Last call for alcohol?

The debate about the safety of even moderate alcohol use has heated up again. An observational study published Aug. 12, 2024, by JAMA Network Open suggested that any amount of regular drinking may affect life expectancy in older adults.

Researchers compared health outcomes with alcohol consumption among more than 135,000 adults ages 60 and older. Based on questionnaires, everyone was placed into three categories of drinking: low, moderate, and high. The results showed no improvements in longevity at any level of drinking. Low drinking showed a slightly increased risk of earlier cancer death, and moderate and high use were associated with a significantly higher risk of death from any cause.

Then in December 2024, a report from the National Academies of Sciences, Engineering, and Medicine gave a conflicting answer. It reviewed scientific evidence on the relationship between moderate alcohol consumption and health outcomes.

The report found no firm evidence that moderate drinking affects weight gain or cognitive decline. It also concluded that compared with never consuming alcohol, moderate drinking was linked with a lower risk of heart attack, stroke, and death from heart disease.

So, what should older adults think now? Should you become a teetotaler, or is it still okay to occasionally raise a glass to your health?

Everything in moderation

These new findings shouldn't immediately change the current recommendations for people who enjoy light to moderate alcohol use, according to Eric Rimm, professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health.

"There's plenty of solid observational data showing a link between moderate drinking and a lower risk for heart disease and a tendency to live longer compared with people who don't drink," he says. "Whether it's related to a direct alcohol health benefit, other lifestyle factors, or some combination is still being explored. But the benefit of moderate alcohol intake appears to be real, especially when consumed as a healthy pattern without binge drinking or heavy episodic drinking."

But the key word here is "moderate." The CDC classifies moderate alcohol intake for adult men as no more than two standard drinks on days when they drink. In the United States, a standard drink is approximately 12 ounces of regular beer (5% alcohol by volume, or ABV), 5 ounces of wine (12% ABV), or 1.5 ounces of 80-proof spirits (40% ABV). However, Rimm points out this definition does not accurately reflect the average moderate drinker. "Most people who classify themselves as moderate drinkers probably consume less than what these guidelines recommend."

Watch your amounts

One aspect of the alcohol debate that everyone agrees on is the big problem of excessive drinking. "Studies have consistently shown that drinking beyond the recommended amount can raise a person's risk for numerous health problems, like liver failure, high blood pressure, heart disease, and several types of cancer," says Rimm.

Binge drinking (consuming five or more drinks on one occasion) is especially dangerous for people with heart conditions, as this may trigger arrhythmias, such as atrial fibrillation.

According to Rimm, if you don't drink, there is no cause to begin for health reasons. Otherwise, it's okay to enjoy the occasional alcoholic beverage — in moderation.

"The healthiest pattern is to have only one or two drinks at one time, and spread it out so you don't drink on multiple days per week," says Rimm. Also, weigh your alcohol intake with your overall health, he adds. "If you have any health issues, it's best to speak with your doctor about what is the proper amount of alcohol for you."

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