Key Points
- Alcohol is one of the key impactors of health in the modern world
- Excessive alcohol intake is socially damaging, results in greater rates of suicide and self-harm and is associated with worse health outcomes for virtually every illness
- However, low intakes are not associated with harm and extremely low intakes may even have health benefits (although this is disputed)
- It is unlikely that people drinking less than 1 drink per day, having alcohol-free days, and having no more than 4 drinks in any one sitting are at greater risk from alcohol than tea-totallers
Systematic reviews of the scientific evidence suggest that a low level of alcohol intake (1-2 drinks per day) is associated with a reduced risk of Alzheimer’s Disease and dementia,1 diabetes,2, 3 reduced HbA1C,4 reduced risk for Ischaemic Heart Disease (IHD),5, 6 and multiple cardiac outcomes,7 improved cardiac markers,8 reduced risk for nasopharyngeal carcinoma,9 and a 10% reduction in total mortality risk,10 and is not associated with kidney function decline11 nor weight gain.12 Evidence for a protective effect of low to moderate drinking on stroke occurrence is lacking13 although light alcohol use appears associated with reduced occurrence of ischaemic stroke.14
A 2013 systematic review while finding (unsurprisingly) that moderate to heavy consumption of alcohol increases the risk of developing cancer of the oral cavity and pharynx, oesophagus, stomach, larynx, colorectum, central nervous system, pancreas, breast, and prostate, failed to find any association between alcohol consumption and an increased risk of cancers of the lung, bladder, endometrium and ovary. It was also observed that alcohol consumption is inversely related to the occurrence of thyroid cancer.15 Other reviews did not find any meaningful association between alcohol consumption and cancer of the ovary16 or glioma.17
Colorectal adenoma is increased at all levels of alcohol consumption18 and oesophageal, and liver cancers are increased even with moderate (approx. 2.5 drinks per day) alcohol use.19
What does this mean?
A recent (2017) systematic review and meta-analysis found that between 3 and 14 drinks per week resulted in reduced all-cause and cardiovascular mortality, while drinking more than 14 drinks per week or ‘binge drinking’ weekly (5 or more drinks in a sitting) was associated with increased all-cause and cancer mortality.20
Therefore, based on this and previous evidence it appears that light drinking of less than 12-14 drinks per week for men and under 3 drinks per week for women is unlikely to offer any significant risk to health and may in fact have some benefits.20, 21
However, it is clear that heavy drinking is detrimental socially, puts one at much greater risk of accident and violence, and increases total mortality risk along with individual risk for nearly every condition that has been studied. Current research conclusively shows that any amount of ‘binge’ drinking is negative, and reverses any benefits from light alcohol use. There are also inherent risks for addiction and abuse arising from otherwise healthy use, and so the recommendation that if you don’t currently drink there is no good reason to start, is a common-sense one. On the other hand, if you do drink it is prudent to keep your intake down to under seven drinks per week, with no more than two drinks per day and ‘alcohol-free’ days each week.
Common-sense tactics
If you currently drink, limit your intake by only buying enough for the week. For example, if you drink beer and are male, buy no more than one dozen beers a week, and preferably buy light beer which would further reduce your alcohol intake. If you finish them, that’s it, no more for that week. If you don’t, roll them over to the following week and don’t restock until they are gone. If you drink wine buying only one bottle of wine per week is a great start.
Also consider the following:
- Have alcohol-free (preferably sugar-free) options available too
- Drink a glass of water between drinks
- Limit drinks to a maximum of 3 on any given day
If you find yourself consistently drinking more than what is recommended for health, consider seeing a health practitioner (counsellor, psychologist, mind-body therapist) who can help you to understand your reasons for drinking and work with you to discover strategies and tactics to reduce or stop your drinking. You can also reflect and do some self-work on why you drink to excess and begin a process of self-discovery.
Note: Alcohol can be problematic for weight-loss. It is not necessarily so, especially if you are drinking within these moderate, healthy limits, but if you are struggling to lose weight reducing or eliminating alcohol for a time can be a great experiment to see what works best for you.
Summary
- Drink less than 12 drinks per week if male and less than 3 per week if female
- Drink no more than 4 drinks in any one day
- Consider reducing drinking further to 1 drink or less each day with alcohol-free days every week
- If you are drinking more than the recommended amounts for health, consider self-work to find the reasons for your drinking and see a health practitioner who can help you to reduce your intake or stop drinking if necessary
References
1. Ilomaki J, Jokanovic N, Tan ECK, Lonnroos E. Alcohol Consumption, Dementia and Cognitive Decline: An Overview of Systematic Reviews. Current Clinical Pharmacology. 2015;10(3):204-12.
2. Knott C, Bell S, Britton A. Alcohol Consumption and the Risk of Type 2 Diabetes: A Systematic Review and Dose-Response Meta-analysis of More Than 1.9 Million Individuals From 38 Observational Studies. Diabetes Care. 2015;38(9):1804-12.
3. Howard AA, Arnsten JH, Gourevitch MN. Effect of alcohol consumption on diabetes mellitus: A systematic review. Annals of Internal Medicine. 2004;140(3):211-9.
4. Schrieks IC, Heil ALJ, Hendriks HFJ, Mukamal KJ, Beulens JWJ. The effect of alcohol consumption on insulin sensitivity and glycemic status: a systematic review and meta-analysis of intervention studies. Diabetes Care. 2015;38(4):723-32.
5. Roerecke M, Rehm J. The cardioprotective association of average alcohol consumption and ischaemic heart disease: a systematic review and meta-analysis. Addiction. 2012;107(7):1246-60.
6. Roerecke M, Rehm J. Alcohol consumption, drinking patterns, and ischemic heart disease: a narrative review of meta-analyses and a systematic review and meta-analysis of the impact of heavy drinking occasions on risk for moderate drinkers. BMC Medicine. 2014;12:182-.
7. Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ (Clinical Research Ed). 2011;342:d671-d.
8. Brien SE, Ronksley PE, Turner BJ, Mukamal KJ, Ghali WA. Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies. BMJ (Clinical Research Ed). 2011;342:d636-d.
9. Chen L, Gallicchio L, Boyd-Lindsley K, Tao XG, Robinson KA, Lam TK, et al. Alcohol consumption and the risk of nasopharyngeal carcinoma: a systematic review. Nutrition & Cancer. 2009;61(1):1-15.
10. Jayasekara H, English DR, Room R, MacInnis RJ. Alcohol Consumption Over Time and Risk of Death: A Systematic Review and Meta-Analysis. American Journal of Epidemiology. 2014;179(9):1049-59.
11. Buja A, Vinelli A, Lion C, Scafato E, Baldo V. Is moderate alcohol consumption a risk factor for kidney function decline? A systematic review of observational studies. Journal of Renal Nutrition. 2014;24(4):224-35.
12. Sayon-Orea C, Martinez-Gonzalez MA, Bes-Rastrollo M. Alcohol consumption and body weight: a systematic review. Nutrition reviews. 2011;69(8):419-31.
13. Mazzaglia G, Britton AR, Altmann DR, Chenet L. Exploring the relationship between alcohol consumption and non-fatal or fatal stroke: a systematic review. Addiction. 2001;96(12):1743-56.
14. Patra J, Taylor B, Irving H, Roerecke M, Baliunas D, Mohapatra S, et al. Alcohol consumption and the risk of morbidity and mortality for different stroke types–a systematic review and meta-analysis. BMC Public Health. 2010;10:258-.
15. de Menezes RF, Bergmann A, Thuler LCS. Alcohol consumption and risk of cancer: a systematic literature review. Asian Pacific Journal Of Cancer Prevention: APJCP. 2013;14(9):4965-72.
16. Huang Y-H, Li J, Luan H, Huang S-S, Li Y, Li J. Association between alcohol consumption and the risk of ovarian cancer: a meta-analysis of prospective observational studies. BMC Public Health. 2015;15(1):1-12.
17. Zhen-Yu Q, Chuan S, Chao Y, Zhong W, Guo-Zhen H. Alcohol Consumption and Risk of Glioma: A Meta-Analysis of 19 Observational Studies. Nutrients. 2014;6(2):504-16.
18. Zhu JZ, Wang YM, Zhou QY, Zhu KF, Yu CH, Li YM. Systematic review with meta-analysis: alcohol consumption and the risk of colorectal adenoma. Alimentary Pharmacology & Therapeutics. 2014;40(4):325-37.
19. Taylor B, Rehm J, Gmel G. Moderate alcohol consumption and the gastrointestinal tract. Digestive Diseases (Basel, Switzerland). 2005;23(3-4):170-6.
20. Xi B, Veeranki SP, Zhao M, Ma C, Yan Y, Mi J. Relationship of Alcohol Consumption to All-Cause, Cardiovascular, and Cancer-Related Mortality in U.S. Adults. Journal of the American College of Cardiology. 2017;70(8):913-22.
21. White IR. The level of alcohol consumption at which all-cause mortality is least. Journal Of Clinical Epidemiology. 1999;52(10):967-75.
