The risks and benefits of drinking alcohol

Consumer Reports on Health: June 2010
Photo: "The Preventable Causes of Death in the United States," PLoS Medicine, April 2009

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As the chart above shows, drinking alcohol harms far more people than it helps. That's especially true for men since they tend to drink more than women and are more likely to binge drink as well.

Of course, the health benefits of alcohol come from moderate drinking and most of the risks come from excessive consumption. So you may be tempted to say, "Alcohol may be bad for the population overall, but it's OK for me." While that may be generally true, there are exceptions.

Even moderately drinking alcohol can contribute to certain cancers, for example, so the risks may outweigh the benefits for people at high risk of those malignancies. And moderate drinking can cause more harm than good if it leads to excessive consumption.

The benefits. Moderate, regular drinking—generally no more than one drink a day for women and two drinks a day for men—raises HDL (good) cholesterol and cuts the risk of death from heart disease by about 25 percent. It may also help prevent type 2 diabetes and ischemic strokes, the kind caused by blood clots.

The risks. Each drink may increase the risk of cancers of the colon, rectum, liver, mouth and throat, and in women, the breast. Alcohol can also contribute to birth defects, depression, and hemorrhagic strokes, the kind caused by bleeding in the brain. Heavy drinking can harm the liver and heart as well as increase the risk of accidents, addiction, and violence. So can binge drinking, which is defined as more than three drinks in any one day for women and more than four for men.

The balance. The benefits of moderate drinking appear to be highest among people at increased risk of heart disease, notably men about 40 or older and women about 50 or older. In younger people, the increased risk of accidents, cancer, and violence may erase that benefit.

The bottom line. No one should start drinking because of alcohol's possible health benefits. Those with a known drinking problem or certain medical conditions, or those who take medications that interact with alcohol should avoid alcohol or restrict their intake. But current drinkers don't need to stop—if they truly have it under control. To see if you do, ask yourself these questions:

  • Have you ever felt you should cut down on your drinking?
  • Have people annoyed you by criticizing your drinking?
  • Have you ever felt bad or guilty about your drinking?
  • Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

The National Institute on Alcohol Abuse and Alcoholism says that if you answer "yes" to two or more questions, you most likely have a problem and should talk with a physician.

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