“We did not find evidence of a beneficial association between low drinking and mortality,” said Dr Rosario Ortolá, an assistant professor of preventive medicine and public health at Universidad Autónoma de Madrid and lead author of the paper, which was published in JAMA Network Open.
On the other hand, she added, alcohol probably raises the risk of cancer “from the first drop”.
The findings add to a mounting body of evidence that is shifting the paradigm in alcohol research. Scientists are turning to new methodologies to analyse the risks and benefits of alcohol consumption in an attempt to correct what some believe were serious flaws in earlier research, which appeared to show that there were benefits to drinking.
Much of this new research compares rates of heart disease and death in moderate and occasional drinkers, instead of abstainers. Abstainers as a group include many individuals who stopped drinking because they were already seriously ill, and relying on this group for comparisons may have falsely made light drinkers look healthier.
The new study comes amid a brewing fight over the official US guidance on alcohol consumption. Two scientific groups are preparing reports on the relationship between alcohol and health in advance of an update of the US Dietary Guidelines.
One group is an intergovernmental subcommittee that includes representatives from numerous health agencies. It launched a study on alcohol intake and health in April 2022. The other group, funded by Congress the same year to do a remarkably similar review, was convened by the National Academies of Science, Engineering and Medicine.
Initially, one of the two alcohol experts NASEM nominated to its committee was Dr. Kenneth Mukamal, a researcher at Beth Israel Deaconess Medical Center, which is a teaching affiliate of Harvard Medical School.
His trial of moderate drinking, which was to have cost US$100 million, was halted in 2018 after revelations that he had solicited funding directly from the alcohol industry while suggesting the study would prove the benefits of drinking.
NASEM pulled back the two nominations after The New York Times disclosed them, but it replaced Mukamal with another Harvard scientist with ties to the alcohol industry.
Current US dietary guidelines say that “drinking less is better for health than drinking more,” and that adults aged 21 and older should, on the days they consume alcohol, limit themselves to one drink a day for women and two for men.
Alcohol use has risen in the United States, with deaths from excessive alcohol use increasing almost 30% in the short period between 2016-17 and 2020-21, according to the Centers for Disease Control and Prevention.
International recommendations are moving toward a more conservative approach amid growing concern about alcohol’s role in promoting cancer and questions about its putative benefits against cardiovascular disease.
Last year, the Canadian Centre on Substance Use and Addiction issued a new guidance stating that no amount or kind of alcohol is good for health and that “even a small amount of alcohol can be damaging to health”.
People who consume one to two drinks a week “are likely to avoid alcohol-related consequences,” the centre said. But the risk of cancer increases with three to five weekly drinks, and the risk of heart disease and stroke increases with seven or more weekly drinks, according to the Canadian guidelines.
The World Health Organisation says that even low levels of alcohol consumption “can bring health risks,” but adds that “most alcohol-related harms come from heavy episodic or heavy continuous alcohol consumption”.
The new study found that while older adults who were light drinkers faced higher risks of dying if they had health-related or socioeconomic risk factors, drinking mostly wine and drinking only with meals moderated the risk, particularly of death from cancer.
The reasons were not entirely clear, Ortolá said. But the reduction may be because of slower alcohol absorption, or it might reflect other healthy choices from these people.
It also wasn’t obvious why individuals with health and socioeconomic risk factors may be more susceptible to the harmful outcomes associated with alcohol, as this was one of the first studies to examine the issue.
It’s possible that these people have a reduced tolerance to alcohol, the authors suggested; they may also take medications that interact poorly with alcohol.
Overall, moderate drinking – defined as between 20 and 40g of alcohol daily for men and between 10 to 20g for women – was associated with a higher risk of death from all causes and a higher risk of dying of cancer.
Heavier drinking – over 40g a day for men and over 20g a day for women – was associated with higher deaths from all causes, as well as cancer and cardiovascular disease.
This article originally appeared in The New York Times.
Written by: Roni Caryn Rabin
Photographs by: Karsten Moran
©2024 THE NEW YORK TIMES
