Not in Moderation

Whenever the subject of alcohol consumption comes up, there is a tendency to say “Everything in moderation.” However, the reality is nobody actually believes that.

Everybody draws a line somewhere. For example:

  • Dogs

  • fried spiders

  • silkworms

  • sago grubs

  • worms

  • snakes

  • other humans

These are eaten in other parts of the world, but would any of us recommend eating any of these in “moderation?” On the contrary, would we not educate people to abstain from these hideous food stuffs if given the platform to do so? You see, we all draw a line somewhere, and thus very few of us can honestly say we actually believe in eating “everything in moderation.”

But somebody might be saying: “Are you serious? You’re actually comparing cannibalism, worms, dogs and spiders to alcohol?” The answer is: Yes. You would be hard-pressed to find rigorous scientific data to suggest that specifically dogs, worms, and spiders are unhealthy, but we all know that there is plenty of evidence to suggest that alcohol is a poison that is hazardous to human health. For example, we know that alcohol…

  • is a group 1 carcinogen. This means we know for sure that it is cancer-causing (1, 2).

  • increases the risk of coronary disease, heart failure, stroke, fatal aortic aneurysms, and fatal hypertensive disease (3).

  • is the fifth leading risk factor for premature death and disability among those 15 to 49 yrs old (4).

  • is toxic to the liver (5).

  • is toxic to the brain (6).

  • increases the risk for acute and chronic infections (7).

  • can be disruptive to the gut microbiome (8).

  • disrupts sleep (9).

  • is associated with intimate partner violence and sexual aggression (10).

  • can lead to addiction.

The above list can go on.

This is not to say that we would recommend eating dogs, spiders and worms. On the contrary, even without rigorous scientific evidence to support it, most of us would be quite comfortable recommending complete abstinence from eating any dogs and spiders. So how about with alcoholic beverages? There is so much scientific evidence to suggest that alcohol is extremely unhealthy.

If any other drink such as soy milk, almond milk, gatorade or orange juice was found to have the same health profile as alcohol, you can be assured most would be calling for total abstinence. Yet for some strange reason, we give alcohol a pass. This makes no sense. The scientific evidence suggests that alcohol is a cancer-causing, brain-destroying, liver-damaging, heart-impairing, family-splitting, morally-degrading poison that does not deserve to be in your body.

Some might counter and say that these health effects only occur when you abuse alcohol; when you drink too much. But is this true? Last year, a major paper was released in the prestigious Lancet journal in which the researchers concluded:

"The level of alcohol consumption that minimized harm across health outcomes was zero standard drinks per week.” (11) (emphasis mine)

How about the current guidelines that recommend “moderate drinking”? Well, recently, this also has been challenged. Researchers in 2018 published a major study in the Lancet that concluded:

"These data support adoption of lower limits of alcohol consumption than are recommended in most current guidelines." (12)

"... there were no clear risk thresholds below which alcohol consumption stopped being associated with lower disease risk." (12) (emphasis mine)

If you want to argue for drinking moderate amounts, then you’re gonna have to demonstrate what you mean by moderate and how much would be the safe amount. For me, I’d rather stick with the latest science that suggests that to ere on the safe side, we should just stay clear.

So, when it comes to alcohol, let’s not say “Everything in moderation” because if we really sit and think about it, nobody actually believes that phrase nor practices it. Most can’t even define what they mean by “moderate". The bottom line is that we all draw a line somewhere, and when it comes to alcohol, the safest line to draw is at zero.

  1. International Agency for Research on Cancer; monographs:

  2. weiderpass, E. Lifestyle and Cancer Risk. Journal of Preventive Medicine and Public Health. November 2010. Vol . 43, No. 6, 459 - 471.

  3. Wood A et al. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. Lancet 2018; 391: 1513 - 23.

  4. Lim, SS et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990 - 2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. (2012); 380 (9859): 2224 - 2260.

  5. Rocco, A et al. Alcoholic disease: Liver and beyond. World J Gastroenterol. (2014); 20 (40): 14652 - 14659.

  6. Abrahao, K et al. Alcohol and the Brain: Neuronal Molecular Targets, synapses, and circuits. Neuron (2017); 96(6): 1223 - 1238.

  7. Szabo G & Mandreker P. A recent perspective on alcohol, immunity, and host defense. Alcohol Clin Exp Res. (2009); 33 (2): 22 - 232

  8. Engen P et al. The gastrointestinal microbiome alcohol effects on the composition of intestinal microbiota. Alchol Res. (2015); 37(2): 223 - 236.

  9. Colrain I et al. Alcohol and the sleeping brain. Handb Clin Neurol. (2014); 125: 415 - 431.

  10. Capaldi, D et al. A systematic review of risk factors for intimate partner violence. Partner Abuse. (2012); 3(2): 231 - 280.

  11. GBD 2016 Alcohol collaborators. Alcohol use and burden for 196 countries and territories, 1990 – 2016: a systematic analysis for the Global Burden of Disease study 2016. The Lancet. August 23, 2018.

  12. Wood A et al. Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. The Lancet. (2018); 391 (10129): 1513 - 1523.

For articles on alcohol, go here.

For books, go here.

George Cho