Niha Zubair, Arivale Clinical Research Scientist, PhD
How much drinking is too much drinking when it comes to your wellness? The answer to that question has been a topic of controversy for decades.
If one chooses to drink alcohol, US public health guidelines recommend it should be consumed in moderation: men can imbibe up to two alcoholic drinks per day and women up to one drink per day. (Other countries have guidelines that range anywhere from half that amount to double it). The US guidelines were created to reduce the risk of alcohol-related harms, such as motor vehicle crashes and high blood pressure. Furthermore, the guidelines stress that if you don’t drink, don’t start for any reason.
Now, a study published this month in The Lancet and covered by NBC News suggests that following US guidelines on alcohol consumption could be dramatically shortening your life by damaging your cardiovascular health. Below we’ll take a look at the study and see if it suggests the US guidelines warrant a second look.
Researchers looked at 599,912 current drinkers from 19 countries around the world, some of whom had been reporting on their drinking habits since as far back as 1964. The drinkers had higher rates of stroke, heart disease, potentially fatal high blood pressure, and fatal aortic aneurysms over the years.
Researchers concluded that people at most could down about five drinks per week without raising their risk of an early death. That’s nine fewer drinks per week than US guidelines for men and two fewer drinks than guidelines for women. (Note: As far as this study and US guidelines are concerned, a drink is 12 ounces of beer, 4 ounces of wine, or 1.5 ounces of 80-prof spirits.)
Researchers estimate that if a 40-year-old man cut back from two drinks per day to five drinks per week, he could add a year or two to his life.
The findings of this new study can’t easily be ignored. It was published in a well-respected medical journal and involves a large number of people across the world over a lengthy span of time.
However, the fact remains that the research on alcohol consumption is conflicting. For example, over the past several decades, many studies have shown how drinking alcohol may be associated with reduced mortality and or decreased heart disease in some populations1,2,3,4. On the other hand, heavy drinking has been associated with increased risk of stroke5, cancer6, hypertension7, malnutrition8, anxiety9, liver cirrhosis10, and more. Due to the mixed evidence, we believe there is no justification for steering away from the current US guidelines.
Furthermore, we all have other health influencing factors (genetic, physiologic, or environmental). Two people consuming the exact same amount of alcohol could have very different outcomes, which may be why alcohol is so difficult to study.
- Rimm, E.B., Giovannucci, E.L., Willett, W.C., Colditz, G.A., Ascherio, A., Rosner, B. and Stampfer, M.J., 1991. Prospective study of alcohol consumption and risk of coronary disease in men. The Lancet, 338(8765), pp.464-468.
- Camargo, C.A., Hennekens, C.H., Gaziano, J.M., Glynn, R.J., Manson, J.E. and Stampfer, M.J., 1997. Prospective study of moderate alcohol consumption and mortality in US male physicians. Archives of Internal Medicine, 157(1), pp.79-85.
- Renaud, S.D. and de Lorgeril, M., 1992. Wine, alcohol, platelets, and the French paradox for coronary heart disease. The Lancet, 339(8808), pp.1523-1526.
- Rimm, E.B., Williams, P., Fosher, K., Criqui, M. and Stampfer, M.J., 1999. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. Bmj, 319(7224), pp.1523-1528
- Patra, Jayadeep, et al. “Alcohol consumption and the risk of morbidity and mortality for different stroke types-a systematic review and meta-analysis.”BMC public health 10.1 (2010): 1.
- N. LoConte, A. Brewster, J. Kaur, J. Merrill, and A. Alberg. (2018). Alcohol and Cancer: A Statement of the American Society of Clinical Oncology. Journal of Clinical Oncology 36, no. 1 (January 1 2018) 83-93. DOI: 10.1200/JCO.2017.76.1155.
- Briasoulis, Alexandros, Vikram Agarwal, and Franz H. Messerli. “Alcohol Consumption and the Risk of Hypertension in Men and Women: A Systematic Review and Meta‐Analysis.” The Journal of Clinical Hypertension14.11 (2012): 792-798.
- Sarin SK, Dhingra N, Bansal A, et al. Dietary and nutritional abnormalities in alcoholic liver disease: a comparison with chronic alcoholics without liver disease. Am J Gastroenterol 1997; 92:777.
- Bellos, Stefanos, et al. “Longitudinal association between different levels of alcohol consumption and a new onset of depression and generalized anxiety disorder: Results from an international study in primary care.” Psychiatry Research 243 (2016): 30-34.
- Corrao, Giovanni, et al. “A meta-analysis of alcohol consumption and the risk of 15 diseases.” Preventive medicine 38.5 (2004): 613-619.