Moderate drinking has long been touted to carry health benefits, including promoting and preventing heart health. However, the word ‘moderate’ is tricky and often misinterpreted. As defined by the National Institute on Alcohol Abuse & Alcoholism or NIAAA, moderate drinking involves consuming up to four alcoholic drinks per day for men and three drinks per day for women, or up to 14 drinks per week for men and seven drinks per week for women. The NIAAA defines ‘one standard drink’ as 12 ounces of regular beer, which is usually about five per cent alcohol, or five ounces of wine, which is typically about 12 per cent alcohol, or 1.5 ounces of distilled spirits, about 40 per cent alcohol.
But most people, unaware of this definition, end up binge drinking. To reduce harmful effects of alcohol, Centers for Disease Control and Prevention of the United States recommends two drinks or less in a day for men and one drink or less in a day for women.
In many cultures, alcohol is a regular beverage, a part of celebration. Studies have shown some benefits of alcohol when consumed within defined limits in the past. However, recent studies challenge these findings.
Also read: Rise of breast cancer in Indian women is alarming but expected. It’s your ‘Western’ diet
Science behind the ‘benefit’ claim
A review and meta-analysis from 2011 went through 63 eligible studies and found moderate drinking was linked to positive changes in several cardiovascular markers such as improved high-density lipoprotein and adiponectin but didn’t raise the level of total cholesterol or triglycerides. In a food frequency questionnaire-based Spanish study from 2014, moderate drinking was found to reduce the relative risk of mortality by 25 per cent. Participants in this study consumed a Mediterranean diet that has already been proven to be one of the best diets for maximum health benefits. In this context, it’s difficult to judge whether the lower mortality rate was due to the whole diet or alcohol alone.
Another US study from 2018 showed that people who drank light to moderate amounts of alcohol were at a lower risk of mortality and that the risk increased in adults who consumed heavy amounts of alcohol. Few studies have shown that moderate drinking can improve mental health conditions. A review study published in 1985 concluded that moderate drinking could reduce depression, stress, tension, and self-consciousness. Additionally, the same study reported that moderate drinking can increase overall affective expression, happiness, and euphoria. In 2020, a randomised control trial conducted in China found lower risk of depression among middle-aged adults who consumed alcohol moderately.
The majority of research citing health benefits of moderate drinking is weak due to methodological flaws since they rely mostly on self-reported drinking habits.
Also read: Don’t trust the ‘superfood’ label. Here are five common foods to boost your health
Latest research suggests otherwise
JAMA Network Open reported a large study in March 2022 that included 371,643 individuals aged around 57 years who consumed 9.2 drinks per week. The investigators found lower risk of cardiac diseases in participants who consumed light to moderate amount of drinks. However, when they applied the latest genetic technique called Mendelian randomisation, the results suggested that all levels of alcohol intake were linked to increased cardiovascular risk. This risk increased with higher consumption of alcohol. The study concluded — “genetic epidemiology suggested that alcohol consumption of all amounts was associated with increased cardiovascular risk, but marked risk differences exist across levels of intake, including those accepted by current national guidelines.”
In 2009, Stockwell and colleagues suggested several research biases associated with alcohol consumption outcomes. They advised wider research by the health and medical community to reflect on the quality of evidence available in this regard. A BMJ study from 2015 suggested that the beneficial association between moderate to low alcohol consumption and all-cause mortality might be influenced by inappropriate selection of participants and weak adjustment for confounders.
In essence, recent research has found that even if moderate drinking improved health outcomes, it doesn’t prove that it was the only factor responsible. Factors such as genetics or behavioral factors, may also play a role.
Also read: Should you fall for anything labelled ‘diet’? Think again on diet soda
Health benefits are linked to lifestyle
An occasional drink or two isn’t discouraged, but it can’t be included in universal dietary guidelines worldwide as a way to reap health benefits.
Frequent addition of alcohol to diet as a way to gain ‘stated benefits’ of liquor might lead to addiction and increase the risk of long-term chronic health problems such as heart disease, some types of cancer, and mental health conditions–stress, anxiety, depression, etc. A holistic lifestyle involves eating a balanced diet, taking part in regular physical activity, getting enough sleep, maintaining financial stability, and being happy. Consuming vegetables full of minerals, antioxidants, vitamins, and fiber would provide much better health benefits than habitual alcohol consumption in moderation.
Dr Subhasree Ray is Doctoral Scholar (Ketogenic Diet), a certified diabetes educator, and a clinical and public health nutritionist. She tweets @DrSubhasree. Views are personal.
(Edited by Anurag Chaubey)