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Less benefit from light alcohol consumption than previously thought

The apparent observed health benefits of stable moderate drinking, and the risks associated with abstention, may be overstated among middle-aged adults, according to research published in the Journal of Studies on Alcohol and Drugs.

“The notion that light-to-moderate alcohol users are healthier and live longer than abstainers attracts considerable media attention and is reflected in some health guidelines,” Jeremy Staff, PhD, the department of sociology at Pennsylvania State University, and Jennifer Maggs, PhD, professor of human development and family studies at Penn State, wrote. “However, mechanisms underlying observed health benefits of light-to-moderate alcohol consumption remain unclear and controversial, particularly in light of elevated risk for major diseases such as cancer.”

Researchers assessed how patterns of alcohol and cigarette use from young adulthood to midlife correlated to health and well-being using longitudinal data from the National Child Development Study, an ongoing study of 9,137 British citizens born in 1958. They identified eight unique paths of alcohol and cigarette use from ages 23 to 55 years using a nonparametric multilevel latent class specification, then examined how these long-term latent paths related to overall health, heart problems, chronic illness and quality of life at midlife.

Light-to-moderate alcohol consumption, and the current maximum amount of alcohol recommended by the UK’s Department of Health, is defined as no more than 14 units of alcohol (about six pints of beer or six medium-sized glasses of wine) per week.

In total, roughly one-third of the cohort who reported drinking at the light-to-moderate level, but didn’t smoke, experienced the best health and quality of life in middle age. Groups of smokers who drank lightly to moderately; smokers who drank more heavily; and those who refrained from drinking alcohol or reduced their drinking over time saw more health problems compared with the group of light drinkers/nonsmokers. Light-to-moderate drinkers had poorer health if they were former smokers or still occasionally smoked, which could either be a direct effect of smoking or because of other lifestyle factors, like lack of exercise or obesity. Adults with few or no educational qualifications were among those who did not drink or drank modestly, whereas those with the highest education level at age 23 were more likely than their peers to drink moderately throughout their adults lives and were less likely to smoke.

“Evidence continues to grow that alcohol has many health risks, including for cancer, therefore it is dangerous to report only benefits of moderate alcohol consumption,” Maggs said in a press release. “Drinking habits are also shaped by our education, health earlier in life and related lifestyle factors including smoking. These other influences may be the real factors underlying the connection between drinking and midlife health.”

Approximately 20% of adults aged 55 years who reported never drinking alcohol in their lives had actually previously reported drinking when they were younger, suggesting that they may underreport previous drinking habits and that studies including this group as lifetime abstainers may overestimate the apparent harms.

“Alcohol abstainers are a diverse group. They include former heavy drinkers who quit due to problems with alcohol, as well as those who quit drinking due to poor health, and not just lifetime abstainers,” Staff added in the release. “Medical professionals and public health officials should be wary of drawing conclusions about the so-called ‘dangers’ of never drinking without more robust evidence.” – by Savannah Demko

Disclosures: This work was partially funded by a grant to the Prevention Research Center at Penn State from the National Institute on Alcohol Abuse and Alcoholism.