Heavy drinking can take a toll on the body. It can cause inflammation of the liver (alcoholic hepatitis) and lead to scarring of the liver (cirrhosis), a potentially fatal disease. It can increase blood pressure and damage heart muscle (cardiomyopathy). Heavy alcohol use has also been linked with several cancers: The World Cancer Research Fund and American Institute for Cancer Research indicate that there is convincing evidence linking alcohol to cancers of the mouth, pharynx, larynx, esophagus, breast, liver, colon, and rectum. [4] The International Agency for Research on Cancer concluded that both the ethanol in alcohol and acetaldehyde, a chemical formed from the breakdown of ethanol, are carcinogenic to humans in high amounts. [5] The risk is multiplied for drinkers who also smoke tobacco or have a poor diet.

Problem drinking also touches drinkers’ families, friends, and communities. According to the National Institute on Alcohol Abuse and Alcoholism and others:

• In 2014, about 61 million Americans were classified as binge alcohol users (5 or more drinks on the same occasion at least once a month) and 16 million as heavy alcohol users (5 or more drinks on the same occasion on 5 or more days in one month). [6]
• Alcohol plays a role in one in three cases of violent crime. [7]
• In 2015, more than 10,000 people died in automobile accidents in which alcohol was involved. [8]
• Alcohol abuse costs about $249 billion a year. [9]

Even moderate drinking carries some risks. Alcohol can disrupt sleep and one’s better judgment. Alcohol interacts in potentially dangerous ways with a variety of medications, including acetaminophen, antidepressants, anticonvulsants, painkillers, and sedatives. It is also addictive, especially for people with a family history of alcoholism.

Alcohol Increases Risk of Developing Breast Cancer

wellhealthorganic.com:alcohol-consumption-good-for-heart-health-new-study-says-no There is convincing evidence that alcohol consumption increases the risk of breast cancer, and the more alcohol consumed, the greater the risk. [10-14]

• A large prospective study following 88,084 women and 47,881 men for 30 years found that even 1 drink a day increased the risk of alcohol-related cancers (colorectum, female breast, oral cavity, pharynx, larynx, liver, esophagus) in women, but mainly breast cancer, among both smokers and nonsmokers. 1 to 2 drinks a day in men who did not smoke was not associated with an increased risk of alcohol-related cancers. [15]
• In a combined analysis of six large prospective studies involving more than 320,000 women, researchers found that having 2-5 drinks a day compared with no drinks increased the chances of developing breast cancer as high as 41%. It did not matter whether the form of alcohol was wine, beer, or hard liquor. [10] This doesn’t mean that 40% or so of women who have 2-5 drinks a day will get breast cancer. Instead, it is the difference between about 13 of every 100 women developing breast cancer during their lifetime—the current average risk in the U.S.—and 17 to 18 of every 100 women developing the disease. This modest increase would translate to significantly more women with breast cancer each year.

A lack of folate in the diet or folic acid, its supplement form, further increases the risk of breast cancer in women. [14] Folate is needed to produce new cells and to prevent changes in DNA. Folate deficiency, as can occur with heavy alcohol use, can cause changes in genes that may lead to cancer. Alcohol also increases estrogen levels, which fuel the growth of certain breast cancer cells. An adequate intake of folate, at least 400 micrograms a day, when taking at least 1 drink of alcohol daily appears to lessen this increased risk. [16, 17]

• Researchers found a strong association among three factors—genetics, folate intake, and alcohol—in a cohort from the Nurses’ Health Study II of 2866 young women with an average age of 36 who were diagnosed with invasive breast cancer. Those with a family history of breast cancer who drank 10 grams or more of alcoholic beverages daily (equivalent to 1 or more drinks) and ate less than 400 micrograms of folate daily almost doubled their risk (1.8 times) of developing the cancer. Women who drank this amount of alcohol but did not have a family history of breast cancer and ate at least 400 micrograms of folate daily did not have an increased breast cancer risk. [14

Alcohol and Weight Gain

wellhealthorganic.com:alcohol-consumption-good-for-heart-health-new-study-says-no One serving of alcohol on average contains 100-150 calories, so even a moderate amount of 3 drinks a day can contribute 300+ calories. Mixed drinks that add juice, tonic, or syrups will further drive up calories, increasing the risk of weight gain over time.

However, a prospective study following almost 15,000 men at four-year periods found only an increased risk of minor weight gain with higher intakes of alcohol. [19] Compared to those who did not change their alcohol intake, those who increased their intake by 2 or more drinks a day gained a little more than a half-pound. It was noted that calorie intake (not from alcohol) tended to increase along with alcohol intake.Possible Health Benefits of AlcoholWhat are some of the possible health benefits associated with moderate alcohol consumption?

Cardiovascular Disease

More than 100 prospective studies show an inverse association between light to moderate drinking and risk of heart attack, ischemic (clot-caused) stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes. [20] The effect is fairly consistent, corresponding to a 25-40% reduction in risk. However, increasing alcohol intake to more than 4 drinks a day can increase the risk of hypertension, abnormal heart rhythms, stroke, heart attack, and death. [5, 21-23]

The connection between moderate drinking and lower risk of cardiovascular disease has been observed in men and women. It applies to people who do not have heart disease, and also to those at high risk for having a heart attack or stroke or dying of cardiovascular disease, including those with type 2 diabetes, [32, 33] high blood pressure, [34, 35] and existing cardiovascular disease. [34, 35] The benefits also extend to older individuals. [36]

The idea that moderate drinking protects against cardiovascular disease makes sense biologically and scientifically. Moderate amounts of alcohol raise levels of high-density lipoprotein (HDL, or “good” cholesterol), [37] wellhealthorganic.com:alcohol-consumption-good-for-heart-health-new-study-says-no and higher HDL levels are associated with greater protection against heart disease. Moderate alcohol consumption has also been linked with beneficial changes ranging from better sensitivity to insulin to improvements in factors that influence blood clotting, such as tissue type plasminogen activator, fibrinogen, clotting factor VII, and von Willebrand factor. [37] Such changes would tend to prevent the formation of small blood clots that can block arteries in the heart, neck, and brain, the ultimate cause of many heart attacks and the most common kind of stroke.

Drinking Patterns Matter

What you drink (beer or wine) doesn’t seem to be nearly as important as how you drink. Having 7 drinks on a Saturday night and then not drinking the rest of the week isn’t at all the equivalent of having 1 drink a day. The weekly total may be the same, but the health implications aren’t. Among participants in the Health Professionals Follow-up Study, consumption of alcohol on at least three or four days a week was inversely associated with the risk for myocardial infarction. The amount consumed, under 10 grams a day or more than 30 grams, didn’t seem to matter as much as the regularity of consumption. [25] A similar pattern was seen in Danish men. [38]

A review of alcohol consumption in women from the Nurses’ Health Study I and II found that smaller amounts of alcohol (about 1 drink per day) spread out over four or more days per week had the lowest death rates from any cause, compared with women who drank the same amount of alcohol but in one or two days. [39]

The most definitive way to investigate the effect of alcohol on cardiovascular disease would be with a large trial in which some volunteers were randomly assigned to have 1 or more alcoholic drinks a day and others had drinks that looked,  wellhealthorganic.com:alcohol-consumption-good-for-heart-health-new-study-says-notasted, and smelled like alcohol but were actually alcohol free. Many of these trials have been conducted for weeks, and in a few cases months and even up to 2 years, to look at changes in the blood, but a long-term trial to test experimentally the effects of alcohol on cardiovascular disease has not been done.

A recent successful effort in the U.S. to launch an international study was funded by the National Institutes of Health.  Although the proposal was peer-reviewed and initial participants had been randomized to drink in moderation or to abstain, post hoc the NIH decided to stop the trial due to internal policy concerns.  Unfortunately, a future long trial of alcohol and clinical outcomes may never be attempted again, but nevertheless, the connection between moderate drinking and cardiovascular disease almost certainly represents a cause-and-effect relationship based on all of the available evidence to date.