Is drinking healthy or not?

Source: Best Health Magazine, March/April 2011

A cold beer with Indian curry, a glass of Malbec at a barbecue, a fancy cocktail on a girls’ night out. There’s nothing wrong with enyoing a drink. Not in the Mad Men sense of the word’driving drunk or making sloppy passes at someone else’s spouse. But rather, savouring a drink. Appreciating what alcohol adds to a meal, a conversation or an evening out. And the fact is, alcohol has health benefits’moderate drinking may lower the risk of heart disease and stroke, and it might even decrease your chances of developing osteoporosis or dementia‘which is a welcome bonus.

Unfortunately, there’s a down side to drinking, too.

“If people drank alcohol like medicine’only one drink a day or every other day, and never more than that’the overall effect would be positive. But few people drink that way,” says Jürgen Rehm, a professor of psychiatry at the University of Toronto and the author of more than 400 studies on substance use and abuse, from his office at the Centre for Addiction and Mental Health (CAMH), where he’s a senior scientist.

Let’s say that you average a drink or fewer a day, but the way you get there is with one drink on one or two days’and then three or four drinks on a weekend evening. You may just think of it as “social drinking.” Turns out that, according to scientific standards at least, those four drinks’even if it is just once a week’are actually “heavy drinking occasions” (for men, it’s five-drink days). Researchers used to call it a “binge,” but that term confused people, so they now opt for the slightly clearer term “heavy drinking.”

Understanding your alcohol consumption pattern

Why does consumption pattern matter? Because research has revealed some bad news for weekend drinkers: A drink a day does have heart health and stroke benefits, but drinking patterns that include “heavy drinking” days don’t, so in fact people with such a consumption pattern end up without those health benefits.

But it’s even more complex than that. When a study says alcohol is “associated with” a reduction in heart disease, stroke or dementia, it doesn’t necessarily mean that the reduction is due to alcohol. One major French study in 2010 of more than 140,000 people argued that the health benefits seen with drinking may simply be because healthy middle- and upper-class people are more likely to be moderate drinkers (one to three drinks a day) than they are to be either abstainers or heavy drinkers. (They also happen to eat well, exercise regularly and have good social support networks, which all contribute to longevity.) This moderation is part of an overall lifestyle, and the benefits of that lifestyle’and not of the drinking on its own’are that these people live longer, healthier lives.

All the same, a small U.S. study of almost 2,000 people, also published in 2010, found that while much of the health benefit of alcohol consumption could be explained away by those middle-class lifestyle factors, moderate drinkers did live longer on average than those who didn’t drink at all, though the role alcohol plays is unclear. But even that study’s author cautions against excess: “Consuming more than two drinks a day exceeds recommended alcohol consumption guidelines and is associated with increased falls, a higher risk of alcohol use problems and potential adverse interactions with medications,” says Charles Holahan, a professor at The University of Texas at Austin.

When drinking becomes bad for your health

The health implications of alcohol are not all positive. A 2009 U.K. study of more than one million women found that low to moderate alcohol consumption (just one to two drinks a day) could account for 13 percent of cancers of the breast, liver, rectum, nose and throat combined. As for breast cancer alone, “it means that in the U.K. every year, 5,000 women get breast cancer who wouldn’t have gotten it without drinking alcohol,” says study author Naomi Allen, an epidemiologist at the University of Oxford’s Cancer Epidemiology Unit.

But because alcohol isn’t the biggest cause of any single disease (unlike, say, smoking and lung cancer), we don’t tend to make that connection. Indeed, drinking contributes to causing some 130 diseases, but all at levels that make it impossible to say that it was the cause in any individual case. Yet according to CAMH, in Canada as in most industrialized countries, alcohol is the third-highest factor contributing to death, disease and disability (just below tobacco and high blood pressure). And according to a 2010 study in the journal The Lancet, alcohol is more dangerous than heroin, crack or crystal meth when the health and social effects for the drinker, and the harm it causes others, are taken into account.

Keep your drinking in check

Need a reality check about your drinking habits? Start by checking out a survey by Evolution Health Systems at checkyourdrinking.net. It was created in consultation with leading researchers on alcohol, and designed in part by Dr. John Cunningham of CAMH. To complete the survey, you’ll need to make your way through the 18 questions, which ask you to estimate drinks per day and costs. Once you’ve finished, you’ll receive a full report, including your rating on a five-level scale of increasing risk of negative consequences from drinking. Based on your results, you will be able to determine if you are on the cusp of being at risk of experiencing alcohol-related harm. Not only that, the survey will also calculate how many pounds worth of calories your drinking is adding to your frame each year. Now that’s a sobering thought.

“The key that leads to behavioural change won’t be the same for each person,” says Cunningham. But whatever your motivation, changing your drinking patterns may make all the difference to your health.

This article was originally titled “How much is too much?” in the March/April 2011 issue of Best Health. Subscribe today to get the full Best Health experience’and never miss an issue!’and make sure to check out what’s new in the latest issue of Best Health