It is always surprising how rarely we question the things we want to be true, especially when those things involve alcohol. By “we”, I mean “I”: my firm belief in the longevity-boosting benefits of alcohol has seen me merrily through several decades of regular moderate consumption. Never mind that this view was informed by vague notions about antioxidants (or was it polyphenols?); and vivid memories of the beautiful people to whom I used to serve civilised pichets of wine at lunch when I worked in Paris as a student. Never mind, either, that I have only a weak grasp of what an antioxidant or a polyphenol is, or that French people no longer drink much wine at lunch.
It’s bad enough for my view of the health impacts of alcohol to be influenced by wishful thinking, but you’d expect a little more from the researchers who have shaped a century’s worth of literature on the subject. One of those to popularise the idea that moderate drinking may be good for you – or at least harmless – was an influential biologist called Raymond Pearl, a man with an exuberant nature, an aversion to dullness and a commitment to the good things in life. This may not be unconnected to the main finding in his 1926 book, Alcohol and Longevity, that – to quote one contemporary researcher – “we have in alcohol an environmental factor which the body can handle at least in moderate quantities and contribution to nutrition that needs no digestion that can to some extent replace other food”.
The claim that alcohol is so harmless you could use it as a form of calories to replace other foods strikes me as belonging to the “prawn-flavoured Pringles are a good source of Omega-3″ school of nutrition. But it’s hard to argue with statistics, especially when you’re dutifully mainlining merlot.
In the 1990s, a further flurry of studies highlighted the alleged cardiovascular benefits of red wine consumption. This, by happy accident, was also the period when wine drinking suddenly became very aspirational, especially for women. By the time I came of drinking age, wine was being sold to us as a sensible accompaniment to holidays, brunch, book club nights, bathing your small child. We gulped it down – at least until our perimenopausal years when we suddenly noticed that even small doses didn’t agree with us at all; that a night spent happily sipping very cold albariño tends to be followed by sickness and regret on a scale not normally seen outside the emergency department of a small hospital. (Again, for “we”, read “I”.)
Now it turns out that Pearl and subsequent researchers may have been guilty of overlooking some salient information. They failed to take account of the fact that moderate drinkers were in better nick than total abstainers – they earn more, exercise more and even have better teeth. According to the Canadian researcher Tim Stockwell, co-author of a 2023 large-scale analysis on the effects of alcohol, previous studies did not account for those who had health reasons to quit – so-called “sick quitters” – or abstainers who were once heavy drinkers. The studies also suffered from an affliction common to clinical trials generally: an overrepresentation of older white men.
There is another plot twist, though. There is now widespread consensus that even moderate drinking does shorten your life – but perhaps not, on its own, by very much
Stockwell’s analysis of more than 107 studies of 4.8 million people found that there was “a significantly increased risk of all-cause mortality among female drinkers who drank 25g or more per day” and among male drinkers who drank 45g or more per day (25g is about two 125ml glasses of 14 per cent wine). An earlier study published in the Lancet in 2018 concluded that the only safe level of alcohol intake is zero. One study published in Nature magazine reported “negative associations between alcohol intake and brain macrostructure and microstructure ... in individuals consuming an average of only one to two daily alcohol units”.
In an age when self-improvement is a pursuit so competitive it should be an Olympic sport, these studies unleashed a whole new temperance movement. The World Health Organisation now warns there is no proven threshold at which alcohol is risk-free. The influential wellness podcaster Andrew Huberman says that even one drink per week can lead to changes in your neural circuits. On Instagram, #sobercurious has overtaken #cleaneating as the most annoyingly smug wellness fad.
There is another plot twist, though. There is now widespread consensus that even moderate drinking does shorten your life – but perhaps not, on its own, by very much. The words missing from lots of the studies on the increased risk associated with moderate consumption are “small” and “incremental”. The Cambridge statistician David Spiegelhalter broke the risk down in an online analysis of the 2018 Lancet study. If 1,600 people drank 20g alcohol a day for a year – around 32 bottles of gin over the year – one additional person would develop a health problem, compared to 1,600 abstainers. (That’s 16 with health problems in the drinking group, compared to 15 among the non-drinkers.)
Stockwell gave the New York Times another way to think about his findings: two drinks a week amounts to less than one week of lost life on average; for seven drinks, it’s about two and a half lost months.
At a population level, of course, even the relatively modest increase involved in moderate drinking is still a lot of lost weeks of life. At an individual level – depending on your other risk factors, your ability to stick to two drinks, and other considerations such as the addictive nature of alcohol – you might decide that you can live with the risk that comes with a glass or two a couple of times a week. Whether you can face the “albariñover” is, of course, another matter.