If you’ve ever turned to a glass of vino to celebrate a special occasion, commiserate after a long day, or ring in the new year, you’re not alone; over 69.5% of US adults say they’ve had alcohol in the past year alone [
21]. And while drinking can be a pleasurable pastime, you may not have put much thought into how this behavior can affect your health.
While the occasional drink isn’t a cause for concern, studies have found that excessive amounts of alcohol can wreak havoc on your health over time and lead to an increased risk of chronic disease, dementia, cancer, and liver damage [
6]. But how much is too much, and what are some ways you can cut back to enhance your health? Here’s everything you need to know about alcohol, according to science.
Recommended drinking guidelines
According to the 2020-2025 Dietary Guidelines for Americans, drinking in moderation is defined as no more than 2 drinks/day for men or 1 drink/day for women [
1].
The following constitutes one serving of alcohol:
12 ounces of 5% ABV beer
8 ounces of 7% ABV malt liquor
5 ounces of 12% ABV wine
1.5 ounces of 40% ABV (80 proof) distilled spirits, such as gin, rum, vodka, or whiskey.
While light to moderate drinking may not raise any red flags, problems start to arise when excess amounts of alcohol are consumed at once. The Substance Abuse and Mental Health Services Administration defines binge drinking as four or more drinks for women or five or more drinks for men on the same occasion, whereas excessive use is classified as heavy drinking five or more days of the past month [
2]. For a typical adult, this pattern of drinking can bring blood alcohol concentration (BAC) to 0.08 percent or higher [
2].
According to the CDC, binge drinking is one of the most common forms of excessive alcohol usage in the USA, with 25% adults doing so at least weekly [
22,
23]. Additionally, binge drinking is most common among younger US adults aged 18–34, and is nearly twice as common among men than among women [
23].
Those who are pregnant or may become pregnant; are under the legal drinking age; have certain medical conditions, or are recovering from an alcohol use disorder should avoid alcohol completely [
1].
How long does alcohol stay in your system?
Everyone metabolizes alcohol differently, for many reasons. Some people might feel the effects right away, whereas it may take others longer, if they feel any effects at all [
3,
4]. This is mainly due to blood alcohol concentration (BAC), which refers to the amount of alcohol in your blood in relation to the amount of water in your blood. Factors such as age, weight, drinking alcohol on an empty stomach, medications, liver disease, your drink of choice, and binge drinking can all affect this [
5].
Here are some general estimates for how long alcohol stays in your system [
6]:
Small shot of liquor: 1 hour
Pint of beer: 2 hours
Large glass of wine: 3 hours
A few drinks: several hours
Because everyone is different, it’s important to keep in mind that what may be “too much” for one person may not be the same for you. Nonetheless, it’s recommended to stick to these guidelines to reduce the risk of some serious health issues.
Benefits of alcohol
Research suggests that low to moderate drinking may positively impact your microbiome, reduce your risk for certain chronic diseases, and provide cardioprotective benefits. Let’s unpack some of the reasons why alcohol consumption may be beneficial.
Improved gut health.
According to a recent study, a beer a day might keep your microbes healthy. New research has found that men who drank either one 12-ounce alcoholic or non-alcoholic lager each day developed a more diverse set of gut microbes, which has been attributed to a reduced risk of diabetes and heart disease [
7]. While we expect to see more research on this part of gut health in the future, we do know that beer also contains compounds, such as polyphenols, that may impact the variety of microbes in the gut [
7].
Cardioprotective benefits.
Red wine has long been hailed as the crème de la crème when it comes to healthful alcoholic beverages, and for good reason–it contains an antioxidant compound called resveratrol, which is associated with a reduced risk of coronary artery disease. Resveratrol is also associated with changes in lipid profiles, reduction of insulin resistance, and a decrease in oxidative stress of low-density lipoprotein cholesterol (LDL-C) [
8]. However, be sure to keep it to one glass per day to avoid any negative effects associated with excessive alcohol consumption.
Reduced all-cause mortality.
Low to moderate alcohol intake (<1 drink/day for women and <2 drinks/day for men) has been associated with a lower risk for type 2 diabetes, stroke, cardiovascular disease, heart failure, and all-cause mortality [
9].
Health implications of chronic alcohol consumption
While alcohol may confer some health benefits, it does come with a few warning labels. Research shows that chronic and excessive drinking (more than 2 drinks/day) is associated with weight gain, cirrhosis, elevated blood lipids, high blood pressure, heart failure or stroke, as well as an increased risk of diabetes, cancer, dementia, inflammatory bowel disease, and brain damage, all of which can negatively impact your lifespan [
10,
11]. Let’s examine some of these health implications in more detail.
Weight gain.
Studies have shown that alcohol can lead to overeating by inhibiting hormones linked to hunger and satiety (such as leptin), as well as influencing pathways in the brain that stimulate appetite [
12]. It’s also suggested that alcohol inhibits fat oxidation, thus prompting the body to store more fat.
Additionally, alcohol packs a caloric punch at 7 calories/g, which is much higher than carbs and protein (4 calories/g), but slightly lower than fat (9 calories/g). Yet unlike these macronutrients, alcohol doesn’t offer any nutritional value or satiety benefits, so these calories are mainly “empty” and can quickly add up if you over consume.
Cancer.
If you're looking to reduce your risk of cancer, you may want to start with what you pour in your cup. Chronic alcohol consumption has been linked to an increased cancer risk, as research shows that alcohol increases DNA mutations, causes inflammation, and converts into acetaldehyde (a carcinogenic compound that increases the risk of liver, breast, pancreas, and colon cancers) [
13,
14]. It’s also been suggested that even having 1 drink/day is linked to a 20% increased risk of mouth and throat cancer [
15].
Cirrhosis.
Research shows that heavy drinkers (>5 drinks/day) and those who binge drink are at a higher risk for cirrhosis, a late-stage liver disease in which healthy liver tissue is replaced with scar tissue and the liver is permanently damaged [
16]. Women may also be at an even higher risk compared to men, even with minimal alcohol consumption, likely due to a multitude of reasons [
16].
Impaired brain function.
While it may feel that alcohol provides temporary happiness, science shows that overdoing it may contribute to depression, mood swings, irritability, and increased stress levels (especially from social pressure).
Moreover, studies suggest that chronic alcohol consumption might increase your risk of dementia, cause deficits in learning and memory, impact mental disorders, and lead to cognitive decline [
17,
18].
Increased inflammation.
While moderate alcohol intake may reduce inflammation, frequent and heavy alcohol use can increase inflammation and put excess strain on the liver. Since alcohol changes the chemicals that are used to break down and remove scar tissue, it can lead to increased cancer risk, high blood pressure, strokes, inflammatory bowel disease, immunity issues, and bloating [
19]. This chronic inflammation has detrimental effects throughout the entire body, and negatively affects your organs, tissues, and gut, brain, and heart health [
20].
Best types of alcohol
While many alcoholic beverages are laden with calories and added sugars (both of which can contribute to weight gain and other health issues), there are lower calorie choices that you can feel good about sipping on. Here are some healthier options for the next time you want to imbibe.
Red wine: 105 calories per 5-ounce serving
Light beer: around 100 calories per 12-ounce serving
Tequila on the rocks: around 100 calories per 1.5-ounce serving
Champagne: 85 calories per 4-ounce serving
Vodka soda: 133 calories per 7.5-ounce serving
Hard seltzer: around 100 calories for a 12-ounce serving
Tips for enjoying alcohol in moderation
If you choose to drink, here are some tips for enjoying alcohol in moderation.
Set a drinking limit. Put a cap on the number of drinks you have, since planning ahead can help you stick to your goals.
Try tasty alternatives. Low sugar, non-alcoholic beverages (such as seltzers, flavored water, kombucha, and iced tea) can be a great replacement for your habitual glass of wine.
Follow the “every other” rule. It takes the body approximately an hour to process one alcoholic beverage, so for each one you drink, alternate with a glass of water.
Don’t give into peer pressure. If you’re out with friends, it can be easy to cave and continue to imbibe, even if you’ve surpassed your personal limit. Don’t be shy to turn down drinks, and let people know when you’ve had enough.
Summary
Alcohol has long been a pleasurable pastime enjoyed by many, and while the occasional drink isn’t cause for concern, chronic alcohol consumption can wreak havoc on your health over time. And even though light to moderate intake has been linked to improved gut health, lowered risk of coronary artery disease, and reduced all-cause mortality, chronic alcohol consumption is associated with numerous negative health implications, including weight gain, cirrhosis, elevated blood lipids, high blood pressure, diabetes, cancer, dementia, inflammatory bowel disease, and brain damage, that can take years off your life [
10,
11]. However, by making healthier swaps and enjoying alcohol in moderation, you can boost your health and stay sober while doing so.
Disclaimer: The text, images, videos, and other media on this page are provided for informational purposes only and are not intended to treat, diagnose, or replace personalized medical care.