Alcohol and Health: The Good, the Bad, and the Ugly

The Internet is full of mixed messages about alcohol.

On the one hand, moderate amounts have been linked to health benefits.

On the other, it is addictive and highly toxic — especially when you drink too much.

The truth is that the health effects of alcohol vary between individuals and depend on the amount and type of alcohol consumed.

This article discusses how alcohol affects your health.

The main psychoactive ingredient in alcoholic beverages is ethanol.

Generally referred to as “alcohol,” ethanol is the substance that makes you drunk.

It’s produced by yeasts that digest sugar in certain carb-rich foods, such asgrapes— used to make wine — orgrains— used to make beer.

Alcohol is one of the most popular psychoactive substances in the world. It can have powerful effects on your mood and mental state.

By reducing self-consciousness and shyness, alcohol may encourage people to act without inhibition. At the same time, it impairs judgment and promotes behavior people may end up regretting ( 1 , 2 ）.

Some people drink small amounts at a time, while others tend to binge drink. Binge drinking involves drinking large amounts at a time to get drunk.

SummaryEthanol, the active ingredient in alcoholic drinks, is generally referred to as “alcohol.” It can have powerful effects on your mental state.

Your liveris a remarkable organ with hundreds of essential functions.

One of its main roles is to neutralize various toxic substances you consume. For this reason, your liver is particularly vulnerable to damage by alcohol intake ( 3 ）.

Liver diseases caused by alcohol consumption are collectively known as alcoholic liver diseases.

The first of these to appear isfatty liver, characterized by increased fat inside liver cells.

Fatty liver gradually develops in 90% of those who drink more than a 1/2 ounce (15 ml) of alcohol per day and is usually symptomless and fully reversible ( 4 , 5 ）.

In heavy drinkers, binge drinking may cause your liver to become inflamed. In worst-case scenarios, liver cells die and get replaced with scar tissue, leading to a serious condition called cirrhosis ( 3 , 6 , 7 ）.

Cirrhosis is irreversible and associated with many serious health problems. In advanced cirrhosis, a liver transplant may be the only option.

SummaryAlcohol is metabolized by the liver, and frequent intake can lead to increased fat inside liver cells. Alcohol abuse can lead to cirrhosis, a very serious condition.

Excessive alcohol consumption can have numerous adverse effects on your brain.

Ethanol reduces communication between brain cells — a short-term effect responsible for many of the symptoms of being drunk.

Binge drinking may even lead to a blackout, a phenomenon characterized by memory loss, or amnesia, during a heavy drinking episode ( 8 ）.

These effects are only temporary, but chronic alcohol abuse may cause permanent changes in your brain, often leading toimpaired brain function( 9 , 10 , 11 ）.

Because your brain is very sensitive to damage, chronic alcohol abuse may increase your risk of dementia and cause brain shrinkage in middle-aged and older adults ( 12 , 13 , 14 , 15 ）.

In worst-case scenarios, severe alcohol-induced brain damage may impair people’s ability to lead an independent life.

反对versely, drinking moderately has been linked to areduced risk of dementia— especially in older adults ( 16 , 17 , 18 ）.

SummaryWhile alcohol intoxication is only temporary, chronic alcohol abuse can impair brain function permanently. However, moderate drinking may have benefits for brain health — especially among older adults.

Alcohol intake and depression are closely but complexly associated ( 19 ）.

While alcohol intake and depression seem to increase the risk of one another simultaneously, alcohol abuse may be the stronger causal factor ( 20 , 21 , 22 ）.

Many people facinganxietyand depression drink intentionally to reduce stress and improve mood. While drinking may provide a few hours of relief, it will worsen your overall mental health and spark a vicious cycle ( 23 , 24 ）.

In fact, because heavy drinking is a major cause of depression in some individuals, treating the underlying alcohol abuse leads to big improvements ( 25 , 26 , 27 ）.

SummaryAlcohol abuse and depression are linked. People may start abusing alcohol due to depression or become depressed by abusing alcohol.

Obesity is a serious health concern.

Alcohol is the second most calorie-rich nutrient after fat — packing about 7 calories per gram.

Beer has a similar number of calories assugary soft drinks, ounce for ounce, whereas red wine has twice as much (28,29,30）.

However, studies investigating the link between alcohol and weight have provided inconsistent results ( 31 ）.

It seems that drinking habits and preferences may play a role.

For example, moderate drinking is linked to reduced weight gain, whereas heavy drinking is linked to increased weight gain ( 32 , 33 , 34 ）.

In fact — while drinking beer regularly may cause weight gain — wine consumption may causeweight loss( 31 , 35 , 36 ）.

SummaryThe evidence on alcohol and weight gain is mixed. Heavy drinking and beer are linked to increased weight gain, while moderate drinking and wine are linked to reduced weight gain or even weight loss.

Heart disease is the leading cause of death in modern society.

It is a broad category of diseases, the most common of which are heart attacks and strokes.

The relationship between alcohol and heart disease is complex and depends on several factors.

Light to moderate drinking is linked to a reduced risk of heart disease, while heavy drinking appears to increase the risk ( 37 , 38 , 39 , 40 ）.

有几个possible reasons for the beneficial effects of drinking moderately.

Moderate alcohol consumption may:

• Raise “good” HDL cholesterol in your bloodstream ( 41 ）.
• Decrease blood pressure, a major risk factor for heart disease ( 42 ）.
• Lower your blood concentration of fibrinogen, a substance that contributes to blood clots ( 43 ）.
• Cut the risk of diabetes, another major risk factor for heart disease ( 44 ）.
• Reduce stress and anxiety temporarily ( 41 , 45 ）.

SummaryWhile moderate alcohol consumption may reduce your risk of heart disease, heavy drinking may increase it.

Type 2 diabetes affects about 8% of the world’s population ( 46 ）.

Characterized by abnormally high blood sugar, type 2 diabetes is caused by a reduced uptake of glucose, or blood sugar, by your cells — a phenomenon known asinsulin resistance.

Drinking alcohol in moderation appears to reduce insulin resistance, fighting the main symptoms of diabetes ( 47 , 48 , 49 , 50 ）.

As a result, drinking alcohol with meals may cut the rise in blood sugar by 16–37% more thanwater. Blood sugar between meals — known as fasting blood glucose — may also decline ( 51 , 52 ）.

In fact, your overall diabetes risk tends to drop with moderate alcohol consumption. However, when it comes to heavy drinking and binge drinking, your risk rises ( 53 , 54 , 55 , 56 ）.

SummaryModerate alcohol consumption may reduce symptoms of type 2 diabetes by enhancing the uptake of blood sugar by your cells.

Canceris a serious disease caused by abnormal growth of cells.

Alcohol consumption is a risk factor for cancers of the mouth, throat, colon, breast and liver ( 57 , 58 , 59 ）.

The cells lining your mouth and throat are especially vulnerable to the harmful effects of alcohol.

Even light alcohol consumption — up to one drink per day — is linked to a 20% increased risk of mouth and throat cancer ( 59 , 60 ）.

Your risk increases the more you consume. More than four drinks daily appear to cause a fivefold increase in your risk of mouth and throat cancer, as well as an increase in your risk of breast, colon and liver cancer ( 58 , 59 , 61 , 62 ）.

SummaryDrinking alcohol may increase your risk of certain cancers, especially mouth and throat cancer.

Alcohol abuse during pregnancy is the leading preventable cause of birth defects in the US ( 63 ）.

Binge drinking early inpregnancyis particularly risky for the developing baby ( 64 ）.

In fact, it may have adverse effects on development, growth, intelligence and behavior — which may affect the child for the rest of its life ( 63 ）.

SummaryAlcohol abuse is one of the world’s most common causes of birth defects. The fetus is particularly vulnerable early in pregnancy.

It may be hard to believe, but alcohol may help youlive longer.

Studies suggest that light and moderate consumption of alcohol may cut the risk of premature death — especially in Western societies ( 65 , 66 ）.

Simultaneously, alcohol abuse is the third main cause of preventable death in the US, as it’s a large factor in chronic diseases, accidents, traffic crashes and social problems ( 67 ）.

SummaryModerate alcohol consumption may increase life expectancy, while alcohol abuse is a strong risk factor for premature death.

Some people become addicted to the effects of alcohol, a condition known as alcohol dependence or alcoholism.

An estimated 12% of Americans are believed to have been dependent on alcohol at some point in their life ( 68 ）.

Alcohol dependence is one of the main causes of alcohol abuse and disability in the US and a strong risk factor for various diseases ( 69 ）.

许多因素可以使人容易得多tic drinking, such as family history, social environment, mental health and genetics.

Many different subtypes of alcohol dependence exist, characterized by alcohol cravings, inability to abstain or loss of self-control when drinking ( 70 ）.

As a rule of thumb, if alcohol is adversely affecting your quality of life, you may have a problem with alcohol dependence or alcoholism.

SummaryAlcohol consumption can lead to alcohol dependence, or alcoholism, in predisposed individuals.

Heavy drinking is the most common form of drug abuse.

Chronic alcohol abuse can have catastrophic health effects, impacting your entire body and causing a range of health problems.

For example, it can cause liver damage — including cirrhosis — brain damage, heart failure, diabetes, cancer and infections ( 9 , 54 , 58 , 71 , 72 , 73 ）.

If you are a heavy drinker, following ahealthy dietand日常锻炼should be the least of your worries.

Getting your alcohol consumption under control, or abstaining completely, should be your first priority.

SummaryChronic alcohol abuse can wreak havoc on your body and brain, increasing your risk of many diseases.

What you drink matters less than how much you drink.

However, some alcoholic drinks are better than others.

Red wine appears to be particularly beneficial because it is very high in healthyantioxidants.

In fact,red wineis linked to more health benefits than any other alcoholic beverage ( 74 , 75 , 76 , 77 , 78 ）.

That said, consuming high amounts does not provide greater health benefits. Heavy drinking causes health problems — regardless of the type of beverage.

SummaryRed wine may be one of the healthiest alcoholic beverages, probably due to its high concentration of antioxidants.

Recommendations for alcohol intake are usually based on the number of standard drinks per day.

The problem is, most people have no idea what qualifies as a “standard drink.” To worsen matters, the official definition of a standard drink differs between countries.

In the US, one standard drink is any drink that contains 0.6 fluid ounces (14 grams) of pure alcohol (ethanol).

This image shows the standard drink amount for some popular alcoholic drinks:

Photo Source: National Institute on Alcohol Abuse and Alcoholism.

Moderate drinking is defined as one standard drink per day for women and two for men, while heavy drinking is defined as more than three drinks per day for women and four for men ( 79 ）.

Drinking patterns are also important. Binge drinking is a form of alcohol abuse and can cause harm.

SummaryModerate drinking is defined as one standard drink per day for women and two for men.

At the end of the day, the effects of alcohol range from a positive impact on your wellbeing to a health catastrophe.

Drinking small amounts — especially of red wine — is linked to various health benefits.

On the other hand, alcohol abuse and alcohol addiction are linked to severe negative effects on both physical and mental health.

If you enjoy alcohol and don’t binge, there is no compelling reason to avoid it. Just keep in mind that your cancer risk may increase — regardless of how much you are drinking.

However, if you tend to drink excessively or notice that alcohol causes problems in your life, you should avoid it as much as possible.

Because alcohol impact depends entirely on the individual, it’s good for some and disastrous for others.