9

All the time I see content online that says moderate alcohol consumption is good for you. Some even say it is better than no alcohol consumption. Other times there is conflicting information that says no alcohol consumption is better. I'm assuming there just isn't a consensus on it but, as a person who doesn't drink alcohol, I'm curious how drinking moderately could improve my health.

migrated from fitness.stackexchange.com Jan 2 at 19:43

This question came from our site for physical fitness professionals, athletes, trainers, and those providing health-related needs.

  • I think what you are talking about is (mainly) the consumption of wine, which, consumed moderatly, actually is healthy. But I don't really think that would apply to alcohol in general. – Suimon Jan 2 at 20:09
  • 4
    @Suimon - While there is competing evidence on both sides, there are suggestions that the type doesn't really matter, it's the amount and timing. – JohnP Jan 2 at 21:09
  • @JohnP really? Damn thats interesting, I definitly have to research that a little more soon :) – Suimon Jan 3 at 5:50
  • 1
    @Suimon Current research rejects this J-curve, that small consumption of alcohol is healthy. Any standard unit of alcohol increases morbidity and mortality. There is this huge meta analysis published in The Lancelet by the GBD 2016 Alcohol Collaborators which takes data into account from 195 countries. – Narusan Jan 3 at 10:33
5

While there is some evidence for what we call a J-shaped curve in the relationship between alcohol consumption and certain health outcomes, at best this evidence only suggests people who already drink modestly have better health outcomes than people who don't drink at all. There is no strong evidence that starting to drink a glass a day, if you do not drink already, would improve your health outcomes. There is an important point here about study design. Evidence for the J-shaped curve is generally observational, often retrospective, and can only tell you about an association between some variable and a disease outcome. It may be an important association, e.g., a valuable marker for risk of disease, but it doesn't tell you what happens if you change the variable. To know what happens when you change the variable, you typically want a randomized controlled trial.

Abstaining from alcohol (vs. moderate consumption) is likely what we call a confounding variable. It is associated with the variable of interest (some health outcome, e.g., mortality), but it is not on the causal pathway. That is to say, people who don't drink at all may be more likely to be ill (or become ill), but they didn't get that way because they don't drink. This is well explored in this meta analysis. A key part here is that former drinkers who currently don't drink any alcohol appear to be the major driver of the higher risk of mortality for individuals who don't drink at all. This suggests earlier heavy drinking or illness that causes someone to stop drinking.

  • The 'illness' part would benefit from clarification. The "former (heavy) drinkers" hypothesis is also pure conjecture, albeit and nevertheless plausible. Other confounder might be found in people who are "other than from-alcohol injured people (pharma-drugs & fructose-victim's fatty-liver first)", "genetically more vulnerable to alcohol", "externally motivated abstaining for pure ideological reasons also reflected in other lifestyles imposed on them", etc. Main point is IMO a re-phrase from pop-media: no and low (steady) alcohol is not associated with significant negative outcomes. – LаngLаngС Jan 3 at 13:38
  • Clarified what I believe was your intent of the first paragraph (just what's in italics) - you're welcome to change it back if you disagree :) – DoctorWhom Jan 3 at 15:40
  • @DoctorWhom Good edit, but I guess it still misses "would change your health outcomes for the better"?. But I wonder whether you have seen really any evidence from reputable sources that concludes anyone should better start drinking alcohol? (Yellow press is of course full of such advice, or sth that the public reads as such.) – LаngLаngС Jan 3 at 17:44
  • 1
    @Langlangc I would not. The act of abstaining is the likely confounding variable. Associated with the outcome measure, but not on the causal pathway. – De Novo supports GoFundMonica Jan 3 at 20:20
  • 1
    @LangLangC That was my point, perhaps I missed explaining it. I also reviewed the studies when they came out showing that the correlation/causation/confounder conundrum of the J point. Based on my analysis of the studies, I do NOT believe there is any health benefit from INCREASING one's ethanol intake, whether from zero to 1 or 1 to 2. I of course HAVE seen evidence for health benefits of REDUCING ethanol intake. So I never recommend starting drinking or increasing it; for those who already drink, I discuss the evidence for at least moderation if not abstaining. – DoctorWhom Jan 4 at 5:40
1

The reason you may want to be a moderate drinker is they're found to have lesser rates of death from heart disease and diabetes, which are dominant causes of death in a developed society.

This is one study I'll be referring to, as it got a lot of press last summer,

Below, if you’re above 1, that means you have greater risk of heart disease. Below 1, lesser risk. Drinkers have less risk, until they get to 6 (!) drinks per day.

heart disease drinkers

Heart disease deaths, up to a point, go down as people drink more. (Specific chart is for females but same trend happens for males; bottom ticks each represent one standard drink per day.)

Note, you need to live long enough for heart disease or diabetes to potentially kill you in order to get this benefit. If you're in a low income country, alcohol only increases your risk of death:

low socioeconomic country alcohol deaths alcohol types of deaths

If you're in a rich country though, you get a lot of benefit from drinking alcohol, practically completely offsetting that initial negative we saw:

alcohol rich country deaths

If you examine the causes of death above more closely, you'll see ones like violence, cirrhosis, self-harm, etc. One could make an argument these don't apply to our moderate drinker, to where you could get rid of some of those deaths. That is, you're getting less negative and more positive.

Cancer

The heart disease connection is fairly well known. Cancer is not as appreciated. Yes, alcohol can increase the risk of cancer, but it can also decrease the risk! cancer alcohol deaths

From

Pinning down to specific people

The natural next question is some variety of "why?"

People pretty much always go digging for biochemical answers, but as a personal trainer who has talked to many different personalities about alcohol through the years, a (I believe) very under appreciated element of alcohol is the kind of personality who swears it off.

For instance, on one extreme, you have the person who is an alcoholic. Any alcohol turns into way too much. Obviously not healthy.

You also have the person who is trying to be too strict about everything in their lives. Where they're inherently neurotic. Not a recipe for longterm health.

There is research showing drinkers weigh less than non-drinkers. Personally, I've found with my clients some of them, if they have a drink after a rough day, that's the end of it. While others, if they don't drink, might eat a tub of ice cream. I've also seen other trainers / nutritionists tell their clients they can't drink at all anymore, only for the clients to be miserable. "Going to my weekly date night with my spouse isn't as enjoyable."

Alcohol can mean a lot to a lot of people's social lives. If swearing it off ends up making you more lonely or isolated, that's not good for the heart. (Seriously. There is literature out there talking about the dangers of loneliness.)

With virtually any health question or topic, you're going to be hard pressed to acceptably paint a brush to how people should behave. (No smoking is probably the only one.) If you have a family history of breast cancer maybe you shouldn't drink; if you have one of thyroid, maybe you should?

  • 2
    Welcome to MedSci! You reached a different conclusion than I did in this answer, which is also solely based on the study you cited. Yes, certain risks are lower when drinking, but the overall risk of dying increases with every bit of ethanol consumed (although in the beginning only marginally). – Narusan Jan 9 at 16:28
  • 1
    Can't really agree to the opening sentence ("– may want to be a drinker…"/sounds like stupid advice-interpretation ) but overall this might be a technically good answer. If you want me to call this "really good", you might have to better summarise & explain the graphics (eg what is "SDI"?) and also set this into a perspective to @Narusan's comment, and add more sources on the "pinning down part" (very minor: smaller initial formats of pics might be less imposing?) – LаngLаngС Jan 10 at 22:38
  • @Narusan I didn't reach any conclusion, which is what I was getting at- the conclusion is ultimately person specific. You're trying to paint a brush; I'm saying I don't know how you do that, certainly not based on this study. If you're the AMA, sure, you can make a broad statement from this. If you have a particular person standing in front of you, with context for their life, then you can't take that approach. – Brian Reddy Jan 16 at 13:59
  • @LangLangC Your comment gave me a good laugh. Thank you. – Brian Reddy Jan 16 at 14:06

Your Answer

By clicking “Post Your Answer”, you agree to our terms of service, privacy policy and cookie policy