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Sorting out the health effects of alcohol

November 3, 2020

About the Author

photo of Robert H. Shmerling, MD

Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. … See Full Bio
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Robert Shmerling
August 28, 2018

There may be a mixed message regarding alcohol consumption because, in fact, the effects of alcohol on health are complex – just how much is too much continues to be debated.

But even if there was a consensus that light drinking was beneficial or “medicinal,” most doctors might not recommend alcohol to non-drinkers because it is not easy to know who will drink too much, drive while intoxicated, etc. – it is hazardous to make individual recommendations based on a population-based, observational studies that combine data from thousands of individuals.

In addition, it’s worth acknowledging that doctors tend to worry about liability – that alone might dampen enthusiasm of recommending light drinking, regardless of what the data shows!

Rachel Courtney
August 21, 2018

I’m not a drinker, don’t like it. I’ll have a few drinks a year, at a special occasion to “fit in” and be “sociable”. Never feels that good, and I don’t sleep well that night.

The mixed messages here are tough to sort out.

First you write:
“Despite these potential health benefits, most doctors don’t recommend that someone who doesn’t drink start drinking”

WHY? Because then you write:
“Light drinkers (those consuming one to three drinks per week) had the lowest rates of cancer or death compared to those drinking less than 1 drink per week.”

SO maybe it has a medicinal benefit, and all should consider including it as a part of a balanced healthy diet?

Mike Stanhill
August 20, 2018

Great article and informative comments. Thanks

Edie Raether, MS, CSP
August 20, 2018

You had nothing really on the effects on the brain. Check out Daniel Amen’s work and studies on that. One of his bestsellers is Change Your Brain…Change Your Life. He does not touch the stuff! And his research asks why one would take even a moderate amt. of poison? I do have about a third of a glass with dinner, but am very moderate….just to play safe!

Ramón Narvaez
August 20, 2018

Check out this point of view. Got me thinking twice!

Any ideas?

Robert Shmerling
August 13, 2018

While there was a linear association between cancer and alcohol consumption, I was referring to the finding of the study that assessed the outcome combining risk of cancer or death as stated by the study authors. Specifically; There was a “J-shaped association observed between average lifetime alcohol consumption and overall mortality, cardiovascular- related mortality, and combined risk of death or cancer.”

So, from in the Kunzmann study, for these measures, never-drinkers had higher risk compared to lifetime light drinkers.

Though the message of ‘less alcohol is better’ is easy, it may not be true.

Miguel Marcos
August 13, 2018

It is an interesting post but the study of Kunzmann et al clearly states that “Analyses of specific causes of mortality revealed (…) a linear association for cancer-related mortality”, therefore I think it is a bit misleading saying that “Light drinkers had the lowest rates of cancer or death compared to those drinking less than 1 drink per week.” Also, this same study clearly states: “This evidence should not be taken to support a protective effect of light drinking.” Alcohol, less is better. Easy message as far as we know right now.

catalina laserna
August 8, 2018

Great information! Could you provide the specific reference to the article about how age affects the effect of alcohol? thanks!

Cliff gallant
August 8, 2018

I was surprised that the article didn’t include the age related effects of alcohol. I read recently that , because the rate of metabolism has slowed down, the effects of alcohol on a 60–70 year old are twice as pronounced as the effects on a 30-40 year old. If a senior citizen is drinking two or more drinks a day their focus and energy level is dramatically affected.

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