Alcohol is an important facet in American life. We use it to celebrate, to relax and to bond to one another. People frequently ask me about it. Is alcohol healthy for me? How much is too much? What kind of alcohol should I drink? These are questions that actually have been studied quite a bit by the medical community.

What’s The Data?

When I was in medical school, I co-authored a paper titled Alcohol Consumption: Can We Safely Toast To Our Health? This article was published in Missouri Medicine, the journal of the Missouri State Medical Association. The paper was a review of 49 studies of the effect that alcohol has on our health. A majority of the studies found that moderate alcohol consumption did have a positive effect on cardiovascular health. The type of alcohol consumed did not really matter. The most important factor is how you drink it. Men who drink 1-2 drinks per day and women who drink 1 drink per day have lower rates of heart disease than those who drink more or less than that. We call this a J-shaped relationship because of the J shape made when you put the data on a graph. Drinking 7 drinks on the weekend is not the same as drinking 1 drink per day for a week. In fact, it is much worse for you. It is important to remember that not all beers or glasses of wine are the same. See this chart below:

Below is an excerpt from the paper that I published. I have also included a link to the complete paper:

“Most studies have found a J-shaped relationship between alcohol consumption and health benefits. Moderate daily alcohol use (1 drink/day in women and 1–2 drinks/day in men) has been shown to provide the most benefit. Greater than three drinks per day has been associated with increased morbidity and mortality except for men with coronary artery disease (CAD) in which there is still a benefit with three drinks/day. Binge drinking does not provide the same benefit as moderate daily intake.

There is no data supporting one type of alcohol over another. The most important aspect appears to be amount and pattern of alcohol intake. Moderate alcohol intake has been found to be beneficial in reducing the risk of all cause mortality in addition to cardiovascular mortality and cardiovascular morbidity.

Clinicians should not discourage healthy patients nor patients with cardiovascular disease from moderate daily alcohol intake unless they have obvious contraindications. These contraindications include atrial arrhythmias, liver disease, gastritis, alcoholism, family history of alcoholism, other substance abuse issues and psychiatric illnesses. Patients with excessive alcohol use should be counseled to reduce their drinking to moderate daily intake (1–2 drinks/day).

Physicians should not counsel patients to start drinking alcohol if they currently abstain. At this time there are no randomized controlled trials (RCT) to evaluate the initiation of alcohol as a therapeutic agent. It is unlikely that any RCT will be done on alcohol consumption.” Alcohol Consumption: Can We Safely Toast To Our Health?

The Lancet published another study in August 2018 claiming that no level of alcohol consumption is safe. See an excerpt below:

“Findings

Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5–3·0) of age-standardised female deaths and 6·8% (5·8–8·0) of age-standardised male deaths. Among the population aged 15–49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2–4·3) of female deaths and 12·2% (10·8–13·6) of male deaths attributable to alcohol use. For the population aged 15–49 years, female attributable DALYs were 2·3% (95% UI 2·0–2·6) and male attributable DALYs were 8·9% (7·8–9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0–1·7] of total deaths), road injuries (1·2% [0·7–1·9]), and self-harm (1·1% [0·6–1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2–33·3) of total alcohol-attributable female deaths and 18·9% (15·3–22·6) of male deaths. The level of alcohol consumption that minimized harm across health outcomes was zero (95% UI 0·0–0·8) standard drinks per week.

Interpretation

Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimizes health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.” Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016  

I agree that alcohol does cause major health problems, however, if you look at the findings of this article, it quotes that most major health problems come from overuse. Tuberculosis, cancer, self-harm, and road accidents come from overuse of alcohol, not moderate daily consumption as I mentioned in the first article.

Based on the data at hand, I would recommend the following:

1. Don’t drink to inebriation

2. Don’t drink and drive

3. Don’t mix alcohol with any medications before consulting your doctor

4. Don’t start drinking solely for health benefits

5. Men don’t drink more than 2 drinks per day and women don’t drink more than 1 drink per day

6. Enjoy yourself responsibly

Interested in other tips for living your best life? Read my blog category Every Day Health