Zero alcohol is likely the healthiest amount

By Dr. Graham A. Colditz, Siteman Cancer Center
    With New Year’s celebrations behind us and the promise of the new year ahead, it can be a great time to talk about the relationship between alcohol and our health.   
    While the dangers of regular heavy drinking and binge drinking (drinking a lot in a short period) are fairly well known, less understood by many are the health risks from regularly drinking more modest amounts of alcohol.  


    This may be in part because of the dominant message of the possible “heart health” benefits of moderate drinking, which have appeared for decades in media and in many health guidelines.
    We know now more than ever that when it comes to drinking there are many other conditions that need to be considered beyond just heart disease.  
    “Alcohol is associated with increased risks of developing cancer - specifically, cancers of the oral cavity, pharynx, larynx, esophagus, colorectum, liver and breast,” said Yin Cao, ScD, an associate professor of surgery and medicine at Washington University School of Medicine in St. Louis, Missouri. “For the majority of these, risk increases with moderate alcohol intake, which also increases the risk of injury, suicide, liver disease, mental illness and infectious disease.”
    Globally, alcohol is a leading factor in deaths of people between the ages of 15 to 49 years old.
    Taken together, the science on alcohol points to a shift in how we should view drinking and health.  
    “The research is now quite clear that, overall, the healthiest choice is not to drink,” said Cao.
    That message can feel like a major change from those we’ve been hearing for years, and it can take a little time to process. But, like recommendations to get more exercise, or eat more whole grains, or get better sleep, knowing that not drinking is likely the best choice allows us to make informed decisions about our health behaviors.
    When working on limiting alcohol, unsweetened coffee, tea and carbonated water can be easy substitutes. Grocery store shelves and online shops also stock an increasing selection of alcohol-free beer, wine and spirits that can taste a lot like the originals that include alcohol. Ideally, try to choose healthy, alcohol-free drinks that aren’t high in sugar and calories.  
    Experiment to find what works best for you when cutting back, or cutting out, alcohol. If you ever feel that you have an alcohol problem, reach out to a health professional for help or call the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357).  
    Try these additional tips for limiting alcohol:
    • Meet up with friends at a coffee shop or park rather than a bar or brewery
    • Bring your own alcohol-free options to parties
    • Don’t center meals or other gatherings around alcohol
    • Keep healthy, alcohol-free drinks on hand
    With over half of people in the U.S. reporting drinking in the past month, it’s important that we have a clear view of how alcohol can impact our health - beyond the heart-health messages that have been so dominant. Alcohol increases the risk of many different diseases, often at moderate or even low levels of drinking. Knowing that can help us each make the best decisions about our health.  
    “It’s well past time to change how we talk about alcohol’s impact on health,” concluded Cao.
    EDITOR’S NOTE: Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention. The Phelps Health Delbert Day Cancer Institute is part of the Siteman Cancer Network.