Dr. Eric Rimm is Professor of Epidemiology and Nutrition at the Harvard School of Public Health. In this interview he describes the role of drinking alcohol in health promotion. David Hanson interviews Dr. Rimm.
Dr. Rimm, you’ve researched the impact of alcohol on health for about a quarter century. Could you explain why moderate drinkers tend to be healthier and live longer on average than either abstainers or heavy drinkers?
Yes, I’d be glad to. Consuming alcohol in moderation either decreases the risk or has no effect on most of the major causes of death in the U.S. Of course, drinking heavily increases the risk of illness and premature death. Moderation is the key.
Well, what exactly is moderation?
Other countries usually define moderation at higher levels of consumption. Federal guidelines in the U.S. define moderation as consuming no more than one drink per day for women. It’s no more than two drinks per day for men.
There’s much evidence about the health benefits of red wine. What’s the story?
Yes, that’s true. A review of 34 studies was completed in which subjects were followed over time. It demonstrates that wine, beer, and distilled spirits are all beneficial. And also that no one alcoholic beverage stands out as superior. The important ingredient in alcohol beverages is the alcohol.
Standard servings of beer, wine, and distilled spirits contain equivalent amount of pure alcohol.
About half the deaths in the U.S. are caused by heart disease. It appears that moderate alcohol consumption can greatly reduce the risk. Could you elaborate?
Yes. There’s an overwhelming amount of evidence that moderate drinking reduces heart disease. A very large number of studies show that those who consume one to two drinks per day have about a 30-40% lower risk of having a heart attack. And the findings are highly consistent around the world.
What about the effects of lifestyle and other factors?
Research has carefully taken these factors into consideration. The results still stand.
What about cancer?
While heavy drinking is linked to mouth and throat cancers, moderate drinking has not been associated with these cancers.
With regard to breast cancer, there appears to be about a 10% increase per drink per average consumption. However, while a woman who consumes one drink per day may increase her risk of breast cancer by about 10%, her risk of developing the much more probable heart attack is reduced by 30-40%. And a woman is many times more likely to die from heart disease than from breast cancer. In the U.S., about 10 times more women die of heart disease than breast cancer.
Of course, this is little consolation if you know of a friend or colleague diagnosed with breast disease. Especially since breast cancer usually strikes at an earlier age than heart disease.
Several studies suggest that moderate drinkers with high levels of folate do not have an increased risk for breast cancer. Folate is a vitamin found in fruits, vegetables, bread and cereals.
What can you tell us about alcohol and diabetes?
Adult-onset (type 2) diabetes is becoming more common as obesity increases in the U.S. A number of studies report a 30-35% reduction in risk for diabetes among moderate drinkers.
Weight is a very important factor in type 2 diabetes. A study of over 70,000 nurses over a period of eight years found that drinkers weighed less on average than abstainers. That was after adjusting for lifestyle factors such as diet an exercise. Those who consumed an average of one-half to one drink per day weighed the least.
This is consistent with other research. It suggests that with moderate alcohol consumption, the metabolic rate may increase. This more than compensates for the modest increase in calories. But at higher levels of consumption, above two drinks a day, the increase in alcohol-related calories leads to weight gain.
You’ve shared some interesting and very important information on alcohol and health promotion. Thank you for your time.
You’re very welcome.
Dr. Eric Rimm is Professor of Epidemiology and Nutrition at the Harvard School of Public Health. He is also Professor of Medicine at the Harvard Medical School. In addition, Professor Rimm is and Director of the Program in Cardiovascular Epidemiology. He is internationally recognized for his extensive research. It focuses on the health effects of moderate alcohol consumption, whole grains, micronutrients, and polyphenols. Dr. Rimm has published over 700 peer-reviewed publications.
Resources on Alcohol in Health Promotion
Select publications (with others) by Dr. Eric Rimm.
Alcohol Intake and Risk of Lethal Prostate Cancer. J Clin Onc, 37(17), 1499-1511.
Alcohol intake, Specific Alcoholic Beverages, and Risk of Hip Fractures. Am J Clin Nutr, 110(3), 691–700.
Alcohol and Immediciacy Risk of Cardiovascular Events. Circ, 133, 979–987.
Light to Moderate Intake of Alcohol, Drinking Patterns, and Risk of Cancer. BMJ, 351, h4238
Key Findings on Alcohol Consumption and a Variety of Health Outcomes From the Nurses’ Health Study. Am J Pub Health, 106( 9 ), 1586-1591. Importance of alcohol in health promotion.
Change in Alcohol Intake in Relation to Weight Change in a Cohort of US Men with 24 Years of Follow‐Up. Obes, 25(11), 1817-2008.
Book Co-authored by Eric Rimm.
(With S. Rimm). Rescuing the Emotional Lives of Overweight Children. What Our Kids go Through – and How We Can Help. Emmaus, PA: Rhodale.