Is drinking good for you?

wineIf, like me, you enjoy a glass of wine with dinner, or a cold beer on a hot day, or a cocktail when out with friends, you probably think a small to moderate amount of alcohol is part of a healthy diet and lifestyle.

So the continuous push-pull in the media about the benefits of alcohol (“Moderate drinking helps you live longer!”) versus the harms (“Moderate drinking increases your risk of death!”) must confuse you as much as it does me.

Why can’t these researchers decide??

Well, there are a lot of problems with this kind of research. First, these lifestyle-type studies are what we call “observational.” That is, subjects fill out questionnaires about their health and habits (honestly, it’s hoped) and then the researchers sort through all that data and try to reach some sort of conclusion.

Second, these studies can be very small. So researchers will do what’s called a “meta-analysis,” and put together the results from several similar studies to get more data. But they have to take into account lots of variables across the different studies.

Third, studies can be biased from the get-go. If researchers are looking to answer a specific question, it’s possible they subconsciously cherry pick the data that best supports their hypothesis.

I don’t want to be a teetotaler, so what’s the best evidence we have about the benefits and risks of moderate drinking? Is drinking good for you or not?

A few months ago, Dr. Aaron Carroll, a pediatrican-statistician, wrote an excellent article for the New York Times: Drink to Your Health (in Moderation), the Science Says 

Maybe I think it’s excellent because he said what I wanted to hear, but he looked at the results of many alcohol studies from the last two decades, some of which followed large numbers of subjects for many years, and he explained very thoroughly how he came to the following conclusion:

Synthesizing all this, there seems to be a sizable amount of evidence that moderate alcohol consumption is associated with decreased rates of cardiovascular disease, diabetes and death. It also seems to be associated with increased rates, perhaps to a lesser extent, of some cancers, especially breast cancer, as well as some other diseases or conditions. The gains from improved cardiovascular disease deaths seem to outweigh all of the losses in other diseases combined. The most recent report of the U.S.D.A. Scientific Advisory Panel agrees with that assessment. [my emphasis]

Good news! And what is moderate drinking? One drink a day for women, and one to two drinks a day for men. (And no, you can’t save up your drinks and have them all on Saturday night! That’s called binge drinking, and no one thinks that’s healthy. Or drinking and driving.)

But shortly after that drinking-is-good-for-you article was published, another alcohol study hit the media: A little alcohol may not be good for you, after all

Argh!

Luckily, Dr. Carroll came out with a response to that study in another New York Times article: In Defense of Moderate Drinking (Again)

At best, this new study shows that for those drinking two or fewer drinks of alcohol a day, there’s no association with higher or lower risks of death. At worst, it’s leaving out trials that show a benefit.

The evidence still says that a moderate amount of alcohol appears to be safe, and that it might even be healthy for many people. There’s nothing in this new analysis that would make me change my mind.

Still confused? Read Dr. Carroll’s articles in full for a more complete explanation of the studies he looked at, and how he came to the conclusions he did.

The Harvard School of Public Health also has a pretty unbiased informational page about the pros and cons of moderate drinking.

If you don’t drink, there’s no need to start. You can get similar benefits with exercise (beginning to exercise if you don’t already or boosting the intensity and duration of your activity) or healthier eating. If you are a man with no history of alcoholism who is at moderate to high risk for heart disease, a daily alcoholic drink could reduce that risk. Moderate drinking might be especially beneficial if you have low HDL that just won’t budge upward with diet and exercise.

If you are a woman with no history of alcoholism who is at moderate to high risk for heart disease, the possible benefits of a daily drink must be balanced against the small increase in risk of breast cancer.

Bottom line: Stressing about whether a drink is bad for me or not is probably worse than any ill effect of the drink. So I’m just not going to worry about it, and will continue to enjoy one of life’s small pleasures—in moderation, of course.

Sláinte,

Frugal Nurse

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