grams of pure alcohol, which equates to 1.5 ounces of hard liquor (40 percent alcohol content), 5 ounces of wine (12 percent alcohol content), or 12 ounces of beer (5 percent alcohol content). However, the alcohol content in different beverages varies and most studies are retrospectives in which participants self-report how much they thought they drank and therefore most likely do not measure precise amounts.
The Dietary Guidelines for Americans published by the U.S. Department of Agriculture (USDA), recommend that if people consume alcohol, they do so in moderation, which is defined as up to one drink per day for women, and up to two drinks per day for men. This refers to the amount consumed on a single day and is not meant to be an average over several days. These recommendations for moderate consumption are echoed by the American Cancer Society and the American Heart Association.
Diving Into the Debate: Possible Benefits of Moderate Alcohol ConsumptionLet’s look first at the claims about the health benefits of moderate drinking.
Heart Health Benefits
Over the past several decades, many studies have found a correlation between red wine consumption and reduced deaths in some populations. In 1992 researchers Serge Renaud and Michel De Lorgeril published a study in The Lancet called “Wine, alcohol, platelets, and the French paradox for coronary heart disease.” The authors observed that even though French people consumed high levels of saturated fat, their death rate from coronary heart disease was lower than their counterparts in the U.S. and the U.K. who had a similar diet with respect to saturated fat. Citing epidemiological studies, the authors stated that this “French paradox” could be partially attributed to the high level of red wine consumption in France.
However, further examination of the original study revealed that the population with the most benefits also ate more fruits, vegetables, polyunsaturated fats, and dietary fiber, so there are probably other factors at play beyond the consumption of red wine. That said, red wine does contain a few elements that can help heart health, including:
- Polyphenols—antioxidants that may protect against damage associated with heart disease and cancer. Polyphenols are commonly found in many fruits and vegetables, such as dark grapes, berries, red cabbage, broccoli, green tea, and apples.
- Resveratrol—one of the beneficial polyphenols found in small concentrations in the skin of dark grapes and hence in red wine. Research has shown that resveratrol can prevent platelets in the blood from sticking together and creating clots, thus reducing the risk of heart attack or stroke. It can also reduce inflammation. However, researchers have found that people would have to consume an enormous volume of wine (with estimates ranging from 100 glasses to 1,000 glasses a day) to get enough resveratrol to create a significant health benefit. In short, any health benefits that come from consuming red wine do not likely come from this compound alone.
Beyond Red Wine
Research shows that moderate consumption of all types of alcohol, not just the alcohol in red wine, may help with heart health because it has some anti-clotting properties and contributes to small increases in HDL cholesterol—the “good” cholesterol. However, regular physical activity and some nutrients (niacin) and herbs (such as guggulu) may also raise HDL cholesterol.
Final Thoughts on Alcohol and Heart Health
Low to moderate alcohol consumption may have some possible health benefits, including a lower risk of heart disease. However, this is not a reason to start drinking and the American Heart Association does not recommend drinking wine or any other alcoholic beverage in order to gain these potential benefits.
Other ways to reduce heart disease risk include:
- Not smoking
- Staying physically active
- Controlling blood pressure
- Maintaining a healthy weight
- Eating a plant-based diet low in trans fats
Alcohol as a Stress ReducerAnother health claim about alcohol is that moderate drinking can reduce stress and promote relaxation. While it’s true that alcohol can reduce the body’s physiological stress response, there are risks to relying on a drink to modulate your mood, including the obvious danger of alcohol dependence. There is a tendency to need greater and greater quantities of alcohol to feel relaxed, which will ultimately create more, rather than less, stress in your body. Also, there can be a dose-response effect, for example, with one drink causing relaxation but two drinks causing a stress reaction in the body. There are much more effective and risk-free ways to relax and unwind after a long or stressful day, including:
- Deep breathing
- Physical activity
- Connecting with others
Health Risks of AlcoholWe’ve seen that the health benefits of drinking alcohol are not cut and dry. What about the risks? As you will see, there are many.
Chronic alcohol consumption can damage the liver, causing inflammation and scarring (cirrhosis). This can cause abnormal function of the liver (which has over 500 functions) and eventually can lead to liver cancer. Alcohol may also slow down the body’s ability to detoxify or get rid of harmful chemicals, which can contribute to illness.
Alcohol consumption is a known cause of cancers of the mouth, throat (pharynx), voice box (larynx), esophagus, liver, breast, colon, and rectum. Alcohol may also increase the risk of cancer of the pancreas. For each of these cancers, the risk increases with the amount of alcohol consumed. In addition, when people smoke as well as drink, their risk of developing these cancers increases far more than if they only smoke or consume alcohol alone.
According to research findings, women who have just a few drinks a week may have an increased risk of breast cancer. Some of this risk may be due to the fact that alcohol can lead to increased estrogen levels in the body. As a study published in The American Journal of Clinical Nutrition found, for women who don’t get enough folate (a B vitamin) in their diet or through supplements, this risk may be further increased. Low levels of folate are also correlated with increased risk of colorectal cancer in both men and women.
Alcoholic beverages have calories with few nutrients (empty calories) and may contribute to weight gain. The calorie content of alcoholic beverages ranges greatly. For example, a 12-ounce light beer has 100 calories, while a 9-ounce piña colada has a hefty 490 calories, which is about 25 percent of the recommended daily calories for a moderately active adult woman.
While research shows that chronic alcohol abuse is associated with weakened immune function, a recent study of healthy, young adults demonstrated that a single episode of binge drinking can lower immunity immediately. Within two hours of drinking enough alcohol to reach or exceed the legal blood alcohol limit for driving (up to five shots of vodka), the study participants had significantly decreased immune activity from that assessed immediately before drinking. These effects can last for several days. Lowered immunity can increase the risk of infections.
To Drink or Not to Drink?From the evidence presented above, it’s clear that the health risks of moderate drinking far outweigh the benefits, which have been greatly exaggerated in the media. As the USDA Guidelines recommend, don’t begin drinking or start to drink more frequently to gain potential health benefits because moderate alcohol intake is associated with increased risk of the diseases and health issues we’ve discussed—as well as an increased incidence of violence, drowning, injuries due to falls, and motor vehicle accidents.
My take is this: if you drink, do so in moderation and not every day. If you’re drinking because you think it will benefit your health, try some other tools and techniques that will give you natural health benefits with no side effects, such as eating a rainbow of vegetables and fruits for beneficial phytonutrients, meditating for stress relief, and spending time with people you love.