If you’re one of the 52% of adults in the US who regularly consume alcohol[1], you may have heard conflicting reports on whether it’s healthy or even safe.
While the negative health effects of heavy drinking are widely recognized, the impact of low to moderate alcohol intake may feel less clear.
But the evidence is piling up that the only truly safe amount of alcohol is ZERO.
Let’s look closer at the prevailing myths about alcohol intake and the emerging research that should guide your choice of how much or whether to drink.
This article will explore:
- Why past research mistakenly promoted moderate alcohol intake as beneficial
- The health risks associated with alcohol consumption
- The level of alcohol intake that leads to health risk
- Suggestions for living alcohol-free
The History of Alcohol and Health
For the past few decades, alcohol has benefited from a health halo of sorts.
Wide reports in the media highlighted studies during the late 1900s and early 2000s seemed to indicate that light-to-moderate drinking was beneficial. Several mechanisms were suggested:
- The HDL (“good” cholesterol”) boosting effect of moderate drinking, especially red wine.
- The “French Paradox” compared the drinking habits of the French population and their relatively low risk of heart disease with the US population and our relatively high risk.
- Resveratrol and other antioxidants in red wine were believed to promote heart health.
If you heard these explanations for why moderate drinking (defined as 1 drink a day for women and 2 drinks a day for men) isn’t so bad, you’re not alone. Enough studies suggested these potential benefits for the viewpoint to gain wide popularity.
And, let’s face it, anyone who enjoys a glass of wine in the evening hopes the habit is beneficial.
However, over time, these initial findings have proved less convincing. Let’s look at each claim a little closer.
Does Alcohol Raise HDL and Protect Against Heart Disease?
It’s true that regular alcohol intake increases HDL.[2] However, this doesn’t tell the whole story.
HDL is considered “good cholesterol” because it transports cholesterol out of the bloodstream and to the liver to be removed. This is good because the build-up of cholesterol in the arteries (atherosclerosis) is the primary cause of heart disease.
Yet, while HDL has an important function, the relationship between HDL and your risk of heart disease is not as direct as it may seem. Recent large-scale studies have failed to confirm a link between higher HDL levels and reduced heart disease risk.[3]
A better question is: Does alcohol increase the risk of heart disease, regardless of whether or not it raises HDL?
A recent study used Mendelian randomization, a highly reliable technique that minimizes confounding variables, to assess the risk of heart disease.[4]
The results showed a clear and direct relationship between any amount of drinking and heart disease risk. If you drink at all, your risk of heart disease is higher than someone who doesn’t drink, and the more drinks you consume per week, the higher your risk becomes.
Drinking alcohol for its HDL-raising benefits doesn’t appear to be justified. Better ways to increase HDL include:
- Exercise
- Lose weight
- Quit smoking
- Consume more whole plant foods such as fruits, vegetables and whole grains
Understanding the “French Paradox”
Cardiovascular disease causes 1 out of 3 deaths in the US. In France, this number is 1 out of 5, yet they consume more alcohol.[5] This observation gave rise in the 1990s to speculation that wine consumption provided protective benefits.
This theory has since been discredited.
There are many factors that influence heart disease risk, and when compared to France, the US comes out worse in several metrics. The US population has higher rates of:[5]
- Obesity
- Hypertension
- High cholesterol
- Type 2 diabetes
The population in France tends to:[6]
- Be more physically active
- Consume smaller portion sizes
- Eat more fruits and vegetables
- Drink fewer sugar-sweetened beverages
Lifestyle, genetics, culture, and health histories are all very different in France. Taking one isolated factor, like alcohol consumption, and trying to extrapolate health benefits is unwise.
Do the Antioxidants in Wine Provide Health Benefits?
Yes, wine does contain some nutrients known to be beneficial to health. However, it does not follow that drinking wine is a health-promoting behavior.
Resveratrol, a naturally occurring antioxidant and anti-inflammatory found in wine, gets a lot of press. But its health-promoting benefits have been overstated.
While animal and in-vitro studies show promise for the effects of resveratrol on heart health, cancer prevention, and brain health, the levels of resveratrol used in these studies are substantially higher than could be reasonably consumed by humans.[7]
Studies on resveratrol in humans who use high-dose supplements have failed to validate resveratrol benefits.[7]
Regardless, wine is not the only source of resveratrol:
- Grapes
- Peanuts
- Tomatoes
- Apples
- Chocolate
Eating a balanced diet high in fruits, vegetables, whole grains, and other plant foods is the best way to boost your diet's antioxidant and nutrient density.
How Much Alcohol is Safe?
Alcohol intake can be broken into different categories, which are important for understanding its safety.[8]
Abstainers - No alcohol
Low intake - <7 drinks a week
Moderate intake - Up to 1 drink a day for women and up to 2 drinks a day for men
Heavy intake - 8 or more drinks for women and 15 or more drinks for men in a week
Binge drinking - 4 or more drinks for a woman and 5 or more drinks for a man on one occasion
Heavy drinking and binge drinking have significant health consequences and confer the greatest health risk. However, even moderate and low intake of alcohol carries risks, though at a lower level than heavy and binge drinking.
- Even low levels of alcohol intake (<1 drink/day) increase the risk of certain cancers, including breast cancer in women.[9]
- Higher risk of all-cause mortality, especially among women.[10]
- Risk of negative effects on brain size and cognition.[11][12]
- Increased risk of heart disease.[4]
- Interferes with quality sleep which negatively impacts health.[13]
There is no level of alcohol intake that doesn’t carry some amount of risk. While many health organizations continue to publish guidelines recommending no more than moderate drinking, they increasingly highlight the hard truth: the safest level of alcohol intake is zero.
Living Alcohol-Free
Each individual has to choose for themselves the amount of risk that feels comfortable. While the risk of low alcohol intake is higher than not drinking at all, only you can decide what feels right for you.
If you choose alcohol-free living, it may feel daunting at first, especially in social situations where you previously drank.
Here are some tips to make the transition easier:
- Bring your own alcohol-free beverages. There are many “mocktail” options or even nonalcoholic wine and beer if that suits your taste.
- Tell your friends and family your intentions and enlist their support.
- Plan gatherings that don’t revolve around drinking. For example, getting together to play basketball may be easier than getting together to watch basketball.
- Recruit friends to undergo a “dry” month with you and share your positive experiences.
- Volunteer as the designated driver
- Go places that don’t serve alcohol, like coffee shops, movie theaters, libraries, and museums.
Exercise to Reduce Alcohol Consumption
Regular exercise is a proven way to reduce alcohol cravings and boost mental health, along with its other many benefits.
One study examined the effects of an intense 12-minute cycling session on alcohol cravings, anxiety levels, and mood in people with an alcohol use disorder. The exercise session significantly reduced alcohol cravings and positively impacted anxiety and mood.[14]
A recent meta-analysis found significant benefits of exercise to reduce alcohol consumption.[15]
Whether you're cutting back on drinking or just need more proof of the benefits of your exercise habit, sticking with a fitness routine benefits all your health goals.
FAQs
What if I only drink when I go out on the weekends?
The research shows there is no safe amount of alcohol, so even limiting your drinking to one or two days a week isn’t risk-free. Weekend drinking can often turn into binge drinking, where you consume multiple drinks in one sitting and may even surpass what’s considered low alcohol intake.
Is it true that drinking wine or beer is safer than hard liquor?
All standard-size drinks contain the same amount of pure alcohol, about 14 grams, and carry the same health risks.
- 12 ounces of beer (5% alcohol)
- 5 ounces of wine (12% alcohol)
- 1.5 ounces of hard liquor (40% alcohol)
I have a high alcohol tolerance. Does that mean it’s safer for me?
The number of drinks you can have before you “feel” the effects of alcohol intoxication has nothing to do with its safety. Your health risk is the same whether you begin to feel drunk at 1 drink or 4.
However, it should be pointed out that drinking to the point of feeling drunk is more dangerous to your immediate physical safety in terms of your risk of accidents and alcohol poisoning.
I have a family member who drank every day of their life and lived to a ripe old age. Does that mean I have a lower risk?
Probably not. There is no evidence that some people can safely drink more than others.
While genetics always plays a role in health, many other factors influence your disease risk. Just because a family member lived a long life despite less-than-healthy choices doesn’t mean you’ll be so lucky.
Final Thoughts
The definition of safe varies from person to person, but in scientific research, what’s truly a safe level of alcohol intake is clear. There is no safe amount of alcohol.
Low to moderate alcohol intake carries some health risks, and the more you drink, the higher your risk becomes.
Avoiding heavy and binge drinking is essential to good health. In the low to moderate range, you have to decide the level of risk acceptable to you. To avoid any risk from alcohol, the best choice is zero.
Exercise is a useful complement to living an alcohol-free life, especially if you’re new to not drinking.
Here at Outwork Nutrition, we’re all about maximizing the benefits of exercise, so you live a long, healthy life and crush your fitness goals.
Our line of quality, science-backed supplements are designed to work as hard as you do. Supporting your workouts with our pre-workout formula will boost performance so you get the most out of your time in the gym. And our recovery and protein supplements give you the building blocks you need to gain muscle and strength.
Exercise isn’t just about sculpting muscle and being fit. It’s one tool to keep you strong for life and support your overall healthy lifestyle, whether you’re alcohol-free or choose to drink in moderation.
References
1. CDC National Center for Health Statistics - Alcohol Use. https://www.cdc.gov/nchs/fastats/alcohol.htm
2. De Oliveira E Silva ER, Foster D, McGee Harper M, et al. Alcohol consumption raises HDL cholesterol levels by increasing the transport rate of apolipoproteins A-I and A-II. Circulation. 2000;102(19):2347-2352. https://doi.org/10.1161/01.CIR.102.19.2347
3. Gulec S., et al. European Society of Cardiology. High-density lipoprotein cholesterol and risk of cardiovascular disease. e-Journal of Cardiology Practice. Volume 19, No 3. 2020.
4. Biddinger KJ, Emdin CA, Haas ME, et al. Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease. JAMA Netw Open. 2022;5(3):e223849. doi:10.1001/jamanetworkopen.2022.3849
5. Brouard, Benoît & Vegreville, Matthieu & Chieh, Angela & Schmidt, Nicolas & Sirieix, Marie-emmanuelle & Simon, Alain. (2016). Abstract 13065: Comparison of the Cardiovascular Health Status of the American and French Populations Using Connected Devices. Circulation. 134. https://doi.org/10.1161/circ.134.suppl_1.13065
6. Powell LH, Kazlauskaite R, Shima C, Appelhans BM. Lifestyle in France and the United States: an American perspective. J Am Diet Assoc. 2010;110(6):845-847. doi:10.1016/j.jada.2010.03.029
7. Weiskirchen S, Weiskirchen R. Resveratrol: How Much Wine Do You Have to Drink to Stay Healthy?. Adv Nutr. 2016;7(4):706-718. Published 2016 Jul 15. doi:10.3945/an.115.011627
8. NIH National Institute on Alcohol Abuse and Alcoholism. Alcohol's Effects on Health. Understanding Alcohol Drinking Patterns.
9. Health and cancer risks associated with low levels of alcohol consumption.
Anderson, Benjamin O et al. The Lancet Public Health, Volume 8, Issue 1, e6 - e7
10. Zhao J, Stockwell T, Naimi T, Churchill S, Clay J, Sherk A. Association Between Daily Alcohol Intake and Risk of All-Cause Mortality: A Systematic Review and Meta-analyses. JAMA Netw Open. 2023;6(3):e236185. doi:10.1001/jamanetworkopen.2023.6185
11. Topiwala A, Allan CL, Valkanova V, et al. Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study. BMJ. 2017;357:j2353. Published 2017 Jun 6. doi:10.1136/bmj.j2353
12. Immonen S, Launes J, Järvinen I, et al. Moderate alcohol use is associated with decreased brain volume in early middle age in both sexes. Sci Rep. 2020;10(1):13998. Published 2020 Aug 19. doi:10.1038/s41598-020-70910-5
13. Katie S McCullar, David H Barker, John E McGeary, Jared M Saletin, Caroline Gredvig-Ardito, Robert M Swift, Mary A Carskadon, Altered sleep architecture following consecutive nights of presleep alcohol, Sleep, Volume 47, Issue 4, April 2024, zsae003, https://doi.org/10.1093/sleep/zsae003
14. Hallgren M, Herring MP, Vancampfort D, et al. Changes in craving following acute aerobic exercise in adults with alcohol use disorder. J Psychiatr Res. 2021;142:243-249. doi:10.1016/j.jpsychires.2021.08.007
15. Lardier DT, Coakley KE, Holladay KR, Amorim FT, Zuhl MN. Exercise as a Useful Intervention to Reduce Alcohol Consumption and Improve Physical Fitness in Individuals With Alcohol Use Disorder: A Systematic Review and Meta-Analysis. Front Psychol. 2021;12:675285. Published 2021 Jul 7. doi:10.3389/fpsyg.2021.675285
