A new review challenges the long-held belief that moderate drinking can have health benefits.
The analysis, conducted by a team of researchers in Canada, points out flaws in several studies that seemed to support moderate drinking and suggests that even low levels of alcohol consumption carry significant health risks.
"Alcohol is a very important substance in our society, so it's important to get it right when it comes to the risks that can come from drinking. Even though it's a legal substance and many people enjoy it, it's also a leading cause of preventable death and disability,†said senior study author Timothy Naimi, director of the Canadian Institute for Substance Abuse Research.
Published earlier this year in the Journal of Studies on Alcohol and Drugs, the study re-evaluated existing research on alcohol consumption and longevity. The findings indicate that many studies showing benefits from moderate drinking have substantial scientific limitations.
In contrast, higher quality studies tended to show no such benefits.
Naimi and his team analyzed 107 published studies that followed individuals over time, examining the relationship between drinking habits and longevity.
Initially, the data suggested that light to moderate drinkers (those consuming between one drink per week and two drinks per day) had a 14% lower risk of dying during the study period compared to abstainers. However, a deeper dive revealed that the studies linking moderate drinking to health benefits were of lower quality.
"Better-done studies tend to show no benefit whatsoever from alcohol, while studies with more scientific limitations are the ones that tend to show benefits," Naimi noted. "This means we've probably been underestimating the risks from alcohol consumption, and in terms of health, less is better."
He also elaborated on why the belief that moderate drinking is beneficial has persisted for so long, despite substantial evidence that moderate drinking carries some health hazards, including increased risks of certain cancers.
“The concept that alcohol might be good for you is really appealing, right? So, because it’s enjoyable, we prefer to read studies saying that it's also good for our health,†he said.
In fact, the notion that moderate drinking leads to a longer, healthier life actually goes back decades. For example the “French paradox†was an idea that became popular in the 1990s, claiming that red wine explains why the French enjoy relatively low rates of heart disease, despite a rich, fatty diet.
However, this study underscores the importance of understanding the true relationship between alcohol consumption and health risks, and also highlights the need for better study designs in future research.
Many existing studies were observational and not randomized, which introduced biases that can skew results.
"Most observational studies don't enroll people until later in life. People who are still drinking into their older age tend to be very healthy, and those who have developed alcohol problems or other health issues are not included," Naimi noted. "This leads to a biased sample and inaccurate conclusions."
Whitney Linsenmeyer, a spokesperson for the Academy of Nutrition and Dietetics, noted the findings were unexpected.
“This finding is a surprising departure from the long-held thinking that moderate alcohol intake [up to 1 drink/day for females, up to 2 drinks/day for males] can be beneficial to our health,†she said. “It’s curious to see how cultures where alcohol is an integral part of their cuisine, like the French, continue to have relatively healthy populations. This underscores the importance of evaluating the totality of the diet rather than focusing on one specific element.â€
In terms of public health guidelines, the study is consistent with the position of major health organizations, which have lowered their recommended limits for alcohol consumption in recent years.
Linsenmeyer noted that the Dietary Guidelines for Americans (DGAs) recommend limiting alcohol intake to 1 drink or less per day for females and 2 drinks or less per day for males.
The DGAs are updated every five years based on the latest science, and the 2025-2030 DGAs are now being developed by an advisory committee.
Two expert groups separate from the DGAs advisory committee are also reviewing the latest research on alcohol and health. Their findings will be submitted to the U.S. Department of Agriculture and the U.S. Department of Health and Human Services, to inform the next set of DGAs.
“This is how good science works—it changes over time,†Linsenmeyer said. “We have our current DGAs, yet the alcohol science in the past few years is rapidly evolving, and the next set of DGAs will reflect this newer science.â€
"In countries like France, England and the Netherlands, which are heavy drinking countries, recommendations for alcohol consumption have actually gone down," Naimi noted.
In January 2023, the World Health Organization (WHO) also published an updated statement that no level of alcohol consumption is safe for your health.
“The good news is that actually in terms of both scientific opinion and public opinion, this idea that alcohol is good for you at low levels has really eroded quite a bit,†Naimi added.
Linsenmeyer had some practical advice for those who enjoy a daily drink.
“My advice is to absolutely enjoy the glass of wine or beer with your meal, and to remember that moderation with alcohol is critically important to our health," she said. "There are plenty of other foods or nutrients that we have in our diet for pleasure, rather than health benefits. Enjoying a treat or a drink in moderation can be part of a balanced lifestyle, but it's essential to stay mindful of the overall impact on health.â€
More information
The National Institutte on Alcohol Abuse and Alcoholism has more on alcohol's effect on the body.
SOURCE: Timothy Naimi, director, Canadian Institute for Substance Abuse Research; Whitney Linsenmeyer, spokesperson, Academy of Nutrition and Dietetics; Journal of Studies on Alcohol and Drugs, January 2024