Is Any Alcohol Consumption Healthy?

In a widely publicized report in The Lancet in 2018, researchers concluded that there is no healthy level of alcohol consumption. This drastic switch from the widely-accepted view that moderate consumption is not harmful — received a lot of attention.

The study authors’ conclusion that: “Our results show that the safest level of drinking is none,” made headlines on major news outlets like the CNN, BBC, and The New York Times.

A re-evaluation of The Lancet study results, however, may bring a sliver of hope to moderate drinkers (as well as more confusion to others.)

In a recent article in JAMA Internal Medicine, researchers took another look at the data in The Lancet study and found that the risks of alcohol consumption may have been overestimated. Since the study relied on participants to report their own consumption levels — and those who abuse alcohol tended to under-report how much they consume — findings were skewed. The study likely concluded moderate consumption has as many health risks as heavy consumption, yet many of the “moderate drinkers” were actually drinking more heavily and not being honest.

So, what does this mean for you as you navigate the pros and cons with drinking?

Experts say, if you enjoy a glass of wine every now and then, you are not doing harm to the body, and may even be lowering your risk for heart disease.

But, like anything in life, it’s all about balance. If alcohol becomes a crutch for pain relief, social anxiety, or to aid with sleep, it may quickly become an addiction.

The cons of daily drinking range from somewhat minor issues — for example, that nightcap you rely on to fall asleep can also wake you up later — to more serious concerns, such as an increased risk of several types of cancer.

The first thing you should know is that if you don’t drink, you should not feel compelled to start. The potential health benefits of drinking aren’t strong enough to change your lifestyle or introduce the possible drawbacks of alcohol. But if you do already imbibe, the science is showing that there appears to be an alcohol “sweet spot” — the just-right amount to get the possible health benefits, without introducing new risks.

So How Much is Just Right?

There are no recommendations for how much we should drink to get the health benefits, but the Dietary Guidelines for Americans suggest that we don’t exceed one drink per day for both men and women. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits.

Again, the key is balance and many experts warn that daily drinking is never good for long-term health, plus one drink tends to lead to another. So if you want to reap the antioxidant benefits from red wine, for instance, addiction specialists would still advise not drinking it every day. Talk with your physician and be honest if addiction runs in your family.

Here’s some information on how alcohol might help and hurt, so you can better decide if any amount is right for you. Use this to start a conversation with your doctor, which should include a review of your own health history:

Alcohol Can Boost "Good" Cholesterol

It’s probably the best-known substance to raise HDL levels, which can be important for people who tend to have low HDL to start with, and it might be the reason that moderate alcohol consumers seem to be at less risk for cardiovascular disease.

One drink a day have been shown to increase HDL cholesterol by about 12 percent; and that extra HDL isn’t just hanging around — it seems to help remove LDL (“bad” cholesterol), helping to keep arteries clear and free of clogging plaque. And you don’t need to drink red wine to get the cholesterol-boosting benefit, either; any kind of alcohol appears to be helpful.

Alcohol Can Reduce — or Increase — Inflammation

Diseases as varied as diabetes, Alzheimer’s, Lupus, and cancer are being linked to chronic inflammation — a constant low-grade immune state. Alcohol has the ability to suppress or reduce inflammation to a degree.

A small trial indicated that consuming moderate amounts of alcohol was useful for reducing C-reactive protein, which is produced by the liver and is an indicator of inflammation and a predictor of heart trouble. But there’s a catch: When you start increasing your intake beyond moderation, drinking can contribute to inflammation. Therefore, this is really just telling you that an occasional spirit is not going to increase your risk for these diseases, and if you have a genetic history for them, an occasional spirit may actually be good for you.

Alcohol is Linked to Cancer

Drinking increases the risk of some types of cancer, including those of the mouth, head, neck, esophagus, liver, colon, rectum, and breast. There are many ways that alcohol may promote some cancers. As our bodies metabolize the ethanol in alcohol, it breaks down to acetaldehyde, a chemical that may damage DNA. Alcohol irritates tissues in the mouth, throat, colon, rectum, and liver; it also reduces levels of beneficial vitamins and adds extra weight.

Alcohol may influence breast cancer by increasing levels of estrogen and other hormones in the body. In fact, each drink per day is associated with a 10- to 12-percent increased risk of female breast cancer, and drinking less is one simple way women can reduce their risk of the disease. On the other hand, drinking is associated with a lower risk for two kinds of cancer — non-Hodgkin lymphoma and renal cell (kidney) cancer — another indication of just how confusing this subject can be. But be aware that all alcohol has sugar, and too much sugar is linked with diabetes and belly weight — which is connected with higher health risks. Bottom line, daily drinking should not be your goal.

Alcohol Affects Your Brain Health

Moderate consumption could give your brain a boost and even reduce your risk for dementia. That’s what a large review of 23 long-term studies of people 65 and older found. Light-to-moderate drinkers also seemed to have fewer depression symptoms and better thinking and memory skills.

But keep refilling your glass and these benefits disappear, hastening a decline in memory and cognitive functioning. Heavy drinking is linked to nerve cell damage, brain shrinkage, and even permanent neurological impairment.

Alcohol Can Harm Your Sleep

At the end of a tough day, a glass of something delicious can seem just the thing to transition a little more easily into a peaceful slumber. And because alcohol is a depressant, it does work that way — for a few hours, anyway. After that, you may find yourself making more trips to the bathroom (alcohol is a diuretic, meaning it makes you need to pee).

And while a drink or two (or more) can help you fall asleep, studies make clear that alcohol has a sort of “rebound” effect, particularly at higher doses. By the second half of the night, its sedating effects have worn off and you may find yourself tossing and turning, or even wide awake in the wee hours. If alcohol is used over time as a way to bring on shut-eye, it can even lead to long-term, disrupted sleep.

Alcohol Can Pack on Pounds

It’s easy to forget the caloric impact of a couple of cocktails. Consider that one 6-ounce glass of wine contains about 120 to 140 calories, one 12-ounce beer adds 145 calories (more if it’s a malt ale) and a standard margarita has 170 calories. Fruity, sugar-laden drinks like a piña colada do even more damage — just one packs roughly 260 calories.

Not to mention, alcohol seems to be an appetite-enhancer, making it hard to forgo, say, a side order of wings with that frosty beer. Plus, when you drink you’re likely to loosen up inhibitions a bit and eat more.

Alcohol Can Lead to Liver Damage

Drinking damages cells of the liver, which converts nutrients from the food we eat and detoxifies harmful substances. Heavy drinking can cause liver diseases including fatty liver and cirrhosis. (The Centers for Disease Control and Prevention defines heavy drinking as eight or more drinks a week for women, and 15 or more weekly for men.)

The more you weigh, the greater the effect alcohol seems to have on the liver, according to multiple studies. Women, too, seem to be at higher risk of liver disease if they drink even moderately, compared to men.

Make the Right Choice for Your Health

As mentioned, striking a balance is key. For some people, though, such as those with an increased risk for breast cancer, or a family history of addiction, drinking is not worth the risk. The benefits are mild, and can be boosted in other ways, through exercise, healthy eating, meditation, joining social groups, or finding hobbies.

It’s also important to keep in mind that the guidelines for moderate drinking are less than what some of us are inclined to follow, as one drink often leads to others. Many of us drink more erratically: You might skip alcohol during the week but enjoy several cocktails Friday after work. Research shows that excessive drinking on weekends is never protective and often is indicative of a problem.

Talk with your doctor honestly about your alcohol consumption — whether you can have a drink and leave it, or get on a slippery slope of consuming more once you start. Your physician can also factor in your medical and family history, and will know whether you’re already at increased risk for, say, colorectal, mouth, or breast cancer, or whether you shouldn’t mix alcohol with your medications.