How to think about drinking alcohol
Nearly everywhere you look there are signs that people are rethinking their drinking. From the rise of sober-curious young people to the former United States Surgeon General’s advisory linking alcohol to cancer, the conversation around drinking is shifting rapidly.
In the U.S., national guidelines currently recommend no more than two drinks per day for men and one drink per day for women. Those Dietary Guidelines for Americans are up for renewal this year, and after two large studies offered two very different visions for federal regulators to consider, recent reporting indicates the government is considering eliminating recommended limits altogether.
Before we get into what the science says, it’s worth noting advocates on all sides have questioned the scientific basis for the current guidelines, with some experts arguing they reflect political compromises more than current research. Some researchers say the guidelines should be more strict, pointing out that one-size-fits-all recommendations fail to account for individual differences in genetic risk, metabolism, body composition, and health status. They also often rely on outdated gender binaries. Others, including alcohol industry advocates, have argued against tightening the guidelines at all.
With so much information swirling, it can be tough to make sense of what it means for you. Here’s how to think about alcohol and your health.
The back and forth from public health officials
The World Health Organization has said in recent years that there is no completely safe level of alcohol, and several countries, including Canada, the United Kingdom, and the Netherlands, have adopted similar messages, putting out guidelines that tighten the recommended limit of drinks. Next year, Ireland will become the first country in the world to introduce elaborate health warning labels on all alcohol products. Other recent research has found that alcohol is one of the key modifiable risk factors for dementia.
This is a notable shift from previous health guidance suggesting that drinking in moderation could be beneficial. While the idea that a glass of wine with dinner was good for cardiovascular health was popular for decades, it has been largely debunked in recent years.
Some experts are concerned the current debate in the U.S. will confuse consumers. Consider that one of the two reports being considered by the federal government revived the idea that moderate drinking is linked to lower risk of heart disease and death from any cause. The other report says any amount of alcohol comes with health risks. For now, Atria experts recommend speaking with your own doctor rather than awaiting new national guidelines—or trying to parse the back and forth in the headlines.
Understanding your personal risk
While it makes sense for governments to release population health guidelines, Dr. David Dodick, a leading preventive neurologist and Chief Science and Medical Officer at the Atria Health and Research Institute, says your individual risk varies depending on many factors, including age, sex, and preexisting conditions, such as heart disease, neurological issues, liver disease, diabetes, and mental health issues. Your genetics also play a role: genes can influence how you metabolize alcohol as well as your risk of cancer, dementia, and other diseases. Even moderate alcohol consumption in people with certain genetic variants is associated with a significantly elevated risk of gastrointestinal tract cancers, brain atrophy (shrinkage), and cognitive decline.
This is the kind of information that genomic sequencing can provide insight into. For those of us who have not done genetic testing, Dr. Dodick recommends considering a few factors: personal history of cancer, family history of cancer, neurodegenerative, and dementia disorders like Alzheimer’s; diet, sleep, and exercise routine; and any current conditions such as obesity, diabetes, hypertension, and heart disease.
“In individuals with underlying health conditions or at significant risk for future conditions, alcohol may act as a biological amplifier, accelerating disease onset and progression, intensifying symptoms, and undermining treatment. In other words, alcohol doesn't just add to the problem, it turns up the volume on whatever health issue you already have or are at risk for,” Dr. Dodick says. By contrast, for adults in good health who eat and sleep well and stay active, and who don't have significant genetic risk or conditions that increase alcohol-related risk, having a drink now and then is considered low risk based on the latest research.
Finding a balance
We know many of our individual behaviors, from sitting at work all day to eating cheeseburgers, may not be optimal for our health, and gleaning knowledge about why that’s the case can motivate us to make different choices.
“As a physician, I can sit here and say you should never smoke—but it took us over a century for medical consensus and public awareness to solidify into the never-smoke message,” Dr. Dodick says. “The key is helping people understand their individual risks.”
There’s evidence education works. A new survey by the Annenberg Center for Public Policy at the University of Pennsylvania found that awareness of the link between alcohol and elevated cancer risk increased from 40% to 56% after the Surgeon General’s warning in January. Nearly 1 in 3 respondents said this information would make them less likely to accept a drink in a social situation.
It’s clear things are changing.
If you’re looking to slow down on drinking in the meantime, there are plenty of steps you can incorporate into your current social life. Here are a few examples from our colleagues:
-
Try a mocktail, a non-alcoholic beer, or mix non-alcoholic herbal bitters into sparkling water—all tasty alternatives to alcohol and a nice ritual for some.
-
Create alcohol-free rituals with enjoyable alternatives such as fancy tea, adaptogenic elixirs, or creative hobbies. These can disrupt the reward loop from alcohol and find other ways to get pleasure.
-
Track your drinking. Use an app such as DrinkControl, Reframe, TryDry, or use a journal to monitor when, where, why, and how much you drink. This can help increase awareness and accountability.
-
Set specific, achievable goals such as no alcohol on weekdays, no more than two drinks per week, or one drink at social events only. Gradual reduction is often more sustainable than abrupt abstinence.
-
If you prefer a more subtle tactic at social events, a glass of seltzer with lime removes the alcohol—and the questions.
Ultimately, the decision to drink or not remains personal—and, as Dr. Dodick says, should be personalized. —Abigail Abrams
| 
