How much alcohol can I drink?
A common question from our members is “how much alcohol can I safely drink?”. This is a question that interests people of every age, 30 to 90+.
This article will explain how to choose how much alcohol to drink for optimal health, including dementia prevention.
What do the experts say?
Leading health organizations recommend you don’t drink more than the following:
Women or those over 65: 1 drink a day, or a total of 7 drinks a week.
If you do have a day with more than one drink, aim to not exceed 3 drinks total on any one occasion, and still keep your weekly total less than 7
Men under 65: 2 drinks a day, or a total of 14 drinks a week
If you do have a day with more than two drinks, aim to not exceed 4 drinks total on any one occasion, and still keep your weekly total less than 14
Why are men and women given different targets? It has to do with our generalized differences in body size, water content, and alcohol dehydrogenase activity.
In those with liver disease, pancreatic disease, esophageal disease, or pregnancy, no alcohol intake at all is recommended.
*Of note, Canada recently published guidance on alcohol use that suggests adhering to 2 drinks or less a week. You can read more here, and read a CBC article on Canadian’s response.
Two drinks a day tops for men, and only 1 for women.
What happens if I drink a lot more?
There is no debate when it comes to drinking a lot of alcohol (meaning more than the numbers listed above) - it’s no good!
Drinking large amounts (more than 3 a day) is linked to a number of very serious health conditions including:
liver disease (known as cirrhosis)
memory problems (known as alcohol-related dementia)
muscle loss (known as sarcopenia)
numbness in your hands and feet (known as neuropathy)
trouble walking (known as ataxia)
heart disease and stroke (known as cardiovascular disease)
cancer (oral, gastrointestinal, breast, colorectal)
and early death
If you think this might apply to you, you can read aldora’s guide to cutting back here.
If you find yourself drinking more than 1 glass of wine a day (or 2 if you're a man or under 65), cutting back could have huge health benefits.
Is drinking linked to dementia?
Drinking more than 12 drinks a week results in an 18% increased lifetime risk of dementia, according to the Lancet commission on dementia prevention.
This risk goes up to 22% when the drinking occurs during midlife (age 40 to around your 60’s).
However, there have been other studies (including a large study over 14 years in Japan) that suggests not drinking at all can also increase risk of dementia.
What to make of this? Perhaps there is a sweet spot. A lot is categorically bad. A little might be helpful.
However, right now experts do not think this means you need to start drinking for dementia protection - if you don’t drink anything, it’s probably best to stick to that for now.
Another case of where balance might be the winning answer.
What about other risks and benefits of minimal drinking?
Research has been done in people who don’t drink in excess - meaning 1 drink a day; 1 drink every other day; or those who spread their total drink consumption out over the week rather than drinking most of their weekly amount in one sitting - with the following results:
Heart Health
Drinking one 4-oz glass of red wine with dinner might be protective against worsening heart problems in people with type 2 diabetes who already have heart disease (read the studies here and here).
This is thought to be through natural anti-oxidant and anti-inflammatory properties of red wine that other types of beverages lack.
Early Death
Observational studies have found that people who minimally drink have less premature death.
This means that while we all die (ahhh!), we don’t die earlier than we would have naturally.
For some of these results, other studies have found no difference between drinkers and non-drinkers (except for excessive drinkers who always fair worse).
Cancer
When it comes to cancer, in a large study of healthcare workers in the US there was no real increase in most cancers with light alcohol use BUT there was for breast cancer, in which women had an increased relative risk of 6-20%.
Several other studies have also shown a link between alcohol and breast cancer.
The American Society of Clinical Oncology recommends against any alcohol consumption for cancer protection (especially, again, when it comes to excessive use).
Alcohol seems to have effects on your heart, lifespan, and cancer risks, sometimes good, sometimes bad.
Do we need more research?
Experts agree it can be hard to combine different studies on drinking, making a 100% guaranteed answer for everyone’s personal circumstances hard to give.
While with time research might shed more light, we also think it would be good to consider a holistic view to such research - in particular, does it matter how or why we drink?
Are you drinking alone to numb emotional pain? Or are you having a glass of red wine over dinner with friends or family? The second option could be boosting health through an active social life.
As with everything in life, it is probably not just what we do, but how we do it that dictates our outcomes to some degree.
This takes into consideration more than just the “biomedical” model of disease, and looks instead at our actions as part of a holistic life that integrates more than just medicine when considering the question of disease.
Does how or why we drink affect the health outcomes?
Why it comes down to balance
In most things in life, there is a sweet spot in between “not enough” and “too much”.
At the end of the day, less alcohol is probably better, some might be better than none, and lots leads to significant suffering.
You don’t need to drink to have a long and healthy life, but if you enjoy a glass of wine or spirits here and there, you will probably be okay.
If you don’t drink at all, you do not need to start for health benefits, since these are not 100% clear.
It’s important to remember that life is a balance of risks and benefits for literally everything that we do.
In closing…
Here’s a run-on sentence that sums up how this article could play-out in your real life: try to have weeks without any alcohol, and maybe don’t drink every day, even though you’re “allowed” to, while also enjoying that party with friends, family, or on a special occasion, and don’t be afraid to crack a bottle of red wine while you make dinner with your partner and dance around the kitchen. Find balance in your life so you live long and well.
Use alcohol to serve you, and if you’re drinking a lot every day (more than 2 drinks if you’re a man, and 1 drink if you’re a woman), chances are it’s causing more harm than good. Read this; drinking less is possible.
If you’re a member, we’ll let you know when new research or expert opinions come out on alcohol so you can adjust your lifestyle to match your goals.
Key References:
Mukamal K, Elmore J, Swenson S. Overview of the risks and benefits of alcohol consumption. Uptodate, 2024. Last updated April 8 2024.
Livingston G, Huntley J, Liu Y, et al. Dementia prevention, intervention, and are: a 2024 report of the Lancet standing commission. Lancet, 2024;404:572-628.
Mewton L, Visontay R, Hoy N, et al. The relationship between alcohol use and dementia in adults aged more than 60 years: a combined analysis of prospective, individual-participant data from 15 international studies. Addiction 2023; 118: 412–24.
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