For years, the conventional wisdom has been that alcohol, consumed in moderation, can have some positive effects on various aspects of health. Recently, however, a wide-ranging analysis concluded that there’s no safe or healthy level of alcohol consumption.¹ The study, published in The Lancet, examined data from 195 countries and concluded that alcohol is a “colossal global health issue” contributing to millions of deaths annually. The authors acknowledge that moderate drinking may provide a degree of protection from heart disease and diabetes, but conclude that the increased risk of cancer, injuries, and infectious diseases outweighs any potential benefit.
This article will dive into some of the popular research findings on alcohol consumption and break down the effects of alcohol on the body. Share it if you enjoy it, and check out our other articles on alcohol consumption and treatment for alcoholism.
Why People Drink Alcohol
People drink for many reasons. Often the primary motivation is social, with people following the norms of their peer group or cultural environment. There are also psychological motivations, such as the desire to relieve anxiety or reduce inhibitions. What if your motivation is to improve your physical health? Global analysis indicates that the net result is negative, but are there ever individual situations in which it might be positive?
- Heart health– The most common health benefits attributed to alcohol are heart related. A Harvard Health publication notes, however, that most alcohol-related research is observational in nature, showing association but not causality. How, exactly, alcohol might improve heart health is debated. It may increase HDL (good) cholesterol, but cardiologist J. Michael Gaziano notes that “this is not the most important factor in preventing heart disease, and there are other ways to increase HDL than drinking alcohol, such as regular exercise.”² Other researchers believe that flavonoids and antioxidants found in red wine, in particular, may provide health benefits, but note that there are various ways to consume them, including by drinking grape juice or simply eating grapes. Any potential cardiac benefits of alcohol are limited to moderate drinking, which is generally defined as no more than one drink a day containing 14 grams of pure alcohol or less. This equates to 12 ounces of regular beer or five ounces of wine. The American Heart Association notes that alcohol consumed in more than moderate amounts is associated with various negative cardiovascular effects, including high triglycerides and blood pressure, cardiomyopathy, cardiac arrhythmia, and sudden cardiac death. They conclude, “The American Heart Association cautions people NOT to start drinking.”³
- Diabetes – A widely publicized Danish study determined that people who had a drink three or four days a week were less likely to develop diabetes than those who didn’t drink.⁴ The effects varied with the type of alcohol consumed, with wine being the most beneficial. Some types of alcohol had a negative effect. In women, for example, drinking gin was associated with an 83 percent increased risk of developing the disease. The study showed correlation, but not causality, and there’s no widely accepted explanation for how alcohol might be protective. Once someone has already developed diabetes, drinking becomes more challenging. The liver contains emergency stores of glucose, but alcohol blocks glucose production and can contribute to dangerously low blood sugar levels. Because of the glucose-blocking effect, people may be tempted to use alcohol to lower high blood sugar, but the American Diabetes Association notes that “the effects of alcohol can be unpredictable and it is not recommended as a treatment for high blood glucose. The risks likely outweigh any benefit that may be seen in blood glucose alone.”⁵
- Cancer – Drinking alcohol, even in moderation, increases the risk of developing at least seven types of cancer, including liver, colorectal, and breast cancer. The type of alcohol consumed doesn’t appear to change the equation and the association is linear, with higher amounts of alcohol contributing to higher cancer risk.
- Infectious diseases – Alcohol negatively affects the immune system by changing the number and function of immune cells. Because of this, people who drink are more likely to contract an infectious disease like HIV, hepatitis, pneumonia, or tuberculosis. They may also have more complications after surgery and take longer to recover from illnesses.
- Sleep – Many people use alcohol to help them sleep. While it’s true that alcohol allows people to fall asleep more quickly, the overall quality of the sleep is diminished. Alcohol causes the brain to turn on both delta activity, associated with sleep, and alpha activity, which generally isn’t. It blocks REM sleep, and also increase the risk of sleep apnea and snoring.
Alcohol Use Disorder
Perhaps the most significant risk associated with alcohol consumption is the possibility of developing alcohol use disorder (AUD), commonly known as alcoholism or alcohol addiction. AUD involves compulsive use of alcohol, loss of control over the amount consumed, and a negative emotional state when it isn’t being used
Addiction to alcohol develops similarly to the way other addictions develop and can have both a psychological and physical component. Psychologically, addiction develops because of positive associations. Drinking, at least in the short term, can help people experience pleasure and avoid pain, making it easy for people to come to rely on it to enjoy or cope with life.
Alcohol addiction is also associated with physical changes in the brain. Drinking increases the activity of the neurotransmitter dopamine and activates the reward pathway. We learn to repeat things that cause dopamine to surge. Alcohol affects other neurotransmitters as well, like serotonin, GABA, and glutamate. The changes in neurotransmitter levels, and the body’s attempt to compensate for them, lead to tolerance, in which larger amounts of alcohol must be consumed in order to feel the effects a smaller amount once produced. If drinking continues, the body can come to see the presence of alcohol as normal and adapt in such a way that withdrawal symptoms occur if it isn’t regularly consumed.
Most people understand that excessive drinking is harmful, not only personally, but societally, with effects that spread to relationships, insurance premiums, the workplace, and the criminal justice system. What’s less understood is whether or not moderate drinking is risky or can even be beneficial, at least in some circumstances. Is alcohol good for your health? At this point, the research indicates that it probably isn’t, so if you choose to drink, it’s wise to understand what your reasons are and to be aware of your risks. See our related articles for more on the effects of alcohol and treatments for alcohol addiction.
By Martha McLaughlin
1 Burton, Robyn and Nick Sheron. “No level of alcohol consumption improves health.” The Lancet, September 22, 2018.
2Solan, Matthew. “Alcohol and heart health.” Harvard Health Publishing, July 6, 2018.
3“Alcohol and Heart Health.” American Heart Association, Accessed October 6, 2018.
4Holst, Charlotte, et al. “Alcohol drinking patterns and risk of diabetes: a cohort study of 70,551 men and women from the general Danish population.” Diabetologia, October 2017.
5“Alcohol.” American Diabetes Association, Accessed October 6, 2018.