The Alcohol Debate: Should You or Shouldn't You?

How drinking affects your health

By Kathleen Zelman, MPH, RD, LD
WebMD Weight Loss Clinic

Reviewed By Charlotte E. Grayson, MD

Has a daily drink replaced the apple a day as a way to keep the doctor away?

Scientists have long touted the heart benefits of drinking small amounts of alcohol. Newer studies have credited moderate drinking with everything from helping to keep our minds sharp as we age to lowering our risk of developing diabetes.

In fact, the new U.S. dietary guidelines give many of us official permission to enjoy one to two drinks daily.

This is great news for folks who follow the French lifestyle of sipping a glass of wine with dinner, or who enjoy an evening cocktail. But what about teetotalers -- should they start drinking? Are there some people who shouldn't drink, under any circumstances? And how do you balance the health effects of alcohol with its high calorie count?

Since some 55% of U.S. adults drink alcohol according to the CDC, it's important to understand how it affects our health. To get some answers, WebMD talked to experts about alcohol's risks and benefits and its place in a healthy diet.

Does It Help or Hurt?

Drinking alcohol can be good for your health, but it can also be harmful. It all depends on how much you drink, your age, and other factors.

There's no denying that too much alcohol can lead to serious problems. Excess alcohol can increase your risk of:

  • Liver disease
  • High blood pressure
  • High blood fats (triglycerides)
  • Heart failure
  • Stroke
  • Fetal alcohol syndrome (if you're pregnant)
  • Certain cancers
  • Injury, violence, and death

And, of course, drinking too much alcohol piles on the calories, which can lead to obesity and a higher risk for diabetes.

For some segments of the population, alcohol can lead to many health problems. Those who should not drink include:

  • Pregnant and breastfeeding women
  • Women at risk for breast cancer
  • People with family histories of alcohol abuse
  • Children and adolescents
  • People taking medications that can interact with alcohol
  • Those with health conditions such as liver problems or ulcers
  • Anyone requiring skill or coordination to perform a task

According to the U.S. Dietary Guidelines, in middle-aged and older adults, moderate consumption is associated with the lowest all-cause mortality (that is, the rate of death from all causes). But in younger adults, alcohol consumption provides little, if any, health benefits, according to the guidelines. Instead, it's associated with a higher risk of serious injury or death.

The CDC has reported that excessive drinking causes more than 75,000 deaths from various causes in the U.S. each year. And what exactly is "excessive"? For men, it's an average of more than two drinks daily, or more than four drinks at one time, according to the CDC. For women, it's an average of more than one drink per day or more than three drinks at one time.

Alcohol's Advantages

Alcohol's effects on the heart -- for both men and women -- are well documented. Studies have shown that moderate drinking can raise levels of "good cholesterol," which helps prevent harmful blood clots and helps keep blood flowing smoothly through our bodies, reducing risks of heart attack and stroke.

In fact, moderate drinking can increase "good cholesterol" levels by as much as 20%, if it's accompanied by a healthy diet and regular physical activity, says Harvard researcher Eric Rimm, DrS.

That's similar to the improvement you might see by taking cholesterol medication or running a half-marathon, Rimm says. (He's quick to point out that exercise has many other health benefits and that alcohol should never replace exercise.)

Research has also suggested that moderate drinking can increase insulin sensitivity, which can reduce the risk of diabetes, among other things. But the empty calories in alcohol can be a problem, as there is a link between type 2 diabetes and excess weight.

Rimm, who has reviewed several large studies, has found a delicate balance between the risks and benefits of alcohol and its impact on diabetes. However, he says, "there appears to be a reduction in risk of type 2 diabetes in adults who consume moderate amounts of alcohol."

Recent research also suggests that women who enjoy a little alcohol may be more likely to keep their minds sharp as they age.

A study published in The New England Journal of Medicine earlier this year evaluated the mental abilities of 12,480 women aged 70-81. The researchers found that moderate drinkers had a 23% reduced risk of mental decline compared with nondrinkers.

What Type, How Much, and When?

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