National Academies report suggests benefits of moderate alcohol use

A new report on the effects of alcohol on health has concluded that moderate consumption is associated with lower all-cause mortality and reduced cardiovascular disease risk compared to individuals who have never consumed alcohol. This study, conducted by the National Academies of Sciences, Engineering, and Medicine (NASEM), is expected to play a key role in shaping the 2025 Dietary Guidelines for Americans. Its publication on December 12 has sparked intense debate, particularly as a second independent report on alcohol is set to be released in the coming weeks.

The 230-page report, titled Review of Evidence on Alcohol and Health, compiles studies from the last five to fifteen years to examine how moderate alcohol consumption impacts various health aspects, including breastfeeding, weight, cancer, cardiovascular diseases, neurocognition, and overall mortality. Moderate consumption is defined in the report as up to two drinks per day for men and one drink per day for women. While the report does not make specific recommendations, its findings challenge stricter positions that have gained traction in recent years regarding the risks of alcohol.

The research indicates that individuals who consume alcohol moderately have a 16% lower risk of all-cause mortality compared to those who have never consumed alcohol, based on an analysis of eight studies. However, this evidence was rated as moderately certain, suggesting the findings are robust but may change with future research. Regarding cardiovascular diseases, moderate drinking was linked to a lower risk of heart attacks, strokes, and mortality from these causes. Still, the certainty of findings on non-fatal heart attacks and strokes was considered low, while conclusions about cardiovascular mortality were rated as moderately certain.

The report also examined the relationship between moderate drinking and weight, finding insufficient evidence to determine any clear link. In terms of cancer, the findings were more specific. Moderate alcohol consumption was associated with an increased risk of breast cancer compared to non-drinkers, with the risk rising proportionally within the moderate range. However, these conclusions were also limited by the quality and consistency of the data.

For other types of cancer, such as colorectal cancer, no definitive conclusions were reached, though a slightly increased risk was identified among those drinking at the higher end of the moderate range. Additionally, the report found insufficient evidence to determine the effects of moderate alcohol consumption on neurocognitive diseases like dementia or Alzheimer's. Similarly, there were no conclusive findings on alcohol's impact on breastfeeding, milk production, or infant development.

This report has reignited the debate about alcohol's potential benefits versus its well-documented risks. Critics have pointed out that some members of the committee have financial ties to the alcohol industry, which could influence the findings. Furthermore, the rise in alcohol-related deaths in the United States, which increased by 29% between 2017 and 2021, underscores the concerns of public health experts. According to data from the Centers for Disease Control and Prevention (CDC), over 140,000 deaths annually in the U.S. are linked to excessive alcohol consumption, accounting for 20% of deaths among individuals aged 20 to 49.

Since the 1990s, U.S. dietary guidelines have recommended moderate alcohol consumption, defining it as up to one drink per day for women and two for men. However, growing evidence about the risks of alcohol, even at low levels, has led countries like Canada to adopt stricter public health messages, warning that any level of consumption may increase health risks.

Although the dietary guidelines are not legally binding, they significantly influence public policies, food assistance programs, school meal plans, and clinical practices. The final recommendations on alcohol in the 2025 guidelines could have lasting implications for at least five years. The ultimate decision will rest with the Department of Agriculture and the Department of Health and Human Services, which will determine whether to incorporate these findings into the forthcoming guidelines.