The truth about alcohol

Alcohol is poured into a highball glass.

Alcohol is poured into a highball glass. gjohnstonphoto/Getty Images

The emerging medical consensus around alcohol is likely to be a disadvantage for drinkers. Here’s everything you need to know:

Is moderate drinking safe?

For decades, doctors have advised that drinking one or two alcoholic beverages a day is healthy, if not beneficial. A growing body of research, however, indicates that toasting “Cheers!” is an oxymoron. Studies have shown that even moderate alcohol consumption can have negative consequences, including increasing the risk of cancer and heart attacks. “The risk is starting to rise well below levels where people would think, ‘Oh, this person has an alcohol problem,'” said Dr Tim Naimi, director of the Canadian Institute for Addiction Research at the University. ‘University of Victoria. This emerging consensus comes amid an increase in alcohol consumption during the pandemic, as Americans sought to escape despair and boredom. Cleveland Clinic cardiologist Stanley Hazen said that in light of new research, he will advise his patients that even current US moderation guidelines – two drinks per night for men and one per night for women – could be risky. “I’m going to recommend cutting down on alcohol,” Hazen said.

What is the risk of cancer?

Alcohol contributes to more than 75,000 new cases of cancer per year in the United States and nearly 19,000 cancer deaths each year, according to the American Cancer Society. When humans consume alcohol, they metabolize it into acetaldehyde. This toxic chemical can damage DNA, allowing uncontrolled cell growth that creates cancerous tumors. Alcohol is known to be a direct cause of seven types of cancer: oral cavity, pharynx (throat), larynx (voice box), liver, breast and colorectal. According to the National Cancer Institute, moderate drinkers are 1.8 times more at risk of cancers of the oral cavity and pharynx, while heavy drinkers are five times more at risk. For liver cancer, the increased risk comes only from excessive alcohol consumption. Studies indicate that for postmenopausal women, just one drink a day increases their risk of breast cancer by up to 9% compared to non-drinkers.

What are the other dangers?

Alcohol is the third leading cause of preventable death in the United States, and alcoholic liver disease kills 22,000 Americans each year. The risk of liver disease is higher in heavy drinkers, but a report has found that drinking just two alcoholic beverages a day for five years can damage the liver. One drink a day, Hazen said, increases the risk of heart attack and stroke by 10 to 20 percent. Research suggests that alcohol can speed up genetic aging and exacerbate dementia, and a study published last year found that drinking just a pint of beer or a glass of wine a day can kill neurons and shrink the brain.

Doesn’t wine help your heart?

For years, researchers believed that moderate amounts of red wine could be healthy, raising “good” HDL cholesterol and protecting the heart. This was based on the presence of antioxidants found in grapes, such as resveratrol, which is believed to protect blood vessels and slow aging. But a 2016 study found that a person would need to drink at least 500 liters of red wine every day to get enough resveratrol to get significant benefits. Some experts argue that alcohol can improve blood sugar control, but even low alcohol consumption can also increase the risk of high blood pressure, stroke, and cardiac arrhythmia. “Contrary to popular opinion,” the World Heart Federation said last year, “alcohol is not good for the heart.”

Why were the experts so wrong?

Alcohol studies are largely observational or based on self-reports; it would be unethical to ask a random group of study volunteers to drink excessively. This means researchers cannot control for other variables that may influence health. Older studies that have shown that moderate alcohol consumption is beneficial relied on comparisons between light drinkers and people who did not drink at all. Researchers have since realized that people can completely abstain from drinking due to underlying illnesses, so while light drinkers seem healthier, it’s not the alcohol that makes the difference. A study published last year based on medical data from nearly 400,000 people from the UK Biobank seemed to confirm this, finding that light drinkers tend to have healthier habits – like exercising and well eat – compared to people who don’t drink at all.

How Much Do Americans Drink?

About 60% of Americans told Gallup in 2021 that they drink and estimated they drank an average of 3.6 drinks per week. But nearly half of Americans said they had had binge eating in the past few months – defined as consuming more than four drinks in one sitting for men and more than three for women. In light of new research, some researchers recommend abstaining altogether, but most doctors and experts suggest cutting back instead. “I’m not going to advocate that people stop drinking completely,” said George Koob, director of the National Institute on Alcohol Abuse and Alcoholism. “We did the ban. It didn’t work.”

Why people react differently

Alcohol has a greater impact on women’s health than on men’s. Women tend to be leaner than men and have lower lean body mass, which determines alcohol concentration in the brain. Women also produce less of the enzyme that metabolizes alcohol, known as alcohol dehydrogenase. Race can also be a factor: Between 15 and 25 percent of white people are at genetic risk for alcohol abuse, compared to less than 5 percent of black Americans, according to Dr. David Streem, medical director of the Cleveland Clinic’s Alcohol and Drug. Recovery. Center. People of East Asian descent often carry two genetic variants that affect how alcohol is metabolized. A variant causes the alcohol to break down more quickly into toxic acetaldehyde. The other variant slows down the metabolism of this compound, causing it to persist longer in the body. People with this genetic variant tend to look flushed or feel sick after just a few sips of alcohol. For most people, alcohol damage “really accelerates once you’ve had a few drinks a day,” Dr. Naimi said. “So people who drink five or six glasses a day, if they can cut it down to three or four, they’re going to do themselves a lot of good.”

This article first appeared in the latest issue of The week magazine. If you want to know more, you can try six risk-free issues of the magazine here.

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