How Much Alcohol Is Healthy?

In the spirit of dry January, I was asked to share my thoughts with Yahoo on whether I consider alcohol to be a part of a healthy lifestyle. The TLDR: yes, but limit it to 1-3 drinks per week.

The French Paradox

It’s widely believed that moderate alcohol consumption (one drink for women and two for men), and especially red wine is associated with a decreased risk of cardiovascular disease. This is the basis for “the French Paradox”— why the French can drink red wine and eat cheese while enjoying lower rates of heart disease. 

But there are several problems with this conclusion. First of all, the studies supporting the idea that alcohol is beneficial are based on observational data. It’s really hard to draw causal conclusions with these types of studies because there are too many confounding variables (other factors that could be responsible for the results). 

For example, you might conclude that living in Colorado is associated with an increased risk of leg breaks than living in Arizona. But there are probably more people skiing in Colorado than in Arizona, and skiers are more likely to break their leg than non-skiers. That’s a confounding variable. 

Many argue that the benefits seen in the French population are instead due to confounding variables like their Mediterranean-style diet, their social connections, and their tendency to walk more. Further complicating this picture, there is evidence that French doctors have underreported heart disease over the years. It’s also now known that many of these studies had ties to the alcohol industry, which definitely begs the question of their validity. 

Resveratrol, a polyphenol found in red wine, is thought to help lower levels of inflammation, which theoretically helps lower the risk of CVD. But the evidence suggesting red wine helps you prevent heart disease is pretty weak. The resveratrol studies are done in mice, and you’d have to drink so much red wine to get the therapeutic amount (over 100 glasses) that it just isn’t possible.  

New Studies Question Alcohol’s Benefits

A recent study by Biddinger et al. used a method called Mendelian randomization which controls for confounding variables better than observational studies. It concluded that all levels of alcohol consumption were associated with an increased risk of cardiovascular disease. Even light drinkers were found to have a higher risk, though the risk was small.

We’ve also seen that moderate and even light alcohol intake (just three or more drinks per week) is associated with a 15% increased risk in developing breast cancer. So even if there is a small preventative benefit for cardiovascular disease, is it worth it?

We know that heavy drinking is clearly associated with increased risk of all kinds of diseases and mortality, and moderate drinking has it’s potential risks as well. But when it comes to light drinking, the risks and benefits we’re talking about here are relatively small. 

What I think we can say is this: any amount of any type of alcohol is likely not good for your health, but light intake is not likely to be harmful.

Why the French Paradox Lives On

With all that said, why do people still widely accept the French paradox? For one thing, it’s definitely convenient and fits in with an American culture that enjoys alcohol. The alcohol industry is big business, so the marketing dollars are flowing. And while the studies suggesting higher risks with cancer are concerning, I wonder if people just need more evidence to be convinced to break a habit that has been so deeply ingrained in our culture. 

Is it Better to Abstain from Alcohol?

What should you do? As with many things, context is king. I always assess my clients’ relationship with alcohol. Does it bring them more joy and social connection? Does it help relieve their stress? Can they still be intentional with their food habits overall while enjoying a drink? Then I say go for it, but keep it light. Life is all about taking calculated risks to enjoy a more full life. These social-emotional factors are often more important than a relatively low statistical risk. 

I happen to be someone who enjoys 1-2 drinks per week. Any more than that and it’s a net negative for me. My sleep suffers, I notice more PMS symptoms, more irritability and my skin feels lackluster. But I try to retain all the good stuff associated with alcohol consumption — like time with friends and loved ones, good conversation, and delicious food. You know, like the French do. Only now, I’m more likely to order a good mocktail or cup of tea instead. 

Favorite Alcohol-Free Beverages

Recess (Strawberry Rose)

Ritual Spirits (especially the Tequila and Apertif)

Hoplark Chamomile Brewed Tea (for beer lovers)