Heavy drinking can contribute to disease and early death, but the health effects of alcohol at lower levels are less clear. Now, a new study in the Journal of the American College of Cardiology offers some of the best news yet for people who enjoy a daily drink: Light-to-moderate alcohol use is associated with a reduced risk of death compared with no alcohol consumption at all.
In the analysis, more than 333,000 people were surveyed about their alcohol consumption and lifestyle habits and tracked for an average of eight years. Light and moderate drinkers (14 or fewer drinks per week for men and seven or fewer for women) were about 20% less likely to die from any cause during the study’s follow-up period, compared to those who have never consumed alcohol. They were also about 25% to 30% less likely to die from cardiovascular disease. These protective effects were more pronounced in women, white participants, middle-aged and older people and non-smokers.
More drinking was not associated with more benefits, however. People who consumed higher-than-moderate amounts were 11% more likely to die of any cause and 27% more likely to die of cancer, compared to the never-drinkers. (No significant link was found between heavy alcohol use and death from cardiovascular disease.)
People who binge drank at least once a week—defined as having five or more drinks in one day—were also at increased risk of dying, especially from cancer.
Previous findings on this topic have been inconsistent; it can be hard to separate the effects of alcohol itself from other related factors. For example, people who choose not to drink may do so because of underlying medical reasons that can also affect their risk of getting sick or dying early.
But in this analysis, researchers took “rigorous statistical approaches” to address those issues, said co-author Dr. Sreenivas Veeranki, assistant professor in preventive medicine and community health at the University of Texas Medical Branch, in a press release. For one, they compared current drinkers to lifetime abstainers, rather than people who used to imbibe but have since stopped.
They also adjusted for many demographic, lifestyle and health variables. Yet the researchers saw a clear J-shaped curve for the association between alcohol consumption and mortality.
In an accompanying editorial, researchers from the Mediterranean Neurological Institute in Italy wrote that the new findings “supported the conclusion that the J-shaped relationship between alcohol consumption and mortality risk cannot be dismissed, and should guide the formulation of public policies.”
The editorial also addresses the fact that women are sometimes advised to limit alcohol to very low levels because it’s been linked to increased breast cancer risk. While younger adults may not see substantial health benefits from moderate drinking, the editorial argues, “for most older persons, the overall benefit of light drinking, especially the reduced [cardiovascular disease] risk, clearly outweigh possible cancer risk.”
The study authors point out that self-reported data is not always accurate and that because the study was observational, it only shows an association between mortality and alcohol levels, not a cause-and-effect relationship.
But overall, they wrote, their research supports previous findings that light-to-moderate drinking “might be protective, especially for [cardiovascular disease], but heavy or binge drinking has serious health consequences, including death.”
“A balance between beneficial and detrimental effects of alcohol consumption on health should be considered when making individual or population-wide recommendations,” they added, “but the reduction of harmful or high consumption of alcohol remains necessary and essential.”
The editorial authors go a step further, arguing that a long-term randomized controlled trial—in which different groups of people are assigned to drink different amounts of alcohol—might help settle the debate about moderate drinking and health outcomes.
Until then, they wrote, lifelong abstainers “should not start drinking for health reasons only, but should be encouraged to adopt healthy lifestyles” like regular exercise, not smoking and maintaining a healthy diet and weight.