A new Canadian study of 4.8 million people says a daily alcoholic drink isn't likely to send anyone to an early grave, nor will it offer any of the health benefits touted by previous studies, even if it is organic red wine.
Low and moderate drinkers have similar mortality rates to those who abstain entirely, researchers from the Canadian Institute for Substance Use Research explain. On the other hand, women who enjoy more than one standard drink per day are at least 20 per cent likely to die prematurely than female non-drinkers.
"In this updated systematic review and meta-analysis, daily low or moderate alcohol intake was not significantly associated with all-cause mortality risk," the study's authors write, "while increased risk was evident at higher consumption levels, starting at lower levels for women than men."
Published Friday in the medical journal JAMA Open Network, the study comes on the heels of a report by the Canadian Centre on Substance Use and Addiction (CCSA) that said Canadians should have no more than two alcoholic drinks per week in order to minimize the health risks associated with alcohol.
Lead researcher Dr. Jinhui Zhao and his co-authors wanted to better understand the link between alcohol and all-cause death, including theories advanced by previous studies that a small amount of alcohol can provide health benefits, and that "moderate drinkers" live longer and are less likely to die from heart disease than non-drinkers.
They reviewed 107 studies from between 1980 and 2021 involving 4.8 million people and found that consuming more than one standard drink per day raised the risk of premature death significantly, especially for women.
In Canada, a standard drink is defined as a 341-ml bottle of five per cent alcohol beer or cider, a 142-ml glass of 12 per cent alcohol wine or a 43-ml shot glass of 40 per cent alcohol spirits. Each standard drink contains 13.45 grams of pure alcohol.
"There was a significantly increased risk of all-cause mortality among female drinkers who drank 25 or more grams per day and among male drinkers who drank 45 or more grams per day,” the authors wrote. "Low-volume alcohol drinking was not associated with protection against death from all causes."
When they looked at previous studies that suggest people who drink a little are less likely to die early or from heart disease than people who don't drink at all, they found the evidence was skewed by systematic bias.
"For example, light and moderate drinkers are systematically healthier than current abstainers on a range of health indicators unlikely to be associated with alcohol use, (like) dental hygiene, exercise routines, diet, weight (and) income," they wrote.
Meanwhile, abstainers may be statistically more likely to experience poorer health, since many have had to stop – or never started drinking in the first place – for health reasons. They also found most of the studies they reviewed overrepresented older white men in their data, failing to account for the experiences of women, racialized people and people from diverse socioeconomic backgrounds.
When Zhao and his colleagues adjusted the data to account for these variables, they couldn't find any evidence that drinking a low or moderate amount of alcohol had any kind of positive effect on life expectancy or heart health.
"Our meta-analysis… found no significant protective associations of occasional or moderate drinking with all-cause mortality, and an increased risk of all-cause mortality for drinkers who drank 25 g or more," the authors conclude.
"Future longitudinal studies in this field should attempt to minimize lifetime selection biases by not including former and occasional drinkers in the reference group, and by using younger cohorts more representative of drinkers in the general population at baseline."
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