Moderate drinking does not boost longevity, new evidence warns

• Moderate alcohol consumption has previously been associated with potential health benefits, including reduced mortality risk.
• However, recent research suggests that these findings were flawed and, compared to abstaining from alcohol, moderate alcohol consumption has no significant benefits for longevity.
• Experts are increasingly encouraging alcohol-free lifestyles and urging a shift in public health messaging to align with this new understanding.

A new study published in the Journal of Studies on Alcohol and Drugs warns that common misconceptions about the health benefits of alcohol can significantly impact the global disease burden and safety guidelines for alcohol consumption.

Many observational studies have previously suggested that moderate drinkers live longer and face fewer health issues than non-drinkers. However, the new research proposes that these comparisons may be misleading.

It argues that these publicly held beliefs often stem from low-quality studies that can distort the perceived risks of low-volume, “moderate” drinking.

The findings suggest that, after adjusting for key study characteristics, the perceived health benefits of light drinking for longevity diminish.

The research supports a growing movement focused on nonalcoholic lifestyles and highlights the need for stricter standards in studies examining the health effects of alcohol consumption, along with the subsequent public health messaging.

Studying alcohol consumption and mortality risk

An earlier investigation conducted by some of the same researchers, published in 2023, found no evidence that moderate alcohol consumption reduces mortality risk. Critics, especially from the alcohol industry, argued these findings were influenced by low-quality research.

In response, the new research rigorously assessed flaws and biases in earlier studies that linked moderate alcohol consumption to health benefits.

Their analysis involved 107 observational studies with over 4.8 million participants and 425,564 recorded deaths, featuring a diverse range of ages and backgrounds. However, studies on individuals with certain illnesses or problematic drinking habits were excluded.

The researchers conducted separate meta-analyses of studies categorized as lower- and higher-quality based on specific criteria and potential biases that could distort the perceived health effects of moderate alcohol use, especially among older adults.

Key considerations included the age of the cohort and whether participants had a lifetime versus recent abstinence from alcohol.

They broadly defined low-volume (moderate) alcohol consumption as 1 to 14 drinks per week, which equated to 1.30 grams (g) to 25 g of ethanol daily.

Using mixed linear regression models, the researchers evaluated mortality risks linked to the quality of the studies, aiming to clarify the health effects of moderate alcohol use.

Moderate alcohol use not linked to lower death risk

Higher-quality studies focused on participants aged 55 or younger, properly separated former and occasional drinkers from those who abstain, and tracked participants from younger into older age.

These higher-quality studies found that low-volume drinkers appear to have a similar estimated mortality risk as those who do not drink at all, showing no longevity benefit from moderate alcohol consumption.

In contrast, lower-quality research often focused on older participants (averaging 56 or older) and misclassified former and occasional drinkers as abstainers. This led to significantly lower mortality estimates for low-volume drinkers compared to abstainers, without considering lifetime drinking habits.

So, individuals who stop drinking due to the onset of health issues later in life may, therefore, seem to have shorter lifespans than those who consume alcohol moderately.

Additionally, while some analyses suggested reduced mortality risks for low-volume drinkers when controlling for smoking or socioeconomic status, the risk estimates were higher in non-smoking groups. This implies potential biases in the research.

Overall, misclassifications and lifetime selection biases might obscure the relationship between moderate alcohol consumption and longevity.

Such biases prevalent in lower-quality research can mislead public understanding of the health risks associated with alcohol.

Despite their rigorous analysis, the study authors acknowledged limitations, including the lack of consideration for various factors influencing alcohol use and mortality risk, and disclosed potential conflicts of interest due to previous funding and support from government and nonprofit organizations.

To better understand the relationship between alcohol consumption and mortality risk, particularly concerning the influence of smoking status, more high-quality studies are needed.

No health benefit, only risks from moderate alcohol consumption

Medical News Today spoke with Thomas M. Holland, MD, MS , a physician-scientist and instructor at the RUSH Institute for Healthy Aging, RUSH University, RUSH Medical College, who was not involved in the study.

He noted that the study challenges the popular publicly held belief that moderate drinking poses minimal health risks and may even confer benefits.

However, Holland emphasized, “[the results align] with the ever-growing growing evidence that moderate alcohol consumption does not significantly extend lifespan and may pose health risks, including increased cancer , heart disease and neurodegenerative risks.”

“To iterate this point, no major health organization has ever endorsed a risk-free level of alcohol consumption, and this study supports that stance by highlighting potential biases in previous research,” he said.

In early 2023, the World Health Organization (WHO) declared that “when it comes to alcohol consumption, there is no safe amount that does not affect health.” Additionally, WHO statistics indicate that over half of the 3 million annual deaths linked to alcohol are due to non-communicable chronic diseases, including cancer.

MNT also spoke with Brooke Scheller, DCN, CNS , a doctor of clinical nutrition specializing in alcohol and sober nutrition, and author of How to Eat to Change How You Drink , not involved in the study.

She stated that “[t]his study strengthens the last few years of research showing that there is no true benefit of alcohol at low levels.”

On the contrary, she warned that “[l]ow amounts of alcohol can affect everything from nutrient levels, to hormonal effects, gut microbiome effects, cortisol effects and more.”

Should you adopt an alcohol-free lifestyle?

Scheller emphasized that “the health messaging around alcohol has created mass confusion” about its effects, whether beneficial or harmful.

As research increasingly underscores the negative effects associated with moderate alcohol consumption, alongside a lack of significant benefits, experts are indeed advocating for alcohol-free lifestyles. This shift is driving the growing sober curious (alcohol-free) movement across various countries.

Scheller noted that this aligns with recent changes in alcohol consumption guidelines, such as Canada’s revised recommendations in 2022 and updates from the WHO.

“The [United States] will expect to see some potential change to guidance come 2025, but until then, it’s up to doctors and healthcare providers to change their narrative and begin pulling back on recommendations to drink alcohol,” she said.

She called for greater support “for healthcare professionals to fully understand the new research on alcohol and how to translate this into recommendations for their patients.”

Scheller concluded that the alcohol-free movement in the U.S. and beyond is providing valuable support for those looking to cut back or quit.

Holland echoed these sentiments, stating that:

“ For clinicians, the study highlights the need to critically evaluate alcohol consumption studies and exercise caution in recommending any amount of drinking, including moderate drinking, for health benefits. Public health messages should emphasize that no level of alcohol consumption is completely safe, as even low-volume drinking carries risks for cardiovascular and advancing neurodegenerative diseases like dementia and multiple sclerosis .”