Study Finds Heavy Drinking Raises Death Risk Across All Types of Alcohol

A large study of more than 340,000 adults in Britain found that heavy drinking was linked to worse health regardless of whether people drank wine, beer, cider or spirits, while lower levels of drinking showed a sharp divide by beverage type.

The research, presented at the American College of Cardiology’s Annual Scientific Session, analyzed data from 340,924 adults enrolled in the UK Biobank between 2006 and 2022. Researchers tracked participants for more than 13 years on average and compared their drinking habits with deaths from all causes, cancer and cardiovascular disease.

The main finding was clear at the highest levels of alcohol use. Compared with people who never drank or drank only occasionally, those classified as heavy drinkers were 24% more likely to die from any cause. They were also 36% more likely to die from cancer and 14% more likely to die from heart disease.

At lower levels of drinking, the results were more mixed. Wine was associated with lower mortality in some measures, while beer, cider and spirits were tied to higher risk even when intake was relatively low.

Researchers said moderate wine drinkers had a 21% lower risk of dying from cardiovascular disease than people who never drank or drank only occasionally. By contrast, even low consumption of spirits, beer or cider was associated with a 9% higher risk of cardiovascular death compared with non-drinkers and occasional drinkers.

The study was led by Zhangling Chen, a professor at the Second Xiangya Hospital of Central South University in China. In remarks released with the findings, Dr. Chen said the results suggest that alcohol-related health risks may depend not only on how much people drink, but also on what they drink.

The analysis used a standard measure of pure alcohol. A 12-ounce beer, a 5-ounce glass of wine and a 1.5-ounce shot of spirits each contain about 14 grams of pure alcohol. People who consumed less than 20 grams a week, roughly equal to fewer than 1.5 standard drinks, were grouped as never or occasional drinkers.

Men who consumed from 20 grams a week up to 20 grams a day, and women who consumed from 20 grams a week up to 10 grams a day, were classified as low-level drinkers. Moderate drinking was defined as 20 to 40 grams a day for men and 10 to 20 grams a day for women. High consumption meant more than 40 grams a day for men and more than 20 grams a day for women.

The study adds to a long-running debate over whether small amounts of alcohol, and wine in particular, may carry some health benefit. In recent years, many public health experts have pushed back against the idea that moderate drinking is protective, arguing that earlier research often failed to account for diet, income, smoking, exercise and other factors that can separate one type of drinker from another.

The new findings do not settle that debate. The researchers themselves said the study was observational, meaning it can show associations but cannot prove that one kind of alcohol directly caused the difference in death rates. They adjusted the analysis for a broad range of factors, including demographics, socioeconomic status, lifestyle, cardiometabolic measures and family history of diabetes, cardiovascular disease and cancer. Even so, unmeasured differences between groups may remain.

That issue is especially important in the case of wine. The researchers said wine drinkers often have different eating and social habits than people who mainly consume beer, cider or spirits. Wine is more likely to be consumed with meals and is often tied to higher-quality diets and other healthier behaviors. Beer, cider and spirits are more often consumed outside meals and were linked in the study to poorer overall diet quality and other lifestyle risk factors.

The researchers also pointed to possible biological differences. Red wine contains polyphenols and other antioxidant compounds that have been studied for possible cardiovascular effects. But whether those compounds explain the lower mortality seen in the study remains unclear.

The dataset came from the UK Biobank, one of the world’s largest health research projects. Participants provided dietary information when they entered the study, and the alcohol analysis was based on those self-reported habits at the start. That creates another limitation: the research could not fully capture changes in drinking over time. Someone who cut back, stopped drinking or increased intake years later would still be classified according to the earlier report.

Researchers also noted that people in the UK Biobank tend to be healthier than the general population, which may limit how widely the results apply. Findings from Britain may also not translate neatly to countries with different drinking patterns, serving sizes and food culture.

Even with those limits, the size of the study gives it weight. More than 340,000 participants and a long follow-up period gave the analysis strong statistical power and allowed researchers to compare several categories of alcohol use across multiple causes of death.

The findings come at a time when governments and health agencies in several countries are reassessing alcohol guidance. In many places, official advice has shifted toward lower consumption, with greater emphasis on the cancer risk linked to alcohol use.

Dr. Chen said the risks identified in the study could be higher in some people, particularly those with chronic illness or cardiovascular disease. That point is likely to matter to doctors counseling patients who still view moderate drinking as harmless.

The researchers said high-quality randomized trials would be needed to better isolate the health effects of different kinds of alcohol, though such trials are difficult to conduct over long periods. For now, the study offers another signal that heavy drinking carries broad risk, and that the apparent health profile of lower-level drinking may depend as much on lifestyle and context as on the drink itself.