Does alcohol harm the heart?

Q. You often say that an alcoholic drink per day improves heart health. But I heard a recent study found that any amount of alcohol is harmful for the heart and health. What's the truth?

A. Every one of us wants advice that's simple and "true." But few important things are simple, and what we think is "true" can change with more information. Also, we're all different in some ways, and what's healthy for you may not be healthy for me.

My colleagues at the Harvard School of Public Health put it succinctly: "Alcohol is both a tonic and a poison." Whether alcohol is a tonic or a poison for you depends on your current state of health (including diseases that run in your family), your habits (such as diet, exercise, smoking), and how much alcohol you drink.

As for that recent study that concluded there was no amount of alcohol per day that was healthy [published online March 25, 2022, by JAMA Network Open], I think the study was flawed, and actually showed health benefits from three to six drinks per week.

In contrast to that single study, more than 100 large studies have found that people who have one drink per day (moderate drinking) have lower risks of cardiovascular disease. By the way, we define "one drink" as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor. And while it's healthy for most people to have one drink on each day of the week, seven drinks all on Saturday night is not healthy.

Many studies also find that people who have more than three drinks per day are at much greater risk for damage to the heart, liver, and brain, and of dying in an automobile accident or from violence.

Any amount of alcohol may increase risk of breast cancer in women. Hearing that, a woman might be inclined to say: "Well, then, I'm going to avoid alcohol." But it's not that simple. For example, a 60-year-old woman is 10 times more likely to die from heart disease than from breast cancer. While a drink a day may slightly increase a woman's risk of breast cancer, it reduces a woman's much greater risk of heart disease.

It's all about achieving a healthy balance of risks… for you! If breast cancer is common in your family, it may well be best to avoid having a drink a day. But if heart disease runs in your family, a drink a day may make sense for you.

Finally, if you are physically active, don't smoke, eat a healthy diet, are not overweight, and have no family history of heart disease, there's little added benefit from drinking alcohol. And if you don't usually drink, no need to start: there are better ways to achieve heart health.

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