The Whole Truth: Te Māramatanga – Stuff – 28/4/22

The Whole Truth: Te Māramatanga explains public health topics prone to misinformation. It seeks to inform rather than inflame.

A few drinks a day – good for you or not?

There’s a belief the odd glass of wine is actually good for you. This is what the evidence says.

We all know binge-drinking is dangerous. But what about a cheeky glass of wine while cooking dinner, or a couple of cold ones after work?

The persistent myth that moderate drinking is healthy comes from studies finding that moderate drinkers are healthier and live longer than binge drinkers and teetotalers. Many of these studies failed to control for wealth, health and other social factors.

Wealthy, healthy people tend to be moderate drinkers, whereas binge drinkers and non-drinkers tend to be poor and/or sick (and that is why they quit drinking). In other words, it is not alcohol causing good health, it is wealth.

There is some evidence moderate drinking can have small benefits to cardiovascular health for middle-aged and older people. But these are far outweighed by a long list of proven health harms.

Alcohol consumption has been linked to at least 200 diseases. There is strong evidence that drinking alcohol increases the risk of cancers including mouth, pharynx, larynx, some oesophageal, breast, colorectal, stomach and liver cancers.

Even one glass a day increases the risk of breast cancer for women. A UK study of over a million middle-aged women found that each standard drink increases a woman’s risk of breast cancer by 10%. Another study found that the more you drink, the more likely you are to have cognitive impairment, like dementia, later in life.

Official drinking guidelines may further cloud our judgement when deciding how much to drink. The World Health Organisation does not set limits, because it says “the evidence shows that the ideal situation for health is to not drink at all”.

Australia’s drinking guidelines advise healthy men and women to drink no more than 10 standard drinks a week. Aotearoa’s Health Promotion Agency – Te Hiringa Hauora – sets the limit higher for men at 15 standard drinks a week. For women, it is 10.

The thing is, if you follow these guidelines, you still have up to one in a 100 chance of dying from an alcohol-related condition. Those are not safe drinking levels; they are harm-reduction measures.

People often have a drink to unwind. It has that relaxing effect because alcohol affects the frontal cortex – the part of the brain doing planning and threat assessment. The more you drink, the more alcohol turns the volume down in your brain. At a lethal dose, it shuts down the part of the brain in charge of breathing and heart function.

The sobering truth is that alcohol is a potent psychoactive drug that can cause cancer and other diseases, with no safe drinking threshold for many of them. Indeed, a study comparing the harm of various drugs to someone’s health and society ranked alcohol as the most harmful, before heroin, crack cocaine and meth.

So, it’s up to consumers to decide their level of risk tolerance when deciding to have one, or two, cheeky vinos.

Reporting disclosure statement: This post was written with expert advice from Otago University preventive and social medicine emeritus professor Jennie Connor, and Massey University senior lecturer in public health Andy Towers. Connor is a medical spokesperson for Alcohol Action New Zealand, an incorporated society advocating for the adoption of evidence-based policy to reduce harm from alcohol. This post was reviewed by The Whole Truth: Te Māramatanga expert panel members Dr Rawiri Jansen and Associate Professor Lisa Te Morenga.