Skip to main content

Advertisement

SpringerLink
Log in

Alcohol Intake Revisited: Risks and Benefits

  • Nutrition (BV Howard, Section Editor)
  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

The relationship between alcohol consumption and health outcomes has a long history and has generated much research. Heavy drinking is detrimental to health; however, there is considerable and convincing evidence from both short-term biochemical experimental studies and observational studies of a beneficial association with certain health outcomes related to atherosclerotic processes. This beneficial association is most important for an average alcohol intake of one to two drinks per day. Important factors in determining the magnitude or direction of effects have been identified. Most criticisms based on methodological issues have been dismissed in recent years from an epidemiological point of view. However, important questions remain about the circumstances of such a beneficial association. The net effect of alcohol consumption on health outcomes is detrimental overall, owing to the negative effect of cancers, infectious disease, gastrointestinal diseases, alcohol-use disorders and injuries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as:• Of importance •• Of outstanding importance

  1. Rehm J, Mathers C, Popova S, et al. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol use disorders. Lancet. 2009;9682:2223–33.

    Article  Google Scholar 

  2. • Rehm J, Baliunas D, Borges GLG, et al.,. The relation between different dimensions of alcohol consumption and burden of disease - an overview. Addiction 2010;5:817–43. Excellent overview of the relationship between alcohol consumption and many disease outcomes.

    Article  Google Scholar 

  3. Pearl R. Alcohol and life duration. BMJ. 1924;3309:948–50.

    Article  Google Scholar 

  4. Mukamal KJ, Rimm EB,. Alcohol consumption: risks and benefits. Curr Atheroscler Rep. 2008;536–43.

  5. Rimm E, Williams P, Fosher K, et al. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ. 1999;7224:1523–8.

    Article  Google Scholar 

  6. • Brien SE, Ronksley PE, Turner BJ, et al.,. Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies. BMJ. 2011;d636. Most recent meta-analysis of several biomarkers of heart disease. Provides strong evidence for a beneficial association of non-heavy alcohol consumption and biomarkers from short-term experiments.

  7. Krenz M, Korthuis RJ. Moderate ethanol ingestion and cardiovascular protection: from epidemiologic associations to cellular mechanisms. J Mol Cell Cardiol. 2012;1:93–104.

    Article  Google Scholar 

  8. Butt P, Beirness D, Cesa F, et al. Alcohol and health in Canada: a summary of evidence and guidelines for low-risk drinking. Ottawa: Canadian Centre on Substance Abuse; 2011.

    Google Scholar 

  9. US Department of Agriculture and U.S.Department of Health and Human Services: Foods and food components to reduce. Dietary guidelines for Americans, 2010. 7th ed. Washington: US Government Printing Office; 2010. p. 30–2.

    Google Scholar 

  10. English D, Holman C, Milne E, et al. The quantification of drug caused morbidity and mortality in Australia 1995. Canberra: Commonwealth Department of Human Services and Health; 1995.

    Google Scholar 

  11. Ronksley PE, Brien SE, Turner BJ, et al. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ. 2011;d671.

  12. Maclure M,. Demonstration of deductive meta-analysis: Ethanol intake and risk of myocardial infarction. Epidemiol Rev. 1993;328–51.

  13. Corrao G, Rubbiati L, Bagnardi V, et al. Alcohol and coronary heart disease: a meta-analysis. Addiction. 2000;10:1505–23.

    Article  Google Scholar 

  14. • Roerecke M, Rehm J. The cardioprotective association of average alcohol consumption and ischaemic heart disease: a systematic review and meta-analysis. Addiction. 2012;7:1246–60. The most recent meta-analysis on ischaemic heart disease providing stratified pooled RR estimates from epidemiological studies using strict inclusion criteria. Results are reported by sex and disease end point (mortality vs. morbidity), in clearly defined categories of average alcohol intake, and separating former-drinker effects.

    Article  Google Scholar 

  15. Rehm J, Gmel G, Sempos C, Trevisan M. Alcohol-related mortality and morbidity. Alcohol Res Health. 2003;1:39–51.

    Google Scholar 

  16. Costanzo S, Di Castelnuovo A, Donati MB, et al. Wine, beer or spirit drinking in relation to fatal and non-fatal cardiovascular events: a meta-analysis. Eur J Epidemiol. 2011;11:833–50.

    Article  Google Scholar 

  17. Costanzo S, Di Castelnuovo A, Donati MB, et al. Cardiovascular and overall mortality risk in relation to alcohol consumption in patients with cardiovascular disease. Circulation. 2010;17:1951–9.

    Article  Google Scholar 

  18. Roerecke M, Rehm J. Irregular heavy drinking occasions and risk of ischemic heart disease: a systematic review and meta-analysis. Am J Epidemiol. 2010;6:633–44.

    Article  Google Scholar 

  19. Kerr W, Fillmore K, Bostrom A,. Stability of alcohol consumption over time: Evidence from three longitudinal surveys from the United States. J Stud Alcohol 2002;325–33.

  20. Rehm J, Irving H, Ye Y, et al. Are lifetime abstainers the best control group in alcohol epidemiology? On the stability and validity of reported lifetime abstention. Am J Epidemiol. 2008;8:866–71.

    Article  Google Scholar 

  21. Caldwell T, Rogers B, Power C, et al.,. Drinking histories of self-identified lifetime abstainers and occasional drinkers: findings from the 1958 British Birth Cohort Study. Alcohol Alcohol 2006;650–54.

  22. Bagnardi V, Zatonski W, Scotti L, et al. Does drinking pattern modify the effect of alcohol on the risk of coronary heart disease? Evidence from a meta-analysis. J Epidemiol Commun Health. 2008;7:615–9.

    Article  Google Scholar 

  23. Roerecke M, Greenfield T, Kerr W, et al. Heavy drinking occasions in relation to ischaemic heart disease mortality - an 11-22 year follow-up of the 1984 and 1995 US National Alcohol Surveys. Int J Epidemiol. 2011;5:1401–10.

    Article  Google Scholar 

  24. Ruidavets JB, Ducimetière P, Vans A, et al.,. Patterns of alcohol consumption and ischaemic heart disease in culturally divergent countries: the Prospective Epidemiological Study of Myocardial Infarction (PRIME). BMJ 2010;c6077.

  25. McKee M, Britton A,. The positive relationship between alcohol and heart disease in Eastern Europe: potential physiological mechanisms. J R Soc Med 1998;402–7.

  26. Puddey IB, Rakic V, Dimmitt SB, Beilin LJ,. Influence of pattern of drinking on cardiovascular disease and cardiovascular risk factors - a review. Addiction 1999;649–63.

  27. Sull JW, Yim SW. Nam Cm, et al., Binge drinking and hypertension on cardiovascular disease mortality in Korean men and women: a Kangwha cohort study. Stroke. 2010;10:2157–62.

    Article  Google Scholar 

  28. Hillbom M, Saloheimo P, Juvela S. Alcohol consumption, blood pressure, and the risk of stroke. Curr Hypertens Rep. 2011;3:208–13.

    Article  Google Scholar 

  29. Patra J, Taylor B, Irving H, et al. Alcohol consumption and the risk of morbidity and mortality from different stroke types - a systematic review and meta-analysis. BMC Publ Health. 2010;1:258.

    Article  Google Scholar 

  30. Sundell L, Salomaa V, Vartiainen E, et al. Increased stroke risk is related to a binge drinking habit. Stroke. 2008;12:3179–84.

    Article  Google Scholar 

  31. Kiechl S, Willeit J, Poewe W, et al. Insulin sensitivity and regular alcohol consumption: large, prospective, cross sectional population study (Bruneck study). BMJ. 1996;7064:1040–4.

    Article  Google Scholar 

  32. Mayer EJ, Newman B, Quesenberry Jr CP, et al. Alcohol consumption and insulin concentrations. Role of insulin in associations of alcohol intake with high-density lipoprotein cholestrol and triglycerides. Circulation. 1993;5(Pt 1):2190–7.

    Article  Google Scholar 

  33. Davies MJ, Baer DJ, Judd JT, et al. Effects of moderate alcohol intake on fasting insulin and glucose concentrations and insulin sensitivity in postmenopausal women: a randomized controlled trial. JAMA. 2002;19:2559–62.

    Article  Google Scholar 

  34. Lazarus R, Sparrow D, Weiss ST. Alcohol intake and insulin levels. The Normative Aging Study. Am J Epidemiol. 1997;10:909–16.

    Article  Google Scholar 

  35. Imhof A, Froehlich M, Brenner H, et al. Effect of alcohol consumption on systemic markers of inflammation. Lancet. 2001;9258:763–7.

    Article  Google Scholar 

  36. Sierksma A, van der Gaag MS, Kluft C, Hendriks HF. Moderate alcohol consumption reduces plasma C-reactive protein and fibrinogen levels: a randomized, diet-controlled intervention study. Eur J Clin Nutr. 2002;11:1130–6.

    Article  Google Scholar 

  37. Pietraszek A, Gregersen S, Hermansen K. Alcohol and type 2 diabetes. A review. Nutr Metab Cardiovasc Dis. 2010;5:366–75.

    Article  Google Scholar 

  38. Baliunas D, Taylor B, Irving H, et al. Alcohol as a risk factor for type 2 diabetes - a systematic review and meta-analysis. Diabetes Care. 2009;11:2123–32.

    Article  Google Scholar 

  39. Naimi TS, Brown DW, Brewer RD, et al. Cardiovascular risk factors and confounders among nondrinking and moderate-drinking U.S. adults. Am J Prev Med. 2005;4:369–73.

    Article  Google Scholar 

  40. Lamy L,. Étude clinique et statistique de 134 cas de cancer de l'oesophage et du cardia. Archives des maladies de L'Appareil Digestif 1910;451–75.

  41. International Agency for Research on Cancer. Alcohol drinking. Lyon: IARC; 1988.

    Google Scholar 

  42. •• International Agency for Research on Cancer. IARC monographs on the evaluation of carcinogenic risks to humans: alcohol consumption and ethyl carbamate. Lyon: IARC; 2010. By far the most comprehensive overview of alcohol and cancer risk.

    Google Scholar 

  43. Fedirko V, Tramacere I, Bagnardi V, et al. Alcohol drinking and colorectal cancer risk: an overall and dose-response meta-analysis of published studies. Ann Oncol. 2011;9:1958–72.

    Article  Google Scholar 

  44. Islami F, Fedirko V, Tramacere I, et al. Alcohol drinking and esophageal squamous cell carcinoma with focus on light-drinkers and never-smokers: a systematic review and meta-analysis. Int J Cancer. 2011;10:2473–84.

    Article  Google Scholar 

  45. Islami F, Tramacere I, Rota M, et al. Alcohol drinking and laryngeal cancer: overall and dose-risk relation–a systematic review and meta-analysis. Oral Oncol. 2010;11:802–10.

    Article  Google Scholar 

  46. Tramacere I, Negri E, Bagnardi V, et al. A meta-analysis of alcohol drinking and oral and pharyngeal cancers. Part 1: overall results and dose-risk relation. Oral Oncol. 2010;7:497–503.

    Article  Google Scholar 

  47. Turati F, Garavello W, Tramacere I, et al. A meta-analysis of alcohol drinking and oral and pharyngeal cancers. Part 2: results by subsites. Oral Oncol. 2010;10:720–6.

    Article  Google Scholar 

  48. Baan R, Straif K, Grosse Y, et al. Carcinogenicity of alcoholic beverages. Lancet Oncol. 2007;4:292–3.

    Article  Google Scholar 

  49. Hamajima N, Hirose K, Tajima K, et al. Alcohol, tobacco and breast cancer–collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease. Br J Cancer. 2002;11:1234–45.

    Google Scholar 

  50. Lachenmeier DW, Przybylski MC, Rehm J,. Comparative risk assessment of carcinogens in alcoholic beverages using the margin of exposure approach. Int J Cancer 2012.

  51. Lachenmeier DW, Kanteres F, Rehm J. Carcinogenicity of acetaldehyde in alcoholic beverages: risk assessment outside ethanol metabolism. Addiction. 2009;4:533–50.

    Article  Google Scholar 

  52. Jarl J, Gerdtham UG. Time pattern of reduction in risk of oesophageal cancer following alcohol cessation-a meta-analysis. Addiction. 2012;7:1234–43.

    Article  Google Scholar 

  53. Rehm J, Patra J, Popova L. Alcohol drinking cessation and its effect on oesophageal and head and neck cancers: a pooled analysis. Int J Cancer. 2007;5:1132–7.

    Article  Google Scholar 

  54. • Schütze M, Boeing H, Pischon T, et al.,. Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study. BMJ. 2011;d1584. This article estimated the contribution of alcohol to cancer incidence in eight European countries on the basis of direct and country-specific RR estimates. About 10 % of all cancers in men and 3 % of all cancers in women were attributable to alcohol consumption.

  55. Rush B. An inquiry into the effects of ardent spirits upon the human body and mind: With an account of the means of preventing, and of the remedies for curing them. 8th edition. Exeter: Richardson, 1785.

  56. Szabo G. Alcohol's contribution to compromised immunity. Alcohol Health Res World. 1997;1:30–41.

    Google Scholar 

  57. Szabo G, Mandrekar P. A recent perspective on alcohol, immunity, and host defense. Alcohol Clin Exp Res. 2009;2:220–32.

    Article  Google Scholar 

  58. Friedman H, Pros S, Klein TW,. Addictive drugs and their relationships with infectious diseases. FEMS 2006;330–42.

  59. Lönnroth K, Jaramillo E, Williams BG, et al.,. Drivers of tuberculosis epidemics: the role of risk factors and social determinants. Soc Sci Med 2009;2240–46.

  60. Rehm J, Samokhvalov AV, Neuman MG, et al. The association between alcohol use, alcohol use disorders and tuberculosis (TB). A systematic review. BMC Public Health. 2009;1:450.

    Article  Google Scholar 

  61. Shuper PA, Neuman M, Kanteres F, et al. Causal considerations on alcohol and HIV/AIDS - a systematic review. Alcohol Alcohol. 2010;2:159–66.

    Google Scholar 

  62. Rehm J, Shield KD, Joharchi N, Shuper PA. Alcohol consumption and the intention to engage in unprotected sex: systematic review and meta-analysis of experimental studies. Addiction. 2012;1:51–9.

    Article  Google Scholar 

  63. Samokhvalov AV, Irving HM, Rehm J. Alcohol consumption as a risk factor for pneumonia: systematic review and meta-analysis. Epidemiol Infect. 2010;12:1789–95.

    Article  Google Scholar 

  64. Albarracin D, Fishbein M, Johnson BT, Muellerleile PA. Theories of reasoned action and planned behavior as models of condom use: a meta-analysis. Psychol Bull. 2001;1:142–61.

    Article  Google Scholar 

  65. Sheeran P, Orbell S,. Do intentions predict condom use? Meta-analysis and examination of six moderator variables. Br J Soc Psychol 1998;231–50.

  66. Sheeran P, Abraham C, Orbell S,. Psychosocial correlates of heterosexual condom use: a meta-analysis. Psychol Bull 1999;90–132.

  67. Lönnroth K, Williams B, Stadlin S, et al.,. Alcohol use as a risk factor for tuberculosis - a systematic review. BMC Public Health 2008;289.

  68. Baliunas D, Rehm J, Irving H, Shuper P. Alcohol consumption and risk of incident human immunodeficiency virus infection: a meta-analysis. Int J Public Health. 2010;3:159–66.

    Article  Google Scholar 

  69. Romeo J, Warnberg J, Marcos A. Drinking pattern and socio-cultural aspects on immune response: an overview. Proc Nutr Soc. 2010;3:341–6.

    Article  Google Scholar 

  70. World Health Organization. International classification of diseases and related health problems, 10th revision. Geneva: World Health Organization; 2007.

    Google Scholar 

  71. Irving HM, Samokhvalov A, Rehm J. Alcohol as a risk factor for pancreatitis. A systematic review and meta-analysis. JOP. 2009;4:387–92.

    Google Scholar 

  72. Rehm J, Taylor B, Mohapatra S, et al. Alcohol as a risk factor for liver cirrhosis - a systematic review and meta-analysis. Drug Alcohol Rev. 2010;4:437–45.

    Article  Google Scholar 

  73. Samokhvalov AV, Popova S, Room R, et al. Disability associated with alcohol abuse and dependence. Alcohol Clin Exp Res. 2010;11:1871–8.

    Article  Google Scholar 

  74. Harris EC, Barraclough B,. Excess mortality of mental disorder. Br J Psychiatry 1998;11–53.

  75. Rehm J. Alcohol consumption and mortality. What do we know and where should we go? Addiction. 2000;7:989–95.

    Article  Google Scholar 

  76. Di Castelnuovo A, Costanzo S, Bagnardi V, et al. Alcohol dosing and total mortality in men and women: an updated meta-analysis of 34 prospective studies. Arch Intern Med. 2006;22:2437–45.

    Article  Google Scholar 

  77. Shield K, Rehm J. Difficulties with telephone-based surveys on alcohol in high-income countries: the Canadian example. Int J Meth Psychiatr Res. 2012;1:17–28.

    Article  Google Scholar 

  78. Lopez AD, Mathers CD, Ezzati M, et al. Global burden of disease and risk factors. New York & Washington: The World Bank and Oxford University Press; 2006.

    Book  Google Scholar 

  79. Rehm J, Patra J. Different guidelines for different countries? On the scientific basis of low-risk drinking guidelines and their implications. Drug Alcohol Rev. 2012;2:156–61.

    Article  Google Scholar 

Download references

Disclosure

No potential conflicts of interest relevant to this article were reported.

Author information

Authors and Affiliations

  1. Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON, M5S 2S1, Canada

    Michael Roerecke & Jürgen Rehm

  2. Dalla Lana School of Public Health (DLSPH), University of Toronto, Toronto, ON, M5T 3M7, Canada

    Michael Roerecke

  3. Dalla Lana School of Public Health (DLSPH), and Department of Psychiatry, University of Toronto, Toronto, ON, M5T 3M7, Canada

    Jürgen Rehm

  4. Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, 01187, Dresden, Germany

    Jürgen Rehm

Authors
  1. Michael Roerecke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jürgen Rehm
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael Roerecke.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Roerecke, M., Rehm, J. Alcohol Intake Revisited: Risks and Benefits. Curr Atheroscler Rep 14, 556–562 (2012). https://doi.org/10.1007/s11883-012-0277-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11883-012-0277-5

Keywords

Search

Navigation