Drinking alcohol: how much is too much?

Drinking alcohol: how much is too much?

For alcohol consumption, how much is too much? Clearly, prolonged heavy drinking or heavy binge drinking is bad; there are a range of negative effects–health, disease, neurological, and behavior. But, occasional, “social” light to moderate drinking? There have been studies that purported to show some health benefits. Is that true? Or, is all alcohol consumption bad? Does it have anything to do with how the research studies are structured?

Quick bibliography: Articles–classic and recent–on the impacts of drinking alcohol.

Burton, R., & Sheron, N. (2018). No level of alcohol consumption improves health. The Lancet, 392(10152), 987-988. [PDF] [Cited by]

“The GBD 2016 Alcohol Collaborators clearly demonstrate the substantial, and larger than previously estimated, contribution of alcohol to death, disability, and ill health, globally. In 2016, alcohol use was the seventh leading risk factor for both deaths and disability-adjusted life-years (DALYs), accounting for 2·2% (95% uncertainty interval [UI] 1·5–3·0) of female deaths and 6·8% (5·8–8·0) of male deaths. The burden is particularly borne among those aged 15–49 years, for whom alcohol ranks as the leading cause of DALYs. In this population, alcohol use was the leading risk factor globally in 2016, with 3·8% (3·2–4·3) of female deaths and 12·2% (10·8–13·6) of male deaths attributable to alcohol use. The conclusions of the study are clear and unambiguous: alcohol is a colossal global health issue and small reductions in health-related harms at low levels of alcohol intake are outweighed by the increased risk of other health-related harms, including cancer.”

GBD 2016 Alcohol Collaborators. (2018). Alcohol use and burden for 195 countries and territories, 1990–2016: A systematic analysis for the global burden of disease study 2016. The Lancet, 392(10152), 1015-1035. [PDF] [Cited by]

Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimizes health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption. ”

Meyerhoff, D. J., Bode, C., Nixon, S. J., de Bruin, E. A., Bode, J. C., & Seitz, H. K. (2005). Health risks of chronic moderate and heavy alcohol consumption: How much is too much? Alcoholism: Clinical and Experimental Research, 29(7), 1334-1340. [PDF] [Cited by]

“Most of what we know about the deleterious effects of alcohol in vivo has been gleaned from studies in sober alcoholics recruited from substance abuse treatment programs. Little is known about effects of chronic drinking in the moderate or heavy range encountered in a much larger fraction of modern society. Extrapolation of information on the adverse effects of chronic drinking on organ function from clinical samples to social drinkers in the general population has to be met with great skepticism, as it may lead to wrong conclusions about the chronic effects of alcohol in social drinkers. Several recent studies suggest that moderate alcohol consumption has certain beneficial health effects, whereas heavy social alcohol consumption has recently been associated with organ abnormalities and cognitive deficits. These social drinking effects have attracted great public interest; reports of benefits of moderate drinking have also inspired inappropriate publications by the media, including misleading advertisements by the alcohol producing and distributing industry. Although adverse effects of moderate to heavy drinking on heart, liver, and cancer development have attracted attention by clinicians and researchers for some time, its compromising effects on brain and cognition have only recently been studied. The symposium aimed to clarify both the potential health benefits of moderate alcohol consumption and risks of moderate and heavy drinking on proper organ function and to provide insights and new data to practicing physicians and public health authorities for education on problem drinking.”

Toma, A., Paré, G., & Leong, D. P. (2017). Alcohol and cardiovascular disease: How much is too much? Current Atherosclerosis Reports, 19(3), 13. [Cited by]

“Previous research suggests that low-moderate alcohol consumption may have cardioprotective effects, while heavy or binge-pattern drinking is harmful. This review examines recent evidence regarding alcohol’s effect on cardiovascular disease, with a special consideration of pattern, drink type, and total quantity. Recent studies have confirmed that heavy alcohol use (>14 drinks per week in women and >21 drinks per week in men) and heavy episodic drinking are associated with an increased risk of mortality. New research raises concerns that even low-moderate alcohol use may not offer cardio- or cerebrovascular protection. Drinking ≥3 drinks per day on a regular basis or ≥5 drinks in any one episode should be discouraged.

Viale, P. H. (2019). The debate over alcohol consumption: How much is too much? Journal of the Advanced Practitioner in Oncology, 10(1), 18-19. [PDF]

“Studies regarding safe levels of alcohol consumption are relatively easy to find in the literature. However, the conclusions of the studies vary, and it’s easy to get confused over the most accurate recommendations regarding the consumption of alcohol. In fact, it’s difficult to truly understand where alcohol falls into place regarding health and risks/benefits. And recent data have emerged to eclipse our current beliefs regarding safe alcohol consumption. What are we supposed to believe is the truth?”

Zeigler, D. W., Wang, C. C., Yoast, R. A., Dickinson, B. D., McCaffree, M. A., Robinowitz, C. B., . . . Council on Scientific Affairs, American Medical Association. (2005). The neurocognitive effects of alcohol on adolescents and college students. Preventive Medicine, 40(1), 23-32. [Cited by]

“Adolescents and college students are at high risk for initiating alcohol use and high-risk (or binge) drinking. There is a growing body of literature on neurotoxic and harmful cognitive effects of drinking by young people. On average, youths take their first drink at age 12 years. Underage alcohol use is associated with brain damage and neurocognitive deficits, with implications for learning and intellectual development. Impaired intellectual development may continue to affect individuals into adulthood.”

For additional research on the impacts of alcohol consumption, please see the Science Primary Literature Database.

Questions?  Please let me know (engelk@grinnell.edu).

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