Should Doctors Recommend Drinking Alcohol to Patients for Good Health?

Moderate drinking is associated with better health and longer life than is either abstaining or abusing alcohol. That’s the consensus of medical researchers based on overwhelming scientific evidence. Well known medical authority Dean Edell, M.D., asserts that “you would have to be living on another planet not to know that alcohol -- in moderation -- is good for your health.” 1

Of course, not everyone should drink alcohol, including pregnant women, those who have ever experienced difficulty controlling their drinking, or anyone whose physician recommends abstinence.

Consuming alcohol in moderation reduces the risk of heart disease dramatically. It also significantly reduces the risk of stroke and other major causes of death. And evidence of the overall health benefits of moderate drinking continues to grow.

Most Americans drink less than the optimum amount desirable for maximum health benefits. Dr. Stanton Peele says that

many object to the idea that doctors should inform their patients that moderate drinking may prolong life. They fear that such advice will justify the excessive drinking some patients already engage in, or they worry that encouragement from doctors will push people who cannot handle alcohol to drink.

The view that people are so stupid or malleable that they will become alcohol abusers because doctors tell them that moderate drinking is good for them is demeaning and self-defeating. If people can't regulate their own diets, drinking, and exercise, then doctors should avoid giving patients any information about their health behavior, no matter how potentially helpful.

Not only can people handle such information on lifestyle, it offers the primary and best way to attack heart disease. Of course, doctors may also prescribe medications. These medications rarely solve underlying problems, however; and they often cause adverse side effects that counterbalance their positive effects. Because they are not a cure, courses of medication, once begun, are rarely discontinued.

People are the best regulators of their own behaviors. Even those who drink excessively often benefit when doctors provide straightforward, accurate information. Clinical trials conducted by the World Health Organization around the world showed that so-called brief interventions, in which medical personnel advised heavy drinkers to reduce their drinking, are the most successful therapy for problem drinking.

But far more Americans drink less, not more, than would be most healthful for them. To fail to inform these patients about the benefits of moderate drinking is both counterproductive and dishonest. 2

What is moderate drinking? The US government currently defines moderation for a woman as consuming no more than one drink per day and for men it is drinking no more than two drinks per day. A drink is

  • a 12 ounce can or bottle of beer,
  • a five ounce glass of dinner way, or
  • a one-and one-half ounce drink of 80 proof distilled spirits. 3

Many other countries define moderation at much higher levels of consumption. For example, in the Netherlands moderation is about three drinks per day for both men and women and in France it’s about two and one-half drinks per day for women and over four drinks per day for men. 4 Until recently, the US National Institute on Alcohol Abuse and Alcoholism defined moderation for men as consuming up to four drinks in a day. 5

People need to be aware of some important medical facts about drinking:

  • The risk of dying in any given year is 25 percent lower for those who consume moderate amounts of alcohol. 6
  • Moderate drinking reduces the risk of stroke by about one-half. 7
  • Moderate drinkers have a 54% lower chance of developing dementia than abstainers. 8
  • Moderate drinkers are over 30-40 percent less likely to develop diabetes. 9

The benefits of drinking in moderation begin early in life 10 and they apply to beer, wine, and liquor or distilled spirits (gin, vodka, whiskey, tequila, rum, bourbon, etc.)

In Great Britain health officials recommend moderate drinking. 11 Physicians need to do the same in the United States.

Nothing on this page constitutes medical opinion or advice. For medical diagnosis, opinion, advice or treatment consult a qualified physician.

References

  • 1. Edell, D. Life, Liberty, and the Pursuit of Healthiness. NY: HarperCollins, 2004, p.488.
  • 2. Peele, Stanton. Should physicians recommend alcohol to their patients? Priorities, 1996, 8(2), 24-28.
  • 3. The American Dietetic Association points out that the facts of alcohol beverage equivalence "are emphasized by the federal government and numerous public health organizations including Nation Institute of Alcohol Abuse and Alcoholism, Departments of Transportation and Health and Human Services, National Consumers League, National Council of Alcoholism and Drug Dependence, and Mothers Against Drunk Driving (MADD)" (American Dietetic Association, Nutrition Fact Sheet: Moderate Consumption of Distilled Spirits and Other Beverage Alcohol in an Adult Diet. Chicago, Illinois: American Dietetic Association, 2001, p.1). See also Alcohol Equivalence (https://www.alcoholproblemsandsolutions.org/alcohol-equivalence)
  • 4. International Center for Alcohol Policies (ICAP). International Drinking Guidelines. (ICAP Reports #14). December 2003.
  • 5. International Center for Alcohol Policies (ICAP). International Drinking Guidelines. (ICAP Reports #14). December 2003, p. 8 and current issue of National Institute on Alcohol Abuse and Alcoholism (NIAAA). Physicians’ Guide to Helping Patients with Alcohol Problems.
  • 6. Alcohol has benefits, but not or everyone. Long Beach Press-Telegraph, January 2, 2005.
  • 7. Sacco, R. L., Elkind, M., Boden-Albala, B., Lin, I-F., Kargman, D. E., Hauser. W. A., Shea, S., & Paik, M. C. The Protective Effect of Moderate Alcohol Consumption on Ischemic Stroke, Journal of the American Medical Association, 1999, 281, 53-60.
  • 8. Mulkamal, K.J., et al. Prospective study of alcohol consumption and risk of dementia in older adults. Journal of the American Medical Association, 2003 (March 19), 289, 1405-1413.
  • 9. Carlsson, S., et al. Alcohol consumption and the incidence of type 2 diabetes: a 20-year follow-up of the Finnish Twin Cohort Study. Diabetes Care, 2003, 26(10), 2785-2786.
  • 10. Power, C., et al. U-shaped relation for alcohol consumption and health in early adulthood and implications for mortality. The Lancet, 1998, 352, 9131.
  • 11. Dr. Eric Rimm of Harvard School of Pubic Health, quoted by John Fauber, Experts reluctant to endorse health benefits of alcohol, Milwaukee Journal Sentinel, January 24, 2005.

Readings

  • Camargo, C.A., et al. Prospective study of moderate alcohol consumption and mortality in US male physicians. Archives of Internal Medicine, 1997, 157, 79-85.
  • Coate, D. Moderate drinking and coronary heart disease mortality: Evidence from NHANES I and NHANES I follow-up. American Journal of Public Health,1993, 83(6), 888-890.
  • Doll, R., and Peto, R. Mortality in relation to consumption of alcohol: 13 years' observations on male British doctors. British Medical Journal, 1994, 309, 911-918.
  • Edell, D. Life, Liberty, and the Pursuit of Healthiness. NY: HarperCollins, 2004.
  • Edell, D. Eat, Drink and be Merry: America’s Doctor Tells You Why the Health Experts are Wrong. NY: HarperCollins, 1999.
  • Ellison, R. C. Does Moderate Alcohol Consumption Prolong Life? New York: American Council on Science and Health, 1993
  • Ford, G. The Science of Healthy Drinking. San Francisco, CA: Wine Appreciation Guild, 2004.
  • Ford, G. The Benefits of Moderate Drinking: Alcohol, Health and Society. San Francisco, CA: Wine Appreciation Guild, 1988.
  • Ford, G. The French Paradox & Drinking for Health. San Francisco, CA: Wine Appreciation Guild, 1993.
  • Fox, B. To Your Health: the Healing Power of Alcohol. Diane Publishing, 2000.
  • Fuchs, C.S., et al. Alcohol consumption and mortality among women. The New England Journal of Medicine, 1995, 332(19), 1245-1250.
  • Gilson, C. and Bennett, V. Alcohol and Women: Creating a Safer Lifestyle. Irving, TX: Fusion Press, 2001.
  • Hellerstedt, W. L., et al. The association between alcohol intake and adiposity in the general population. American Journal of Epidemiology, 1990, 132(4), 594-611.
  • Hennekens, C.H.. Alcohol and Risk of coronary Events. In: National on Alcohol Abuse and Alcoholism. Alcohol and the Cardiovascular System. Washington, DC: U.S. Department of Health and Human Services, 1996.
  • Kahn, H. S., et al. Stable behaviors associated with adults' 10-year change in body mass index and the likelihood of gain at the waist. American Journal of Public Health, 1997, 87(5), 747-754.
  • Kowalski, R.E. The New 8-Week Cholesterol Cure. NY: HarperCollins, 2002.
  • Liu, S., et al. A prospective study of alcohol intake and change in body weight among US adults. American Journal of Clinical Nutrition, 1994, 140(10), 912-920.
  • MacDonald, E. (Ed.) Health Issues Related to Alcohol Consumption. Oxford, UK: Blackwell Science, 1999.
  • Manson, J.E., et al. Prevention of Myocardial Infarction. New York: Oxford University Press, 1996.
  • Peele, S., and Grant, M. Alcohol and Pleasure: A Health Perspective. Philadelphia, PA: Brunner/Mazel, 1999.
  • Perdue, L., and Shoemaker, W. The French Paradox and Beyond. Sonoma, CA: Renaissance Publishing, 1992.
  • Razy, G., et al. Alcohol consumption and its relation to cardiovascular risk factors in British women. British Medical Journal, 1992, 304, 80-83.
  • Rimm, E., et al. Prospective study of alcohol consumption and risk of coronary disease in med. The Lancet, 1991, 338, 464-468.
  • Stuttaford, T. To Your Good Health! The Wise Drinkers Guide. London: Faber & Faber, 1997.
  • Willett, W. C. with the assistance of others. Eat, Drink, and be Healthy: The Harvard Medical School Guide to Healthy Eating. New York: Simon & Schuster, 2001, p. 17. The alternative US Department of Agriculture food pyramid was first developed before much of our current nutritional information was available, reflects the strong influence of agricultural producers, and is highly over-simplified. The Harvard food Pyramid is free of all those shortcomings.

Filed Under: Health