This Facts About reviews the benefits and risks of alcohol consumption. It also provides a guide for selecting appropriate amounts.

What are the recommended servings per day?

• Optional: 1-2 servings per day depending on age, gender, and history

Optional - Although there are some documented health benefits to moderate alcohol consumption, we do not encourage people to start drinking. As with other categories listed in this pyramid, there are potential health risks that must be weighed (see health concerns section).

What is moderate drinking?

• One drink or less a day for women and people over 60
• Two drinks or less a day for men (no more than one an hour)

This limit is based on the differences between men and women both in weight and the way they metabolize alcohol.

Is the risk-benefit balance for an individual drinker favorable or unfavorable?

Risk-benefit balance depends on the individual's age, gender, and history. We do not recommend alcohol consumption for:

• Women who are pregnant or planning to become pregnant
• People who plan to drive or engage in other activities that require attention or skill
• People taking medications that interact with alcohol, including some over-the-counter medications
• Individuals with a history of alcoholism or alcohol abuse
• Those under the age of 21

Selected Alcohol Beverage Sources with Serving Sizes

What are the potential health benefits of moderate alcohol consumption?

• May lower risk of coronary artery disease and heart attack
• May decrease risk of stroke caused by blocked blood vessels
• Decreases tension, anxiety, and self-consciousness
• In the elderly, stimulates appetite and may promote regular bowel movement
• May be associated with a decreased risk of gall bladder surgery in women

Red Wine

• Moderate consumption may be associated with longevity
• Contains tannins, which may raise HDL (good) cholesterol levels and inhibit platelet cells in the blood from clumping together
• Contains resveratrol, an antioxidant compound found in grapes, which may decrease the development of some cancers
• Resveratrol affects the immune system and inflammation in the body; both immune and inflammatory components are thought to be important in the development of plaque buildup in blood vessels, which often leads to heart disease
• Significant source of saponins, antioxidants believed to promote heart health by binding to cholesterol in the blood and preventing its absorption
• Saponins may play a role in decreasing inflammation, which could have beneficial effects in reducing heart disease and cancer risks

Liquor and Beer

• Raises HDL (good) cholesterol levels
• Inhibits platelet cells in the blood from clumping together

What are the health concerns of alcohol consumption?

• Increases risk of accidents
• Often a trigger for migraine headaches
• Increases strokes caused by bleeding
• Higher risk of fetal alcohol effect (FAE), low birth weight, and stillbirth
• Increases physical, mental, and behavioral problems among the children of mothers who drink during pregnancy
• Medication interactions - including non-prescription drugs
• Increases the risk for cancers of the oral cavity, pharynx, esophagus, and larynx
• Increases the risk for cancers of the stomach, colon, rectum, liver, and ovaries
• Increases accumulation of fat in the liver, alcoholic hepatitis, and cirrhosis. This contributes to liver disease and sometimes liver failure.
• Increases estrogen levels, a risk for breast cancer
• Tobacco use enhances alcohol's effects on the risk for cancers of the upper digestive and respiratory tract
• Liquor consumption (not beer or wine) may be associated with higher homocysteine levels in the blood which is associated with an increased risk of heart disease

Specific Considerations

• Abstinent individuals should not begin to drink solely for health benefits
• Some benefits can be achieved from whole foods instead of alcohol. Resveratrol contained in grape skins is available in whole grapes, grape juice or wine.
• Ask your physician about potential benefit and harm of alcohol consumption in your individual case, considering your age, gender, medical history, and medications

This Facts About document is published by Monica Myklebust, MD, and Jenna Wunder, MPH, RD, at University of Michigan Integrative Medicine Clinical Services. Our mission is to care for people using an Integrative Medicine model that reaffirms the importance of relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches to achieve optimal health and healing.

Resources
Adult Beverage Consumption:  Making Responsible Drinking Choices
American Dietetic Association
www.eatright.org
Accessed May 17, 2006

Alcohol Alert – Moderate Drinking
National Institute on Alcohol Abuse and Alcoholism
www.niaaa.nih.gov
Accessed May 17, 2006

Alcohol and your health:  Weighing the pros and cons
Mayo Clinic
www.mayoclinic.com
Accessed May 17, 2006

But I heard drinking was good for my health!
Bowles Center for Alcohol Studies
University of North Carolina at Chapel Hill
www.med.unc.edu/alcohol/education/benefits.html
Accessed May 17, 2006

Lesson 2 – A Drink is a Drink, but People are Different
National Institutes of Health
www.nih.gov
Accessed May 25, 2006

New Healthy Ingredient Found in Red Wine
Warner, J
My Web MD
http://my.webmd.com
Accessed May 17, 2006

Why Wine May Be Good For You
Tracey, E
My Web MD
http://my.webmd.com
Accessed May 17, 2006

Original Research and Review Articles

Bagnardi V, et al.  Alcohol consumption and the risk of cancer.  Alcohol Research and Health.  2001;25(4):263-270.

Cheeke PR, et al.  Anti-inflammatory and anti-arthritic effects of yucca schidigera:  a review.  Journal of Inflammation.  2006;3:6-12.

Cordova AC, et al.  The cardiovascular protective effect of red wine.  Journal of the AmericanCollege of Surgeons.  2005;200(3)428-438.

De la Lastra CA, et al.  Resveratrol as an anti-inflammatory and anti-agent:  mechanisms and clinical implications.  Molecular Nutrition & Food Research.  2005;49:405-430.

Di Castelnuovo A, et al.  Meta-analysis of wine and beer consumption in relation to vascular risk.  Circulation.  2002;105:1-9.

Horn-Ross PL, et al.  Patterns of alcohol consumption and breast cancer risk in the California teachers study cohort.  Cancer Epidemiology Biomarkers & Prevention.  2004;13:405-411.

Jacques PF, et al.  Determinants of plasma total homocysteine concentration in the Framingham Offspring cohort.  American Journal of Clinical Nutrition.  2001;73:613-621.

Leitzmann MF, et al.  Alcohol consumption in relation to risk of cholecystectomy in women.  American Journal of Clinical Nutrition.  2003;78:339-347.

Ulrich S, et al.  Molecular mechanisms of the chemopreventative effects of resveratrol and its analogs in carcinogenesis.  Molecular Nutrition & Food Research.  2005;49:452-461.