The routine consumption of alcohol (ethanol) is the number one substance use disorder/ drug addiction in the world. Yet, early research suggested that moderate alcohol consumption may promote some health benefits, like the recommendation of a glass of red wine to protect the heart. This fed a false sense of security and common mindset that health pioneer, Dr. John McDougall, described as people looking for a good excuse for bad habits. 

However, more recent and larger, extensive studies have shown that the body processes all alcohol the same way, there are no protective effects of alcohol in any form, and there are a constellation of health risks associated with moderate use that begin with the intake of even a single alcohol-containing drink. (1)(2)(3) A single drink is defined as one 12 ounce bottle of beer, 5 ounces of table wine, or 1.5 ounces of spirits (hard liquor), each of which contains 14 grams of pure alcohol. A recent government study suggested that consuming more than 1 drink per day increased the risks of overall mortality (risk of death), and morbidity, and progressively increased the risk of breast cancer, cardiovascular injury and disease. (4)

Alcohol intake provokes the brain to release the neurotransmitters serotonin, natural opiates (endorphins and enkephalin), gaba, and dopamine that promote a short-term increase in pleasure, and a decrease in feelings of pain, stress and anxiety. This makes alcohol the go to drug for so many people trying to reduce their daily tension, stress, and anxiety. However, as with all mood altering substances, repeat use will result in a decrease in the production, availability and action of the body’s own neurotransmitters, creating long-term reward deficiency and driving a cycle of alcohol craving, increased use, tolerance, and eventually dependency/addiction. 

Alcohol disrupts the deep delta wave phase of restorative sleep and can promote an increase in next day anxiety. Using alcohol to relieve stress can promote an opposite effect over time by intensifying  negative emotions between drinking episodes. As a result, you may tend to consume alcohol in larger amounts more frequently, increasing the risk of dependency and negative health outcomes. Routine alcohol consumption can disrupt brain communication and damage the microstructure of the brain. (5) Consuming 1-2 drinks daily provokes brain atrophy via a loss of both nerve cells and myelinated white fibers (gray and white matter) that promote electrical impulses and communication in the brain, and these negative effects become intensified as alcohol consumption increases. When alcohol is metabolized, it is first converted into acetaldehyde in the liver. There are data to suggest that the increase in this by-product may be toxic to the brain, and may be a major key to the negative brain changes associated with routine alcohol consumption. (6)

Alcohol can have significant deleterious effects on the digestive system and liver. (7) Excessive alcohol use alters and damages the healthy microbes of the gut microbiome promoting a condition of dysbiosis. This increases inflammation in the gut and decreases the production of short chain fatty acids that support the tight connection of cells of the gut lining, and the production of the gut’s protective mucous layer . As a result, the integrity of the gut lining can breakdown and allow large molecules to pass through the leaky gut into the bloodstream , and provoke allergic and autoimmune responses by your immune system. Since alcohol is metabolized in the liver, increased alcohol consumption can provoke damage to liver cells resulting in fatty liver disease, hepatitis and cirrhosis.  Since about 20% of alcohol is absorbed in the stomach, alcohol intake can also significantly increase acid reflux and damage to the stomach lining. 

The heart and cardiovascular system are also remarkably affected by even moderate alcohol intake. (8) The risk of cardiac mortality increases steadily after an average consumption of 10 mg of ethanol per day, which is less than one 12 ounce beer. The toxic effects of alcohol and its metabolites on cardiac cells promote a dangerous form of cardiac pathology called dilated alcoholic cardiomyopathy. Blood pressure is elevated in a dose dependent manner by the regular consumption of alcohol, and just 1 month of abstinence results in significant reductions of blood pressure.  Alcohol consumption of 14 grams per day (one 12 ounce beer) is associated with the development of cardiac arrhythmias, primarily atrial fibrillation, and the relative risk increases 10% for every extra standard drink (14 grams of alcohol). 

A recent advisory report by the Surgeon General of the U.S. has described an important relationship between alcohol consumption and cancer. (9) Alcohol has been described as a major cancer causing agent (carcinogen) in the same category of dangerous carcinogens  as asbestos, benzene, arsenic, radiation, tobacco, vinyl chloride, and plutonium. It is the third leading preventable cause of cancer in the U.S., and alcohol related deaths cut lives short by an average of 15 years. Even very modest amounts of daily alcohol intake increase the risk of at least 7 types of cancer including cancers of the breast, colon, rectum, esophagus, liver, mouth, and voice box. 

For Healthy adults that choose to drink, the U.S. Dietary guidelines recommend less than or equal to 1 drink per day for women , and less than or equal to 2 drinks per day for men. (2) These recommendations are different because women typically have less body water content than men to dilute alcohol, and less of the enzyme alcohol dehydrogenase that breaks alcohol down, so that lower alcohol intake results in higher blood levels of alcohol in women. 

There are no benefits from alcohol consumption, and major health risks in a wide variety of body cells and systems that begin with just a single drink a day. So there no place for drinking and including alcohol in any form in a health promoting lifestyle. 

References

1. Burdeos J and Romaine J. Is any alcohol good for you? New health risks. US News and World Report. June 11, 2026.

2. U.S. Department of Agriculture and U.S. Department of Health and Human Services: 2020-2025. Dietary Guidelines for Americans.

3. Zhao J, et al. Association between daily intake and risk of all-cause mortality: a systematic review and meta-analyses. JAMA Netw Open. 2023;6(23):e236185.

4. George S, et al. Alcohol intake and health study: no protective effect at low levels qith mortality increasing to 1 in 25 at 14 drinks per week. Journal of Studies on Alcohol and Drugs. 87(4):621-638.

5. Darret R, et al. Associations between alcohol consumption and grey and white matter volumes in the UK Biobank. Nat Commun. 2022 March 4;13:1175.

6. Sullivan EV, et a;. Alcohol’s effect in brain and behavior. Alcohol Res Health. 2016;33(1-2): 127443.

7. Pohl K, et al. Alcohol’s impact on the gut and liver. Nutrients Sept 4;13(9):3170.

8. Day E, and Rudd JHE. Alcohol use disorders and the heart. Addiction 2019 Sept;114(9):1670-1678.

9. Alcohol and Cancer Risk. The Surgeon General’s Advisory Report. 2025