Alcohol and Your Health: How Much is Too Much?

Alcohol and Your Health: How Much is Too Much?

by Lisa Larkin, MD, FACP, NCMP, IF

It’s no wonder people are confused about the health effects of alcohol. We’ve seen headlines ranging from “A Drink a Day is Good for your Heart,” to “Studies Show Even Moderate Drinking Increases Breast Cancer Risk.” In recognition of April as Alcohol Awareness Month, let’s get to the facts about the health benefits–and health impacts–of alcohol consumption.

How Much Is Moderate Drinking?

First, let’s talk about what constitutes a drink and drinking. One drink is equal to 12 ounces of beer or wine cooler, 5 ounces of wine, or 1.5 ounces of 80-proof liquor. “Light” to “moderate” drinking is considered to be no more than one drink per day for women and two for men. Anything more than that is considered heavy drinking and is associated with many health issues, including taking a toll on the liver (cirrhosis, fibrosis or fatty liver) and causing damage to the heart which can elevate blood pressure and increase chances of heart attack and stroke. In addition, heavy drinking has been shown to weaken the immune system, negatively affect the pancreas (leading to pancreatitis,) and increase the chance for many types of cancer, including cancer of the mouth, esophagus, throat, liver and breast. And of course, heavy drinking increases the chance of alcohol addiction, weight gain and poor reflexes. Most people are well aware of the dangers of heavy drinking.

Many adults fall into the light to moderate drinker category. Moderate drinking is what has left many confused: is moderate drinking good for you? Safe or harmful? The answer is: it depends.

How Does Alcohol Impact Heart Health?

Studies have shown that light to moderate drinking appears to protect some healthy people (those don’t already have a heart condition) against heart disease. A review published by the Harvard School of Public Health of more than 100 prospective studies showed that moderate drinkers had a 25 to 40 percent reduced risk of heart attack, stroke, peripheral vascular disease, and death from cardiovascular causes compared to nondrinkers. Alcohol appears to raise HDL – “good cholesterol”—and prevents damage caused by higher levels of LDL (“bad cholesterol.”) Additionally, alcohol appears to reduce inflammation and helps stop blood from clotting (which can help prevent heart attack and stroke, but can also increase bleeding.)

How Does Alcohol Impact Breast Cancer Risk?

More recently, a major report released in March 2017 by the American Institute for Cancer Research (AICR) and the World Cancer Research Fund (WCRF) showed that just one drink per day increases women’s risk of developing breast cancer. Again, more than moderate drinking is associated with increased risk in certain cancers – including breast cancer – but this report showed a demonstrated link between moderate alcohol consumption and increased risk of developing breast cancer. This may be due to a number of reasons. First, we know that alcohol can lead to unwanted weight gain, and excess fat can lead to increased cancer risk. Secondly, alcohol can increase levels of estrogen and other hormones associated with breast cancer. And lastly, alcohol users are more likely to have increased amounts of folic acid in their systems, which can lead to increased cancer risk. (The same study also showed that regular exercise can help decrease the risk of developing breast cancer. Multiple studies show that maintaining a healthy weight and adhering to a Mediterranean diet can decrease a woman’s risk of developing breast cancer.)

The bottom line? Drinking in moderation, when combined with other healthy habits, like moderate exercise and a Mediterranean diet, appears safe, and for some people, has heart health benefits. But drinking more than one drink a day increases women’s risk of developing breast cancer.