Alcoholic beverages have been part of human life for millennia.
People drink for many different reasons, whether for social enjoyment, relaxation or simply taste.
However, it’s important to be aware of the pros and cons of alcohol consumption.
This article takes a look at healthy drinking habits and the short and long-term health effects.
In particular, it looks at the often-reported link between alcohol and longevity. Is it real, as some claim?
Or is alcohol damaging to our health?
Alcoholic Beverages and Longevity
First of all, let’s take a look at some recent research into the links between alcohol and lifespan.
Here are some conclusions from recent peer-reviewed studies—both positive and negative—that examine the issue:
Studies With Weak or No Links Between Alcohol Intake and Longevity
- Low volume drinkers may appear to benefit only because alcohol abstainers are more likely to be in ill health. There are no significant reductions in mortality risk in moderate drinkers (1).
- Patients hospitalized with alcohol use disorder (abuse or dependence) die 24-28 years earlier than the general population (2).
- A meta-analysis finds a weak reduction in mortality in people with lower intakes of alcohol compared to non-drinkers. Conversely, there is an apparent higher mortality risk with heavy consumption (3).
Studies With Moderate to Strong Links Between Alcohol and Lifespan
- There is consistent evidence for a mortality advantage among moderate wine drinkers compared to abstainers. However, this may be the result of confounding social and behavioral factors (4).
- Controlling for all confounders, a study involving 124,000 people finds that moderate alcohol drinkers have lower all-cause mortality than non-drinkers. Further, there is strong evidence for the relationship being causal (5).
- Alcohol affects the mTOR pathway, which slows the aging of cells. Moderate alcohol consumption reduces mortality risk, and there’s compelling evidence this is due to the effect on mTOR suppression. Calorie restriction is also a suppressor of mTOR, so alcohol may work through a similar pathway (6, 7).
- Epidemiological studies consistently show that alcohol drinkers have a lower risk of cardiovascular events. The case for the benefits of light drinking is compelling (8).
Does the Dose Make the Poison?
By looking at the studies, there does appear to be a connection between alcohol consumption and longevity.
Additionally, this is just a small sample, and there are dozens of studies that find alcohol lengthens lifespan.
That said, the key is to drink alcohol in modest doses. Specifically, the research shows that moderate drinkers show decreased mortality risk compared to non-drinkers.
However, this isn’t a free license to drink as much as you want. The research is also clear that heavy drinkers have a higher mortality risk.
The Health Effects of Alcohol
Here is a summary of some research looking into the health effects of alcohol.
Alcohol and Cholesterol
- Alcohol lowers the risk of atherosclerosis (hardening of the arteries) by increasing HDL levels, otherwise known as “good cholesterol.” HDL rises in a dose-dependent fashion with alcohol consumption (9, 10).
- Reverse cholesterol transport (RCT) increases by 10.8% following an alcoholic beverage. RCT refers to the process of removing free cholesterol from the body, and research shows that higher rates of RCT help minimize CVD risk (11).
Alcoholic Beverages Reduce Inflammation
- As well as promoting higher HDL levels, alcohol decreases fibrinogen levels – a marker of inflammation (12).
- There is a ‘U’ shape curve between alcoholic drink intake and inflammatory markers. A little alcohol has an anti-inflammatory effect, but larger amounts can cause inflammation (13, 14).
- As part of a cardiovascular health study, out of 5865 adults aged 65 or above, those who drink had lower systemic inflammation (15).
- Wine contains significant amounts of health-protective polyphenols, and it has demonstrated protective effects against cardiovascular disease and some cancers. Several compounds in wine also display anti-carcinogenic properties in clinical trials (16).
- Among all types of alcohol, especially red and berry wines seem to offer greater cardiovascular protection due to their polyphenolic content. As a result, red wine is one of the best alcohol options for health (17).
- The polyphenols in red wine help reduce oxidative stress and protect against inflammatory lesions in the arteries. Both human and animal studies have shown this beneficial effect (18, 19).
Heavy Drinking Damages Health
Despite the advantages of alcoholic beverages, we forfeit them when we drink too much.
In fact, drinking to excess is one of the most damaging things to our health and prematurely kills millions of people every year (20).
While a glass of red at the weekend or an occasional beer might have some benefit, drinking several beers a day will not.
As alcohol dose increases, the disadvantages of alcohol quickly become apparent.
Excessive Alcohol and Lipids
In high amounts, alcoholic beverages can worsen cardiovascular markers of health.
- Light to moderate alcohol consumption can decrease triglyceride levels, but high alcohol intake “is associated with elevated plasma triglycerides” (21, 22).
- In patients with diabetes, heavy alcohol intake may cause excessive production of triglycerides (23).
Alcoholic Beverages and Liver Damage
While small amounts of alcohol can be beneficial, higher doses can cause liver problems.
But how much does it take to cause liver damage?
- Among men and women drinking daily (or 14-28 drinks per week,) there’s a much higher risk of alcoholic cirrhosis compared to those drinking less (24).
- On average, between 90% and 100% of heavy drinkers develop fatty liver disease. Also, 10-35% will suffer from alcoholic hepatitis, and 8-20% will develop alcoholic cirrhosis (25).
- Over time, binge drinking has significant associations with liver cirrhosis mortality–irrespective of drinking frequency (26).
Alcohol and Cancer
Unfortunately, higher amounts of alcohol have close links to several types of cancer.
- There is “strong evidence” that alcohol can cause cancer at seven sites in the body. As always with epidemiological studies, this relies on self-reporting and ignores potential confounders (27).
- Low levels of alcohol consumption increased breast cancer risks in a prospective observational study of 105,986 women. The most significant risk factor was cumulative lifetime intake (28).
- In the PURE study, research involving 114,970 people showed alcohol reduces cardiovascular risk but increases the risk of alcohol-related cancers. The increase in mortality is visible in those with a high intake (29).
There is little evidence on precisely how much might be harmful in this respect, but I suspect it mainly relates to heavy drinkers.
Alcohol and Alcoholic Life Expectancy
We’ve discussed how alcohol has both positives and negatives. Although this may be true, there is a big caveat: alcoholics.
It goes without saying that those with past alcoholism or who feel an addiction to alcohol should never drink. Not even a single drop.
Alcoholic Life Expectancy
By how much can chronic alcohol consumption shorten your life? There is a range of estimates on this, and none of them are good.
At present, the global life expectancy is 71.4 years (30).
In contrast, the global life expectancy for people suffering from alcoholism is believed to be 10-12 years lower.
And as previously mentioned, in patients hospitalized through alcoholism in Scandinavia the life expectancy plummets to (2):
- 47-53 years in men
- 50-58 years in women
Granted, these figures represent the lifespan of heavy drinkers.
However, there is a ‘U’ shape curve with alcohol; a little is good, and after that point, progressively more seems to equal progressively higher risk.
The Prevalence of Heavy Drinking
The pervasiveness of heavy drinking is more common than you might expect.
In fact, 24 million Americans drink 74 alcoholic beverages a week: more than ten every single day.
Many of these people try giving up alcohol but can’t break their addiction
Which Types of Alcohol Are Best?
If you’re going to drink alcohol, then there’s a big difference between a glass of wine and a bottle of sweet flavored vodka.
In my view, the two alcoholic beverages with the most real science behind them are red wine and hard liquor – especially whiskey.
Best Alcohol: Red Wine
Out of all alcoholic drinks, red wine has the largest body of evidence supporting its numerable health benefits.
- A randomized controlled trial (RCT) shows that red wine helps improve glucose metabolism and decreases cardiometabolic risk (31).
- Links between red wine and heart health are well known. A randomized prospective study split 108 patients who have atherosclerosis into two groups: one group avoided all alcohol, and the other had a daily glass of red wine. The wine drinkers had a significantly reduced triglyceride level after 20 weeks, and a better overall cholesterol profile (32).
- Red wine contains resveratrol; a compound thought to help protect against cancer and promote longevity (33).
- In a 2-year trial of well-controlled diabetics, half were assigned to drink a daily glass of red wine with their dinner as opposed to water in the other half. After two years, the wine drinkers demonstrated better lipids and blood glucose control (34).
Health Properties of Whiskey
Whiskey has also demonstrated numerous beneficial effects over a range of studies.
- Aged whiskey contains polyphenol compounds that show better free-radical scavenging activity than vitamin E (35).
- In one study, test subjects consumed either 100ml of red wine, whiskey, or a new-make distilled spirit. In subjects drinking whiskey and red wine, the total blood concentration of antioxidants experienced a similar rise within 30 minutes. However, the other spirit induced no change (36).
- A controlled study investigated the ability of alcoholic beverages to improve glucose control. In healthy male subjects beer increased blood glucose levels by 26.7%; in contrast, whiskey had no effect (37).
How Much Alcohol is Optimal?
To sum up, we can see that there are numerous potential benefits of alcohol.
However, alcoholic beverages are far from a magic pill and drinking is always a trade-off between the positives and negatives.
The data does suggest that moderate intake could potentially have beneficial effects on heart health. On the other hand, a moderate amount also appears to raise the risk of several cancers.
Given this, for those who drink, just a light amount of alcohol seems to be most beneficial.
However, the best bet for non-drinkers would be to continue refraining from alcohol consumption.