No, drinking alcohol moderately is not safe for health, says new analytical study

What the study aims to do is to correct observational reports that found how moderate drinkers were less likely to die of all causes, including those not related to alcohol consumption. The researchers point out that the older studies failed to recognise that light and moderate drinkers had many other healthy habits and advantages or that the abstainers, who were used as a comparison group, included reformed drinkers, who quit when their health disallowed it. “When you compare this unhealthy group to those who go on drinking, it makes the current drinkers look healthier and like they have lower mortality,” said Tim Stockwell, a scientist with the Canadian Institute for Substance Use Research and one of the authors of the new report, which was published in JAMA Network Open. Once the methodology was corrected, “Lo and behold, the supposed health benefits of drinking shrink dramatically and become non-statistically significant,” he added. Profiling moderate drinkers, the researchers said they “tend to be wealthier, are more likely to exercise and eat a healthy diet, and are less likely to be overweight. They even have better teeth.”

This review is in line with newer studies that have found how even moderate consumption of alcohol — including red wine — may cause cancers of the breast, oesophagus and head and neck, high blood pressure and a serious heart arrhythmia called atrial fibrillation.

Reacting to these new findings, Dr Pankaj Chaturvedi, Deputy Director, Centre for Cancer Epidemiology, Tata Memorial Centre, says, “I think what years of many articles and reports on moderate drinking have done is to drown the fundamental understanding that less harm does not mean harmless. There could be a safe level of alcohol to reduce the risk but there is no safe level to eliminate the risk of alcohol-related harms. There is absolutely no good evidence of the beneficial effects of moderate or low level of alcohol consumption.”

He feels that “alcohol has great social acceptability because of several decades of shrewd marketing. Its manufacturers continue to be a profit-making industry despite an abundance of evidence against them. Alcohol is one of the leading risk factors for disease burden in developing countries and the third largest risk factor in developed countries. Even the recent WHO report concluded that ‘there are more life years lost due to alcohol consumption than deaths prevented.’ Alcohol is causally related to cancers of the mouth, oropharynx, liver, oesophagus and breast. It causes dependence syndrome, cirrhosis, pancreatitis (acute and chronic), gastritis, polyneuropathy, haemorrhagic stroke, psychoses, epileptic seizures and other mental conditions. Recent studies reported that south-central Asia ranks third in percentage of cancer cases attributable to alcohol use and noted that further increases in alcohol consumption were projected in India.”

He points out how alcohol drinkers have higher rates of sickness absence, leading to lower productivity. “Unfortunately, rather than discouraging people to drink, alcohol is being heavily advertised in all forms of media. The positive portrayal of alcohol in cinemas has dramatically increased in the last decade. Graphic warning labels on alcohol packs/bottles may be the most cost-effective intervention with an impact on all users regardless of educational status,” he adds.

The health benefits of moderate drinking are still a topic of debate with conflicting results. “Of course, this is still just one study and should be interpreted in the context of other research in this area. Overall, the current scientific consensus is that heavy drinking is detrimental to health. Moderate drinking has never been recommended as a strategy for promoting health but as a limiting habit. The risks and benefits of alcohol consumption can vary depending on individual factors, such as age, sex, overall health status and genetics,” says Dr Nishith Chandra, Principal Director, Interventional Cardiology, Fortis Escorts Heart Institute, Okhla.

Adds Dr Sunil Kumar, Senior Consultant, Interventional Cardiologist, Manipal Hospital, Bengaluru, “Cariologists never advise any kind of drinking, not even moderate drinking. What we do is try to wind down patients who are already consuming alcohol and follow the US guidelines that women should not have more than one drink a day and men not more than two drinks a day. Most moderate drinkers in the review were found to belong to affluent circles, with better access to facilities to manage their health parameters or take up a wellness regime to counteract the bad effects of drinking. The majority of people don’t have these benefits. Even studies on the benefits of red wine have been purely observational. None of them have been randomised control trials. So medically, the benefits of moderate or any kind of drinking are not proven.”

In January, the World Health Organization (WHO) published a statement that when it comes to alcohol consumption, there is no safe amount that does not affect health. “Alcohol is a toxic, psychoactive, and dependence-producing substance and has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer decades ago – this is the highest risk group, which also includes asbestos, radiation and tobacco. Alcohol causes at least seven types of cancer, including the most common cancer types, such as bowel cancer and female breast cancer. Ethanol (alcohol) causes cancer through biological mechanisms as the compound breaks down in the body, which means that any beverage containing alcohol, regardless of its price and quality, poses a risk of developing cancer,” it said in a release.

It even cited its latest available data as indicating that half of all alcohol-attributable cancers in the WHO European Region “are caused by ‘light’ and ‘moderate’ alcohol consumption – less than 1.5 litres of wine or less than 3.5 litres of beer or less than 450 millilitres of spirits per week. This drinking pattern is responsible for the majority of alcohol-attributable breast cancers in women, with the highest burden observed in countries of the European Union (EU). In the EU, cancer is the leading cause of death – with a steadily increasing incidence rate – and the majority of all alcohol-attributable deaths are due to different types of cancers.”