Alcohol: What Amount is Safe?

Alcohol has been considered an acceptable risk to partake in amongst many cultures. There have been studies to suggest some alcohol is safe or even protective in many ways which can be misleading. I like to try to evaluate my risk of alcohol my looking at what alcohol actually “is” and what it chemically does to my body. When we drink, we first metabolize alcohol in to a chemical acetaldehyde. Acetaldehyde is toxic to our cells- it damages our DNA and can prevent our natural repair mechanisms from kicking in and correcting damage. Our repair mechanisms are responsible for repairing precancerous cells before they turn into a malignant tumor. By weakening this mechanism with alcohol, we are limiting our natural ability to repair cellular damage.  There are even people who have a deficiency in the enzyme that metabolizes alcohol, putting them at even higher risk for this cellular damage.

For years, we ignored the risks of cigarette smoking and we now know cigarette smoking is a tremendous carcinogen.

But alcohol is too! In fact, alcohol is a Group 1 carcinogen and was classified as such decades ago. This is the highest risk group- along with asbestos, radiation and tobacco.

A 2019 study[1] that was published compares alcohol consumption to smoking in regard to our increased risk of cancer. This was for me, a very eye-opening study. We all know smoking is bad – it definitively increases many cancers and chronic diseases. So, to me, it was fascinating to see a study quantifying how much alcohol compares to a pack of cigarettes. This study found that ONE BOTTLE OF WINE per week is associated with an increased absolute lifetime risk of 1.4% in women! This equals 10 cigarettes per week for women. So, to summarize, for women- 1 bottle of wine = 10 cigarettes in regard to the effect alcohol can have on cancer risk. This really has forced me to reevaluate if alcohol is worth the short-term enjoyment. The cancers we see a specific increase for women who drink light-moderate are breast cancer, colorectal, liver, esophageal, and head and neck cancer.

Studies on dementia and cardiovascular risk can be contradictory- many say low amounts of alcohol may in fact be protective against CV disease and dementia while heavier drinking (defined as 14 drinks per week) is associated with high risks of dementia and CV disease.

We do know alcohol weakens our immune system putting us at higher risk for viruses, pneumonia, UTI’s.  Alcohol use increases our risk for mood disorders like depression and anxiety. Alcohol significantly effects our sleep quality- the 6-8 hours when our body should be getting a chance to repair itself. We also know alcohol increases our risk of death from motor vehicle accidents and accidental deaths in general.

I rarely say anything is all good or all bad, and that rule applies to alcohol too. But it is clear that over 14 drinks per week can put us at higher risk for dementia, heart disease, cancer, the list goes on. As we age, women metabolize alcohol differently, so I try to advise less then 5 drinks per week with no more than 2 in one sitting.  Everyone should make the choices that help them live their best and healthiest lives but consider keeping track of those weekly drinks and sub out for a mocktail occasionally!

[1] Hydes, T.J., Burton, R., Inskip, H. et al. A comparison of gender-linked population cancer risks between alcohol and tobacco: how many cigarettes are there in a bottle of wine?. BMC Public Health 19, 316 (2019).