After a holiday season full of good cheer—and extra cocktails for many—more Americans than ever participated this year in “Dry January,” a month-long sobriety challenge that began as a public-health campaign in England. Surveys found that between 13 and 15 percent of Americans decided to forgo alcohol that month, an increase from last year.
That’s likely a good thing for their health.
For decades, public health officials touted evidence that moderate drinking (1-2 glasses a day), actually improved wellness. Large studies and systematic reviews found that moderate drinking improved cholesterol levels, reduced the risk for heart disease, improved cognition, and even helped you to live longer.
Today, researchers are questioning those benefits.
A central problem is that most research on alcohol consumption is observational, meaning researchers simply track how much participants drink and then look for associations. This research typically trusts participants to make accurate reports. And it can make it difficult to quantify other factors in participants’ lives.
Researchers try to tease out obvious health influences such as diet, smoking, and exercise, but they don’t always take into account lifestyle factors, and in some cases, they aren’t able to. Maybe moderate drinkers tend to sleep more or have less taxing jobs compared to people who drink more. Maybe people who consume more alcohol live with more stressful family situations. These are all factors that could cloud the research on alcohol.
In fact, there is also observational research that finds consuming any alcohol has negative consequences. A 2018 paper in The Lancet combined the data from more than 600 studies on alcohol consumption and found that alcohol use is “a leading risk factor for global disease burden and causes substantial health loss.” The study found that drinking more than 100 grams of alcohol per week—that’s about seven glasses of beer or wine—was associated with an increased risk of death.
Looking at specific diseases, the review found that alcohol consumption led to an increased risk for stroke, coronary disease (but not heart attacks), heart failure, fatal high blood pressure, and aortic aneurysm. Moderate alcohol consumption did lower the risk of having a heart attack.
Beyond observational research, researchers are exploring new ways to study alcohol consumption using a technique called Mendelian randomization, which looks at participants’ genes. Basically, scientists have found gene variants that impact how much someone is compelled to drink; if you have the variant, you are less likely to enjoy drinking alcohol because of the way your body metabolizes it. By identifying study participants with these gene variants and tracking their health, researchers can see the connection between drinking and disease.
A 2019 study conducted in China with more than 500,000 participants used this method. More than 30 percent of men and 2 percent of women in the study reported drinking alcohol most weeks. In addition to participants’ own reports, researchers identified those with the gene variants that discourage alcohol consumption. When participants self-reported, researchers saw the protective effects of moderate alcohol consumption previously demonstrated: A few drinks a day seemed to lower the risk of stroke and heart attack. But when researchers separated out participants with gene variants, they found that any drinking increased blood pressure and stroke risk; the more participants drank, the higher their risks. That’s an indication that observational research may not be providing us with an accurate picture of how alcohol affects health.
What does all of this mean? The take-home message on moderate alcohol consumption is not completely clear, but researchers are increasingly finding data that shows that drinking any alcohol increases your risk a little. And the more you drink, the greater the risk.
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