The truth about alcohol

Alcohol is being poured into a rocks glass. gjohnstonphoto/Getty Images

The emerging medical consensus about alcohol is likely to come as a downer to drinkers. Here’s everything you need to know:

Is moderate drinking harmless?

For decades, doctors advised that consuming one or two alcoholic drinks a day was good for health, or perhaps even beneficial. However, a growing body of research shows that toast “For your health!” is an oxymoron. Studies have found that even moderate drinking can have negative consequences, including increased risk of cancer and heart attacks. “The risk starts to rise well below levels where people would think, ‘Oh, that person has an alcohol problem,'” said Dr. Tim Naimi, director of the University of Victoria’s Canadian Institute for Substance Use Research. This consensus The development comes amid an increase in alcohol consumption during the pandemic, as Americans sought an escape from despair and boredom.Cleveland Clinic cardiologist Stanley Hazen said that, in light of the new research, he will advise his patients that even current U.S. guidelines for moderation — two drinks a night for men and one a night for women — can be dangerous. “I would recommend cutting down on alcohol,” Hazen said.

How high is the risk of cancer?

Alcohol contributes to more than 75,000 new cases of cancer annually in the US and about 19,000 annual cancer deaths, according to the American Cancer Society. When people consume alcohol, they metabolize it into acetaldehyde. This toxic chemical can damage DNA, enabling the uncontrolled growth of cells that creates cancerous tumors. Alcohol is known to be a direct cause of seven types of cancer: oral cavity, pharynx (throat), larynx (voice box), liver, breast and colorectal. According to the National Cancer Institute, moderate drinkers are 1.8 times more likely to develop mouth and pharyngeal cancer, while heavy drinkers are five times more likely to develop it. For liver cancer, the increased risk comes only from heavy drinking. Studies show that for postmenopausal women, just one drink a day increases the risk of breast cancer by up to 9 percent compared to non-drinkers.

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What are the other risks?

Alcohol is the third leading cause of preventable death in the US, and alcoholic liver disease kills 22,000 Americans each year. The risk of liver disease is greater in heavy drinkers, but one report found that drinking just two alcoholic drinks a day for five years can damage the liver. One drink a day, Hazen said, increases the risk of heart attack and stroke by 10 to 20 percent. Research suggests that alcohol can speed up genetic aging and worsen dementia, and a study published last year found that drinking just one pint of beer or glass of wine a day can kill neurons and shrink the brain.

Doesn’t wine help your heart?

For years, researchers believed that moderate amounts of red wine could be healthy, raising “good” HDL cholesterol and protecting the heart. This was based on the presence of antioxidants found in grapes, such as resveratrol, which is thought to protect blood vessels and slow down aging. But a 2016 study found that a person would have to drink at least 500 liters of red wine every day to consume enough resveratrol to get significant benefits. Some experts claim that alcohol can improve glucose control, but even low levels of drinking can also increase the risk of high blood pressure, stroke and an abnormal heart rhythm. “Contrary to popular opinion,” declared the World Heart Federation last year, “alcohol is not good for the heart.”

Why were the experts so wrong?

Studies of alcohol are mostly observational or based on self-reports; it would be unethical to instruct a random group of study volunteers to drink more. This means that researchers cannot control for other variables that may affect health. Older studies that found moderate drinking to be beneficial relied on comparisons of light drinkers with people who did not drink at all. Researchers have since realized that people can abstain from drinking altogether because of underlying illnesses, so if light drinkers appear healthier, the difference isn’t the alcohol. A study published last year based on medical records from nearly 400,000 people in the UK Biobank seems to confirm this, finding that light drinkers tend to have healthier habits – such as exercise and healthy eating. well – compared to people who don’t drink at all.

How much do Americans drink?

About 60 percent of Americans told Gallup in 2021 that they drank and estimated they drank an average of 3.6 drinks per week. But nearly half of Americans reported drinking in the past few months — defined as consuming more than four drinks in one sitting for men and more than three for women. In light of new research, some researchers recommend complete abstinence, but most doctors and experts suggest cutting back. “I’m not going to advocate that people stop drinking altogether,” said George Koob, director of the National Institute on Alcohol Abuse and Alcoholism. “We did Prohibition. It didn’t work.”

Why do people react differently?

Alcohol has a greater impact on women’s health than men’s. Women tend to be lighter than men and have a lower body mass, which determines the concentration of alcohol in the brain. Women also produce less of the alcohol-metabolizing enzyme known as alcohol dehydrogenase. Race may also be a factor: Between 15 and 25 percent of white people carry a genetic risk for alcohol abuse, compared with less than 5 percent of black Americans, according to Dr. David Streem, medical director of Alcohol and Drug Recovery at the Cleveland Clinic. Center. People of East Asian descent often carry two genetic variants that affect alcohol metabolism. One variant causes alcohol to break down more quickly into the toxin acetaldehyde. The other variant slows the metabolism of that compound, causing it to remain in the body longer. People with this genetic variant tend to look flushed or ill after just a few sips of alcohol. For most people, the harm from drinking “really accelerates once you have a few drinks a day,” said Dr. Naimi. “So people who drink five or six drinks a day, if they can cut down to three or four, they’ll do themselves a lot of good.”

This article was first published in the latest issue of The Week magazine. If you want to read more like it, you can try six risk-free issues of the magazine here.

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