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Consumer Report

What to know about alcohol and your health

The American Heart Association and other health organizations advise that if you do drink alcohol, do so in moderation.
Tony Cenicola/New York Times/File 2017
The American Heart Association and other health organizations advise that if you do drink alcohol, do so in moderation.

The latest evidence suggests that wine could help your heart but might also raise your risk of cancer slightly. Here, a few facts you should know about how alcohol consumption (wine or anything else) really affects your health.

The benefits

No matter which studies you look at, any purported benefits associated with drinking are related specifically to “moderate” consumption: one drink per day for women and up to two for men. Men are allowed more to account for their generally larger size and differences in the way they metabolize, or break down, alcohol. A glass of wine is 5 ounces.

If you stick to those guidelines, the evidence is pretty clear that alcohol can boost your heart health. “The association between moderate alcohol intake and lower risk of myocardial infarction [heart attack] has been studied in well-designed observational studies for nearly 50 years,” says Dr. Kenneth Mukamal, a professor of medicine at Harvard Medical School who has researched this topic extensively.

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“Alcohol affects platelets, acting like a mild blood thinner,” Mukamal explains. Moderate alcohol consumption also raises HDL cholesterol (the “good” kind) and lowers levels of the blood component fibrinogen, which might also help keep blood thinner.

The risks

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Alcohol has been linked to a small increased risk of cancer in general. A 2015 study published in the British Medical Journal found that compared with nondrinkers, moderate drinkers had a 2 to 6 percent higher risk.

But the association between moderate alcohol intake and the risk of breast cancer was stronger. Women who drank the amount of alcohol in one-third to one glass of wine per day had a 13 percent increased risk of cancer, mostly driven by breast cancer.

Once drinking goes beyond the small amounts defined as moderate, the risks quickly start to outweigh potential cardiovascular benefits. Higher levels of alcohol intake are linked to increases in heart disease, high blood pressure, heart attack, and stroke, as well as the development of various types of cancer.

The unknowns

The data on alcohol are consistent, but studies don’t prove cause and effect. Many are observational — that is, they look at what people do in their real lives rather than randomly assign people to drink or abstain from alcohol, then follow them to chronicle the effects on their health. The latter type of study would be ideal, but creating a placebo for alcohol to give to a control group is tricky. And attempting to separate large groups of subjects and randomly instruct them to drink or not drink for several years has proved to be almost impossible.

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Without that clinical evidence, some experts are reluctant to recommend moderate drinking as a health strategy. Therefore, the American Heart Association and other health organizations advise that if you do drink alcohol, do so in moderation. And if you don’t, you shouldn’t start.