No amount of alcohol is safe – and most people don’t know it
You know all those ads for alcoholic beverages that remind you to “drink responsibly”? Well, I’ve got some bad news for you: When it comes to your health, there’s no amount of alcohol that is beneficial, or even safe. In fact, even a small amount of alcohol increases your risk of cancer, heart failure and stroke. So from a health, social, and safety perspective, a more accurate warning would be: Be responsible: Don’t drink.
Light drinking takes a heavy toll
Most people are aware that heavy drinking and binge drinking are risky, but their knowledge about the potential dangers of moderate levels of alcohol consumption (defined as no more than 1 drink/day for women or 2 drinks/day for men) are cloudy.
Back in 2014, the International Agency for Research on Cancer issued a report stating that there is no safe amount of alcohol when it comes to cancer risk.1 Alcohol is metabolized by the human body into acetaldehyde, a carcinogen. Light drinking is linked to higher risk than no drinking, and heavy drinking increases risk further.2 Alcohol is a causative factor in several different cancer types, including esophageal, oral, colorectal, breast, and liver cancers.3-5
A 2021 study estimated that alcohol is responsible for over 75,000 deaths every year in the U.S., including about 19,000 deaths from cancers.6 Light drinking (approximately 1 drink per day) is estimated to cause 5,000 deaths from oral and pharynx cancers, 24,000 deaths from esophageal squamous cell carcinoma, and 5,000 deaths from breast cancer worldwide each year.7
A recent survey suggests that people have not gotten the message about alcohol and cancer. The survey assessed awareness of the link between alcohol and cancer in 3,865 U.S. adults. The survey asked participants how they thought alcoholic beverages (liquor, wine, and beer) affect the risk of cancer. More than half of participants answered they did not know how alcohol affects cancer risk. Only 31% answered that liquor increases cancer risk, 25% answered that beer increases risk, and 20% for wine. Alarmingly, 10% of participants said that wine reduces the risk of cancer. Only about 2% thought that either beer or liquor reduced cancer risk.
Also in the survey, adults over 60 were less aware than those under 40 of the cancer risk associated with alcohol.8
There is a dangerous lack of awareness of the link between alcohol and cancer.
In addition to cencers, moderate drinking is also linked to cardiac arrhythmias, stroke and heart failure.. Buildup of alcohol, acetaldehyde, and other breakdown products cause oxidative damage as well as electrical disturbances in heart muscle that can lead to arrhythmia.9 Even in non-drinkers or light drinkers, a single alcohol binge could cause an episode of arrhythmia.10
Alcohol is a major contributor to “holiday heart,” the rise of hospitalizations due to with arrhythmias and cardiac events after holiday binge-drinking.11,12 Heart attack deaths peak around the winter holiday season, with approximately 30% more deaths from coronary artery disease occurring during December and January, compared to the summer months.13 In the weeks surrounding the winter holidays, people tend to eat more, drink more, and move less. This is a disease-causing combination.
However, binge drinking is not the only culprit when it comes to arrhythmias. Recent research has found that more modest levels of alcohol intake are also associated with atrial fibrillation risk, with an 8% increase in risk for each additional alcoholic drink consumed daily.14 Alcohol use, even moderate drinking, is also associated with greater risk of stroke and heart failure.15
In the late 1980s and early 1990s, researchers proposed that moderate red wine drinking (up to 1-2 glasses per day) could mitigate the harmful effects of a high-saturated fat diet, as an explanation of the “French paradox” — the observation of lower rates of heart disease and deaths from heart disease in France compared to the U.S. and U.K. at the time.16,17 The theory was that the phytochemicals in red wine, such as resveratrol, flavonoids, and other polyphenols, offered protection against heart disease. Red wine began to be touted as “heart-healthy.”
The observational studies that followed seemed to agree. Many found a “J-shaped” association: moderate drinking was associated with the lowest cardiovascular risk, with no alcohol consumption associated with a somewhat higher risk, and heavy drinking with a much higher risk.18
However, there were controversies surrounding these findings. Some researchers argued that unmeasured diet and lifestyle factors (such as physical activity levels and vegetable intake) might explain the lower heart disease risk in France. Or that French dietary patterns had risen in saturated fat only recently. Or that heart disease deaths had been under-reported in France.17,19
Probably most important, in these observational studies, a group of people who don’t consume alcohol would include both long-term abstainers from alcohol and others who had quit drinking due to illness. As a result, some studies may have overestimated disease risk in those who rarely or never consume alcohol.20
The relationship between moderate alcohol consumption and cardiovascular health is still not completely clear. A 2018 analysis of 83 observational studies including almost 600,000 participants found that each 100 g/week (about 7 drinks/week) alcohol consumption was associated with a 6% lower risk of heart attack, but a higher risk of several other types of cardiovascular disease including heart failure (9%) and stroke (14%). In cardiovascular disease categories other than heart attack, lower alcohol consumption was associated with lower risk – there was no reduction in risk associated with moderate drinking.15 The link between alcohol and reduced risk of heart attack is now thought to be due primarily to the fact that alcohol interferes with blood clotting by reducing platelet aggregation.21 Moderate consumption of alcohol may also have small beneficial effects on HDL and LDL cholesterol levels.20
Grape skins contain a variety of polyphenols including resveratrol. In human studies, resveratrol supplementation has antioxidant effects, increased anti-inflammatory markers, enhanced insulin sensitivity, improved endothelial function, and reduced insulin-like growth factor 1 (IGF-1) levels.22-25
Resveratrol is a beneficial dietary phytochemical, but it isn’t necessary to consume alcohol to get it. Dealcoholized red wine has increased antioxidant capacity in the blood.17 Resveratrol is found, of course in red grapes and raisins, and also blueberries, cranberries, peanuts, and other plant foods.
The relationship between moderate alcohol consumption and cardiovascular health is not clear. But the relationship between alcohol and cancer is.
Even if we gain some anti-inflammatory benefit from resveratrol, coupled with the anti-coagulation effect of alcohol, it is unlikely that benefit would outweigh the many other health risks associated with alcohol consumption. Using data from the Global Burden of Disease Study in 195 countries, researchers concluded the lowest risk level of alcohol intake considering all health conditions associated with alcohol was zero.26 Alcohol also interferes with sleep,27 and as discussed above, even light drinking is linked to increased cancer risk.
It is safer to follow a diet that prevents heart disease and get our resveratrol, flavonoids, and other phytochemicals from grapes, berries, leafy greens, and other plant foods than to use alcohol to decrease the potential of the blood to clot.
Bagnardi V, Rota M, Botteri E, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis.Br J Cancer 2015, 112:580-593.
Stokowski LA: No Amount of Alcohol is Safe. Medscape Cardiology. 2014[http://www.medscape.com/viewarticle/824237_1]
Baan R, Straif K, Grosse Y, et al. Carcinogenicity of alcoholic beverages.Lancet Oncol 2007, 8:292-293.
Connor J. Alcohol consumption as a cause of cancer.Addiction 2016.
Goding Sauer A, Fedewa SA, Bandi P, et al. Proportion of cancer cases and deaths attributable to alcohol consumption by US state, 2013-2016.Cancer Epidemiol 2021, 71:101893.
Bagnardi V, Rota M, Botteri E, et al. Light alcohol drinking and cancer: a meta-analysis.Ann Oncol 2013, 24:301-308.
Seidenberg AB, Wiseman KP, Klein WMP. Do Beliefs about Alcohol and Cancer Risk Vary by Alcoholic Beverage Type and Heart Disease Risk Beliefs?Cancer Epidemiol Biomarkers Prev 2022:OF1-OF8.
Brown KN, Yelamanchili VS, Goel A: Holiday Heart Syndrome. In StatPearls. Treasure Island (FL)2022
Thornton JR. Atrial fibrillation in healthy non-alcoholic people after an alcoholic binge.Lancet 1984, 2:1013-1015.
Ettinger PO, Wu CF, De La Cruz C, Jr., et al. Arrhythmias and the "Holiday Heart": alcohol-associated cardiac rhythm disorders.Am Heart J 1978, 95:555-562.
Tonelo D, Providencia R, Goncalves L. Holiday heart syndrome revisited after 34 years.Arq Bras Cardiol 2013, 101:183-189.
Kloner RA, Poole WK, Perritt RL. When throughout the year is coronary death most likely to occur? A 12-year population-based analysis of more than 220 000 cases.Circulation 1999, 100:1630-1634.
Voskoboinik A, Prabhu S, Ling LH, et al. Alcohol and Atrial Fibrillation: A Sobering Review.J Am Coll Cardiol 2016, 68:2567-2576.
Wood AM, Kaptoge S, Butterworth AS, et al. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies.Lancet 2018, 391:1513-1523.
Ferrieres J. The French paradox: lessons for other countries.Heart 2004, 90:107-111.
Haseeb S, Alexander B, Baranchuk A. Wine and Cardiovascular Health: A Comprehensive Review.Circulation 2017, 136:1434-1448.
Klatsky AL. Alcohol and cardiovascular health.Physiology and Behavior 2010, 100:76-81.
Fragopoulou E, Antonopoulou S. The French paradox three decades later: Role of inflammation and thrombosis.Clin Chim Acta 2020, 510:160-169.
Hoek AG, van Oort S, Mukamal KJ, Beulens JWJ. Alcohol Consumption and Cardiovascular Disease Risk: Placing New Data in Context.Curr Atheroscler Rep 2022, 24:51-59.
Saremi A, Arora R. The cardiovascular implications of alcohol and red wine.American Journal of Therapeutics 2008, 15:265-277.
Ramirez-Garza SL, Laveriano-Santos EP, Marhuenda-Munoz M, et al. Health Effects of Resveratrol: Results from Human Intervention Trials.Nutrients 2018, 10.
Liu K, Zhou R, Wang B, Mi MT. Effect of resveratrol on glucose control and insulin sensitivity: a meta-analysis of 11 randomized controlled trials.Am J Clin Nutr 2014, 99:1510-1519.
Koushki M, Dashatan NA, Meshkani R. Effect of Resveratrol Supplementation on Inflammatory Markers: A Systematic Review and Meta-analysis of Randomized Controlled Trials.Clin Ther 2018, 40:1180-1192 e1185.
Haghighatdoost F, Hariri M. Can resveratrol supplement change inflammatory mediators? A systematic review and meta-analysis on randomized clinical trials.Eur J Clin Nutr 2018.
Collaborators GBDA. Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.Lancet 2018, 392:1015-1035.
He S, Hasler BP, Chakravorty S. Alcohol and sleep-related problems.Curr Opin Psychol 2019, 30:117-122.
Joel Fuhrman, M.D. is a board-certified family physician, seven-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient dense, plant-rich eating style.
For over 30 years, Dr. Fuhrman has shown that it is possible to achieve sustainable weight loss and reverse heart disease, diabetes and many other illnesses using smart nutrition. In his medical practice, and through his books and PBS television specials, he continues to bring this life-saving message to hundreds of thousands of people around the world.
There’s no such thing as ‘drinking to your health’
December 30, 2022 by Joel Fuhrman, MD
No amount of alcohol is safe – and most people don’t know it
You know all those ads for alcoholic beverages that remind you to “drink responsibly”? Well, I’ve got some bad news for you: When it comes to your health, there’s no amount of alcohol that is beneficial, or even safe. In fact, even a small amount of alcohol increases your risk of cancer, heart failure and stroke. So from a health, social, and safety perspective, a more accurate warning would be: Be responsible: Don’t drink.
Light drinking takes a heavy toll
Most people are aware that heavy drinking and binge drinking are risky, but their knowledge about the potential dangers of moderate levels of alcohol consumption (defined as no more than 1 drink/day for women or 2 drinks/day for men) are cloudy.
Back in 2014, the International Agency for Research on Cancer issued a report stating that there is no safe amount of alcohol when it comes to cancer risk.1 Alcohol is metabolized by the human body into acetaldehyde, a carcinogen. Light drinking is linked to higher risk than no drinking, and heavy drinking increases risk further.2 Alcohol is a causative factor in several different cancer types, including esophageal, oral, colorectal, breast, and liver cancers.3-5
Related: Even a small amount of alcohol increases breast cancer risk
Sources:
Alcohol consumption
Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis
Carcinogenicity of alcoholic beverages
A 2021 study estimated that alcohol is responsible for over 75,000 deaths every year in the U.S., including about 19,000 deaths from cancers.6 Light drinking (approximately 1 drink per day) is estimated to cause 5,000 deaths from oral and pharynx cancers, 24,000 deaths from esophageal squamous cell carcinoma, and 5,000 deaths from breast cancer worldwide each year.7
Sources:
Proportion of cancer cases and deaths attributable to alcohol consumption by US state, 2013-2016
Light alcohol drinking and cancer: a meta-analysis
Ignorance of the link between alcohol and cancer
A recent survey suggests that people have not gotten the message about alcohol and cancer. The survey assessed awareness of the link between alcohol and cancer in 3,865 U.S. adults. The survey asked participants how they thought alcoholic beverages (liquor, wine, and beer) affect the risk of cancer. More than half of participants answered they did not know how alcohol affects cancer risk. Only 31% answered that liquor increases cancer risk, 25% answered that beer increases risk, and 20% for wine. Alarmingly, 10% of participants said that wine reduces the risk of cancer. Only about 2% thought that either beer or liquor reduced cancer risk.
Also in the survey, adults over 60 were less aware than those under 40 of the cancer risk associated with alcohol.8
There is a dangerous lack of awareness of the link between alcohol and cancer.
Source:
Do Beliefs about Alcohol and Cancer Risk Vary by Alcoholic Beverage Type and Heart Disease Risk Beliefs?
The holidays: Peak season for heart attacks
In addition to cencers, moderate drinking is also linked to cardiac arrhythmias, stroke and heart failure.. Buildup of alcohol, acetaldehyde, and other breakdown products cause oxidative damage as well as electrical disturbances in heart muscle that can lead to arrhythmia.9 Even in non-drinkers or light drinkers, a single alcohol binge could cause an episode of arrhythmia.10
Alcohol is a major contributor to “holiday heart,” the rise of hospitalizations due to with arrhythmias and cardiac events after holiday binge-drinking.11,12 Heart attack deaths peak around the winter holiday season, with approximately 30% more deaths from coronary artery disease occurring during December and January, compared to the summer months.13 In the weeks surrounding the winter holidays, people tend to eat more, drink more, and move less. This is a disease-causing combination.
Related: Don’t Succumb to "Holiday Heart"
However, binge drinking is not the only culprit when it comes to arrhythmias. Recent research has found that more modest levels of alcohol intake are also associated with atrial fibrillation risk, with an 8% increase in risk for each additional alcoholic drink consumed daily.14 Alcohol use, even moderate drinking, is also associated with greater risk of stroke and heart failure.15
Sources:
Holiday Heart Syndrome
When throughout the year is coronary death most likely to occur? A 12-year population-based analysis of more than 220 000 cases
Alcohol and Atrial Fibrillation: A Sobering Review
Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies
Moderate drinking and heart health
In the late 1980s and early 1990s, researchers proposed that moderate red wine drinking (up to 1-2 glasses per day) could mitigate the harmful effects of a high-saturated fat diet, as an explanation of the “French paradox” — the observation of lower rates of heart disease and deaths from heart disease in France compared to the U.S. and U.K. at the time.16,17 The theory was that the phytochemicals in red wine, such as resveratrol, flavonoids, and other polyphenols, offered protection against heart disease. Red wine began to be touted as “heart-healthy.”
The observational studies that followed seemed to agree. Many found a “J-shaped” association: moderate drinking was associated with the lowest cardiovascular risk, with no alcohol consumption associated with a somewhat higher risk, and heavy drinking with a much higher risk.18
However, there were controversies surrounding these findings. Some researchers argued that unmeasured diet and lifestyle factors (such as physical activity levels and vegetable intake) might explain the lower heart disease risk in France. Or that French dietary patterns had risen in saturated fat only recently. Or that heart disease deaths had been under-reported in France.17,19
Probably most important, in these observational studies, a group of people who don’t consume alcohol would include both long-term abstainers from alcohol and others who had quit drinking due to illness. As a result, some studies may have overestimated disease risk in those who rarely or never consume alcohol.20
The relationship between moderate alcohol consumption and cardiovascular health is still not completely clear. A 2018 analysis of 83 observational studies including almost 600,000 participants found that each 100 g/week (about 7 drinks/week) alcohol consumption was associated with a 6% lower risk of heart attack, but a higher risk of several other types of cardiovascular disease including heart failure (9%) and stroke (14%). In cardiovascular disease categories other than heart attack, lower alcohol consumption was associated with lower risk – there was no reduction in risk associated with moderate drinking.15 The link between alcohol and reduced risk of heart attack is now thought to be due primarily to the fact that alcohol interferes with blood clotting by reducing platelet aggregation.21 Moderate consumption of alcohol may also have small beneficial effects on HDL and LDL cholesterol levels.20
Sources:
Wine and Cardiovascular Health: A Comprehensive Review
The French paradox three decades later: Role of inflammation and thrombosis
Alcohol Consumption and Cardiovascular Disease Risk: Placing New Data in Context
Phytochemicals in grape skins
Grape skins contain a variety of polyphenols including resveratrol. In human studies, resveratrol supplementation has antioxidant effects, increased anti-inflammatory markers, enhanced insulin sensitivity, improved endothelial function, and reduced insulin-like growth factor 1 (IGF-1) levels.22-25
Resveratrol is a beneficial dietary phytochemical, but it isn’t necessary to consume alcohol to get it. Dealcoholized red wine has increased antioxidant capacity in the blood.17 Resveratrol is found, of course in red grapes and raisins, and also blueberries, cranberries, peanuts, and other plant foods.
Related: Optimal IGF-1 Levels for Longevity
Related: Restrict calories to boost immune function
Sources:
Effect of resveratrol on glucose control and insulin sensitivity: a meta-analysis of 11 randomized controlled trials
Effect of Resveratrol Supplementation on Inflammatory Markers: A Systematic Review and Meta-analysis of Randomized Controlled Trials
The risks outweigh any minor benefits
The relationship between moderate alcohol consumption and cardiovascular health is not clear. But the relationship between alcohol and cancer is.
Even if we gain some anti-inflammatory benefit from resveratrol, coupled with the anti-coagulation effect of alcohol, it is unlikely that benefit would outweigh the many other health risks associated with alcohol consumption. Using data from the Global Burden of Disease Study in 195 countries, researchers concluded the lowest risk level of alcohol intake considering all health conditions associated with alcohol was zero.26 Alcohol also interferes with sleep,27 and as discussed above, even light drinking is linked to increased cancer risk.
It is safer to follow a diet that prevents heart disease and get our resveratrol, flavonoids, and other phytochemicals from grapes, berries, leafy greens, and other plant foods than to use alcohol to decrease the potential of the blood to clot.
Sources:
Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016
Alcohol and sleep-related problems
Joel Fuhrman, M.D. is a board-certified family physician, seven-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient dense, plant-rich eating style.
For over 30 years, Dr. Fuhrman has shown that it is possible to achieve sustainable weight loss and reverse heart disease, diabetes and many other illnesses using smart nutrition. In his medical practice, and through his books and PBS television specials, he continues to bring this life-saving message to hundreds of thousands of people around the world.