The National Institute of Alcohol Abuse and Alcoholism defines moderate drinking as no more than one drink per day for women (7 drinks per week) and two drinks per day for men (14 drinks per week). The first research report showing that moderate alcohol consumption increased lifespan was published in 1981. Since then, moderate alcohol use has been shown to improve a variety of health conditions including: cardiovascular disease, anxiety, dementia, and type 2 diabetes. However, despite these previous findings, more recent data has begun to emerge questioning whether moderate alcohol use is healthy or not.
A health condition that is becoming more relevant with each passing year is the nationwide epidemic known as obesity. It is important to note that there are many contributing factors to obesity, but increased food availability and the subsequent increase in caloric consumption is a primary culprit. So how does obesity (and caloric excess) relate to alcohol consumption?
An underappreciated fact about alcohol is the caloric content of the alcohol itself. Most people recognize that alcoholic beverages contain calories, but oftentimes the caloric density of the alcohol is not fully realized.
Consider this: one gram of fat has nine calories, one gram of carbohydrate has four calories, and one gram of alcohol has seven calories. This means that alcohol is more closely related to fat in terms of caloric density. If I mix a drink containing one ounce of whisky with three ounces of cola – I get 64 calories from the one ounce of alcohol and 35 calories from three ounces of cola. This means that 65% of the calories in my mixed drink are from the alcohol, not the cola. Beer is similar. A standard 5% beer has approximately 145 calories and 92 calories of those 145 are from the alcohol. Again, at 63%, the alcohol within the beer contains the majority of the calories. So, if a man abides by the moderate drinking rule wherein he consumes 14 beers over the course of a week, he will have consumed an extra 2000 calories – which is almost a full day worth of extra calories. Considering the negative impact excess calories has on rising obesity rates and overall health, the fact that moderate alcohol consumption is associated with improved health is surprising.
It was contemplations like these which may have motivated a Canadian researcher out of the University of Victoria to take a closer look at the health effects of alcohol. In this recent study published in March 2016, which included close to 4 million people, it was found that many of the previous reports which had highlighted positive health effects of alcohol, had neglected to control for “potentially confounding lifestyle variables,” including exercise levels and fruit and vegetable intake. Moderate drinkers as a group are more likely to engage in physical activity, be non-smokers, be nutritionally conscious, and rank health as a high personal value. This is a well-established phenomenon whereby healthy habits tend to cluster together - that is, people who engage in one healthy behavior, such as exercise, also engage in other healthy behaviors, such as maintaining a nutritious diet. This leads us to believe that previous reports concluding that moderate alcohol consumption improves health, may have simply been observing the positive effects of a healthy lifestyle. In the study out of the University of Victoria, when these lifestyle variables were controlled for, moderate alcohol consumption was no longer associated with health and longevity, and in fact the opposite trend began to emerge whereby alcohol use dose-dependently decreased health.
While these more recent studies are thought-provoking, one of the most important take home messages is to recognize the value of a healthy lifestyle. Another way to interpret the findings is that if you take your health seriously (exercise and eat nutritious foods), you may reduce the detrimental effects of drinking alcohol. In other words, a healthy lifestyle may be protective against the negative effects of moderate alcohol consumption, (e.g. the increase in calorie intake). The end result is that you can enjoy a drink or two without having to worry too much about the health consequences, which is motivation enough (at least for me) to engage in healthy living patterns.
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By Brennan Smith, PhD
