Is there a safe amount of alcohol?
If you want to limit your health risks, stopping completely is the most evidence-based choice. Major international health organisations recognise no safe lower threshold, and even moderate drinking is associated with a slightly elevated mortality risk compared with lifelong abstinence in large-scale research.
The WHO, the International Agency for Research on Cancer (IARC) and the American Cancer Society regard alcohol as a potent carcinogen. No safe amount has been established. This applies to everyone, and certainly to pregnant women.1,2,3,4
For a long time the idea persisted that one drink a day is good for your heart. Older studies suggested that moderate drinkers had a lower risk of cardiovascular disease than people who never drank. But that picture is probably wrong. Sick ex-drinkers were classified in the 'never-drinkers' group, making that group look less healthy than it actually was. Well-controlled research to prove a benefit is entirely absent. Furthermore, any supposed cardiac benefit is outweighed by a proven higher risk of cancer, stroke and cardiac arrhythmias at the same amounts.1,4
The large Norwegian HUNT study, with nearly 25,000 participants and a mean follow-up of 16.6 years, shows that increasing alcohol consumption over ten years is associated with a significantly higher risk of death. Even people who had always been abstinent and then began drinking within the officially recommended limits already had an approximately 20% higher mortality risk compared with people who remained abstinent for life. 'Responsible drinking' is therefore not without risk.5
The same study shows that good physical fitness appears to partially offset the disadvantages of alcohol. Fitness proved to be an even stronger predictor of mortality than alcohol use. But that does not mean that exercising makes alcohol safe. It simply means that good fitness is protective, regardless of whether you drink.
For red wine, the idea exists that certain plant compounds provide extra protection, especially as part of a Mediterranean diet. Studies do show benefits of that diet as a whole, but not that those benefits come from the alcohol or the wine itself. When it comes to cancer risk, red wine is no exception.4,1 For pregnant women the boundary is absolute: there is no safe amount and no safe moment. Alcohol reaches the unborn child via the placenta and is one of the most preventable causes of developmental delay and congenital abnormalities.6,7
The claims are based on large cohort studies in humans, including the Norwegian HUNT study with approximately 25,000 participants, official positions of the WHO, IARC and the American Cancer Society, and a classic review from 1984. Well-controlled research into the direct effect of alcohol on mortality and cancer is almost entirely absent. The cohort studies have well-known limitations: it is difficult to exclude other factors, and in older studies sick ex-drinkers were incorrectly classified among the never-drinkers.