Drinking is a regular part of social life for a lot of people. Around 80% of Americans have consumed alcohol at some point in their lifetime. And why not: a cocktail can take the edge off a rough day, a beer can liven up a sporting event, and a glass of wine can make dinner more romantic.

The scientific and health communities have always been divided on whether “moderate” drinking is good or bad—how much is okay, and how much (if any) can benefit your health.

Current guidelines in the US tell us one “standard drink” or less per day is okay for women, and two “standard drinks” or less per day is okay for men. In the US, a standard drink is defined as 14 grams of alcohol (ethanol), the equivalent of:

• A 12-ounce can of beer.
• 5 ounces of wine.
• One shot (1.5 ounces) of 80-proof distilled spirits like gin, rum, vodka or whiskey.

Although the volume of these drinks is different, they each contain the same amount of alcohol (ethanol) because they differ in their percent of alcohol by volume. There’s no difference in the type of alcohol in beer, wine, or liquor—it’s all ethanol.

Alcohol is considered a nutrient just like protein, carbohydrates, and fat, providing 7 calories per gram, which is higher than protein and carbohydrates (4 calories per gram) but lower than fat (9 calories per gram).

Alcohol can’t be stored in the body for use as energy. It provides “empty calories” because it doesn’t contain beneficial nutrients. In fact, alcohol interferes with our body’s ability to absorb crucial micronutrients such as:

• Glucose
• Amino acids
• Vitamin B1 (thiamine)
• Vitamin B2 (riboflavin)
• Vitamin B9 (folate)
• Vitamin C
• Iron
• Zinc
• Selenium

Heavy chronic drinking (more that 7 drinks per week for women, and more than 14 drinks per week for men) can increase the risk of several nutrient deficiencies. Heavy drinking can increase magnesium secretion in urine up to two to three times what is considered normal.

Adults with alcohol use disorder (alcoholics) are usually deficient in zinc.

Averaging no more than about one drink per day is relatively low risk, according to scientists who study alcohol. But the risk of cancer rises significantly when you exceed that. Studies have suggested that alcohol contributes to about half a dozen types of cancers, including breast and colorectal, as well as heart and liver disease.

So for a while, we’ve been told that red wine is good for your heart. In fact, the Mayo Clinic advocates drinking limited amounts of any type of alcohol helps the heart by raising HDL cholesterol, preventing the formation of blood clots, and improving the lining of blood in our blood vessels. But now that thinking is being challenged.

Last year a major meta-analysis that looked at 107 studies on alcohol over the past 40 years concluded no amount of alcohol improves your health. The Cleveland Clinic recently made a statement that “no amount of alcohol is safe for your heart.”

To make matters worse, last year Nature published research stating that as little as one or two drinks a day (even less for women) was associated with shrinkage in the brain—the same kind of shrinkage normally associated with aging.

But what about the research that told us wine is good for our hearts? The “sick quitter effect” and “healthy user bias” can help us understand why moderate drinkers appear to be healthier than non-drinkers.

The sick quitter effect refers to a bias in observational studies on alcohol consumption, where former drinkers who quit due to health problems are grouped with lifetime abstainers. This makes moderate drinkers appear healthier because the abstainer group contains people who quit drinking due to health issues caused by drinking.

The healthy user effect refers to a bias in observational studies where individuals who engage in a particular healthy behavior (such as moderate drinking) also tend to have other health-promoting habits (like exercising and eating well). In fact, that data tells us that light to moderate drinkers have better dental hygiene, exercise routines, weight, diet quality, and income than abstainers.

When the confounding factors are controlled for, most or all of the protective effects of alcohol on disease risk are abolished.

I understand this newer research on alcohol may not change the drinking habits of too many people. But this should cause some of us to think about how much we drink and how it impacts our health. Based on what I’ve learned recently, I would say that one drink a day is too much. Maybe three to four drinks spread out throughout the week would be okay.

If you’re going to drink, I highly recommend you drink a full glass of ice water after every alcoholic drink to replenish water loss. Never drink on an empty stomach—food slows down the absorption of alcohol, reducing its effect. And consider taking a magnesium supplement, because any amount of alcohol increases magnesium excretion.

Let’s end on a positive note. A recent study at the University of Michigan found that couples who have similar drinking habits live longer. In other words, couples who drink together have better marital outcomes. That’s definitely a reason to open a bottle of wine on a Saturday night or enjoy a glass of bourbon at end of a long work week.

Stay Strong,

Bo Railey