Is low dose alcohol safe?

For many years, the battle between the proponents of temperance and the alcohol industry has raged on. Both sides have used medical evidence to support its case. There are not too many people on either side who would suggest that heavy drinking has any benefits apart from filling the coffers of the people who sell alcohol.

Heavy drinking, defined as the regular consumption of four or more standard drinks on a daily basis or intermittent binging which is five or more drinks during one particular drinking session is definitely associated with a vast majority of health issues. These typically involve the liver, the brain, the heart and a significant increased cancer risk for a variety of cancers. The World Health Organisation has suggested that 5% of the global burden of disease and injury was directly related to alcohol.

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But, the age-old three questions are:

  1. Is all alcohol harmful?
  2. Is there a safe dose?
  3. Is any particular type of alcoholic beverage beneficial to the health?

I have recently written my view on the low-dose alcohol and breast cancer association and since that article, 2 studies have emerged expressing concern in regard to low or moderate consumption of alcohol. The third study relates to indiscretions of youth and later health issues.

The first study, in my view, does answer the question about the safety of alcohol during pregnancy. The study performed in Australia and Belgium examines 415 children born as part of the AQUA study — (Asking questions about alcohol in pregnancy study). The study reviewed the alcohol consumption of 1600 women. As a sub study, the offspring of some of these women were examined at one year old and related the findings to the maternal alcohol consumption during pregnancy. The children underwent 3D imaging of the face to detect any variations in facial features based on the mother’s alcohol consumption.

Low-dose alcohol consumption was defined as less than 20 g on any one occasion and less than 70 g per week. Moderate dose was defined as 21 to 49 g per occasion and less than 70 g per week and high dose was defined as more than 50 g on any occasion. 15 g is a schooner of beer, 150 mL of wine and a standard 30 mL nip of spirits. When compared to women who did not consume any alcohol during pregnancy, there were definite variations in the nose, lips and eyes of children born to mothers who consumed alcohol.

The second study was 30-year data from the Whitehall II study which followed British civil servants. This particular sub study looked at 550 healthy men and women with an average age of 43. Consuming more than 30 units per week of alcohol which is the equivalent of around 10 pints of strong beer or 10 large glasses of wine was definitely associated with damage to part of the brain known as the hippocampus which is intricately associated with memory. But, consuming 14 to 21 units per week was also associated with the degree of hippocampal atrophy and problems in the white matter of the brain and also language fluency.

The final study, performed in Sweden, was a 27-year study looking at the drinking habits of young men and women and followed their risk for disease as they age. The study began at age 16 and found that binge drinking in younger age, only in women was associated with increased risk for higher blood sugar levels after age 40. This was independent of weight, blood pressure or cigarette smoking. There was not the same association with males. High blood sugar was only associated with weight and BP.

Although studies such as these cannot be extrapolated completely to every individual, they do raise concerns about society’s increasing exposure to alcohol. I have always been a strong supporter of the consumption of low-dose alcohol which I would define as somewhere between 1–3 glasses most days of the week but only when combined with a healthy diet, such as the Mediterranean diet, and the daily consumption of a high-quality multivitamin.

Also, not considered in any of the studies is the reason why people consume alcohol in the first place. Many people consume alcohol for social reasons or to enhance the flavour of food, in the case of wine. But, a number of people also consume alcohol for more pervasive reasons such as stress management, loneliness or to relieve feelings of anxiety and depression. Could it also be that the people in the studies who are not alcoholics and therefore not consuming alcohol to excess had higher stress levels thus contributing to disease? Regardless, the studies do highlight the importance of not only choosing your poison wisely but also choosing the dose of your poison. Although it is often said, all things in moderation, it is also very important to look at the setting of the moderation i.e. the other factors in your life which may be leading to this particular behaviour.