For hundreds if not thousands of years, humans have had a complicated relationship with alcohol. It has served as religious and cultural institution in many societies. For example, in current university culture, alcohol plays an enormous role in social norms. At the same time, alcohol’s health effects are equally enormous. According to one study 12.5% of the US population will suffer alcohol dependence in their life, and the toll on individuals and their families can be devastating.
I’ve recently been reading some of the work of Professor Carl Hart, who has called into question what the true burden of addiction is in the US, and how that should shape our health policy. I’d like to blog about more of his work in future posts, but here he raises the issue of moderate alcohol consumption and beneficial health effects. I’ve heard in the past claims like “red wine will extend lifespan”, and so I thought I would take the opportunity to explore the literature myself. I utilised several online resources including Stop Overdose IL’s handy guide on how to find a rehab facility near you to come to my conclusion(s).
First and foremost, excessive drinking (defined by CDC as >8 drinks per week for women and >15 drinks per week for men) is hands down bad for your health. It is associated with increased risk of heart disease, cancer, and mental and social health problems. http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm.
What about moderate drinking though, which the CDC defines as no more than 1 drink per day for women and no more than 2 drinks per day for men? Well, for starters, the CDC doesn’t make any statement one way or the other on their website, which suggests it’s still a controversial statement. However, they do state the following,
“The Dietary Guidelines also state that it is not recommended that anyone begin drinking or drink more frequently on the basis of potential health benefits because moderate alcohol intake also is associated with increased risk of breast cancer, violence, drowning, and injuries from falls and motor vehicle crashes.”
If we look to the National Institute on Alcohol Abuse and Alcoholism, on their website, they state that
“Research also shows that drinking moderate amounts of alcohol may protect healthy adults from developing coronary heart disease.”
If we look to resources with expert review like the Merck Manuals, they make a statement that “… low to moderate levels of alcohol consumption (? 1 to 2 drinks/day) may decrease the risk of death due to cardiovascular disorders.” The site UpToDate.com, another expert-generated resource, takes a more emphatic stance, stating that “Total mortality is reduced (about 18 percent) in men who drink one to two drinks daily and women who drink one alcoholic drink daily, compared to nondrinkers.” This statement is largely derived from a 2006 meta-analysis. .
Lastly, (and sorry to get too wonky on the details), I spent a fair amount of time searching the primary literature. What I found was that most systematic reviews found protective effects of low-moderate alcohol use, but it was also a mixed bag, with some studies suggesting there was no benefit. For example, this meta-analysis, this study of a Mendelian randomization, or this critique on the confounding factors in alcohol studies.
Generally when we see conflicting results in the literature, it means that we need more data in order to find the truth. So, the answer to the question, “Does moderate consumption of alcohol offer health benefits?”