A major report released this week found that compared with abstaining from alcohol, moderate drinking was linked to a lower risk of death from any cause and a lower risk of death from heart disease, but it was also linked to an increased risk of breast cancer.
Far from settling the debate over whether drinking in moderation is healthy or dangerous, the report’s conclusions further muddied the issue.
The report, released Tuesday, was commissioned by Congress and carried out by a committee from the National Academies of Science, Engineering and Medicine. An update to federal dietary guidelines next year could include new recommendations about how much alcohol people should drink.
The current guidelines recommend people limit alcoholic beverages and say that if they choose to drink, they should do so in moderation, defined as two drinks a day for men and one drink for women.
But over the last few years, mounting evidence has questioned the health benefits of drinking. In 2022, the World Health Organization concluded that no amount of alcohol is safe. A large report this year found that heavy drinking is linked to six cancers, including cancers of the head and neck, the esophagus, the liver and the stomach.
For the report, the committee reviewed research dating to 2010 to look at the relationship between moderate drinking and a number of outcomes, including death from any cause, death from heart disease, breast cancer, colorectal cancer, head and neck cancer, weight changes and Alzheimer’s disease.
“We looked at that body of literature and were able to make three conclusions with what we call moderate certainty, and what that means is that we feel comfortable in making these conclusions based on the evidence we had available,” said Dr. Ned Calonge, chair of the NASEM committee.
Calonge and his team stopped short of linking moderate drinking to colorectal cancer, saying there is insufficient evidence to make a firm conclusion, though that could change in the future with more research.
Dr. Michael Siegel, a Tufts University public health and community medicine professor, said the cancer connection should be the main takeaway from the new report.
“Essentially, what this means is that alcohol is clearly a carcinogen,” Siegel said. “There isn’t a level of moderate or light drinking that can be recommended to people, because at that level it will increase their cancer risk.”
Dr. Michael Pignone, a professor of medicine at Duke University, said that he hasn’t seen enough evidence to tell people to stop drinking but that they shouldn’t start.
“I am skeptical that low levels of alcohol consumption really reduce mortality or cardiovascular mortality,” Pignone said. “I would not recommend someone start drinking for health benefits.”
A second report conducted by a group within the Department of Health and Human Services to be published in the coming weeks will also help inform the 2025 guidelines.
“I think this report sort of highlights all the things that we don’t know,” said Dr. Nicholas Lim, a hepatologist and associate professor of medicine at the University of Minnesota Medical School, adding he hopes it will prompt better research to clarify understanding of alcohol and health.
