Any observed benefit likely results from other lifestyle factors common among light to moderate drinkers, say researchers.
- In an observational analysis of UK Biobank participants, light to moderate drinkers had the lowest heart disease risk, followed by people who abstained from drinking. But, light to moderate drinkers tended to have healthier lifestyles than abstainers, which likely accounted for better heart health.
- Genetic evidence in this same population suggested that all levels of alcohol intake are associated with increased cardiovascular risk.
- Notably, the risk of cardiovascular disease linked to light alcohol consumption was modest but rose exponentially with higher intake, even at intake levels currently endorsed as “low risk.”
Observational research has suggested that light alcohol consumption may provide heart-related health benefits, but in a large study published in JAMA Network Open, alcohol intake at all levels was linked with higher risks of cardiovascular disease. The findings, which are published by a team led by researchers at Massachusetts General Hospital (MGH) and the Broad Institute of MIT and Harvard, suggest that the supposed benefits of alcohol consumption may actually be attributed to other lifestyle factors that are common among light to moderate drinkers.
The study included 371,463 adults—with an average age of 57 years and an average alcohol consumption of 9.2 drinks per week—who were participants in the UK Biobank, a large-scale biomedical database and research resource containing in-depth genetic and health information. Consistent with earlier studies, investigators found that light to moderate drinkers had the lowest heart disease risk, followed by people who abstained from drinking. People who drank heavily had the highest risk. However, the team also found that light to moderate drinkers tended to have healthier lifestyles than abstainers—such as more physical activity and vegetable intake, and less smoking. Taking just a few lifestyle factors into account significantly lowered any benefit associated with alcohol consumption.
“Reducing alcohol intake will likely reduce cardiovascular risk in all individuals.”
Krishna G. Aragam, MD, MS
Cardiology, Massachusetts General Hospital
Mendelian Randomization and Genetic Analysis
The study also applied the latest techniques in a method called Mendelian randomization, which uses genetic variants to determine whether an observed link between an exposure and an outcome is consistent with a causal effect—in this case, whether light alcohol consumption causes a person to be protected against cardiovascular disease. “Newer and more advanced techniques in ‘non-linear Mendelian randomization’ now permit the use of human genetic data to evaluate the direction and magnitude of disease risk associated with different levels of an exposure,” says senior author Krishna G. Aragam, MD, MS, a cardiologist at MGH and an associate scientist at the Broad Institute. “We therefore leveraged these new techniques and expansive genetic and phenotypic data from biobank populations to better understand the association between habitual alcohol intake and cardiovascular disease.”
When the scientists conducted such genetic analyses of samples taken from participants, they found that individuals with genetic variants that predicted higher alcohol consumption were indeed more likely to consume greater amounts of alcohol, and more likely to have hypertension and coronary artery disease. The analyses also revealed substantial differences in cardiovascular risk across the spectrum of alcohol consumption among both men and women, with minimal increases in risk when going from zero to seven drinks per week, much higher risk increases when progressing from seven to 14 drinks per week, and especially high risk when consuming 21 or more drinks per week. Notably, the findings suggest a rise in cardiovascular risk even at levels deemed “low risk” by national guidelines from the U.S. Department of Agriculture (i.e. below two drinks per day for men and one drink per day for women).
Exponential Risk with Increased Alcohol Consumption
The discovery that the relationship between alcohol intake and cardiovascular risk is not a linear one but rather an exponential one was supported by an additional analysis of data on 30,716 participants in the Mass General Brigham Biobank. Therefore, while cutting back on consumption can benefit even people who drink one alcoholic beverage per day, the health gains of cutting back may be more substantial – and, perhaps, more clinically meaningful – in those who consume more.
“The findings affirm that alcohol intake should not be recommended to improve cardiovascular health; rather, that reducing alcohol intake will likely reduce cardiovascular risk in all individuals, albeit to different extents based on one’s current level of consumption,” says Aragam.
Reference: “Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease” by Kiran J. Biddinger; Connor A. Emdin, MD, DPhil; Mary E. Haas, PhD; Minxian Wang, PhD; George Hindy, MD; Patrick T. Ellinor, MD, PhD; Sekar Kathiresan, MD; Amit V. Khera, MD, MSc; Krishna G. Aragam, MD, MS, 25 March 2022, JAMA Network Open.
DOI: 10.1001/jamanetworkopen.2022.3849
The study’s lead author was Kiran J. Biddinger, and additional authors included Connor A. Emdin, MD, DPhil, Mary E. Haas, PhD, Minxian Wang, PhD, George Hindy, MD, Patrick T. Ellinor, MD, PhD, Sekar Kathiresan, MD, and Amit V. Khera, MD, MSc.
Funding was provided by the National Institutes of Health and the American Heart Association.
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5 Comments
Coffee was good for you and then it was bad for you and then it was good for you again and then bad for you again. It’s hard to take these studies seriously when they constantly contradict one another.
The problem is two-fold. You tend to find evidence to support the hypothesis you’re trying to prove (bias) and controlling multiple variables in large scale studies is almost impossible. The real question is who comes up with these studies in the first place and why? Clearly, they wanted to challenge the notion that drinking is “good” for you at all and therein lies the implied bias. They did the study in the first place to prove it’s bad for you and amazingly, they found their evidence! ALL drinking is BAD BAD BAD!
It was once thought soda caused brittle bones, but further studies showed their tests didn’t account for a lot of soda drinkers who had no other source of calcium. A study where calcium was supplied showed ZERO difference between soda and water drinkers. Yet my grandmother used to go on and and on about soda causing brittle bones.
Now we see the same thing with artificial sweeteners and very very weak links to a slight increase in cancer. The mere fact the increase is small tells me precisely the opposite of their headlines on the topic. It’s nowhere near as dangerous as all these anti-artificial sweetener people on the Internet make it out to be. Sugar is far more likely to cause both obesity and early onset of Type 2 diabetes. Unless you drink water only, what’s the riskier alternative? But the “narrative” of the reported articles never discuss things like that. They just demonize artificial sweeteners with the scant most of evidence. It’s ridiculous. But if their goal was to rid the world of the demon known as alcohol, they’ve got their ammunition, real or imaginary, it probably doesn’t matter to them as long as they can say it’s BAD.
The take away here is simple. Excessive drinking is probably bad. Mild drinking may or may not have any slight benefit or risk, but it’s not worth worrying to death over it. Life entails risk. If you worry about everything with any risk at all, you will probably have no real life.
You can you can’t. It gets old.
I see that some have difficulties accepting these facts. Yet it’s known to all of us that alcohol have poisonous characteristics. Humanity may elevate higher by withdrawing all kind of harmful drugs.
It is kind of pathetic to find ourselves so wrapped up with alcohol, cannot part our mind with it, similar to ‘dog to a bone’ .. We do not have the same fixation to, the potato or corn, for example ..
I guess I was born lucky [or unlucky, as alcohol connoisseurs might suggest], that I never could figure out what the attraction is .. It is bitter, sour, and always nasty to swallow .. evidence of all the injured facial expression people exhibit when they swallow down hard liquor .. even if they are devout and well practiced alcoholics and really love it ..
This study doesn’t address the type of alcohol consumed. It is well known that red wine, for example, offers health benefits when consumed in moderation (The French Paradox) whereas low quality drinks, such as alcopops or spirits in mixer drinks containing sugar and/or artificial sweeteners, are obviously going to be bad for heart health.