Perspectives on Whether or Not Alcohol Has a Place in a Healthy Diet

Young people having a toast with a glass of wine.
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Alcohol is public health's quintessential "double-edged sword." Moderate intake of alcohol is consistently associated with reduced cardiovascular risk, and since heart disease is the number one killer of men and women alike, a reduction in overall mortality. But, of course, excess alcohol is terribly harmful to health in a variety of ways, and even moderate alcohol intake is associated with an increase in the number two cause of premature death: cancer.

Given these subtleties, it's not surprising that even expert opinions on the topic vary. The perspectives below illustrate the subtleties and complexities of this topic and indicate the importance of well-informed, personalized choices.

Raysa Buyukbahar, M.Sc., R.D.

Yes, alcohol can have a place in a healthy diet. However, how much you are drinking affects your life. Alcoholic beverages don’t contain any vital nutrients. This is why they are often called “empty calories.”

A healthy diet consists of the right amount of food from each food group. One gram of alcohol provides 7 calories compared to 4 calories per gram of carbohydrate and 9 calories per gram of fat. If you choose alcohol to provide most of the calories you need, then your risk of having nutritional deficiencies.

In the United States, one drink provides 14 grams of alcohol. For instance, one drink would be:

  • 12 fluid ounces of regular beer with 5 percent alcohol
  • 5 fluid ounces of wine with 12 percent alcohol
  • 1.5 fluid ounces of distilled spirits (gin, rum, tequila etc.) with 40 percent alcohol

To adjust your alcohol consumption for a healthy lifestyle, it is important to have all the facts. Eighty-eight thousand deaths are alcohol-related each year in the United States.

According to National Center for Chronic Disease Prevention and Health Promotion, binge drinking (consumption of 4 or more drinks a day for women and 5 or more drinks a day for men) and heavy drinking (consumption of 8 or more drinks a week for women and 15 or more drinks a week for men) can lead to injuries, birth defects, and social and chronic health problems such as several types of cancer, high blood pressure, heart disease, stroke, and liver disease.

With alcohol, like everything else, moderation is key. First, keep track of how often and how much you drink. Then, set a goal on the amount of drinks on the days that you drink. Have no more than 4 drinks on any day if you are a man and 3 drinks if you are a woman. These limits may help reduce, though not completely eliminate, alcohol-related risks.

You can change your life by reducing your alcohol consumption. Remember, you are in control of how much you drink! Ask for help before it is too late if you think you have a drinking problem.

Margaret I. Cuomo, M.D.

Author of A World Without Cancer
Host/Writer of PBS documentary A World Without Cancer: The Power of Prevention
Member, New York State Cancer Consortium

When you drink beer, wine, or hard liquor, do know that alcohol increases your risk for cancer?

Do we teach our children that one of the many harms associated with alcohol is that it will raise their risk for cancer? There should be no confusion about this simple truth.

Alcoholic beverages are carcinogens, according to the National Toxicology Program of the U.S. Department of Health and Human Services and the International Agency for Research on Cancer. The more we drink, the greater our cancer risk. Cancers of the head and neck, esophagus, liver, colon, and rectum and breast are associated with drinking alcohol. There is increasing evidence that cancers of the pancreas, prostate, and skin (melanoma) are also linked to alcohol consumption.

There are many ways in which alcohol raises cancer risk. For example, alcohol is converted in the body to acetaldehyde, a known carcinogen which damages DNA and proteins. Alcohol also increases the hormone estrogen in the body, which is linked to breast cancer.

What about red wine and cancer risk? There is no scientific evidence that resveratrol, found in red wine and reported to have anticancer properties, can prevent or treat cancer in humans.

When you drink alcohol and smoke cigarettes, your risk for cancer is even greater than doing either alone. Any amount of alcohol increases your cancer risk. "Stop drinking alcohol" should be heard as widely as "stop smoking."

Joel Kahn, MD, FACC

Clinical Professor of Medicine (Cardiology), Wayne State University School of Medicine

Many aspects of our health can be described by a U-shaped curve, which is the idea that too much or too little of a behavior can be unhealthy, and the sweet spot is where you tend to have optimal results.

1. “Light to moderate” drinking (defined as 1 drink a day for women, 2 drinks a day for men) is associated with lower rates of overall mortality, heart deaths, diabetes mellitus, heart failure, and stroke.

2. In an analysis of studies combining data on over 1 million people and overall death rates, the U-shaped curve was “sweetest” at 1 to 2 drinks per day for women and 2 to 4 drinks per day for men. Most authorities recommend less.

3. In a separate analysis of drinking in 250,000 US adults, researchers found that up to 7 drinks per week for women and 14 drinks per week for men was associated with over a 30 percent drop in mortality.

The American Heart Association advises people not to start a drinking habit for health gains. Nonetheless, for those that enjoy an alcoholic drink, a daily 5-ounce glass of red wine (or two) has scientific support.

Long ago, Benjamin Franklin said that “wine makes daily living easier, less hurried, with fewer tensions and more tolerance.” If you will stick to the “sweet spot” it may make life longer too.

Kathleen Zelman, MPH, RD

Nutrition Expert

Alcohol has been addressed in every version of the Dietary Guidelines for Americans urging adults who drink to do so in moderation. In addition, the recommendations were expanded to include calories, standard drink definitions, and a list of people who should avoid alcohol including, including

  • Individuals taking certain over-the-counter or prescription medicines
  • Individuals with certain medical conditions
  • Those who are unable to control the amount they drink
  • Anyone under the age of 21
  • Individuals who are driving, planning to drive, or are participating in other activities requiring alertness and coordination
  • Women who are pregnant or may be pregnant.

Another important factor to keep in mind when drinking alcohol is to limit consumption to one drink a day for ladies and two drinks for men. There is a trend for higher alcohol craft beers and increasing the alcohol content of wines, higher than the standard drink equivalent.

Factor in the alcohol content when it exceeds the standards. To calculate one drink-equivalents, multiply volume in ounces by the percent alcohol content and divide by 0.6 (ounces of alcohol per drink). For example: 16 fluid ounces beer at 5 percent alcohol: (16)(0.05)/0.6  equals 1.3 drink-equivalents. Large glassware can also tend to be over-served and exceed drink limits.

For most moderate drinkers, alcohol has overall health benefits, including a boost in cardiovascular health, especially in middle-aged adults. Enjoy the health benefits of alcohol within the recommended limits.

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