Many people want to know how much to drink for health and long life benefits. They usually look to official guidelines listing maximum limits. Indeed, health professionals use them as well for guidance.
I. The Problem
II. Twelve Essential Facts
I. The Problem
Countries around the world have created official alcohol guidelines. Public policies about alcohol tend to be based on them.
But what is the medical evidence for these guidelines? How accurate are they?
Here are answers to those and other questions. These can help you decide how much alcohol to drink for health and long life.
II. Twelve Essential Facts
Official drinking guidelines are political in nature rather than medical. So they vary from country to country.
The medical evidence is the same everywhere. Yet some countries set their limit for moderate are about two and one half times higher that of other countries. Medical evidence appears to play a minor role in the decisions.
The US guidelines were first conceived and promoted by government lawyers. They weren’t doctors, nutritionists, or scientists at all.
The situation in the UK was hardly better. But at least the guidelines were conceived by doctors. Dr. Richard Smith was editor emeritus of the British Medical Journal. He was a member of a special Royal College of Physicians committee. It created the UK’s first drinking guidelines in 1987.
Dr. Smith later wrote that the drinking limits were not based on any clear evidence at all. Instead, they “were really plucked out of the air.” He said “It was a sort of intelligent guess by a committee.”
So much for careful medical analysis. So perhaps government guidelines aren’t helpful in deciding how much to drink for health and longevity.
Risks differ by disease. The drinking level that that reduces the risk of one disease can increase it for another. So it’s important to consider the big picture. And the big picture is simple. People who drink in moderation tend to enjoy better health than either abstainers or alcohol abusers.
Research also shows that alcohol abstainers who begin drinking in moderation also enjoy health benefits.
Drinking advice should be tailored to each person. People have different family medical histories, personal medical histories, lifestyles, and medical concerns.
For instance, a woman may have a family history of cardiovascular deaths. She may be obese, sedentary, and smoke. Her doctor might well suggest that she drink in moderation. That may reduce her risk of cardiovascular death by about half.
On the other hand, a woman may have a family history of breast cancer. She may still have relatively low risk of breast cancer. In most women, it’s about 5%. That’s one of every 20 women. Most women have a 50% chance of cardiovascular death.
Also, she should weigh her fears of cardiovascular diseases against those of breast cancer. The thought of breast cancer may threaten her sense of self and cause great fear. That is, even more than the much greater likelihood of cardiovascular death.
Ultimately, this becomes a very personal decision. Only she can decide how much to drink for health. And the advice given to her should reflect her own unique situation.
The actual consumption levels at which specific health risks increase are almost certainly much higher than found in research. That’s because most people greatly under-estimate and under-report their actual drinking. This fact is ignored.
So, for example, research may report increased risk for a particular condition at three drinks per day. But the actual increased risk may be at, perhaps, four or more drinks per day.
Also, many, many studies report various health benefits from drinking at much higher levels than official guidelines.
Moderate drinking either (a) reduces the risks of most diseases or (b) has no impact on the risks.
The risk of many diseases in increased with heavy or abusive drinking. And especially over decades. The risk is often further increased with smoking. Or obesity. Sometimes it’s also increased by a lack of exercise.
Research in several countries finds that the health benefits of light and moderate drinking in the population outweighs the harm caused by alcohol abuse.
That means that if the entire population abstained from alcohol, health would be worse. And also that people wouldn’t generally live as long.
For some people, drinking may not be wise. For example, pregnant women, alcoholics, people on certain meds, etc.
If in doubt about meds, ask your doctor. Or simply read the labels on your meds.
Changes to dietary guidelines are based largely on lobbying pressures. Egg producers, cattle groups, and vegetarians exert pressure. Anti-alcohol groups, heart associations, cancer groups, and other special interests press for themselves.
On the other hand, there are both dietary guidelines and food pyramids created by doctors and nutritionists. They have no ax to grind. So the guides are based objectively on medical evidence. There are no pressure groups involved.
One example is the food pyramid created at Harvard.
For more information about Harvard’s Healthy Eating Pyramid, visit Harvard Health Publications.
Another example is the Mediterranean Diet Food Pyramid described by Oldways Preservation Trust.
Get free mediterranean diet recipes, menus, and more at Oldways.
The pattern of drinking is very important. Drinking daily gives greater benefits than drinking less often. On the other hand, heavy episodic drinking is bad for health. (It’s sometimes falsely called “binge drinking.”)
A person might choose to have two drinks per day. That’s 14 drinks in a week. But they shouldn’t save them up to have 14 drinks on Saturday.
The health benefits of moderate drinking tend to be roughly the same for beer, wine, and spirits (liquor).
Some research finds beer to be best. In some, wine is the most beneficial. And in others, spirits is most effective in providing benefits. But in most studies there is little or no difference. It appears that alcohol itself is the primary beneficial substance in alcoholic beverages.
Cardiovascular diseases are the major cause of death. Moderate drinking promotes good heart and blood vessel health. It doe this in a number of ways. Here are some of them.
Alcohol improves blood.
- Reduces LDL or “bad” cholesterol.
- Increases HDL or“good” cholesterol.
- Improves the size of cholesterol particles.
Alcohol decreases blood clotting.
- Reduces platelet clumping.
- Increases the process of dissolving blood clots.
- Reduces fibrinogen. That’s a blood clotter.
Alcohol works in other ways.
- Reduces coronary artery spasm.
- Increases blood flow.
- Reduces blood pressure.
- Reduces blood insulin levels.
Most older people may not be drinking enough alcohol for good health and long life. Older adults are at much higher risk of a number of diseases.
- Heart diseases.
- Dementia (including Alzheimer’s).
- Rheumatoid arthritis.
- Enlarged prostate (BPH).
- Gallstones and gallbladder disease.
- Type 2 diabetes.
Moderate drinking greatly reduces the risk of all the above diseases and conditions. Yet nation-wide government surveys show very low drinking among older people.
These are the results a recent survey. Only 55% people over 50 had an alcoholic drink within the previous month. And it dropped to only 40% among those 65 and older.
This very high rate of alcohol abstinence may cause unnecessary pain, suffering, and earlier death. Deciding how much alcohol to drink for health and long life is a very personal decision. But abstaining from alcohol is a risk factor for poor health and shorter life. That is, abstaining increases our chances of poor health and shorter life.
III. Resources: Drink for Health
- This site doesn’t give advice. Please see your doctor with questions.