Do Any Benefits of Alcohol Outweigh the Risks?

Check out this answer from Consensus:

While moderate alcohol consumption may offer some cardiovascular benefits, these must be weighed against the significant risks associated with heavy and binge drinking. Individual variability in response to alcohol further complicates the issue, making personalized recommendations essential. Overall, the potential benefits of moderate drinking are often outweighed by the risks, particularly when considering the broader social and economic impacts. Public health guidelines increasingly favor low-risk drinking or abstinence, especially for vulnerable populations.

The debate over whether the benefits of alcohol consumption outweigh its risks is ongoing and complex. Research has shown both positive and negative health effects associated with alcohol use, which vary depending on the amount and pattern of consumption, as well as individual factors such as age, sex, and genetic predisposition.

Key Insights

• Cardiovascular Benefits of Moderate Drinking:
  • Moderate alcohol consumption is associated with a lower risk of cardiovascular diseases, including coronary heart disease, myocardial infarction, and ischemic stroke, as well as reduced total mortality in middle-aged and older adults2 3 4 5 9 10.
• Risks of Heavy and Binge Drinking:
  • Heavy and binge drinking are linked to numerous health issues, including increased risks of hypertension, atrial fibrillation, cardiomyopathy, stroke, and various forms of cancer. These patterns of drinking also contribute to higher overall mortality and significant social and economic costs1 4 5 6 9 10.
• Psychosocial and Productivity Issues:
  • Even moderate drinking can lead to psychosocial problems, such as reduced productivity and strained relationships, which may outweigh the physical health benefits for some individuals1.
• Individual Variability and Genetic Factors:
  • The effects of alcohol vary significantly among individuals due to genetic differences, sex, and other personal health factors. This variability necessitates personalized recommendations regarding alcohol consumption2 4 6.
• Potential Mechanisms for Benefits:
  • The beneficial effects of moderate alcohol consumption on cardiovascular health may be due to increased high-density lipoprotein (HDL) cholesterol, antithrombotic activity, and other favorable biochemical changes2 5 7.
• Public Health Recommendations:
  • Recent guidelines have become more restrictive, emphasizing low-risk drinking or complete abstinence for certain groups. The potential benefits of moderate drinking can often be achieved through other lifestyle changes, such as regular exercise and a healthy diet1 8.
• Harm Reduction and Screening:
  • Reducing alcohol intake, even without complete abstinence, can lead to significant health improvements, including lower blood pressure, improved heart function, and reduced psychiatric symptoms. Early screening and brief interventions in healthcare settings are effective in promoting reduced alcohol consumption6.

Do any benefits of alcohol outweigh the risks?

Ramon Bataller has answered Unlikely

An expert from University of Pittsburgh in Hepatology, Gastroenterology, Alcohol Use

No. Even 1 drink per day can increase all cause mortality.

Do any benefits of alcohol outweigh the risks?

Richard Hoffman has answered Likely

An expert from University of Hertfordshire in Nutrition

Low to moderate alcohol has been shown to reduce the risk of cardiovascular disease and so people at particularly high risk of CVD such as middle aged men may consider drinking. Drinking alcohol slowly with a meal and choosing red wine is probably the best way. 

Is alcohol bad for you? It depends on the drink and how you drink it

Recent headlines claim that a glass of wine or a pint of beer a day shortens your life. It’s enough to dampen any thoughts of a celebratory drink or two at Christmas. But those conclusions are based on a partial view of the alcohol debate.

No one disputes the fact that many people drink too much alcohol. The controversy centres on whether even low levels of consumption are safe. There is now good evidence that the risks versus benefits of alcohol are strongly influenced by the type of alcohol and the way it is drunk. Yet many studies have not included these factors when making recommendations about safe levels of alcohol consumption. So can you drink alcohol in a way that is safe or even beneficial?

The data seems to say “yes”. When drinking is spread out over the week, death from any cause is lower than when the same amount of alcohol is drunk on only one or two days of the week. The way alcohol is consumed matters because spikes in blood alcohol concentrations are far higher from binge drinking. Above a certain blood alcohol concentration, the body breaks down alcohol in ways that produce harmful molecules called free radicals that can damage the liver and are associated with an increased risk of cancer. But, unfortunately, many alcohol studies are based on the overall amount consumed in a week – they don’t distinguish between different drinking patterns.

Drinking with a meal also has a big influence on the health effects of alcohol because food slows the emptying of the stomach, which lowers the blood alcohol concentration. And when alcohol is consumed as part of a Mediterranean diet, it seems to carry far less cancer risk than most other ways of consuming alcohol.

This can be explained, at least in part, by nutrients that are present at high levels in the Mediterranean diet, such as folates, which reduce the carcinogenic effects of alcohol. It is now widely accepted that the health effects of an individual food or nutrient can only be evaluated within the context of the overall diet. But that understanding is sometimes lost when drawing up guidelines for alcohol consumption.

Drinking low amounts of wine is usually found to reduce the risk of an early death more than not drinking or drinking other forms of alcohol. A unit of alcohol in wine drunk slowly with a meal results in lower blood alcohol concentrations than a unit of alcohol taken as a single swig of spirit on an empty stomach. It is not yet understood whether the benefits of drinking wine – and especially red wine – are due to this more leisurely way of drinking or to wine’s many antioxidants (substances believed to protect cells from damage).

Wine as medicine

Some public health experts strongly believe that to prevent harm from misuse, alcohol should be declared a drug of abuse. But, when taken in moderation, alcohol reduces cardiovascular disease, and possibly dementia. So it may be more appropriate to view alcohol as if it were a pharmaceutical drug.

It would be rather odd to be prescribed a course of medicine without it being made clear that only a few tablets should be taken each day – not all of them on a Friday night, which would turn a beneficial drug into an extremely harmful one. Similar precautions also need to be employed to benefit from alcohol.

Most nutrients, from saturated fats to many vitamins, have safe upper limits, and exceeding those limits can be harmful. These limits reflect the body’s capacity to safely metabolise the nutrient. The dose makes the poison.

Of course, some people, such as pregnant women and people who produce high levels of the cancer-causing substance acetaldehyde when they metabolise alcohol, should avoid alcohol altogether. Binge drinking is also rightly condemned as harmful. But the current evidence suggests that for those who choose to drink, the benefits from moderate meal-time drinking (wine with a Mediterranean-style meal, preferably) outweigh the risks. Making a clear distinction between binge drinking and moderate meal-time drinking can help clear up the confusion and allow alcohol its appropriate place in a healthy lifestyle.

I have adapted this answer from my original article in The Conversation

Do any benefits of alcohol outweigh the risks?

Maciej Zatonski has answered Unlikely

An expert from GlaxoSmithKline in Vaccines, Vaccinology, Medicine, Otolaryngology, Public Health

Most likely any amount of alcohol consumed increases overall mortality.

In the past, there was limited evidence (amplified from limited number of studies), that consumption of certain products, such as red wine, in a limited volumes (no more than 1 unit per day) could reduce the risk of cardiovascular disease, however the studies did not control for long-term outcomes and confounding factors (such as the socio-economic profile of consumers, other risk factors, diet, etc).