Study says drinking offers no health help

Report provides harsher analysis than past research on alcohol consumption

To minimize health risks, the optimal amount of alcohol someone should consume is none. That’s the simple, surprising conclusion of a massive study, co-authored by 512 researchers from 243 institutions, published last week in the prestigious journal the Lancet.

The researchers built a database of more than a thousand alcohol studies and data sources, as well as death and disability records from 195 countries and territories between 1990 and 2016. The goal was to estimate how alcohol affects the risk of 23 health problems. The number that jumped out, in the end, was zero. Anything more than that was associated with health risks.

“What has been underappreciated, what’s surprising, is that no amount of drinking is good for you,” said Emmanuela Gakidou, a professor of global health at the University of Washington and the senior author of the report.

“People should no longer think that a drink or two a day is good for you,” she said. “What's best for you is to not drink at all.”

The report found that 2.8 million people across the globe died in 2016 of alcoholrelated causes, which is about the same proportionally as the 2 million who died in 1990. For people ages 15 to 49, alcohol is the leading risk factor for experiencing a negative health outcome.

This is a sobering report for the roughly 2 billion human beings who drink alcohol. The report challenges the controversial hypothesis that moderate drinking provides a clear health benefit. That notion took hold in the 1990s after news reports on the “French paradox”: The French have relatively low rates of heart disease despite a fatty diet. Some researchers pointed to red wine consumption among the French as potentially protective.

Numerous peer-reviewed studies found evidence that people who have a drink or two a day are less likely to have heart disease than people who abstain or drink excessively.

But the new study, while noting the lower risks of heart disease from moderate drinking, as well as a dip in the diabetes rate in women, found that many other health risks offset and overwhelm the health benefits. That includes the risk of breast cancer, larynx cancer, stroke, cirrhosis, tuberculosis, interpersonal violence, selfharm and transportation accidents.

“Current and emerging scientific evidence does not suggest that there are overall health benefits from moderate drinking,” said Robert Brewer, who directs the alcohol program at the U.S. Centers for Disease Control and Prevention and was not involved in the new research. He pointed out that alcohol studies have long been dogged by “confounders” — factors that create a misleading impression of cause and effect.

“People who report drinking in moderation tend to be very different from people who don’t drink at all. They tend to be a healthier population, they tend to exercise more, they tend to be more affluent, they tend to have more access to health care,” Brewer said.

Lead author Max Griswold of the University of Washington said this new report is the largest alcohol study conducted to date.

It follows another, less-sweeping analysis of alcohol and mortality published in the Lancet in April. The earlier one suggested that mortality rates begin to rise when people drink more than 100 grams of pure alcohol (roughly what’s in seven standard American beers) a week.

Drinkers may take some reassurance from the fact that the new Lancet report focuses not on individuals but on populations. It estimates risks of alcohol-related diseases and disabilities per 100,000 people as a function of alcohol consumption. The authors do not suggest that there is significant danger in having a sip of alcohol. The risks spike dramatically with heavy drinking.

The U.S. dietary guidelines define lowrisk drinking as one drink a day for women and two a day for men (and none for people under 21 or pregnant). The CDC’s Brewer said that if people stick to the guidelines, “the risk of harms across the board is going to be low. It’s not going to be zero. But it’s going to be low.” Gakidou echoed that. “It’s a very small risk at one drink a day. It goes up when you go to two drinks a day. It all depends on all the other risk factors that the individual has, as well,” she said. “For a given individual, having a drink a day may not hurt them.”