How Much Alcohol Is Okay?

The science is shifting. Here’s what you need to know.

Wine glass Photo Illustration: Lacey Browne/Consumer Reports, Getty Images

No doctor would advise drinking alcohol strictly for its health benefits. But moderate consumption—defined as no more than one drink per day for women and two for men—has been considered low-risk, possibly even good for you. Yet recently, the expert advisory committee for the 2020 U.S. Dietary Guidelines took a more cautionary position, recommending that the daily limit be lowered to one drink for men.

“We realized that the risks of alcohol have probably been underestimated,” says a committee member, Timothy Naimi, MD, director of the Canadian Institute for Substance Use Research. “If you drink alcohol, less is better for your health than drinking more.”

That message is key now that alcohol consumption has risen during the pandemic. In a recent CR nationally representative survey of more than 2,500 adults in the U.S., 23 percent said they drank more after COVID-19 hit than before. But even prior to that, heavy drinking was on the rise among older adults. A 2019 study estimated that 11 percent of people 65 years and older were binge drinkers (at least four drinks at one sitting for women, five for men).

Loneliness, isolation, and health concerns can increase stress, leading some to drink more now, says Shelly F. Greenfield, MD, a professor of psychiatry at Harvard Medical School in Boston.

Although the final dietary guidelines don’t include the committee’s recommendation, experts are still divided on the role of alcohol in a healthy diet. Here’s what we know about alcohol and health, and how to cut back if you’d like to.

Potential Benefits, Real Risks

The question of whether drinking alcohol is beneficial is a controversial and complicated one, according to Naimi.

Several studies have linked having a drink or two per day—one is equivalent to 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor—to certain health benefits. For instance, a 2020 study in the journal JAMA Network Open found that middle-aged and older adults who consumed low to moderate amounts of alcohol had better cognitive function than those who never drank. Another study, which involved 333,247 people and was published in the Journal of the American College of Cardiology, found that when compared with lifetime abstainers, light and moderate drinkers were 26 and 29 percent less likely to die from heart disease, respectively.

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But while some have attributed that lower risk to factors like a boost in HDL (good) cholesterol associated with moderate drinking, those drinkers may simply have been healthier to begin with.

What’s clear is that the potential benefits of alcohol are outweighed by the harm of drinking too much. For instance, binge and heavy drinking can increase the risk for high blood pressure, stroke, and congestive heart failure. Alcohol is also a proven cause of at least seven types of cancer, such as breast and liver cancer, says Marjorie McCullough, ScD, senior scientific director for epidemiology research at the American Cancer Society. For some cancers, any consumption is harmful. “The risk goes up with each drink,” she says.

For older adults, “the risks and unpleasant effects of alcohol get more pronounced,” Naimi says. Even modest drinking may increase feelings of fogginess or sleepiness, or increase the risk of falling. Plus, it can interfere with drugs for many conditions, such as sleep problems, anxiety, and high blood pressure.

How to Drink Less

If you’re concerned about your alcohol intake, these tips can help.

Plan ahead. Consider how often and how much you want to drink.

Keep a record. Use some kind of system—a notecard in your wallet or an app—so you know how much you’re drinking.

Replace drinking with an activity. This can be especially helpful if you typically drink to de-stress or cope, Naimi says.

Avoid triggers. If you can determine the people, places, or times of day that prompt you to pour a drink even if you’re trying not to have one, you can plan to avoid those situations or develop alternate responses to those moments.

Talk with your doctor. If friends or family members express concerns about your drinking (or if you’re worried about it), ask your doctor to help you identify the safest and healthiest ways for you to cut back.

Learn. See what 5 ounces of wine looks like in different-sized wineglasses.

Editor’s Note: A version of this article also appeared in the March 2021 issue of Consumer Reports On Health.

Head shot image of CRO Health editor Kevin Loria

Kevin Loria

I'm a science journalist who writes about health for Consumer Reports. I'm interested in finding the ways that people can transform their health for the better and in calling out the systems, companies, and policies that expose patients to unnecessary harm. As a dad, I spend most of my free time trying to keep up with a toddler, but I also enjoy exploring the outdoors whenever possible. Follow me on Twitter (@kevloria).