A drink a day keeps the doctor away.. or does it? Perhaps not. Sorry to get your hopes up. This advice comes from the Chief Medical Officers in the UK as well as the Center for Disease Control (public health body in the US). It is acknowledged even in a recent study in the British Medical Journal. The study showed that moderate drinkers had a lower risk of initially being diagnosed with various cardiovascular diseases than people who were teetotal. So alcohol does harm, even in small doses.
The reason: it’s complicated.
1) Although moderate drinking was linked to a lower risk of cardiovascular disease (including myocardial infarction -‘heart attack’), this was not true for subarachnoid haemorrhage (bleeding on the brain). Trading one for another.
2) The study did not look at what happens when a group of teetotal people start drinking or when a group of moderate drinkers quit. It only looks at associations between categories of drinkers and cardiovascular disease. Association does not imply causation because there may be other undetected ‘confounding variables’ which are responsible. For example, people who are moderate drinkers might be more likely to cook with olive oil or do more exercise which might be the actual cause of the lower cardiovascular risk. Simply put, lifestyle factors are very important.
3) As mentioned in the study, there are other safer ways of lowering cardiovascular risk which do not incur risks of alcohol-related harm (alcohol dependence, liver disease and cancer). These include smoking cessation and increased physical activity.
4) The UK guidelines state that alcohol increases the risk of other conditions. In particular, they identified that for some cancers (mouth, throat and breast) there was increased risk for any level of regular drinking. People could reduce risk by drinking less than the guidelines or not drinking at all.
5) Even within the 14 units per week recommendation, drinking too much alcohol within a short period of time carries a greater risk of harm. The guidelines do not state a specific limit for a single episode of drinking because it will vary from person to person. However certain groups (e.g. those on medications or young adults) may be particularly at risk. For some people, just 5-7 units (2-3 pints of 4% lager) over 3-6 hours can increase risk of acute injury by 2-5 times.
Although some links have been found between moderate alcohol intake and reduced cardiovascular risk, overall there is no recommendation to take up drinking alcohol for people who are teetotal or to regularly drink alcohol (even at moderate levels). This is because alcohol is linked to other harmful outcomes and cardiovascular risk can be reduced in other, safer ways.
So what next?
The BMJ study suggests that further work could be done to calculate the risk of alcohol consumption to individuals. Indeed now that it is much easier to analyse data on a large scale (including people’s genetic code), perhaps in the future people will have personalised alcohol recommendations based on their specific characteristics and risk factors.
For more information on how to calculate units of alcohol and health-related effects click here.
For advice on how to reduce or stop drinking click here.
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Any opinions above are the author’s alone and may not represent those of his/her affiliations. Any comment is based on the best available evidence at the time of writing. All data is based on externally validated studies unless expressed otherwise. Novel data is representative of sample surveyed. Online recommendation is no substitute for seeing your own doctor and should not be taken as medical advice.
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