The Troubling Truth About Drinking in Moderation

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It turns out that drinking moderate amounts of alcohol daily does not—as previously thought—protect against heart disease or contribute to a longer life. Apologies if your alcohol consumption depends in part on this popular belief and (until now) useful rationalization.

For decades, scientific studies suggested moderate drinking was better for most people’s health than not drinking at all, and could even boost longevity. But, a new analysis of more than 40 years of research has concluded that many of those studies were flawed and that the opposite is true.

Just published in JAMA Network Open, this meta-analysis reviewed 107 observational studies that involved more than 4.8 million people. The massive study stressed that previous estimates of the benefits of moderate alcohol consumption on the risk of death by “all causes”—meaning anything, including heart disease, cancer, infections, and automobile accidents—were “significantly” biased by flaws in study design.

According to the researchers, earlier research did not adjust for numerous factors that could influence the outcome, for example, age, sex, economic status, and lifestyle behaviors such as exercise, smoking, and diet. Using statistical software, they essentially removed such bias, adjusting for various factors that could skew the research. After doing so, there were no significant declines in the risk of death by any cause among the moderate drinkers. [1]

While these previous observational studies could identify potential links or correlations, they could also be misleading and didn’t prove cause and effect. Moreover, they failed to recognize that many light and moderate drinkers had other healthy habits and advantages and that non-drinkers used as a comparison group often included people who had given up alcohol after developing health problems.

This represents the largest study to effectively call B.S. on the widely held belief that moderate drinking of wine or other alcoholic beverages is healthy. In contrast, it found that the risk of numerous health problems, as well as that of dying prematurely, increased significantly after less than two drinks per day for women and after three per day for men.

This data adds to that of another substantial meta-analysis from 2022 in which researchers in Britain examined genetic and medical data of nearly 400,000 people and concluded that alcohol consumption at all levels was associated with an increased risk of cardiovascular disease. [2]

The modern-day belief that daily alcohol consumption promotes health emerged in the 1980s, when researchers identified the so-called “French paradox,” which suggested that low rates of cardiovascular disease among men in France was associated with daily wine consumption. Although later analyses found flaws in the research, the idea that moderate drinking improved health became broadly accepted. Wine—particularly red wine—developed a reputation for having health benefits after news stories highlighted its high concentration of resveratrol, a protective antioxidant also found in blueberries and cranberries.

However, the hypothesis that moderate alcohol use is health-enhancing has come under increasing scrutiny over the years as the alcohol industry’s role in funding research became clear, revealing that many of the studies that purport the alleged health effects of alcohol have been funded by that industry. A 2020 report found that 13,500 studies have been directly or indirectly paid for by the alcohol industry. [3] Concurrently, a range of other studies has found that even moderate consumption of alcohol—including red wine—may contribute to cancers of the breast, esophagus, head, and neck; high blood pressure; and atrial fibrillation, a serious heart arrhythmia.

Dietary guidelines for Americans 2020-2025 recommend that adults limit alcohol intake to two drinks or fewer a day for men and one drink or less for women, adding “that drinking less is better for health than drinking more.” The guidelines also warn that even drinking within the recommended limits may increase the overall risk of death attributable to various causes, including some types of cancer and heart disease, even at levels of less than one drink per day. [4]

This past January, Canada issued new guidelines warning that no amount of alcohol consumption is healthy and urges people to reduce drinking as much as possible. Issued by the Canadian Centre on Substance Use and Addiction, the new guidance was a significant departure from its 2011 guidelines, which recommended women limit themselves to no more than 10 standard drinks a week and men no more than 15. [5]

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Alcohol is the most used recreational drug, and unfortunately, for those who enjoy drinking for relaxation and recreation, this is unwelcome news. As comforting as it might be to think that it’s good for one’s health, increasingly the science simply does not support it. The extensive new research decimates the hope of many that moderate alcohol use is healthy and makes clear that people should not drink alcohol for the express purpose of improving their health. If maintaining and/or improving health is your priority, in terms of alcohol consumption, less is more.

Copyright 2023 Dan Mager, MSW

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