Is any amount of alcohol good for you?

For decades, studies seemed to show that moderate drinkers lived longer than people who didn't drink at all. The chart even had a name, the "J-curve": a little alcohol looked protective, a lot looked harmful. Red wine got most of the credit.

Why the J-curve didn't hold up

The problem was who ended up in the "non-drinker" group. Many older studies lumped lifelong abstainers together with people who had stopped drinking because they were already ill, or who had a history of heavy drinking. Of course that group looked less healthy.

When researchers separated them out, the protective effect largely disappeared. A 2023 analysis of 107 studies covering almost five million people found that low-volume drinkers didn't live longer than lifelong non-drinkers once those biases were accounted for. Genetic studies, which get around some of the confounding, point the same way: people genetically inclined to drink less tend to have lower cardiovascular risk, not higher.

What alcohol does

• Cancer. Alcohol is classified as a Group 1 carcinogen, alongside tobacco. It raises the risk of at least seven cancers, including breast and bowel cancer, and for breast cancer the risk rises from low levels of drinking. In 2023 the World Health Organization stated that no level of alcohol consumption is safe for health.
• Sleep. Alcohol helps you fall asleep and then fragments the second half of the night, cutting deep and REM sleep. Even one or two drinks show up clearly on a sleep tracker.
• Blood pressure and triglycerides both rise with regular drinking, and often fall within weeks of cutting back.
• Weight. Alcohol adds calories and tends to bring less careful eating with it.

So what's the practical advice?

This isn't about being puritanical. Plenty of people enjoy a drink and will keep doing so. The point is to stop believing it's a health habit. If you drink:

• Less is better, and none is best for sleep and long-term health.
• Keep some alcohol-free days every week, and avoid drinking on consecutive days.
• Watch the evening drink. If you track sleep, compare a dry week with a normal one. It's often the most convincing experiment there is.

In the Longevity Journal, the Foundational target is fewer than five drinks a week and never daily. For many people, alcohol is the quickest lever on sleep, blood pressure and waist all at once.

In the journal: "No alcohol today" is one of the most common stop boxes, and weekday alcohol is on the stop list.

Sources: Zhao et al., JAMA Network Open 2023 · Anderson et al., WHO statement, Lancet Public Health 2023 · Millwood et al., The Lancet 2019 · IARC Monographs volume 96.