Tip/Thought of the Day

No, Moderate Drinking Isn’t Good for You

According to the 2021 National Survey on Drug Use and Health (NSDUH), 213.2 million adults ages 18 and older (84.0% in this age group) reported that they drank alcohol at some point in their lifetime and roughly 52% reported they drank in the past month. One source stated that the alcoholic beverage sector is entering a new “Golden Age” due to market access, favorable taxes, and growing consumer demand. In 2021, the global market size of alcoholic beverages amounted to 1.45 trillion U.S. dollars. This represented an increase of 72 billion dollars over 2019. These numbers may not be surprising though, as more than 60% of Americans increased their drinking levels during the COVID lockdowns.

The short story: alcohol consumption has risks

The increase in alcohol consumption is no doubt partially bolstered by the mixed messages we’ve heard as far as the risks and benefits. Like that a glass of red wine a day can potentially benefit heart health, moderate drinking can lower cholesterol, and increase blood flow. And then we hear that no alcohol consumption is healthy. While older studies have largely shown low risk, even benefits to light-to-moderate drinking, more recent studies are now widely uncovering that’s just not the case.

Some risks of alcoholic use are well-known, like cirrhosis of the liver or Alcoholic Fatty Liver Disease (AFLD) as a result of prolonged, heavy consumption. According to the CDC, drinking alcohol raises your risk of getting six kinds of cancer:

  • Mouth and throat.
  • Voice box (larynx).
  • Esophagus.
  • Colon and rectum.
  • Liver.
  • Breast (in women).

The CDC shares other long-term risks include:

  • High blood pressure, heart disease, stroke, liver disease, and digestive problems.
  • Weakening of the immune system, increasing the chances of getting sick.
  • Learning and memory problems, including dementia and poor school performance.
  • Mental health problems, including depression and anxiety.
  • Social problems, including family problems, job-related problems, and unemployment.
  • Alcohol use disorders, or alcohol dependence.

What exactly equates “a drink”?

The image below shows the alcoholic equivalent of a “standard drink”. A significant issue as people self-evaluate their consumption is that portions are most often not served along these guidelines. Ultimately this leads people to believe they are drinking less than they actually are. One-topped off glass of wine in reality could actually be 2-3 portions, significantly increasing a variety of health risks.

The image above shows the alcoholic equivalent of one “standard drink”. In the United States, that is defined as any beverage containing 0.6 oz or 14 grams of pure alcohol. Keep in mind that this doesn’t reflect customary portions of drinks. Image courtesy of rethinkingdrinking.niaaa.nih.gov

New studies highlight significant flaws in previous research

Many older studies that concluded light or moderate drinking could actually be beneficial to our health were largely observational; other study-related flaws have resulted in a wide range of information asserting that moderate drinking was low-risk, even beneficial. Observational studies can show associations, but results don’t definitively point towards causation.

In fact, when it comes to previous studies, many of them ignore that other lifestyle habits of people that are light or moderate drinkers (no more than 2 drinks/day for men and no more than 1 drink/day for women) are more likely the reason behind results showing a decrease in health risks. One source shared that moderate drinkers tend to be “moderate in all ways”. Examples include having habits like regularly exercising, consuming a higher quality diet, earning a higher income, and even having better dental health- all factors that heavily influence health outcomes, and are not associated with alcohol habits.

A new review, published in Jama Network Open, April 2023, evaluated over 100 studies of nearly 5 million adults that had consistently found moderate drinking was tied to decrease risk of all-cause mortality. The researchers involved in the review adjusted for study flaws and biases in previous studies. In doing so, “the appearance of the benefit from moderate drinking greatly diminishes and, in some cases, vanishes altogether,” said study co-author Tim Stockwell.

One large issue with previous studies is that former drinkers-turned-abstainers were often lumped in with non-drinkers, despite often already having developed health issues related to their previous drinking habits. The new analysis found that former drinkers actually have a 22% higher risk of death compared to abstainers. Their presence in the “non-drinker” group biases the results, creating the illusion that light daily drinking is healthy, Stockwell said.

Another recent study had similar results, showing that moderate drinking does not account for decreased risk of cardiovascular disease. In the cohort study, favorable lifestyle factors were also found to diminish the supposed (and observational) benefits of modest alcohol consumption. The study had nearly 38,000 participants from the U.K. Biobank (2006-2010, follow-up until 2016), which is a large-scale biomedical database. The data showed that the risk of cardiovascular disease linked to light alcohol consumption was modest but rose exponentially with higher intake, even at intake levels currently endorsed as “low risk.”

Cut back on alcohol, for prolonged health

As new studies uncover the risks behind alcohol use, it is becoming clearer that the less you drink, the better. It can be a challenge, with many people reporting that factors including stress levels, family history, social influence and pressure, and mental health all impact whether they drink or not. Reducing the amount of alcohol you consume is a smart choice. While it is true that the alcohol market is flush with options, there are just as many new choices for non-alcoholic spirits and fantastic recipes to mix satisfying, refreshing, healthy drinks.

If you are struggling with controlling your alcohol consumption, speak to your provider or find support resources here.















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