Sure, we could all probably stand to drink a little less. But generally, if you stick with just one to two drinks a day—what doctors classify as ‘moderate’ and the public classifies as ‘healthy’—you don’t have any risks to worry about…right?
“The short and honest answer is we don’t know,” says Gregory Marcus, M.D., director of clinical research of cardiology at the University of California, San Francisco, who studies alcohol’s effect on the heart.
The science and biology are multi-faceted and nearly impossible to untangle from lifestyle and environmental factors, which leads to conflicting research findings. These are then compounded by conflicting messages from the media.
Here’s what we do know: Binge drinking is really bad for your health—everyone in the medical community is unanimous on that one. When it comes to moderate drinking, the benefits and risks aren’t quite clear, Marcus says. But here’s what we do know about the most commonly held beliefs about booze.
Misconception #1: Alcohol is good for your heart
Reality: Alcohol is good for aspects of your heart, but harmful for others. One study of Marcus’, published in The BMJ, found that compared to hospital patients in dry counties in Texas, people in wet counties were less likely to have heart attacks and congestive heart failure, but more likely to have atrial fibrillation.
“Moderate alcohol intake helps with ‘plumbing issues’—the buildup of plaque in your arteries and disruption of blood flow that would lead to a heart attack—but exacerbates ‘electrical issues,’ or the rhythm of your atrial contractions that can lead to atrial fibrillation,” he explains.
Also, for the record, that heart attack help only stands if you limit yourself to two drinks a day—research shows even people without any risk factors increase their chances of developing cardiovascular disease by drinking heavily.
Misconception #2: Sticking to two drinks a day keeps the habit within healthy limits
Reality: This is the traditional path of thinking, but science has started to show 14 drinks per week spread evenly is still harmful. New research from Washington University in St. Louis reports that even when people sipped just one or two drinks a day, doing so more than three times per week increased their risk of premature death by 20 percent.
“If you think of alcohol as a drug—which it is—the frequency with which you take a drug matters,” says lead study author Sarah Hartz, M.D., Ph.D., assistant professor of psychiatry at Washington University in St. Louis.
Even the one way we know alcohol can help—in preventing heart attacks—actually peaked at imbibing just four times a week. “Even if you’re at risk for cardiovascular disease, drinking every day cancels out the benefits you’d get from one glass of wine,” Hartz adds.
Misconception #3: A glass of wine is healthy
Reality: “It’s certainly possible moderate drinking really does have some benefit to overall health,” Marcus concedes. And yes, wine does have antioxidants and anti-inflammatory properties. But outside of reducing the risk of heart attacks, we have no data to suggest one to two drinks a day is specifically beneficial to your health, he says. Chances are more likely that any health boost we see in people who imbibe conservatively come from secondary factors of that person’s lifestyle or personality—healthier eating and exercise habits, more affluence, a thriving social life.
Misconception #4: Alcohol affects every body the same
Reality: Genetics are the silent co-pilot driving the ship here, and the way in which alcohol interacts with them means the way drinking affects one person is different from another, Marcus says. For example, some people are genetically prone to heart attacks and chances are that’s what will do them in regardless of their choices—but alcohol may help delay D-Day. Meanwhile, if you’re genetically predisposed to liver disease, dementia, hypertension, or atrial fibrillation, two drinks a day may lead to more harm than good, he adds.
Misconception #5: Moderate drinking can help you live longer
Reality: This rumor, backed by studies like one published earlier this year out of UC Irvine, looked at people who live to be over 90 and found those who drank moderately nearly every day lived longer than folks who abstained. At first glance, research does suggest people who imbibe in a controlled fashion fare better than those who go without. But you have to consider why those people don’t drink, Hartz points out. In addition to people who choose to abstain, this population is also made up of former alcoholics who’ve already done years of damage to their organs, people who quit because of health problems, and people who can’t drink because of certain medications.
“If you don’t drink, your health will not be improved by starting,” she adds.
Misconception #6: You need to quit drinking
Reality: It’s certainly time to stop justifying opening a bottle of wine by saying it’s healthy. And for some, abstaining is the healthiest option, Marcus says (if you’re prone to alcoholism, for example). But for most people, we should think about booze less as an evil and more as dessert, Hartz says.
“It’s something we’re actively choosing to consume because we like it, even though it isn’t good for us.” And just like with cleaning up your eating habits, tackle quantity first to get down to two drinks a day, then work on cutting back frequency, Hartz advises.