There’s been a lot of alcohol in the news recently. Several new studies have reported some additional risks of alcohol itself and in the behaviors (like working long hours) that make us more likely to consume the stuff. But perhaps most surprising is a new review in the journal Alcoholism: Clinical and Experimental Research, in which the author suggests that doctors tell lifelong abstainers to start downing a drink with dinner every night, so robust are alcohol’s health benefits. Emanuel Rubin writes that although it should be an individualized recommendation by one’s doctor, “the overwhelming evidence suggests that physicians should counsel lifelong nondrinkers at about 40 to 50 years of age to relax and take a drink a day, preferably with dinner.”  In the past, experts have gone out of their way to avoid making this recommendation, since the research on beginning to drink in middle age just isn’t there. As you might guess, the new study inspired some pushback from critics who say that nondrinkers should definitely NOT start drinking in mid-adulthood, since the research doesn’t yet exist to support it.  While the experts duke out this new point of contention, the advice should probably remain the same: If you’ve always been a light drinker, most researchers agree that it’s ok to carry on. With heavier drinking, it’s best to cut back. As always, talk with your doctor if you have questions about alcohol use, particularly if you have current health problems or are taking medication. But here’s a rundown of what the research tells us are the health benefits and drawbacks of alcohol consumption.  A number of research studies have found that light drinking may reduce the risk of coronary artery disease and of heart attack. Even among people who have had heart attacks, low to moderate alcohol use has been linked to a lower mortality rate. The heart healthy benefits may be due in part to alcohol’s beneficial effect on HDL (“good”) cholesterol, although the mechanisms aren’t fully understood. Some research has suggested a heart healthy benefit of red wine in particular, since its antioxidants may reduce oxidative stress and inflammation in the body, and thereby the risk of heart disease (though some newer research, has unfortunately, disputed that). The American Heart Association points out that heavier alcohol use clearly has a negative effect on heart health, in the way of high triglycerides, high blood pressure, and weight gain, which all increase the risk of heart disease.  Low to moderate alcohol intake has been linked to a reduced risk of stroke, particularly in women, likely due to its anti-coagulant properties. Higher intake, however (even more than two drinks/week, in one study), has been routinely shown to increase the risk of stroke.  There is some fairly strong evidence that alcohol consumption is linked with certain cancers, like cancers of the mouth, esophagus, larynx and pharynx. Connections to other types of cancer have been more variable (i.e., stomach, colon, liver, breast and ovarian cancers), though the risk for these cancers does seem to increase with higher levels of alcohol. Recent research has found, however, that even light drinking can increase the risk of mouth and breast cancer, so the idea that light drinking is totally innocuous may not be valid.  Obesity and Type 2 Diabetes  Alcohol has long been linked to weight gain, since it’s high in calories, and without much residual nutrition. However, some studies have shown that light to moderate alcohol use is linked to a lower risk of becoming obese over time. Light to moderate alcohol consumption, particularly of wine, has also been linked to a reduced risk of type 2 diabetes, while higher intake appears to be linked to an increased risk (though there may be some sex differences here).  Light to moderate alcohol consumption seems to be good for bones, in the way of reduced risk of osteoporosis. Rheumatoid arthritis risk may also be reduced in women who drink moderate amounts of alcohol. But as always, high alcohol intake seems to deteriorate bone health.  Alcohol has long been used as a soporific, but in reality, it’s not very good for sleeping through the night. While it may help you fall asleep faster, a new study finds, it’s likely to lead to the disruption of restorative sleep during the night, as evidenced by changes in brain waves. “The take-home message here is that alcohol is not actually a particularly good sleep aid even though it may seem like it helps you get to sleep quicker,” said Christian L. Nichols, in a news release. “In fact, the quality of the sleep you get is significantly altered and disrupted,” which can lead to significant problems with cognition during waking hours. Another new study found that poor sleep in teens can be a precursor of problematic alcohol use (and other risky behaviors) years down the road, in a kind of vicious cycle.  Heavy drinking is linked to increased risk for dementia like Alzheimer’s disease (and very heavy drinking is linked to a dementia-like disorder known as Korsakoff’s syndrome), while some studies have suggested that light to moderate alcohol consumption may have some protective effects for dementia.  Most work has found connections between alcohol intake and depression. But one recent study found a different relationship: That moderate alcohol use, especially of wine, is linked to reduced risk of depression. The researchers suggest that it has to do with wine’s anti-inflammatory properties, since, in addition to mediating other health problems like heart disease, inflammation is also thought to at least partially underlie depression. That said, there’s a more complicated relationship between higher levels of alcohol consumption and depression, where each may exacerbate the other.  A study out this week shows that over 40% of Americans who drink are simultaneously taking “alcohol interactive” medications, which, for a variety of reasons, is quite dangerous. And it’s much higher for elderly people. Depending on the medication, the effects of mixing in alcohol can range from stomach bleeding (e.g., with aspirin) to hypoglycemia (with diabetes meds) to severe sleepiness or dizziness (with opioids like Vicodin or OxyContin). The researchers advise people to read labels and talk with their doctors or pharmacists about whether alcohol should be avoided completely, or whether it may still be consumed if staggered with medication use.  The Takeaway: Continue Lightly or Cut Back – But Don’t Start  No one disputes that there are some health benefits of alcohol consumption – that is, of light alcohol consumption. Higher levels of alcohol use both chronically and acutely (i.e., bingeing) are linked to many more health risks than benefits, both to body and brain. The consensus seems to be that if you’re a light drinker and it’s working for you, keep on doing it – at that level. But starting to drink in one’s 40s or beyond is still questionable, despite one author’s controversial recommendation that doctors tell their non-drinking patients to go ahead and start. Most experts seem to agree that there’s not enough evidence that the benefits outweigh the risks at this point in life, and in fact more people reduce drinking at this age than start it. Use common sense and listen to your body – and if you have any questions at all about your particular alcohol habits, consult with your doctor rather than the Internet.  Follow me @alicewalton or find me on Facebook.
A little alcohol seems to benefit health in most ways. But if you’re a non-drinker, don’t start drinking now.