Moderate drinking isn’t likely to extend your life, according to a new meta-analysis that adds to the mounting scientific consensus that alcohol consumption offers few health benefits and comes with serious risks.
That conclusion may be surprising to anyone who’s heard that moderate drinking—usually defined as no more than two alcoholic beverages per day for men, or one for women—is good for the heart, potentially helping prevent heart disease, strokes, and heart attacks. Numerous studies have also linked the Mediterranean diet, red wine and all, with long, healthy lives.
“The idea that alcohol is good for your health is so ingrained in many cultures,” says Tim Stockwell, who co-authored the new meta-analysis and is a professor of psychology at Canada’s University of Victoria and former director of the Canadian Institute for Substance Use Research. While there’s still some back and forth in the research world, Stockwell says that concept is built on decades of flawed science.
Many studies on alcohol and health compared light or moderate drinkers to people who abstain from alcohol, without adequately accounting for the fact that many people quit drinking because they have health problems or previously drank heavily. Many studies also focused on older adults, in whom this trend may be particularly apparent. “People who are still healthy in their 70s and 80s can continue to drink,” Stockwell says. “Those who become frail, are on medication, or socialize less [tend to] stop or cut down on their drinking.” Moderate drinkers may indeed be healthier than abstainers, but alcohol isn’t necessarily the reason.
Stockwell and his colleagues, who published their meta-analysis in JAMA Network Open on Mar. 31, set out to correct some of those issues. They reviewed more than 100 previously published studies on alcohol consumption and mortality, involving nearly 5 million research participants in all, and accounted for how “sick quitters,” older study groups, and other factors may have skewed earlier results.
When compared to lifetime non-drinkers, people who had roughly two drinks per day or less did not have a significantly lower risk of premature death, the researchers found. People who drank heavily—defined as about three drinks per day or more—had higher mortality risks than non- or occasional drinkers.
“At higher levels, per drink, women seem to be at greater risk of mortality than men,” Stockwell adds. That may be because women, on average, are smaller than men and become impaired by less alcohol, he says.
Nonetheless, excessive alcohol use is linked to health issues that affect people of any gender, including a range of cancers, liver disease, dementia, and—despite the narrative that alcohol is heart-healthy—cardiovascular disease.
Earlier this year, both the Canadian Centre on Substance Use and Addiction and the World Health Organization (WHO) published guidance saying the safest amount of drinking is none. “When it comes to alcohol consumption,” the WHO’s statement reads, “there is no safe amount that does not affect health.” (Stockwell was on the advisory panel behind Canada’s guidelines.)
U.S. regulators have not been as explicit in their guidance. The U.S. government’s Dietary Guidelines for Americans say that “drinking less is better for health than drinking more” and recommend men have no more than two drinks per day, and women no more than one.
Science aside, Stockwell says deciding whether and how much to drink is a personal choice. Based on his research, Stockwell estimates that someone who drinks one alcoholic beverage per day shaves about five minutes off their lifespan with each drink, and the losses compound at higher levels of consumption. Whether that’s an acceptable tradeoff, Stockwell says, is up to the drinker.
Write to Jamie Ducharme at jamie.ducharme@time.com.
