More than 17.5million Britons – around a third of the adult population – are said to be taking part in Dry January this year, attempting to get through the month without a single sip of alcohol.
It’s an admirable endeavour – and a striking cultural shift from just two decades ago, when Britain was widely thought to have hit ‘peak booze’.
In 2004, official figures showed young adults were among the heaviest drinkers on record, consuming the equivalent of about 100 bottles of wine a year on average. Drinking was baked into social life. Abstinence was rare.
Today, the picture has flipped. Around a third of young adults now don’t drink at all, according to Office for National Statistics data.
For many, the motivation is health. More than 45 per cent of those doing Dry January this year say improving their physical or mental wellbeing is their main motivation, according to Alcohol Change UK.
But some experts warn the benefits of short-term abstinence may be overstated and that, for some people, going teetotal could backfire.
And according to one of the most pre-eminent health bodies in the US, having a couple of drinks a day may be better for your health than stopping drinking altogether.
A new review from the American Heart Association (AHA) has reopened the debate about whether drinking might offer some protection for the heart.
A study found that those who drink small amounts of alcohol do not appear to have a higher risk of coronary heart disease, stroke or sudden cardiac death than those who abstain (picture posed by models)
The review found that people who drink small amounts of alcohol do not appear to have a higher risk of coronary heart disease, stroke or sudden cardiac death than those who abstain completely.
And light drinkers were actually found to have a lower risk.
The idea that modest alcohol consumption could protect the heart was widely accepted throughout the 20th century. That thinking has fallen out of favour, overshadowed by evidence linking alcohol to cancer and other harms.
But some experts now say the cardiovascular benefits may have been dismissed too quickly. A growing body of evidence suggests light drinkers – those who consume one to two drinks a day – have healthier hearts than abstainers.
Speaking to The Mail on Sunday, Dr Gregory Marcus, professor of medicine at the University of California, San Francisco, who led the AHA review, said studies consistently show that light drinkers live longer than both heavy drinkers and abstainers. ‘Most studies that look at mortality demonstrate this effect. It’s remarkable,’ he said.
But the review and its authors have faced criticism from fellow medical professionals, who say the data is flawed and that any sort of endorsement of alcohol will encourage and endanger drinkers.
Dr Luis Seija, an internal medicine specialist who studies alcohol control and liver disease, claimed the review was premised on ‘outdated, conflicting observational studies’ in a post on his Substack blog, Last Call. ‘This isn’t just an academic spat,’ he wrote. People will ‘see headlines or quotes like “One to two drinks a day may reduce coronary artery disease.” That’s the soundbite – and exactly what the alcohol industry wants.’
So what’s the truth?
The question of whether drinking can be part of a healthy lifestyle is complex.
Throughout the Middle Ages, booze was prescribed for anything from intestinal worms to plague. One of the most prevailing health claims wasn’t popularised until the 1920s, however – that drinking is good for the heart.
Scientist Raymond Pearl of Johns Hopkins University in the US first described the effects of alcohol consumption as a ‘J-shaped curve’ in 1926. Studying rates of heart disease in drinkers, he noted that heavy drinkers had the highest death rates – the top of the ‘J’ on a graph – while light drinkers had the lowest – the bottom.
Abstainers, meanwhile, were more likely to have heart disease and die than light drinkers, but not as much as heavy drinkers.
Though experts were unsure why this occurred, dozens of subsequent studies appeared to confirm the trend. The idea that light drinking was good for your health became gospel.
Then, in the 2010s, researchers in the US began to question who was being counted as an ‘abstainer’ or a ‘moderate drinker’ in earlier studies. Were the non-drinkers avoiding alcohol because they were already ill or because they had quit drinking after health problems began?
Likewise, were moderate drinkers more likely to practise moderation in other aspects of their lives, such as healthy eating?
Jeanne Calment, who was the world’s oldest person until her death in 1997 aged 122, famously enjoyed a daily glass of port – along with wine, a cigarette and copious amounts of chocolate
Newer studies focused on a different group: people who do not drink for genetic reasons, such as variants that make alcohol difficult to metabolise. These offered a cleaner comparison. Researchers found these people were at no higher risk of heart disease or early death than light drinkers – undermining the idea alcohol itself was providing the protection.
In the past decade, alcohol has been linked to increased risk of seven different cancers. In a swift pivot, it began to appear that any level of drinking was unequivocally bad for us.
Last year, US Surgeon General Vivek Murthy called for cancer risk warnings on alcoholic drinks, like those on cigarettes.
In the UK, recommendations were cut from three to four units a day to 14 units spread across a week by then chief medical officer Dame Sally Davies in 2016.
Now some experts in the US say that the medical profession may have dismissed the health benefits of drinking too soon.
‘We aren’t saying go ahead and drink,’ said Dr Mariann Piano, professor of nursing at Vanderbilt University and a member of the AHA’s writing committee.
‘In fact, one of our major points was that drinking too much can be really bad for your health.
‘But the papers we reviewed found that light drinkers had a lower risk of heart disease and death than heavy drinkers and non-drinkers alike.’
The review did not explain why drinking might have this effect. But new research may have found the answer.
A study at Massachusetts General Hospital in Boston examined the medical data of more than 50,000 people to evaluate the relationship between light to moderate drinking and heart attacks and strokes.
The paper came to the same conclusion as previous studies: one drink a day for women, or two for men, was associated with a substantial reduction in the risk of cardiovascular disease.
This time, however, they also identified a possible explanation.
Looking at brain scans of participants with a range of drinking habits, they found that alcohol, in light to moderate quantities, appeared to reduce long-term stress signals in the brain.
‘When the amygdala [a region of the brain that processes stress] is too alert and vigilant, the sympathetic nervous system [the body’s fight-or-flight response] is heightened, which drives up blood pressure and increases heart rate, and triggers the release of inflammatory cells,’ explained Dr Ahmed Tawakol, professor of medicine at Harvard University.
‘If the stress is chronic, the result is hypertension, increased inflammation and a substantial risk of obesity, diabetes and cardiovascular disease.
‘Alcohol reduces these stress signals. We believe this is one, likely of many, reasons why we see light drinking having a protective effect on heart health.’
It’s a remarkable discovery. But the experts are clear that the advice is not to start drinking in order to reduce the risk of cardiovascular disease.
Those at high risk of cancer should recognise that even a single drink a day will further raise that risk, said Prof Tawakol.
But others with a low risk of cancer yet a high risk of heart attacks might think differently.
He added: ‘I would aim to limit drinking to seven or fewer drinks a week, as that’s where the data is strongest. But I would say yes, they should consider the risks and benefits that light alcohol consumption could have for their health.’ This, Prof Tawakol believes, is why it is important for reviews such as the AHA’s to be published.
‘It has been raised before that if you point out the benefits of alcohol, it might encourage people to drink,’ he said. ‘But there are plenty of things people do that have both harms and benefits.
‘Allowing people to hear only one side is frustrating and confusing. If we provide the full picture, we can empower people to make better decisions about their own health.’
Likewise, Dr John Holmes, professor of alcohol policy at the University of Sheffield, says that if you’re drinking less than 14 units a week, you’re probably at low risk of serious health issues from alcohol regardless.
‘There is no body in the UK recommending people drink, but there’s also no cliff edge where if you drink more than a certain level you’re going to die,’ he said.
But health officials have begun to dial back messaging on the risks of moderate drinking.
Professor Sir Chris Whitty, the current Chief Medical Officer, has also previously listed ‘drinking in moderation’ alongside stopping smoking, healthy eating and exercise when discussing how to reduce the risk of illness and disability in later life.
Other experts agree. Professor Sir David Spiegelhalter was among those consulted during the 2016 update of the UK’s guidelines, which defined ‘low-risk’ drinking as carrying a one per cent lifetime risk of dying from an alcohol-related cause.
At the time, he argued that moderate drinking should be viewed alongside other everyday risks people readily accept. Measured over a lifetime, he said, habits such as watching an hour of television a day or eating a bacon sandwich a couple of times a week may pose a greater risk to long-term health than moderate alcohol consumption.
‘In contrast, an average driver faces much less than this lifetime risk from a car accident,’ he said. ‘It all seems to come down to what pleasure you get from moderate drinking.’
His point was that we routinely accept activities we enjoy, despite their non-zero risk.
One person who would no doubt have sympathised is Jeanne Calment, the world’s longest-lived person, who died in 1997 aged 122. She famously enjoyed a daily glass of port – along with red wine, a cigarette and copious amounts of chocolate. Asked about the secret of her remarkable longevity, she put it simply: ‘I took pleasure when I could.’
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Some of Britain’s most beloved – and longest-living – public figures were also among its most enthusiastic drinkers.
Until her death aged 101, the Queen Mother maintained an impressive daily drinking routine. Mornings began with a gin and Dubonnet. Lunch was served with red wine and finished with port. Her so-called ‘Magic Hour’ featured martinis, while dinner was washed down with pink champagne.
Many joked that her fondness for a ‘drinkypoo’ may have contributed to her longevity. ‘I couldn’t get through all my engagements without a little something,’ she once said.
Meanwhile, one particularly bibulous prime minister was keeping a similar schedule.
Even during his time in office, Sir Winston Churchill reportedly began each day with a whisky and soda, drank champagne at lunch, followed it with cognac or brandy, kept an ever-present glass of whisky through the afternoon and finished the day with wine at supper.
Italian actress Sophia Loren, pictured in 1965, has long dismissed strict abstinence, saying she would ‘much rather eat pasta and drink wine than be a size zero’
The Queen Mother began her mornings with gin and Dubonnet before having red wine and port with lunch and washing down dinner with pink champagne
And this, he believed, was no indulgence. Churchill was said to be convinced that European leaders showed more respect to those who could hold their liquor.
In the decade before his death, aged 90, he drank more than ever – never missing a bottle of champagne at lunch, and often another at dinner.
One visitor from the period observed: ‘There is always some alcohol in his blood, and it reaches its peak late in the evening after he has had two or three scotches, several glasses of champagne, at least two brandies and a highball… but his family never sees him the worse for drink.’
Others shared a similar outlook. Italian actress Sophia Loren, now 91, has long dismissed strict abstinence, saying she would ‘much rather eat pasta and drink wine than be a size zero’.
And writer Sir John Mortimer, who died aged 85, once admitted he ‘never ate a meal without white wine’.