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Alcoholism

Sorry, Moderate Drinking May Not Be Good for You After All

Previous research was likely wrong. How could this happen?

Key points

  • A new meta-analysis challenges previous research stating moderate alcohol consumption is healthier than drinking no alcohol at all.
  • The new study points to significant biases the previous alcohol-consumption studies likely missed, such as healthy habits of moderate drinkers.
  • Research funding from the alcohol industry and a cultural admiration for the European lifestyle may have promoted the idea of moderate drinking.

For decades, in study after study, health researchers told us the same thing: Moderate alcohol consumption was healthier for us than drinking no alcohol at all. And that an average of two drinks a day for men, or one drink a day for women, could provide significant protection against all-cause mortality.

Turns out, that research, and those recommendations, were very likely wrong. A new, exhaustive analysis of more than 40 years of data covering nearly 100 studies and almost five million adults finds that, in fact, moderate alcohol intake doesn’t help us live longer. Rather, the difference in mortality risk between nondrinkers and moderate drinkers is statistically insignificant—and risk may even be slightly higher for the drinkers.

How could this have happened?

Published by JAMA Network Open in March, the meta-analysis pointed to three significant biases that the previous alcohol-consumption studies likely missed:

  1. Many moderate drinkers in the earlier studies had several healthy habits that researchers didn’t account for, such as higher activity levels, better diet, lower weight, and even better dental hygiene. The implication is, these factors likely made the difference in mortality risk, not moderate alcohol consumption.
  2. Earlier studies failed to separate out what the new study authors call “sick quitters,” or those people who abstained from alcohol after developing health problems. In other words, the abstainers were less healthy in general, which made the moderate drinkers seem more healthy (because of their drinking).
  3. Older white men were also overrepresented as study subjects in earlier studies. This made the moderate drinkers look healthier, presumably because this demographic tends to be healthier than nonwhite older men.

Funding of research by the alcohol industry

It’s possible that earlier studies on alcohol consumption were biased for another reason as well: They were funded by the alcohol industry. In a 2020 study published in the European Journal of Public Health, the authors found that between 2009 and 2020, there was a 56 percent increase in research funded by alcohol companies and their affiliates.

The study authors believe this may have increased the potential for bias, conflicts of interest, and the selective reporting of outcomes. These factors may have combined to make the consumption of alcohol look healthier than it is.

Our admiration for, and emulation of, the European lifestyle

There’s a cultural mechanism at work that may have perpetuated the “moderate drinking is healthy” phenomenon. Many Americans admire the way people live in Europe—at least how it's portrayed in the media. As in, red wine with dinner, hours-long family get-togethers out on the patio with wine on the table, the outdoor cafe culture, and so on.

We also see lower alcohol use disorder rates and less stigma about alcohol in Europe, so it seems like a healthy pastime—and one we’re attracted to.

The result of all this? Our European friends are certainly making moderate alcohol consumption work for them, so let us Americans do the same. And maybe some of their sophistication, relaxed attitude about work, and daily pursuit of “la dolce vita” will come our way as well.

4 good reasons to lower your intake

If moderate alcohol consumption isn’t the health panacea we thought it was, and if you’re not interested in emulating Europeans with their sophisticated wine-drinking habits, maybe it’s time to cut back. Here’s why that could be a smart move:

  1. You’ll likely lose weight. Given that an average glass of wine is 120 calories, and a beer more like 200 calories, those numbers can really add up. That beer gut or the extra five pounds may go more quickly once you cut out the alcohol.
  2. It would save you money. Surveys show that the average person spends between $50,000 and $120,000 on alcohol in a lifetime. That’s a lot of money that could be put toward healthier pursuits.
  3. You’ll likely sleep better. Alcohol can negatively affect the brain’s sleep/wake cycles. For example, people who drink close to bedtime can disrupt their REM sleep. Unfortunately, that’s when restorative sleep occurs, which helps with overall health, stress, body tissue repair, and mental health.
  4. Your brain will thank you. Studies show that moderate levels of alcohol use are linked to brain damage in the memory centers. Moderate consumption can also slow the development of your brain’s white matter, which helps regulate how fast your brain works.

Final thought: Even if moderate alcohol consumption doesn’t provide the health boost we thought it did, doing things in moderation and in a balanced manner is still good health advice. After all, it was likely behind the better health that moderate drinkers were enjoying all those years.

References

Zhao, J., Stockwell, T., Naimi, T. (2023). Association Between Daily Alcohol Intake and Risk of All-Cause Mortality: A Systematic Review and Meta-analyses. JAMA Network Open.

Golder, S., Garry, J., McCambridge, J. (2020). Declared funding and authorship by alcohol industry actors in the scientific literature: a bibliometric study. European Journal of Public Health.

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