Is moderate alcohol consumption really beneficial?

Humans have always consumed fermented beverage — for thousands of years. And arguments about the merits and demerits of drinking alcohol have always been around. What is not without doubt is that alcohol is both a tonic and a poison. If taken in moderation, there appears to be some health benefits. If consumed beyond certain limits, alcohol is certainly lethal. Medical literature is full of research data about alcohol and health. Moderate drinking appears to reduce some cardiovascular risks, improve cognition, and even reduce the risk of Type 2 Diabetes. But there is a thin line between moderate drinking and heavy drinking. If this line is crossed, alcohol becomes a major health hazard, with evidence linking it to some cancers, chronic liver disease, heart disease and avoidable deaths related to abuse and addiction.

Accepted definitions of moderate drinking are however variable. In general terms, moderate drinking implies one to two drinks per day. The definition of what constitutes a drink also varies, but roughly equates to a small glass of wine, or beer, or a single measure of spirits. It goes without saying that consuming a weekly amount all at once, then abstaining for several days thereafter, doesn’t count as moderate drinking. That is called binge drinking, and has its unique adverse health effects. How does moderate alcohol intake actually mediate health benefits? There appears to be several mechanisms involved. Some substances in alcohol appear to raise the levels of good cholesterol, thus conferring a protective effect on the cardiovascular system. There also appears to be a protective effect on the formation of small blood clots which may block blood flow to the heart and the brain. Thus the observed benefit of lowered risks of heart attacks and strokes. Additionally, there appears to be an increase in sensitivity of insulin, the hormone responsible for sugar control. Hence the protective effect from Type 2 Diabetes.

How does all this inform your current relationship with alcohol? For starters, the research data is not convincing enough to recommend drinking as a health strategy. If you do not drink alcohol, don’t start. You can get all the associated health benefits with other strategies like eating a healthy diet, and exercising regularly. If you already drink in moderation, you can get reassured that your drinking pattern may outweigh potential harm. But there is no sure way of knowing who actually benefits and who doesn’t, as other things like genetics and familial history come into the equation.

If you are a heavy drinker, you are certainly on the poisonous end of the effects of alcohol. Your predisposition to serious alcohol-related diseases is way too high. The way out is to limit your drinking, or stop altogether and engage in additional healthier habits.

— Dr Alfred Murage is a consultant gynaecologist and fertility specialist.