We’ve been told these past few years that drinking in moderation is good for your health. So good, in fact, that some journalists (though as yet no physicians) have recommended that those who are already in basically good health will be even more healthy—they’ll be better protected from heart disease and strokes—if they add a glass of wine or a can of beer to their “daily bread.”

But is this true? Can we put alcohol alongside fruits, vegetables, vitamins, and minerals, as contributors to our health and longevity? If so, then drinking alcoholic beverages had better confer some very significant benefits, because alcohol carries some very measurable—and quite serious—risks.

The Most Serious Risk

Let’s begin by considering the most serious problem with moderate drinking: the risk of becoming an immoderate drinker—an alcoholic. Most writers, when discussing the risks of moderate drinking, don’t include the risks assumed by all who drink. Because a person who begins to drink heavily is no longer a moderate drinker, he or she is dropped from the group whose health is being studied. This results in a serious underestimation of the risks of moderate alcohol consumption. It’s very important not to exclude from the study of moderate drinkers those who move on to abusing alcohol, for studies have shown that in the Caucasian population, one out of twelve moderate drinkers (8 percent) will become an alcoholic.

Perhaps a simple illustration will clarify the point. Picture if you will a man holding a six-shooter in each hand with the guns pointed at either side of his head. All six barrels of one gun are empty, while one of the six barrels of the other gun contains a bullet. The man pulls one trigger at random, playing a two-handed version of Russian roulette. Statistically, that is how likely it is that a moderate drinker will become an alcoholic.

In the Native American population, the downside of drinking is even worse. Twenty percent of moderate Native American drinkers will become alcoholics! That’s the same as placing three bullets instead of one in the chamber of one of the guns in our illustration!

So why is there any question about alcohol being harmful? Because, as I noted earlier, for some time now the popular press has claimed that “science shows” that alcohol in moderation will protect you from heart disease, stroke, and other unpleasant ways of dying. In other words, there’s supposed to be a health benefit to moderate drinking just as there’s a health benefit to eating fruits and vegetables.

Does science really show this?

I try to keep informed about alcohol and its effect on health, both the scientific evidence and the views reported in the popular press. I will acknowledge that the popular press is reporting on a truly impressive body of evidence produced by the scientific community. Of the last 29 research reports that I read, 28 concluded that moderate drinkers are significantly less likely to die from heart disease and stroke. The 29th study was inconclusive.

The Other Side of the Story

However, there’s a major logical fallacy in this so-called scientific reasoning, and it is vital that we consider it. I’ll illustrate the point with a hypothetical illustration of two schools. The students in School A are doing very well, and the students in School B are doing very poorly. It would be easy to conclude that the students in School A are doing well because they have better teachers than the students in School B. But suppose we switch each school’s teachers to the other school—and the students continue to perform as before. This would expose the logical fallacy of assuming that the skills of the teachers were the cause of the success of the students in School A and the lack of teaching skills in School B was the cause of those students’ failure.

Any sensible school district would consider the possibility that poor teaching skills contributed to the lower achievement of the students in School B. However, they would also look for factors other than the skills of the teachers, including the students’ differing home environments, the educational achievement and economic status of their parents, etc.

Similarly, it’s easy to conclude at first glance that moderate drinking is the cause of the health benefits that moderate drinkers enjoy. But are there other contributing factors? Is it possible that the moderate drinkers tend to be better educated and therefore are better informed about health matters? As a result do they eat better, exercise more, and practice other good health habits more than the nondrinkers? Is it possible that they earn more than the nondrinkers and therefore can afford better health care? If so, then the fact that they have fewer heart attacks and strokes may be the result of their better health habits and better health care, not the result of their moderate consumption of alcohol.

A recent study funded by the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, has provided a great deal of evidence that this is in fact the case. Every year the CDC collects health information on a large number of citizens to see if any new health threats or challenges are developing in the nation. The study in question, which included 250,496 people, asked, among other things, how many drinks a person had had in the previous 12 months. After the data had been collected, a group of scientists selected those who drank moderately (up to two drinks a day for men, one for women) and those who drank less than once a month or not at all. They dropped from the study those who were ill and those who were heavy drinkers.

Of the group that remained, 118,889 were moderate drinkers, and these were compared with 116,841 nondrinkers—almost a quarter of a million people in all. The researchers were interested in exploring the characteristics of the moderate drinkers and the nondrinkers to see if any significant differences between the groups emerged besides the differences in the amount of alcohol they drank.

Significant Differences

And, indeed, there were differences and those differences were very significant! Moderate drinkers, the researchers found, earned more money, were better educated, and had better access to health care. They also had more leisure-time for physical activity than the non-drinking population (82.3 percent vs. 68.1 percent), and they were half as likely to be couch potatoes (10.1 percent vs. 21.4 percent). The moderate drinkers were healthier in other ways as well. They were less likely to suffer from asthma (6.9 percent vs. 8.7 percent), arthritis (23.5 percent vs. 32.3 percent), and obesity (20.0 percent vs. 27.3 percent). Can alcohol ward off arthritis, asthma, and obesity? Not likely! And for alcohol to provide the drinker with a better paying job and a private physician (not to mention more knowledge about health) is even more unlikely!

So the moderate drinkers and the nondrinkers were clearly different in many ways, not just in their drinking habits. And these other differences are far more likely to be the factors that helped them to be more healthy, not their moderate consumption of alcohol.

So what of the alleged health benefits of moderate drinking? It’s easy enough to calculate how many years of productive life are lost by the 8 out of 100 moderate drinkers who move on to become alcoholics. This group has been well studied, and the damage to their health is well documented. But in order to truly determine whether moderate drinking contributes to health, we would have to make the same switch that our hypothetical school board made. All the moderate drinkers would have to stop drinking for at least five years and all the nondrinkers would have to drink moderately for the same period. Meanwhile, both groups would have to keep everything else about their lifestyle and habits the same. After five years the same survey would have to be repeated to determine which group was healthier.

Such a study is, of course, impossible. However, if it could be done, I propose that it would show that the moderate use of alcohol did not improve the health of the former nondrinkers (now drinkers), because they would still have among their number a higher percentage of couch potatoes and consumers of junk food as well as all the other factors that originally contributed to their poor health as nondrinkers. On the other hand, I suspect that the new nondrinkers would continue to enjoy the better health that they had as moderate drinkers. Indeed, more than likely their health would improve because the beneficial effects of those good health habits would not be lessened in any way by alcohol’s known negative effects on the cells and tissues of the body. We will now look at some of those effects.

Moderation vs. Abstinence

Let’s examine what we do know about alcohol: Whenever the cells or tissues of our bodies are exposed to even low concentrations of alcohol the effects are, almost without exception, harmful. We also know that 8 out of every 100 moderate drinkers will become alcoholics. Thus, taking that first drink with the intention of drinking only moderately is like playing the two-gun version of Russian roulette, because it’s generally impossible for a person to know before taking that first drink whether he or she will be among that 8 percent.

We’re left, then, with two significant questions. For those readers who do not yet drink, should you start to do so because of some possible health benefits that moderate drinking might confer? I will answer that question the same way nearly all other physicians would answer it: No! Even if there were some minor health benefit to be had from moderate drinking, it would come nowhere near to compensating for the 1 chance in 12 that you would have of becoming an alcoholic with all the health problems that alcoholism entails.

Second, if you currently use alcohol, whether heavily or in moderation, should you stop? The answer to that question is very simple: Your body will thank you for choosing not to drink at all!

Alcohol in Moderation: is it Good for You by Brian Bull	From the February 2008 Signs