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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

Food for Thought, Watching Your Intake Food for Thought, Watching Your Intake

Defensive Drinking: Alcohol and Your Health

January 16, 2013

Healthy Lifestyle
Watching Your Intake
Defensive Drinking: Alcohol and Your Health
Defensive Drinking: Alcohol and Your Health
If you take a look at the scientific studies about the potential health effects of alcohol, you'll likely find your head spinning as if you just polished off an entire bottle of Merlot. Defining alcohol's role in a balanced lifestyle is not clear-cut.
Harvard Medical School Commentary

By Tara Mardigan, M.S., R.D., M.P.H.
Brigham and Women's Hospital

Is that frosty mug of your favorite brew helping or harming you? Could your daily glass of wine at dinner actually be protective? It depends.

If you take a look at the scientific studies about the potential health effects of alcohol, you'll likely find your head spinning as if you just polished off an entire bottle of red wine. The data are inconclusive at best.

Defining alcohol's role in a balanced lifestyle is not clear-cut. To date, there have been no long-term randomized trials of alcohol consumption. What we know about alcohol stems from two sources — short-term trials looking at physical effects and observational studies comparing moderate drinkers with those who abstain.

What's more, both sources have their limitations. Most of the studies focus on intermediate measures rather than disease outcomes, so drawing complete conclusions may be inappropriate. Additionally, some of the health benefits and risks associated with alcohol consumption may be related to some other factor, not the actual intake of alcohol itself.

Where the science is limited, a shot of common sense can come in handy in determining if alcohol is appropriate for you.

Defining a Drink

A drink is defined as 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80- to 100-proof distilled spirits. Experts say that when it comes to alcohol, a little goes a long way for the potential health effects. Once again, moderation appears to be the key. Sip past moderation and the effects of alcohol can quickly become negative.

So, what's moderation when it comes to alcohol? Most studies suggest that moderate drinking is up to one drink per day for women and two drinks per day for men. Heavy drinking is considered anything above this amount and may include the common pattern of abstaining during the week and "binge" drinking on the weekends.

A culmination of research studies involving alcohol suggests that the potential beneficial properties of moderate drinking are not limited to wine alone. Whether you choose beer, wine or spirits, you'll reap the benefits from the form of alcohol known as ethanol.

What must be clearly distinguished is that the potential health benefits of drinking alcohol are associated with moderate drinking. In some cases, an increase past moderate drinking may actually reverse the benefits and lead to increased risks. Here's a look at some of the possible pros of moderate drinking and cons of heavy drinking.

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Rewards of Moderation

Moderate drinking may:

  • Reduce your risk of developing heart disease, peripheral vascular disease and intermittent claudication (leg pain). Alcohol raises HDL "good" cholesterol, prevents plaque from forming in arteries, and prevents clotting.
  • Reduce your risk of dying of a heart attack.
  • Reduce your risk of strokes, particularly ischemic strokes.
  • Lower your risk of gallstones.
  • Reduce your risk of age-related cognitive decline. Alcohol may reduce plaque buildup common with Alzheimer's disease.

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More Is Not Better

Heavy drinking may lead to:

  • Cancer, such as gastrointestinal, oral, pharynx, larynx, esophageal and liver cancers, as well as breast cancer in women. Alcohol appears to increase the risk of estrogen and progesterone receptor positive breast tumors more than estrogen and progesterone receptor negative tumors. This suggests a hormonal basis for the effect of alcohol on breast cancer.
  • Acute and chronic pancreatitis, especially in people with high levels of triglycerides in their blood
  • Elevated levels of triglycerides in the blood
  • High blood pressure
  • Miscarriage
  • Injuries resulting from impaired motor skills
  • Sudden death in people with cardiovascular disease
  • Heart failure
  • Stroke
  • Alcoholic cirrhosis of the liver
  • Fetal alcohol syndrome in an unborn child, including slow growth and nervous system problems
  • Depression
  • Suicide

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Tips for Healthful Consumption

  • Drink alcohol with food to slow its release into the bloodstream.
  • Drink sips of water between sips of alcohol.
  • Choose either a drink or a dessert when eating out to avoid excess calories.
  • Take a multivitamin fortified with folic acid every day.
  • Be mindful of liquid calories. A drink usually has between 100 and 135 calories.
  • Avoid drinking alcohol at all if you have had a hemorrhagic stroke or have liver disease or pancreatic disease.
  • Know your family history. You may be at risk of alcoholism if you have a family history of it.
  • Remember that alcohol can interfere with common medications such as anticoagulants, antidepressants, beta-blockers, chemotherapies and pain relievers. Be sure to check with your doctor or pharmacist about potential interactions.

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The Bottom Line

Moderate drinking appears to play a role in chronic disease prevention when the other elements of a balanced lifestyle are also present. These elements include a healthful diet, healthy weight, adequate physical activity, no smoking, ample stress reduction and rest. Moderate drinking is only one component of a balanced lifestyle. The choice is yours.

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Tara Mardigan, M.S., R.D., M.P.H., is a nutritionist at Brigham and Women’s Hospital. She earned a Bachelor of Science degree in nutrition from the University of New Hampshire. She completed her internship at Yale-New Haven Hospital in Connecticut and worked for three years as an inpatient dietitian at Massachusetts General Hospital before getting her master's degrees in nutrition and communication as well as public health at Tufts University.

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