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Jamie Pronschinske: Balancing risks, benefits of alcohol

Jamie Pronschinske: Balancing risks, benefits of alcohol

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Moderate intakes of alcohol appear to have relatively low health risk for many people. However, alcohol consumption remains a challenging lifestyle factor to study so most of what we know about it comes from observational research. No long-term randomized trials of alcohol consumption have been done. Additionally, multiple lifestyle factors are associated with patterns of alcohol use and can confound research results. It is quite possible that many of the health benefits and risk associated with alcohol consumption could be unrelated to the alcohol intake itself. Because of this, some experts disagree on what the “safe” or recommended amount of alcohol to consume is.

A standard drink is typically defined as twelve ounces of beer, five ounces of wine or one and a half ounces of hard liquor. “Moderate” drinking is defined by the Dietary Guidelines for Americans 2020-2025 as:

  • Females: less than or equal to one drink per day, or no more than three drinks on any single day, and no more than seven drinks per week
  • Males: less than or equal to two drinks per day, or no more than four drinks on any single day, and no more than 14 drinks per week

Recommendations for “safe” alcohol intake is generally lower in females due to lower body size, lower muscle mass and lower levels of alcohol dehydrogenase, the enzyme that breaks down alcohol. For people with certain medical conditions or on certain medications, alcohol should be avoided as no level can be reliably regarded as safe. It is also important to note that the information discussed in this article pertains to those of legal drinking age. Many studies show significant risks for youth (those under 21) who drink alcohol and therefore, no amount of alcohol is recommended for this age group. Below are a few of the potential health risks and benefits of alcohol consumption.

Potential risks:

  • Alcohol use has been associated with increased risk of several types of cancer including breast, gastrointestinal and head and neck.
  • Heavy alcohol use can increase risk of liver disease.
  • Heavy alcohol use increases risk of both acute and chronic pancreatitis.
  • Alcohol intake is associated with increased risk of gout flare in patients who have gout.
  • Intake of alcohol increases risk of morbidity and mortality from trauma. Driving ability can be impaired with blood alcohol concentration as low as 0.02 percent (legal driving limit is 0.08 percent).

Potential benefits:

  • Some studies have found that moderate drinkers had lower mortality rates compared to abstainers or heavy drinkers.
  • Research has found the risk of diabetes is lower in those who consume alcohol moderately.
  • Several studies have displayed lower risk of dementia or decreased cognitive decline over time with mild to moderate alcohol intake.
  • Moderate alcohol intake can reduce the risk of developing gallstones.
  • Evidence suggests that mild to moderate alcohol consumption decreases the risk of coronary heart disease and cardiovascular mortality.

Some research suggests that wine provides the strongest protection against cardiovascular disease, possibly due to naturally occurring compounds known as flavonoids. However, other studies indicate that all alcoholic beverages offer cardioprotective benefits. Whether beverage type matters for other diseases remains uncertain, although most evidence suggests that it does not.

Individuals who do not currently drink should not start drinking alcohol for the sole purpose of its potential health benefits. Those who do choose to drink should do so in moderation. Talk with your health care provider to understand your specific risks and benefits to alcohol use.

For those over 21 who would like to enjoy a refreshing alcoholic drink, try either of the recipes below. For those under 21 or prefer not to drink alcohol, follow the modifications to make it a non-alcoholic “mocktail.” Cheers!

Honeycrisp Maple Sipper

Cooking Light

Serves 4

  • 3 medium Honeycrisp apples, sliced
  • 1 cup water
  • ½ cup apple cider, pasteurized
  • 3 tablespoons lemon juice
  • 1½ tablespoons maple syrup
  • 5 ounces bourbon
  • Garnishes: ice, additional apple slices, thyme sprigs

Directions: Process Honeycrisp apple slices, water, apple cider, lemon juice, and maple syrup in a blender until smooth, about 90 seconds. Pour through a fine sieve. Discard solids. Stir in bourbon. Pour into individual glasses filled with ice. Garnish, if desired. To make it a non-alcoholic mocktail: Swap out the bourbon for 5 ounces light ginger beer.

Per serving (1 cup): 154 calories, 0 g fat, 0 g saturated fat, 0 g protein, 19 g carbohydrates, 1 g fiber, 2 mg sodium

Peach Wine Cooler

Eating Well

Serves 4

  • 3 cups seltzer water
  • 1 cup peach juice or nectar
  • 1 cup dry white wine
  • 2 tablespoons honey
  • 4 slices fresh peach

Directions: Combine all ingredients in a pitcher and stir until honey is dissolved. Pour into individual glasses and garnish with peach slices. To make it a non-alcoholic mocktail: Swap out the wine for 1 cup of sparkling white grape juice and omit the honey.

Per serving (1 ¼ cup): 114 calories, 0 g fat, 0 g saturated fat, 0 g protein, 19 g carbohydrates, 0 g fiber, 8 mg sodium


Jamie Pronschinske, RDN, CD, is a registered dietitian at Mayo Clinic Health System in La Crosse.


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