Hadley’s Intro: During “Dry January” The New
York Times report clears up confusion over the
safe amount of alcohol you can drink for healthy
longevity in a guest post by Dana G. Smith.
Recent research makes it clear that any amount of
drinking can be detrimental. Here’s why you may
want to cut down on your consumption beyond Dry
Sorry to be a buzz-kill, but that nightly glass or
two of wine is not improving your health.
After decades of confusing and sometimes
contradictory research (too much alcohol is bad
for you but a little bit is good; some types of
alcohol are better for you than others; just
kidding, it’s all bad), the picture is becoming
clearer: Even small amounts of alcohol can have
Research published in November revealed that
between 2015 and 2019, excessive alcohol use
resulted in roughly 140,000 deaths per year in the
United States. About 40 percent of those deaths
had acute causes, like car crashes, poisonings and
homicides. But the majority were caused by chronic
conditions attributed to alcohol, such as liver
disease, cancer and heart disease.
When experts talk about the dire health
consequences linked to excessive alcohol use,
people often assume that it’s directed at
individuals who have an alcohol use disorder. But
the health risks from drinking can come from
moderate consumption as well.
“Risk starts to go up well below levels where
people would think, ‘Oh, that person has an
alcohol problem,’” said Dr. Tim Naimi,
director of the University of Victoria’s
Canadian Institute for Substance Use Research.
“Alcohol is harmful to the health starting at
very low levels.”
If you’re wondering whether you should cut back
on your drinking, here’s what to know about when
and how alcohol impacts your health.
How do I know if I’m drinking too much?
“Excessive alcohol use” technically means
anything above the U.S. Dietary Guidelines’
recommended daily limits. That’s more than two
drinks a day for men and more than one drink a day
There is also emerging evidence “that there are
risks even within these levels, especially for
certain types of cancer and some forms of
cardiovascular disease,” said Marissa Esser, who
leads the alcohol program at the Centers for
Disease Control and Prevention.
The recommended daily limits are not meant to be
averaged over a week, either. In other words, if
you abstain Monday through Thursday and have two
or three drinks a night on the weekend, those
weekend drinks count as excessive consumption.
It’s both the cumulative drinks over time and
the amount of alcohol in your system on any one
occasion that can cause damage.
Take Our Alcohol Quiz
How Much is Too Much?
Why is alcohol so harmful?
Scientists think that the main way alcohol causes
health problems is by damaging DNA. When you drink
alcohol, your body metabolizes it into
acetaldehyde, a chemical that is toxic to cells.
Acetaldehyde both “damages your DNA and prevents
your body from repairing the damage,” Dr. Esser
explained. “Once your DNA is damaged, then a
cell can grow out of control and create a cancer
Alcohol also creates oxidative stress, another
form of DNA damage that can be particularly
harmful to the cells that line blood vessels.
Oxidative stress can lead to stiffened arteries,
resulting in higher blood pressure and coronary
“It fundamentally affects DNA, and that’s why
it affects so many organ systems,” Dr. Naimi
said. Over the course of a lifetime, chronic
consumption “damages tissues over time.”
Isn’t alcohol supposed to be good for your
Alcohol’s effect on the heart is confusing
because some studies have claimed that small
amounts of alcohol, particularly red wine, can be
beneficial. Past research suggested that alcohol
raises HDL, the “good” cholesterol, and that
resveratrol, an antioxidant found in grapes (and
red wine), has heart-protective properties.
However, said Mariann Piano, a professor of
nursing at Vanderbilt University, “There’s
been a lot of recent evidence that has really
challenged the notion of any kind of what we call
a cardio-protective or healthy effect of
The idea that a low dose of alcohol was heart
healthy likely arose from the fact that people who
drink small amounts tend to have other healthy
habits, such as exercising, eating plenty of
fruits and vegetables and not smoking. In
observational studies, the heart benefits of those
behaviors might have been erroneously attributed
to alcohol, Dr. Piano said.
More recent research has found that even low
levels of drinking slightly increase the risk of
high blood pressure and heart disease, and the
risk goes up dramatically for people who drink
excessively. The good news is that when people
stop drinking or just cut back, their blood
pressure goes down. Alcohol is also linked to an
abnormal heart rhythm, known as atrial
fibrillation, which raises the risk of blood clots
What types of cancer does alcohol increase the
Almost everyone knows about the link between
cigarette smoking and cancer, but few people
realize that alcohol is also a potent carcinogen.
According to research by the American Cancer
Society, alcohol contributes to more than 75,000
cases of cancer per year and nearly 19,000 cancer
Alcohol is known to be a direct cause of seven
different cancers: head and neck cancers (oral
cavity, pharynx and larynx), esophageal cancer,
liver cancer, breast cancer and colorectal cancer.
Research suggests there may be a link between
alcohol and other cancers as well, including
prostate and pancreatic cancer, although the
evidence is less clear-cut.
For some cancers, such as liver and colorectal,
the risk starts only when people drink
excessively. But for breast and esophageal cancer,
the risk increases, albeit slightly, with any
alcohol consumption. The risks go up the more a
“If somebody drinks less, they are at a lower
risk compared to that person who is a heavy
drinker,” said Dr. Farhad Islami, a senior
scientific director at the American Cancer
Society. “Even two drinks per day, one drink per
day, may be associated with a small risk of cancer
compared to non-drinkers.”
Which condition poses the greatest risk?
The most common individual cause of
alcohol-related death in the United States is
alcoholic liver disease, killing about 22,000
people a year. While the risk rises as people age
and alcohol exposure accumulates, more than 5,000
Americans in their 20s, 30s and 40s die from
alcoholic liver disease annually.
Alcoholic liver disease has three stages:
alcoholic fatty liver, when fat accumulates in the
organ; alcoholic hepatitis, when inflammation
starts to occur; and alcoholic cirrhosis, or
scarring of the tissue. The first two stages are
reversible if you stop drinking entirely; the
third stage is not.
Symptoms of alcoholic liver disease include
nausea, vomiting, abdominal pain and jaundice —
a yellow tinge to the eyes or skin. However,
symptoms rarely emerge until the liver has been
The risk of developing alcoholic liver disease is
greatest in heavy drinkers, but one report stated
that five years of drinking just two alcoholic
beverages a day can damage the liver. Ninety
percent of people who have four drinks a day show
signs of alcoholic fatty liver.
How do I gauge my personal risk for
alcohol-related health issues?
Not everyone who drinks will develop these
conditions. Lifestyle factors such as diet,
exercise and smoking all combine to raise or lower
your risk. Also, some of these conditions, such as
esophageal cancer, are pretty rare, so increasing
your risk slightly won’t have a huge impact.
“Every risk factor matters,” Dr. Esser said.
“We know in public health that the number of
risk factors that one has would go together into
an increased risk for a condition.”
A pre-existing condition could also interact with
alcohol to affect your health. For example,
“people who have hypertension probably should
not drink or definitely drink at very, very low
levels,” Dr. Piano said.
Genes play a role, too. For instance, two genetic
variants, both of which are more common in people
of Asian descent, affect how alcohol and
acetaldehyde are metabolized. One gene variant
causes alcohol to break down into acetaldehyde
faster, flooding the body with the toxin. The
other variant slows down acetaldehyde metabolism,
meaning the chemical hangs around in the body
longer, prolonging the damage.
So should I cut back — or stop drinking
You don’t need to go cold turkey to help your
health. Even reducing a little bit can be
beneficial, especially if you currently drink over
the recommended limits. The risk “really
accelerates once you’re over a couple of drinks
a day,” Dr. Naimi said. “So people who are
drinking five or six drinks a day, if they can cut
back to three or four, they’re going to do
themselves a lot of good.”
Light daily drinkers would likely benefit by
cutting back a bit, too. Try going a few nights
without alcohol: “If you feel better, your body
is trying to tell you something,” said George
Koob, director of the National Institute on
Alcohol Abuse and Alcoholism.
Notably, none of the experts we spoke to called
for abstaining completely, unless you have an
alcohol use disorder or are pregnant. “I’m not
going to advocate that people completely stop
drinking,” Dr. Koob said. “We did prohibition,
it didn’t work.”
Generally, though, their advice is, “Drink less,
live longer,” Dr. Naimi said. “That’s
basically what it boils down to.”
Let’s choose to love food and drinks that love you back,