The RCP report concluded that advising on ‘safe’ levels of alcohol consumption is difficult and that there was ‘insufficient evidence to make completely confident statements about how much alcohol is ‘safe’
However, the report argued that it is essential that this was not used as an excuse for inaction, and this is where they chose to put their emphasis. Note that this is a subjective judgment, albeit well-intended.
The truth is the detailed report
by Public England shows that the amount you drink, how often, individual factors such as your general health, your age and genetic factors all play a part (3). These are very significant. Their concerns also took into account factors like mental wellbeing, the effect of drinking on your family, relationships, employment, crime and disorder too.
So the scope is wide, as you would expect for setting government policy. This quite different from YOUR particular personal risk.
Their focus is on RISKS, because that was what they were tasked to do: This review was commissioned by the Department of Health, which asked Public Health England (PHE) to provide an overview of alcohol-related harm in England and possible policy solutions
. NB benefits are not mentioned.
It’s worth giving this a special mention.You know the idea that the more we drink the tolerant we get? Well, yes, kind of – but here’s the rub – the damage is still the same. Do you see? In other words, your TOLERANCE is really only affecting how you FEEL when you drink; but the physiological effects – including POTENTIAL DAMAGE – remain the SAME.
That means, tolerance really is an ENEMY of your health and well-being – do you see? The Drinkaware charity talks about ‘RESETTING’ your tolerance which you can do. How? By cutting back significantly or even better, committing to an alcohol holiday for your body.
Affects on the Body
This article gives a nice and easy at-a-glance overview of what alcohol does (4): http://www.healthline.com/health/alcohol/effects-on-body
Now, there may be some benefits too, which we’ll look at now.
The Potential Benefits
A large study reported in the American Journal of Public Health concluded that: Regular alcohol intake has both risks and benefits. In analyses using repeated assessments of alcohol over time and deaths from all causes, women with low to moderate intake and regular frequency (greater than three days/week) had the lowest risk of mortality compared with abstainers and women who consumed substantially more than one drink per day. (5)
And, as regards a healthy lifestyle, we have found that light to moderate alcohol consumption was one of the five most important modifiable contributors to lowering the risk of coronary heart disease, stroke, and total mortality.
Another interesting large study in the journal of Social Science and Medicine concluded: Our findings are generally consistent — especially for younger women — with an accumulating body of research demonstrating positive associations between moderate alcohol use and health, even after accounting for abstainer bias. (5)
Beyond the heart, gallstones, and type 2 diabetes occurred less frequently with moderate drinkers than non-drinkers.
Red v White? Beer v Wine?
Some studies have suggested that red wine – particularly with a meal – can give more cardiovascular benefits than beer or spirits. The tend to be comparisons between countries, where coronary heart disease is less common in “wine-drinking countries” than in beer- or liquor-drinking countries.
Red wine may contain more substances (other than alcohol) that could prevent blood clots, relax blood vessel walls, and prevent the oxidation of low-density lipoprotein (LDL, so called “bad” cholesterol), a key early step in the formation of cholesterol-filled plaque.
In practice, though, beverage choice appears to have little effect on cardiovascular benefit (6). Equally, the conventional belief that cholesterol is a cause of problems is increasingly looking doubtful; there is evidence that it may be an effect rather than a cause, and even beneficial (7).
What is Moderate Drinking?
In the older guidance, moderate drinking was defined as within the limits shown below. You still need them to figure what the research means when it uses terms like moderate or heavy drinking. Beware though, it varies in the literature.
MEN 21 Units 21 single shots of spirits, 9 and a half pints, 14 VERY SMALL glasses of wine; ten TYPICAL 175ml glasses wine; seven LARGE 250ml glasses wine; two and a bit bottles.
WOMEN: 14 single measures of spirits; seven pints; nine VERY SMALL glasses of wine; seven TYPICAL 175ml glasses of wine; four and a half LARGE 250ml glasses wine; one and a half bottles.
This is really good Alcohol Units calculator:
The bottom line seems to be that blanket recommendations about alcohol are out of the question because of alcohol’s complex effects on the body and the complexity of the people who drink it.
Because each of us has unique personal and family histories, alcohol offers each person a different spectrum of benefits and risks. Whether or not to drink alcohol, especially for “medicinal purposes,” requires thoughtful review and balancing up the benefits and risks (8). Here are the factors to consider
- Your personal overall health related to your individual risks for alcohol-associated conditions. If you are slim, physically active, don’t smoke, eat a healthy diet, and have no family history of heart disease, drinking alcohol won’t add much to decreasing your risk of cardiovascular disease.
- If you don’t drink, there’s no need to start. You can get similar benefits with exercise (beginning to exercise if you don’t already or boosting the intensity and duration of your activity) or healthier eating.
- If you are a man with no history of alcoholism who is at moderate to high risk for heart disease, a daily alcoholic drink could reduce that risk. Moderate drinking might be especially beneficial if you have low HDL that just won’t budge upward with diet and exercise – although the link between cholesterol and heart disease is increasingly being questioned.
- If you are a woman with no history of alcoholism who is at moderate to high risk for heart disease, the possible benefits of a daily drink must be balanced against the small increase in risk of breast cancer.
- If you already drink alcohol or plan to begin, keep it moderate—no more than two drinks a day for men or one drink a day for women. And make sure you get plenty of folate, at least 600 micrograms a day.
- Government announcement on new guidelines: https://www.gov.uk/government/news/new-alcohol-guidelines-show-increased-risk-of-cancer
- Summary of Evidence by the Royal College of Physicians: https://www.publications.parliament.uk/pa/cm201012/cmselect/cmsctech/writev/1536/ag22.htm
- Detailed Review by Public Health England:
- The Effects of Alcohol on the Body: http://www.healthline.com/health/alcohol/effects-on-body
- Growing evidence of benefits: https://health.spectator.co.uk/the-evidence-keeps-on-growing-alcohols-health-benefits-are-no-old-wives-tale/
- Type of Alcohol: https://www.hsph.harvard.edu/nutritionsource/is-wine-fine-or-beer-better/ :
- Cholesterol not linked to heart disease: http://www.nhs.uk/news/2016/06June/Pages/Study-say-theres-no-link-between-cholesterol-and-heart-disease.aspx
- Balancing the pros and cons: https://www.hsph.harvard.edu/nutritionsource/alcohol-full-story/