On the Health Benefits of Drinking Alcohol

by Brian Dunning
November 8, 2022

Nobody doubts that being a heavy alcoholic is harmful to your health, but it also seems that most of us have heard anecdotally that small amounts of alcohol can actually have a beneficial effect. Maybe it works sort of like a vaccine, by giving your system a small challenge to help strengthen it. Or maybe the alcohol has some kind of antiseptic effect. Or, maybe something else, who knows; but regardless, it's a thing many of us think and believe. So today we're going to separate science from pseudoscience (it's a thing we've done once or twice before on Skeptoid) and see if there truly are any health benefits from drinking just that right amount of alcohol.

Those of you who do your own research at Google University should be warned: there are a lot of crap articles online touting the health benefits of alcohol, often specific types. For example, one article on the "7 Health Benefits of Tequila" contains plenty of information that is, at best, dubious — and there are a million articles making these same claims; I just happened to pick this one. Let's have a quick look at those seven benefits:

1. Diabetics can drink it. The claim is that those with type 2 diabetes can indeed tolerate tequila better than some other spirits, because one of the sugars in it is agavin (found in the agave plant), which is non-digestible. Unfortunately, all the agavins are converted to ethanol during fermentation. Whatever benefits agavins may have to diabetics cannot be had from tequila. So it's bogus claim.
   
   
2. It cleanses the colon. The agave plant is a rich source of fructans, which are polymers of fructose molecules, and one type is called inulin. Fructans, and inulin specifically, are soluble dietary fibers and do have health benefits, which is the source of this claim. However, like the agavins, fructans do not survive the fermentation process and are not found in tequila, rendering this claim bogus. When agave is harvested for its fructan, it's usually obtained from the unused byproducts of tequila production.
   
   
3. It can aid in weight loss. This is to do with agavins again, and again, because there are no agavins in tequila, it's a bogus claim. The original claim came from a presentation at an American Chemical Society meeting, which was badly misinterpreted and misreported. Today it's all over the Internet that tequila helps you lose weight. No it most certainly does not, and neither does any other alcoholic drink.
   
   
4. It helps fight dementia. There is pretty good evidence that those who drink alcohol have a slightly lower risk of developing dementia, and we'll talk more about this later. But it has to do with any alcohol; there's nothing specific to tequila about it.
   
   
5. It aids digestion. This is the same as #2, colon health, digestive health. It always cites the inulin, which as already discussed, is not found in tequila. Bogus claim.
   
   
6. It's probiotic. The fructans in agave are selective substrates for certain probiotic bacteria. But not only are fructans not in the fermented tequila, any probiotic bacteria in your tequila would succumb to its alcohol content. But even if it did survive, we know from Skeptoid #801 that probiotic supplementation has no benefits at all. Bogus claim.
   
   
7. It's a cold-buster. The article compares tequila to Emergen-C, the maker of which lost a class-action lawsuit for claiming that their product has health benefits, when in fact it does nothing at all except perform a wallet extraction. They do also claim that Mexican doctors in the 1930s recommended tequila for cold suffers, but I don't know that I'd call knocking yourself out with the Hammer of Quetzalcoatl a heath benefit.

And this is just one type of liquor. You can find similar articles making similar claims for just about any alcoholic beverage. We could dissect any of those articles claiming the special health benefits of whiskey, of gin, or anything else you want to name; but the conclusions would be of the same basic form as we've just given.

I said above that we'd talk about the dementia study. Dementia is no fun, and the numbers aren't great either. Of adults over age 70, 11% of women and 8% of men have dementia. Of those lucky enough to be 90 or older, a full 33% have it. There have been a number of large studies over the years, but the most recent, published in 2022 in the journal Addiction, was a meta-analysis of 15 major studies covering over 150,000 subjects with an average age of about 72. Compared with abstainers, occasional drinkers had a 22% lower chance of developing dementia during the study. Light-moderate drinkers also had a 22% lower chance, and moderate-heavy drinkers had a 38% lower chance. Overall, people who drink up to 40g of alcohol per day (that's just under 3 drinks) have a reduced chance of dementia compared to lifetime abstainers.

But don't let these impressive sounding numbers fool you. Statistics are used and abused every day. Those percentage numbers of your reduced chances are only of getting dementia during the years of the study. This study had 151,636 person-years of followup of the 27,529 subjects, so it only covered of an average of 5.6 years per person. And in just those 5.6 years, 7.7% of them got dementia. Drinkers had a 22-38% lower chance of getting dementia during those 5.6 years, but that says nothing about their later years after the study. That 22% reduction means that your chances would have been 6% instead of 7.7%. That's a rough number without going in and breaking down the exact numbers with real statistical accuracy, but it's not that huge of an improvement.

Red wine is one type of alcohol that's received a lot of attention over the years for its reported heart health benefits. The first thing to know about this is that the evidence is weak. Some studies find no benefit, and some find a little bit. The compound in question, and which is the focus of such studies, is resveratrol. It's thought that it may lower the risk of inflammation and blood clotting, helping to protect blood vessels from damage. Resveratrol comes from the skin of grapes, and the benefit is said to be from red wine more than from white wine simply because red wine is fermented with grape skins longer than white. The alcohol in red wine is not a part of the picture, it's just the resveratrol; and if resveratrol is what you want, you're better off getting it from grape juice — or even just plain grapes — than from alcoholic wine. You can also get resveratrol from peanuts, blueberries, or cranberries. If the benefits of resveratrol are even real, red wine is probably the least healthy way to get them.

In the early 2000s we began to see data published about the relationship between moderate alcohol consumption and type 2 diabetes risk. One famous such study was published in 2011 in the journal Diabetes, and it followed over 38,000 men for 20 years. Its primary finding was that men who are rare or light drinkers, and who moderately increased their consumption of alcohol, did indeed see a significant reduction in their risk of developing type 2 diabetes. The study controlled for a whole variety of other health related behaviors and eating habits. Just to be very clear, the benefit was not seen among other groups; only among those who increased their alcohol consumption from 0-4.9 g/day to 5.0-29.9 g/day.

However, the researchers were very clear on an important point: Nobody should start drinking alcohol in the hope of reducing their risk of type 2 diabetes. The lifestyle changes to achieve this are losing weight, increasing exercise, and eating a healthy diet — and a healthy diet can include moderate alcohol consumption. That's all — if your overall diet is not a healthy one, adding alcohol will not reduce your risk of type 2 diabetes.

To be responsible, we'll spend a few minutes on the other side of the coin: the ways that alcohol can be harmful to your health. Here is a blurb at the top of the CDC's white paper on Alcohol Use and Your Health:

Drinking too much can harm your health. Excessive alcohol use led to more than 140,000 deaths and 3.6 million years of potential life lost (YPLL) each year in the United States from 2015 – 2019, shortening the lives of those who died by an average of 26 years. Further, excessive drinking was responsible for 1 in 10 deaths among working-age adults aged 20-64 years. The economic costs of excessive alcohol consumption in 2010 were estimated at $249 billion, or $2.05 a drink.

The next time you're holding a drink, look at it, and consider that $2 of the price of that drink goes to cover the health costs of alcohol consumption.

But that's not all. The National Cancer Institute also has something to say on this. Based on data from 2009, some 3.5% of cancer deaths in the United States, or 19,500 deaths, were alcohol related. Drinking alcohol is associated with certain head and neck cancers, one type of esophageal cancer, two types of liver cancer, breast cancer, and certain colorectal cancers. In short, the US Department of Health and Human Services' National Toxicology Program lists the consumption of alcoholic beverages as a known human carcinogen.

So there might be some good news for drinkers, and there's definitely some bad news for drinkers. How does the arithmetic add up? There was a large analysis of 1,286 data sources published in the Lancet in 2018. The authors found that, with a 95% uncertainty interval, the level of alcohol consumption that minimized har across health outcomes was — drum roll please — zero.

So in summary? The health benefits of drinking alcohol are real, though small enough to be unlikely to noticeably improve your health. The proven detrimental effects of drinking, on the other hand, are definitely noticeable and far outweigh any benefits. So do your own math (if you don't trust the the Lancet), and weigh whatever enjoyment you get against the costs. That's the part Skeptoid can't help you with.

By Brian Dunning
Follow @BrianDunning