Researchers have found that drinking alcohol regularly, even in small amounts, reduces the risk of cardiovascular disease. If Americans suddenly stopped drinking, data suggest that thousands more deaths due to heart disease would occur each year.
Whether to drink is a personal decision. At the very least, alcoholic beverages cost money and add calories to the diet. More seriously, alcohol can cause accidents, family conflicts and medical problems. Keep in mind, too, that there’s little or no cardiovascular benefit for premenopausal women or for men under 40, since they are at much lower risk.
Alcohol’s protective effect is twofold. Like aspirin, alcohol reduces blood clotting—a transient effect that persists for about a day. When consumed regularly, alcohol also raises levels of HDL cholesterol over the long term; HDL removes cholesterol from arterial walls and helps prevent atherosclerosis (also known as hardening of the arteries). Despite what you may have heard about red wine and the French paradox, most studies have found that one type of alcoholic beverage is as protective as another. The alcohol is primarily responsible for the effect. Red wine does contain other compounds that may be beneficial as well.
A drink every day?
It’s not clear what pattern of consuming alcohol is best, except that small amounts of alcohol consumed regularly are better than larger amounts occasionally. Some research suggests that daily (or almost daily) drinking is best for the heart, while other studies suggest that drinking every other day is just as good. Some studies have found that all it takes is half a standard drink a day. Drinking with meals is preferable, since that slows the absorption of the alcohol. In addition, people who drink at meals are more likely to drink moderately.
Moderate drinking is the amount sufficient to confer heart benefits, while minimizing the dangers of heavier drinking. In the United States, this is generally defined as up to one drink a day for a woman, up to two for a man. (A “drink” is 5 ounces of wine, 12 ounces of beer or 1.5 ounces of 80-proof liquor, all of which contain about 14 grams of pure alcohol.) Women are advised to drink less than men, largely because they tend to be smaller and have proportionately more body fat and less body water than men (alcohol is diluted in body water). Thus, a given amount of alcohol will result in a higher blood level of alcohol in women and could cause more impairment.
The definition of moderation does differ from country to country. French authorities, for example, suggest up to three drinks daily for men and women. In Canada, the official recommendations about moderation vary from province to province. The definition of a standard drink also varies from country to country. Most governments, however, recommend abstinence for pregnant women or women trying to become pregnant. Alcohol can harm the fetus, and no one knows what amount, if any, is safe.
These are just guidelines, not rules, since a given amount of alcohol can affect people differently, depending on body size, age and other factors. Older people are affected more by alcohol, since their bodies don’t process it as well. And alcohol doesn’t mix well with many drugs older people take. Thus, many governments recommend that people over 65 drink less than the official guidelines. Also, drinking patterns matter. Heavy drinking, even confined to special occasions, is dangerous.
Does moderate drinking pose health risks?
The serious health risks come mostly from heavy drinking: alcoholism, heart and liver disease, hypertension, certain cancers (of the breast, mouth, esophagus, larynx, liver and colon, for instance), osteoporosis, and car crashes and other accidents. But even moderate drinking can affect coordination and impair your ability to drive, operate machinery or swim. It also slightly increases the risk of breast and some other cancers; the combination of smoking and drinking multiplies the risk of oral cancers. Some people should not drink at all, including children, pregnant or breastfeeding women, people who cannot drink moderately and/or are at high risk for alcoholism, those with certain medical conditions and those taking medications that interact with alcohol.