Alcohol And Health

Moderate drinkers tend to have better health and live longer than those who are either abstainers or heavy drinkers. In addition to having fewer heart attacks and strokes, moderate consumers of alcoholic beverages (beer, wine or distilled spirits or liquor) are generally less likely to suffer hypertension or high blood pressure, peripheral artery disease, Alzheimer's disease and the common cold.

Additional Information

Sensible drinking also appears to be beneficial in reducing or preventing diabetes, rheumatoid arthritis, bone fractures and osteoporosis, kidney stones, digestive ailments, stress and depression, poor cognition and memory, Parkinson's disease, hepatitis A, pancreatic cancer, macular degeneration (a major cause of blindness), angina pectoris, duodenal ulcer, erectile dysfunction, hearing loss, gallstones, liver disease and poor physical condition in elderly.

Some Background

Alcohol has been used medicinally throughout recorded history; its medicinal properties are mentioned 191 times in the Old and New Testaments. 1 As early as the turn of the century there was evidence that moderate consumption of alcohol was associated with a decrease in the risk of heart attack. 2 And the evidence of health benefits of moderate consumption has continued to grow over time.

The health benefits of moderate alcohol consumption have long been known. One of the earliest scientific studies on the subject was published in the Journal of the American Medical Association in 1904. 6

Reviews of research evidence report a strong, consistent relationship between moderate alcohol consumption and reduction in cardiovascular disease in general and coronary artery disease in particular. 3 On the basis of its extensive review of research, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) reported that moderate drinkers have the greatest longevity. It also found that moderate drinking is beneficial to heart health, resulting in a sharp decrease in heart disease risk (40%-60%). 4 This is important because cardiovascular disease is the number one cause of death in the United States, and heart disease kills about one million Americans each and every year. 5

The Director of the National Institute on Alcohol Abuse and Alcoholism wrote that "Numerous well-designed studies have concluded that moderate drinking is associated with improved cardiovascular health," and the Nutrition Committee of the American Heart Association reported that "The lowest mortality occurs in those who consume one or two drinks per day."7 A World Health Organization Technical Committee on Cardiovascular Disease asserted that the relationship between moderate alcohol consumption and reduced death from heart disease could no longer be doubted. 8 But the benefits are not limited, important as they are, to reductions in heart disease.

Alcohol vs. Lifestyle

Why drink to reduce the risk of heart disease? Wouldn't eating a good diet, exercising, and losing weight do the same thing?

No, it wouldn't. The moderate consumption of alcohol appears to be more effective than most other lifestyle changes that are used to lower the risk of heart and other diseases. For example, the average person would need to follow a very strict low-fat diet, exercise vigorously on a regular basis, eliminate salt from the diet, lose a substantial amount of weight, and probably begin medication in order to lower cholesterol by 30 points or blood pressure by 20 points.

But medical research suggests that alcohol can have a greater impact on heart disease than even these hard-won reductions in cholesterol levels or blood pressure. Only cessation of smoking is more effective.Additionally, other medical research suggests that adding alcohol to a healthful diet is more effective than just following the diet alone. 9

Longevity

Moderate drinkers tend to live longer than those who either abstain or drink heavily.

A Harvard study found the risk of death from all causes to be 21% to 28% lower among men who drank alcohol moderately, compared to abstainers. 10
A large-scale study in China found that middle-aged men who drank moderately had a nearly 20% lower overall mortality compared to abstainers. 11
Harvard's Nurses' Health Study of over 85,000 women found reduced mortality among moderate drinkers. 12
A British analysis of 12,000 male physicians found that moderate drinkers had the lowest risk of death from all causes during the 13 year study. 13
A large study of about 88,000 people conducted over a period of ten years found that moderate drinkers were about 27% less likely to die during the period than were either abstainers or heavy drinkers. The superior longevity was largely due to a reduction of such diseases as coronary heart disease, cancer, and respiratory diseases. 14
A large study funded by the National Institute on Alcohol Abuse and Alcoholism found that moderate drinking increased the length of life by about 3% among white males. 15
A twelve year long prospective study of over 200,000 men found that subjects who had consumed alcohol in moderation were less likely to die than those who abstained from alcohol. 16
A study of more than 40,000 people by the Cancer Research Center in Honolulu found that "persons with moderate alcohol intake appear to have a significantly lower risk of dying than nondrinkers.” 17
An analysis of the 89,299 men in the Physicians' Health Study over a period of five and one-half years found that those who drink alcohol in moderation tend to live longer than those who either abstain or drink heavily. 18
An Italian study of 1,536 men aged 45-65 found that about two (2) years of life were gained by moderate drinkers (1-4 drinks per day) in comparison with occasional and heavy drinkers. 19
A study of 2,487 adults aged 70-79 years, who were followed for an average period of over five and one-half years, found that all-cause mortality was significantly lower in light to moderate drinkers than in abstainers or occasional drinkers (those who drank <1 drink per week). 20

Healthier Lives

Moderate drinkers tend to enjoy better health than do either abstainers or healthy drinkers.

A nation-wide survey in the U.S. revealed that daily moderate drinkers experienced significantly less acute hospitalization. 21
A nine year study of predictors of good health found moderate alcohol consumption to be associated with the most favorable health scores. 22
A nation-wide Canadian study found moderate drinkers who consumed alcohol daily to have 15% less disability than the general population. 23
A Dutch study found that moderate drinkers under stress were less likely to be absent from work than were either abstainers or heavy drinkers. 24

Heart Attacks

Moderate drinkers are also less likely to suffer heart attacks than are abstainers or heavy drinkers.

Harvard researchers have identified the moderate consumption of alcohol as a proven way to reduce coronary heart disease risk. 25
An exhaustive review of all major heart disease studies found that "Alcohol consumption is related to total mortality in a U-shaped manner, where moderate consumers have a reduced total mortality compared with total non-consumers and heavy consumers." 26
A National Institute on Alcohol Abuse and Alcoholism study asserts that "The totality of evidence on moderate alcohol and CHD (coronary heart disease) supports a judgment of a cause-effect relationship... there are cardioprotective benefits associated with responsible, moderate alcohol intake." 27
An extensive review of recent medical research by the National Institute on Alcohol Abuse and Alcoholism found that, with few exceptions, studies from at least 20 countries around the world demonstrate a 20- to 40-percent lower coronary heart disease CHD incidence among drinkers compared to nondrinkers. Moderate drinkers exhibit lower rates of CHD-related mortality than either heavy drinkers or abstainers. 28
A study of 18,455 males from the Physicians Health Study revealed that those originally consuming one drink per week or less who increased their consumption to six drinks per week or less has a 29% reduction in CVD risk compared to those who did not increase their consumption. Men originally consuming 1-6 drinks per week who increased their consumption moderately has a 15% decrease in CVD risk compared to those who made no change. 29
The Harvard Health Professionals Follow-Up Study of over 44,000 males found moderate alcohol consumption to be associated with a 37% reduction in coronary disease. 30
A British study of women found moderate consumption of alcohol to be associated with lower levels of cardiovascular risk factors. 31
A study of over 5,000 women with type 2 diabetes mellitus by Harvard researchers found that coronary heart disease rates "were significantly lower in women who reported moderate alcohol intake than in those who reported drinking no alcohol." Women who drank more than 5 grams (about half a glass) a day reduced their risk of CHD (fatal or nonfatal) by more than half. 32
In a study of nearly 88,000 men, Harvard researchers found that drinking reduced risk of coronary heart disease (CHD) risk among both diabetics and non-diabetics. Weekly consumption of alcohol reduced CHD risk by one-third (33%) while daily consumption reduced the risk by over half (58%) among diabetics. For non-diabetics, weekly consumption reduced CHD risk by 18% while daily consumption reduced the risk by 39%. 33
Light to moderate consumption of alcohol appears to reduce the risk of coronary heart disease by as much as 80% among individuals with older-onset diabetes, according to a study published in the Journal of the American Medical Association. 34
The Honolulu Heart Study found a 49% reduction in coronary heart disease among men who drink alcohol in moderation. 35
Harvard researchers concluded about coronary heart disease that "Consumption of one or two drinks of beer, wine, or liquor per day has corresponded to a reduction in risk of approximately 20-40%." 36
At a scientific conference, researchers from Korea, Italy, Germany, Poland, the Netherlands, and the United States reported striking reductions in death among moderate drinkers, with heart disease and total mortality rates about one half or less compared to non-drinkers. 37
After over 6,000 participants in the Framingham Heart Study were followed for a period of six to ten years, researchers found that "when consumed in moderation, alcohol appears to protect against congestive heart failure." 38
After reviewing the research, Dr. David Whitten reported that "The studies that have been done show pretty clearly that the chances of suffering cardiac death are dramatically reduced by drinking" one or two drinks a day and asserted that "We don't have any drugs that are as good as alcohol."39
Based on the medical evidence, noted investigator Dr. Curtis Ellison asserted that "abstinence from alcohol is a major risk factor for coronary heart disease."40
The American Heart Association, based on the research evidence, concludes that the “Consumption of one or two drinks per day is associated with a reduction in risk of (coronary heart disease) approximately 30% to 50%.” 41

Heart Attack Survivability

In addition to reducing the risk of heart attacks, the moderate consumption of alcohol also increases their the survivability.

Drinking alcohol in moderation throughout the year before an acute myocardial infarction (AMI) has been found o reduce the risk of dying afterward. Information on the prior drinking behaviors of about 1,900 patients was collected during their hospitalization for AMI. Deaths of participants were then monitored over the next four years. After adjusting for age, sex and other factors, investigators found that light and moderate drinkers had lower death rates than patients who abstained. Moderate drinkers had the lowest mortality rate, reducing their risk by 32%, compared to abstainers. The health benefits were virtually identical for beer, distilled spirits, and wine. 42
Men who consume two to four drinks of alcohol after a heart attack are less likely to experience a second heart attack than are abstainers, according to a study of 353 male heart attack survivors. Researchers found that men who consumed an average of two drinks of alcohol per day were 59% less likely than non-drinkers to have another heart attack. Those who drank an average of four drinks per day experienced a risk reduction of 52% compared to abstainers. 43
Drinking alcohol (beer, wine, or distilled spirits) in moderation reduces the damage to effected tissue following a heart attack, according to research by Dr. Ron Korthuis, Distinguished Professor and Chair of the Department of Medical Pharmacology and Physiology at the University of Missouri-Columbia. 44

Fetal Alcohol Syndrome

To learn about this preventable health problem visit Fetal Alcohol Syndrome.

How does alcohol reduce heart disease? It appears that moderate consumption of alcohol improves health and longevity in a number of ways, including the following:

Alcohol improves blood lipid profile 45
- It increases HDL ("good") cholesterol 46
- It decreases LDL ("bad") cholesterol 47
- It improves cholesterol (both HDL and LDL) particle size 48
Alcohol decreases thrombosis (blood clotting)
- It reduces platelet aggregation 49
- It reduces fibrinogen (a blood clotter) 50
- It increases fibrinolysis (the process by which clots dissolve) 51
Alcohol acts through additional ways 52

Gaining Weight?

Drinking puts on pounds, right? Wrong! To learn more, visit Alcohol, Calories and Weight.
- It reduces coronary artery spasm in response to stress
- it increases coronary blood flow 53
- It reduces blood pressure 54
- It reduces blood insulin level 55
- It increases estrogen levels
- It reduces harmful arterial plaque 56

Other Benefits

The moderate consumption of alcohol is also apparently effective in reducing the incidence of a broad range of diseases and other health problems.

Strokes

A study published in the American Heart Association's journal found abstainers' risk of stroke to be double that of moderate drinkers. 57
The American Heart Association has also reported moderate consumption of alcohol to be associated with dramatically decreased risk of stroke among both men and women, regardless of age or ethnicity. 58
A study of men with high blood pressure found that those who averaged one to six drinks per week has a 39% lower risk of death from cardiovascular causes than were abstainers. Those who averaged one or two drinks each day were 44% less likely to experience such death. 59
A study of over 22,000 men found that light to moderate drinking significantly reduces the overall risk of stroke. 60
A study published in the Journal of the American Medical Association found that consuming one or two drinks a day can reduce the risk of ischemic stroke by about half. Its findings support the National Stroke Association Stroke Prevention Guidelines regarding the beneficial effects of moderate alcohol consumption. 61

Hypertension or High Blood Pressure

A Harvard University study found the lowest levels of hypertension among young adults who consumed one to three drinks per day. 62
A study of alcohol consumption and subsequent high blood pressure for eight years among over 7,000 women found that those who consumed an average of about half a drink a day had a 15% lower chance of developing high blood pressure than did women who abstained from alcohol. This is very important because it's one of the few risk factors over which a person has control. 63

Diabetes

Medical researchers examined the results of 15 different studies and found that moderate drinkers are less likely to have type 2 diabetes than are abstainers. Teetotalers and heavy drinkers have equally high risk of the disease.
The 15 studies were conducted in the U.S., Japan, Finland, Korea, the Netherlands, Germany and the UK and followed a total of 369,862 men and women for an average of 12 years.
Moderate drinkers (those who drank between about a half a drink to four drinks per day) were found to be 30% less likely to develop type 2 diabetes than abstainers or heavy drinkers.
Whether drinkers consume beer, wine or distilled spirits makes little difference, but the pattern of consumption does. It’s much better to consume frequently (such as daily) rather than infrequently for maximum health benefits. 64
The American Diabetes Association reports that "In people with diabetes, light-to-moderate amounts of alcohol are associated with a decreased risk of heart disease, probably because alcohol raises HDL cholesterol, the so-called 'good cholesterol.'" 65
An analysis of pairs of twins with different drinking patterns found that those who consumed alcohol in moderation had half the risk of developing type 2 (adult-onset) diabetes compared to those who consumed less alcohol. The study involved nearly 23,000 Finnish twins. 66
A study of almost 21,000 physicians for over 12 years has found that men who are light to moderate drinkers have a decreased risk of Type 2 (non-insulin dependent) diabetes mellitus. 67
A study of 8,663 men over a period of as long as 25 years found that the incidence of type 2 diabetes was significantly lower among moderate drinkers than among either abstainers or heavy drinkers. These findings persisted after adjusting for age, smoking, blood pressure, HDL cholesterol, waist circumference, parental diabetes, fasting plasma glucose, body mass index (BMI), serum triglyceride concentration, and cardiorespiratory fitness. 68
Pre-menstrual women who consume a daily drink of beer, wine or distilled spirits (whiskey, rum, tequila, etc.) have a much lower risk of developing type 2 diabetes than abstainers, according to a study that duplicates similar findings in men. The Harvard study involved about 110,000 women age 25 to 42 over a ten-year period. Dramatic reductions (about 60%) occurred among women who drank between 1/2 and two drinks daily compared to abstainers. The reduction of risk was lower for those who drank less. 69
Drinking alcohol (beer, wine, or distilled spirits) in moderation was associated with a lower risk of developing type 2 diabetes among women age 40-70 in a large study in the Netherlands that followed them for an average of over six years. The authors wrote that the “findings support the evidence of a decreased risk of type 2 diabetes with moderate alcohol consumption and expand this to a population of older women.” 70
Research, conducted at the University of Padova Medical School in Italy found that consuming alcohol directly improved the action of insulin in both healthy diabetics. Alcohol also improved fatty acid levels. 71
And the list of research evidence about the positive effects of moderate drinking on diabetes continues. 72

Alzheimer’s Disease and Other Dementia

A French study found moderate drinkers to have a 75% lower risk for Alzheimer's Disease and an 80% lower risk for senile dementia. 73
Research on 7,460 women age 65 and older found that those who consumed up to three drinks per day scored significantly better than non-drinkers on global cognitive function, including such things as concentration, memory, abstract reasoning, and language. The investigators adjusted or controlled for such factors as educational level and income that might affect the results, but the significant positive relationships remained. 74
Researchers in Australia studied 7,485 people age 20 to 64 years. They found that moderate drinkers (males who consumed up to 14 drinks per week and females who consumed up to 7) performed better than abstainers on all measures of cognitive ability. Sex, race, education and extroversion-introversion failed to account for the findings. 75
Older people who drink in moderation generally suffer less mental decline than do abstainers, another study finds. Over one thousand persons age 65 and older were studied over a period of seven years. Overall, light and moderate drinkers experienced less mental decline than did non-drinkers. 76
Women who consume alcohol (beer, wine or distilled spirits) moderately on a daily basis are about 20% less likely than abstainers to experience poor memory and decreased thinking abilities, according to data from 12,480 women age 70 to 81 who participated in the long-term study. 77
A study of about 6,000 people age 65 and older found that moderate drinkers have a 54% lower chance of developing dementia than abstainers. The type of alcohol beverage consumed (wine, spirits, or beer) didn't make a difference in the protective effects of drinking in moderation. 78
A study of 7,983 people aged 55 of age or older in The Netherlands over an average period of six years found that those who consumed one to three drinks of alcohol (beer, wine, or distilled spirits) per day had a significantly lower risk of dementia (including Alzheimer's) than did abstainers. 79
A study of over 400 people at least 75 years old who were followed for a period of six years found that drinkers were only half as likely to develop dementia (including Alzheimer’s disease) as similarly-aged abstainers from alcohol . Abstainers were defined as people who consumed less than one drink of alcohol per week. 80
Moderate drinking among older women can benefit memory according to research funded by the National Institutes of Health. Moderate drinkers performed better on instrumental everyday tasks, had stronger memory self-efficacy and improved memory performance," said Dr. Graham McDougall, who led the research. The performance memory tests include such topics as remembering a story, route, hidden objects, future intentions and connecting random numbers and letters. In all cases, the group who drank scored better than those who did not drink. Women who drank alcohol in moderation (defined as consuming up to two drinks of beer, wine or spirits per day) also performed better on attention, concentration, psychomotor skills, verbal-associative capacities and oral fluency. 81
A study of 1,018 men and women age 65-79 whose physical and mental health was monitored for an average of 23 years found that “drinking no alcohol, or too much, increases risk of cognitive impairment,” in the words of the editor of the British Medical Journal, which published the study. 82
A study of over 6,000 people in the U.K. found that those who consume as little as a single drink of alcoholic beverage per week have significantly greater cognitive functioning than teetotalers. Abstainers were twice as likely as occasional drinkers to receive the lowest cognitive functioning test scores. The beneficial mental effects of alcohol were found when a person drinks up to about 30 drinks per week, and increased with consumption. The researchers did not test the effects of higher levels of alcohol drinking. The research team suggests that alcohol (beer, wine, or liquor) improves mental functioning because it increases blood flow to the brain. Dr. Guy Ratcliffe, the Medical Director of the Medical Council on Alcohol, said that “this is a well-researched study, and it’s important that information such as this is available so that people can make informed decisions about alcohol consumption.” 83
Moderate alcohol consumption protects older persons from the development of cognitive impairment, according to a study of 15,807 Italian men and women 65 years of age and older. Among the drinkers only 19% showed signs of mental impairment compared to 29% of the abstainers. The relationship continued even when other factors in cognitive impairment, such as age, education, and health problems were considered. 84
An 18-year study of Japanese American men found "a positive association between moderate alcohol intake among middle-aged men and subsequent cognitive performance in later life." Moderate drinkers scored significantly higher on the Cognitive Abilities Screening Instrument (CASI), which includes tests of attention, concentration, orientation, memory, and language. Both nondrivers and heavy drivers had the lowest CASI scores. 85
The moderate consumption of alcohol was associated with superior mental function among older women compared to abstainers in a study of 9,000 women aged 70 to 79 over a period of 15 years. The women's mental function was assessed with seven different tests. After adjusting for other factors that might affect mental function, the researchers found that the women who drank in moderation performed significantly better on five of seven tests. They also performed significantly better on a global score that combined all seven tests. The researchers found that the effect of moderate alcohol consumption on cognitive functioning was the equivalent of being one to two years younger. 86
Drinking alcohol (beer, wine or liquor) in moderation is one of the strategies that can reduce the risk of cognitive decline and dementia in later life according to a review of research conducted by scholars from the School of Aging Studies at the University of South Florida (Drs. Ross Andel and Tiffany Hughes) and the University of Alabama at Birmingham (Dr. Michael Crowe). They carefully analyzed the existing research to identify how dementia can be reduced. Abstaining from alcohol and abusing alcohol are both risk factors for cognitive decline and dementia. 87

Other

Common Cold. Moderate drinkers have been found to be more resistant than abstainers to five strains of the common cold virus. Those who consumed 2 to 3 drinks daily had an 85% greater resistance. Those drinking 1 to 2 drinks daily had a 65% lower risk and those who drank less than daily had a 30% lower risk than abstainers. 88
Intermittent Claudication (IC). In a study of 18,339 observations, researchers found that drinking alcohol in moderation significantly reduces the risk of intermittent claudication. IC is associated with a two- to four-fold increased risk of death from cardiovascular disease. 89
Kidney Cancer. An analysis of data from 760,044 men and women who were tracked for seven to 20 years found that moderate drinkers are about 30% less likely to develop kidney cancer than are abstainers. 90 A large prospective study of 59,237 Swedish women age 40-76 found that those who consumed at least one drink per week had a 38% lower risk of kidney cancer than did abstainers or those who drank less. For women over 55, the risk dropped by two-thirds (66%). 91
Metabolic Syndrome. Researchers at Boston Medical Center analyzed data from 8,125 participants in the Third National Health and Nutrition Examination Study. They found that drinkers had a 43 percent lower chance of having Metabolic Syndrome than did abstainers or non-drinkers. After taking into account age, sex, race, education, income, tobacco use, physical activity, and diet, the researchers found that subjects who consumed 1-19 alcoholic drinks per month had a 35% reduction in risk, and those who had 20 or more drinks each month had a 66% reduction in risk of Metabolic Syndrome. 92
Non-Hodgkin’s Lymphoma (Cancer). A review of findings from nine international studies suggests that drinking alcohol reduces the risk of non-Hodgkin’s lymphoma (NHL) by 27%. The protective effect of alcohol did not vary by beer, wine, or distilled spirits consumption.. The research also found that alcohol's protective effect varies by form or subtype of non-Hodgkin‘s lymphoma. Drinkers were about half as likely as non-drinkers to develop Burkitt's lymphoma. The cancer is the sixth most common in the USA. 93
Peripheral Artery Disease. Harvard researchers have found moderate drinkers to be almost 1/3 less likely to suffer Peripheral Artery Disease (a significant cause of death among the elderly) than those consuming less than one drink per week. 94
Rheumatoid Arthritis. Research studies suggest that the consumption of alcohol reduces the risk of developing rheumatoid arthritis. A large study in Sweden additionally found that the risk of developing the painful disease decreased as the consumption of alcohol increased from light to moderate levels. 95

And the list goes on...

Moderate consumption of alcohol appears to be beneficial to reducing or preventing even more diseases and health problems:

Angina Pectoris 96
Bone Fractures and Osteoporosis 97
Digestive Ailments 98
Duodenal Ulcer 99
Erectile Dysfunction 100
Essential Tremors 101
Gallstones 102
Hearing Loss 103
Hepatitis A 104
Hodgkin’s Lymphoma (Cancer) 105
*Kidney Stones 106
Macular Degeneration (a major cause of blindness) 107
Pancreatic Cancer 108
Parkinson's Disease 109
Poor Cognition and Memory 110
Poor Physical Condition in Elderly 111
Stress and Depression 112
Type B Gastritis 113

What Is Moderation?

Medical researchers generally describe moderation as one to three drinks per day. It appears that consuming less than about half a drink per day is associated with only very small health benefits. Four or five drinks may be moderate for large individuals but excessive for small or light people. Because of their generally smaller size and other biological differences, the typical woman should generally consume 25 to 30 percent less than the average man. 114 And, of course, recovering alcoholics, those with any adverse reactions to alcohol, and those advised against drinking by their physicians should abstain.

A drink is a 12 ounce can or bottle of beer, a five ounce glass of wine, or 1.5 ounces of liquor (either straight or in a mixed drink). 115 Learn about Alcohol Equivalence and visit Standard Drinks.

Harvard's Healthy Eating Pyramid, produced by the Harvard Medical School Guide to Healthy Eating, was co-developed by scientists at the Harvard School of Public Health. It is based on the best available Harvard Food Pyramid scientific knowledge and recommends drinking alcohol in moderation (unless there is a good reason to abstain). 116

Drinking patterns appear to be as important as the amounts consumed. "The key to healthy, moderate consumption is a regular, one to three drinks per day pattern." 117 However, drinking a "weeks worth" of alcohol over a period of a few hours would be unhealthful, even dangerous, and clearly to be avoided.

All of the many health benefits of drinking apply only to moderate consumption - - never to heavy drinking. To the contrary, heavy drinking is associated with reduced longevity and increased risk of a diversity of diseases. Unfortunately, there really can be too much of a good thing.

Salud, skoal, a votre sante', prost, l'chayim, or, in English, "to your health," but all in moderation!

The material on this site is for information only and is not advice

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