For decades, moderate drinking has been linked to modest health benefits — including a reduced risk of coronary heart disease, type 2 diabetes, stroke and even all-cause mortality. In fact, the federal government has long suggested that consuming two drinks per day for men and one for women was aligned with a healthy lifestyle. But new recommendations reveal a flip-flop in thinking.
It’s expected that federal government 2020 dietary guidelines will partially walk back previous instruction. Both men and women will be advised to consume no more than one drink per day — a 50 percent reduction for males. A similar sentiment was recently echoed by the American Cancer Society. After previously suggesting moderate drinking was not a meaningful risk factor for cancer diagnosis, the group now claims it’s best not to consume alcohol at all.
The revisions have sparked a flood of stories questioning the health halo moderate drinking has historically enjoyed. Good Morning America proclaimed, “New cancer prevention guidelines call for no alcohol consumption.” A Fox News headline read, “New guidelines on cancer prevention recommend cutting out alcohol completely.” And a popular Politico morning newsletter featured the change, saying “Ease up on alcohol …”
But does the newly advertised relationship between moderate drinking and serious health consequences warrant the hysteria? For otherwise healthy Americans, research when put in context suggests no. The recommendations are rooted in a body of work that is commonly exaggerated in the media or relies on flawed methodology.
Take, for example, a widely publicized 2017 report from the Institute of Cancer Research and World Cancer Research Fund that explores the correlation between breast cancer and moderate alcohol consumption. The authors indicate that consuming a single daily drink increases the relative risk of breast cancer by roughly 5%. The conclusion without explanation is alarming, but what does it really mean?
According to the National Cancer Institute, a 40-year old woman has a 1.5% chance of being diagnosed with breast cancer during the following 10 years. When applying the reported 5% uptick to the demographic, the absolute risk from consuming about a single daily drink increases by less than one-tenth of 1%. Not hit by lightning territory but close.
At the same time, other risk factors are largely ignored. For example, one of the largest factors associated with breast cancer is family history. For those who have inherited a damaged gene associated with the condition, the probability of a diagnosis can be as high as 80% over the course of a lifetime. Testing for these genetic markers should be a focus of prevention, rather than dictating if someone should have a drink with dinner.
Moreover, much of the recent science exploring the health consequences of moderate drinking relies on historically unreliable observational studies. When someone is asked how many drinks they’ve consumed over the course of years, it’s not difficult to imagine inaccurate information being reported. Most Americans can’t remember what they had for dinner last Wednesday.
Surveys are also unable to account for a variety of other confounding variables that taint results — including previous smoking habits or an unhealthy diet. It’s also not only important to know how much a person drank, but over what period of time. Were several drinks spread out evenly over the course of one week or were they all consumed on a Saturday night?
Observational studies may contribute useful information to some researchers as the best bad option but they shouldn’t be relied upon as an accurate guide for public policy without strong confirming data.
Being cognizant of the connection between moderate drinking and new medical concerns should be encouraged. But a healthy awareness shouldn’t snowball into irrational fear. The devil is in the details, and the notion that “any alcohol is bad” fails to take into account the nuance. Public health officials and the American public should take note.