Do You Need to Teetotal?

is alcohol good for healthIt’s always interesting watching reactions to my Seattle Times columns on social media and via email, partly because some topics that I think might garner a reaction don’t, some topics that I feel are more “quiet” get a big reaction. My most recent column on whether alcohol is healthful got a lot of mentions on social media, but it also got pushback from some clear wine aficionados, as well as a number of comments that suggest that the commenter didn’t read my entire column.

I’m not saying, “Don’t drink wine.” I’m not saying, “Don’t drink alcohol.” (The obvious exception would be if you struggle, or have struggled with alcoholism or other forms of problem drinking.) What I am saying is, “If you don’t drink and have no inclination to start, then don’t start.” I’m also saying, “If you enjoy your wine or craft beer or martinis or scotch, then enjoy them in moderation and be clear that it’s about enjoyment and probably not about health.”

Yes, I Like My Wine

In the interest of full disclosure, I deeply enjoy wine (usually red, but a nice chilled white or rose in the summer), craft beer, martinis, good Scotch and the random artisan cocktail that my husband concocts after reading about it in Esquire, New York Times, or elsewhere. But much as I know that, despite having gone to pastry school several years ago, it’s not a good idea to keep a regular supply of cookies and cake on hand, I know that it’s not a good idea to drink as much wine as the characters on Cougar Town (if you’ve ever watched that show, you know exactly what I’m talking about). Not if I want to remain healthy, in any case.

I’ve written recently about  abstinence vs. moderation, and when it comes to alcohol (and baked goods), I am a semi-abstainer. I find that if I want to keep my intake to moderate levels, I need to abstain sometimes. In other words, I find it much easier to stick to kombucha or San Pellegrino Monday through Thursday and have a second beer or glass of wine on the weekends than it is to stick to one drink per day. I know other people who really enjoy a glass of wine with dinner each night and find it easier (and more joyful) to adopt that habit.

The Twists and Turns of Scientific Research

The idea that moderate drinking had health benefits, as I mention in my column, came about because observational studies (studies that look at frequency of certain behaviors or health problems in a particular group of people) found that moderate drinkers tend to have less risk of cardiovascular disease and sometimes some other health problems. But just because two things happen to someone doesn’t mean one caused the other. An analogy I often see is this: If you notice that people only use their umbrellas when it’s raining, it doesn’t mean that using an umbrella causes it to rain.

So researchers were noticing an association between moderate drinking and lower rates of cardiovascular disease, but they weren’t sure why. In other words, how might moderate amounts of alcohol cause better cardiovascular health? Was it the resveratrol in red wine? The alcohol (aka ethanol) itself? Well, scientists haven’t nailed down a cause, which is quite the conundrum considering that alcohol is a toxin (that your liver has to detox) and a known carcinogen (substance that can increase cancer risk).

But Wait, There’s More

For a while, the two biggest potential problems with drawing conclusions from observational studies were:

  1. Researchers couldn’t show cause-and-effect.
  2. Moderate drinkers tended to share other qualities that might be the real reason for lower rates of cardiovascular disease (healthier eating, more exercise, etc.).

Then a new problem was revealed. Almost all observational studies were looking at whether, or how much, people drank at the time of the study. They weren’t making any distinction between “never drinkers” and people who used to drink but had stopped. It turns out that’s huge, because many former drinkers stopped either because they had a problem with alcohol and finally quit, or because they had other health problems that lead them to stop drinking.

When you separate out never drinkers from former drinkers, the never drinkers tend to be healthier. That’s the group that needs to be compared to moderate drinkers, and we are finally starting to see that comparison done in studies, which is revealing a whole new layer of information about the potential benefits of moderate alcohol consumption—or the lack thereof.

The Bottom Line

Moderate amounts of alcohol are probably fine for most people, but they are likely not healthy in and of themselves. What is certain is that eating lots of vegetables is healthy, getting regular physical activity is healthy, and getting enough quality sleep is healthy. I just want people to have the information they need to be empowered to make the best choices for themselves!