“No Safe Amount of Alcohol”? Not So Fast.

本站添加: 2026-05-26

[00:00:03]I drink one to two glasses of wine almost every night. I've done this for years. I know more about wine than most people care to know. I've built my entire career helping people understand wine with my company, Wine Folly. And lately, I've started to worry that I might be doing it wrong. I remember the exact moment. I was scrolling and then I saw this headline.

[00:00:29]no safe amount of alcohol. My stomach dropped. I actually put my beautiful glass of wine down because if there's really no safe amount, then what does that say about the last 15 years of my life? About my work, about the thing I pour every single night.

[00:00:48]So, I started digging and here's what made it worse. The science doesn't agree with itself. Some of the biggest health reviews in the world still show that people who drink moderately, especially in middle age, actually have the lowest death rates overall. But other reviews say there's no safe amount. Both of these views sit in literature. Both are cited by serious people. And I'm standing in the kitchen here wondering which world I'm living in. So I decided to find out.

[00:01:23]So, if I came into your office and said that I drink one to two glasses a day, almost every night pretty much, um, what would you need to ask me next to be able to tell me that that's okay?

[00:01:38]>> Meline, I' I'd ask you first of all, if you think it's a problem for you, have you had has your drinking caused any problems? Humans are wonderfully bad at reporting alcohol intake. I'd ask you if you have any problems stopping after one or two glasses. And then I'd zoom out and just uh inquire about your medical history, your blood pressure, how are you sleeping, exercise habits, uh medications that you're on, liver tests, and uh and your family history.

[00:02:08]>> Let me tell you how wine became a regular part of my life. I spent my career working in restaurants, then in wine bars, and finally building Wine Folly, where I've traveled to amazing places around the world, like Italy and Portugal, and wine is just part of the meal. Not a big deal, not a vice, just something you enjoy when you sit down and eat with people that you think are awesome. I remember this one dinner in particular. We all got together to open a very old bottle of red wine and we made it a special occasion where the wine came out with everything on the table around great conversation. It felt like the most natural civilized thing in the world. Nobody was counting drinks.

[00:02:48]Nobody was worried. We were all enjoying the moment with each other. But that's not how my feed is showing alcohol.

[00:02:58]Alcohol is the new tobacco. I've seen that one everywhere. That comparison is not an accident. It's a deliberate framing pushed by anti-alcohol advocacy groups and it's a bit misleading. Here's why. There is no amount of tobacco that's safe. Technically, none. At any level of smoking, your mortality goes up. The data is a straight line heading in the wrong direction. With alcohol, the data looks completely different.

[00:03:27]There's a curve where moderate drinkers live longer than people who don't drink at all. You can argue about why. You can argue about how much. But you can't pretend that alcohol and tobacco have the same data profile because they don't. Now, here's where it gets complicated. The biggest health study in the world called the Global Burden of Disease Report published by the Lancet actually changed its position in 2022.

[00:03:55]The updated analysis acknowledged that there may be health benefits for people over 40 depending on the disease and the region and that's a big deal. But the WH, the World Health Organization, didn't go along with it and still points back to its 2016 report which says no safe level. So you have the Lancet saying one thing and the WHO saying another. And most headlines don't bother to tell you that. If you hear someone say, "But wine is part of my culture and my work." Does that carry any weight in your advice? This this sort of background of wine being part of your life, your daily life.

[00:04:35]>> Absolutely. And and health isn't just about squeezing out the maximum number of years. People don't drink wine in a vacuum. There's friendship, enjoyment, celebration, food, those all matter, too. Having wine slowly with dinner and a healthy lifestyle is very different from stress drinking or drinking alone.

[00:04:57]>> Okay, let me just put my actual week on the table. This is last week. Monday, I had one drink after work. Tuesday, I had one drink while I was making dinner.

[00:05:11]Wednesday, that was a studio tasting, so that's two. Thursday, I had two glasses. Making dinner at home with Dustin again.

[00:05:20]Friday, I went out with friends, three glasses with appetizers. Saturday, big bike ride, only a half a glass of wine at the end of the day. Sunday, another big bike ride, and then a glass and a half when I got home and made dinner.

[00:05:35]That's somewhere between 10 and 12 glasses. 11 to be exact. None of them felt excessive in the moment. Now, let me hold that up against what the experts say. The National Academy of Sciences, that's the top scientific body in the US, says that one drink a day for women is associated with lower death rates overall, including from heart disease compared to people who don't drink. For men, it's up to two. The American Heart Association says one to two drinks a day shows no risk to possible risk reduction for several heart outcomes, but the harms go up fast with heavier or binge drinking. And then there's the dietary guidelines for Americans, the official government advice on what to eat and drink. Until recently, they said up to one drink per day for women and up to two per day for men. That was specific.

[00:06:31]It was something I could measure myself against since 2025 and until 2030 at least. What do the guidelines say now?

[00:06:41]Well, they dropped the numbers entirely.

[00:06:45]Now they just say limit alcoholic beverages, consume less alcohol for better overall health. So, the official advice went from something I could hold on to and hold against my actual week to a vibe less. What does that mean? Less than what I'm drinking, less than I was drinking, less than zero. It's not very helpful. And for someone like me who genuinely wants to make a smart decision about my own health, it's kind of infuriating. So, I decided to stop waiting for the guidelines to sort themselves out and go look up the actual evidence myself. I gave you a chart last week about how much I was drinking.

[00:07:31]Looking at that chart for the real week.

[00:07:33]Uh was there any parts that worry you and uh what part doesn't worry you about what's there?

[00:07:39]>> What reassures me about that is that I don't see any loss of control of your drinking. Uh your drinking looks structured and largely food associated rather than being compulsive or or binging. For women, once you get above two standard drinks a day on average, then cardiovascular disease and and breast cancer both appear to increase.

[00:08:03]So based on what you sent me, I really don't have problems with that.

[00:08:10]>> But before I can make sense of any study, I have to answer one more basic question. What am I actually drinking?

[00:08:18]because all the studies talk about one standard drink and what I call a glass might not be the same thing.

[00:08:26]Okay, that this is what I would call one glass.

[00:08:33]Apparently, one standard glass of wine is 5 o.

[00:08:39]Let's see how close I got.

[00:08:47]You see this?

[00:08:50]But here's the thing. I like to drink two half pores because it feels like more.

[00:08:57]Honestly, that's about 3 to 3 and 1/2 oz. Two of those is probably more like 6 to 7 oz, which means my two half glasses are actually closer to 1.2 to 1.4 standard drinks. Now, a standard drink according to the American Heart Association is 14 gram of pure alcohol.

[00:09:22]And that works out to 5 oz of wine at 12 to 13% alcohol. But here's the thing, not all wine is 12 to 13% alcohol. This is 5 ounces of wine.

[00:09:42]That would be a standard drink. if this wine was 12.5%. But if we want a standard drink with a wine that has 15% alcohol, you would need to pour 20% less to achieve a standard drink in your glass. And remember, wine isn't caloriefree. My nightly wine habit runs somewhere around 800 to a,000 calories per week. So that one glass a night sized pour is maybe closer to two standard drinks on some nights and certainly with the alcohol level. Does that change the risk profile of my behavior?

[00:10:24]>> Well, are they 8% alcohol relings >> sometimes? That's a favorite.

[00:10:31]>> Okay. Uh, I would say not unless it's consistently two, you know, two standard drinks because, um, the data that looks at cardiovascular risk for women is centered around one drink. And at at two drinks, if you pull all those things together, uh, study, at two drinks, you're basically back to the baseline risk of a non-drinker, >> but there's probably a small increased risk of breast cancer at that point compared to drinker. Some modern wine pores are less a glass of wine and more a small carffe. People think they're having one glass of wine when they're really having two standard drinks with the size of bowls and all that these days. The great news is you're already aware of it and honestly that puts you ahead of most people.

[00:11:20]>> The guidelines couldn't give me a straight answer. So I went to the studies and what I found is a little bit more nuanced and honestly more encouraging. Let me show you something.

[00:11:32]When you plot how much people drink along one axis and their overall death rates on the other, you get this shape.

[00:11:39]It's called the J curve. And here's what it shows. The lowest death rates aren't at zero. They're right here. At about one to two drinks a day. Below that, death rates are a bit higher. And above that, especially past three to four drinks, they climb steeply. This isn't a new finding. This pattern has shown up consistently in large studies tracking hundreds of thousands of people over decades. And in 2023, the Nationalmies of Sciences confirmed it. Moderate drinkers have lower overall mortality than both heavy drinkers and people who don't drink. Now, that raised a question for me. If moderate drinking is generally associated with lower death rates, what about wine specifically?

[00:12:26]This was presented at the American College of Cardiology conference. That's the biggest heart health meeting in the country. The researchers used the UK Bioank, which is a database tracking the health records of half a million people.

[00:12:40]And they looked at wine drinkers specifically, not just alcohol, as one big category. What they found was moderate wine drinkers are associated with 21% lower rate of dying from heart disease. 21%.

[00:12:55]That's a big number and it's specific to wine. Now, this study hasn't been published in a journal yet, so it still needs peer review and I really want to be upfront about that, but this is a bio bank scale data that was presented at ACC. This isn't a press release or a blog post or a YouTube video. This is serious science. But a number on its own doesn't explain anything. I wanted to understand why. What is wine actually doing in your body that might be helpful? And here is what the research points to. There's four main mechanisms.

[00:13:33]First, it helps keep your blood flowing smoothly. Blood clots are great when you cut yourself, not so great when one forms inside an artery going to your heart. That's a heart attack. Similar effects resemble lowdose aspirin.

[00:13:48]Second, it raises your HDL. That's your good cholesterol. And third, it's associated with lower diabetes risk. And fourth, and this one's really interesting, moderate alcohol reduces hyperactivity in a part of your brain that controls your stress response. This area is called the amygdala. And when your amygdala is constantly overactive, which happens with chronic stress and anxiety, that directly increases your heart attack risk. Moderate alcohol intake calms that response down and the data linking lower amila activity to fewer cardiac events is strong. So that's the potential upside. But I still wanted to answer the question I'd been asking myself for years. Is wine actually different from other alcohol or am I just rationalizing what I love?

[00:14:42]And I do love it because let's be real, the American Heart Association says ethanol is ethanol at the molecular level. And that's undeniable. A gram of alcohol from wine and a gram of alcohol from vodka are chemically identical. But here's what's not identical. What happens to your body when you consume them? You can have the same total amount of alcohol and if you drink it as wine with dinner over an hour, your blood alcohol level stays down here in the gentle curve. Drink that same amount as a shot on an empty stomach and your blood alcohol spikes to 40 to 150% higher. Same substance, totally different peak. Is my instinct correct that my two glasses of wine with dinner is not the same as two to three shots on an empty stomach even if the alcohol content might be similar.

[00:15:44]>> Absolutely. Um your liver strongly prefers civilized pacing. There there's a huge difference between this. Two glasses of wine uh slowly with dinner is physiologically very different from two shots on an empty stomach.

[00:15:59]uh the food slows the absorption of alcohol and so that your blood alcohol level stays lower and it's cleared more quickly. When alcohol hits an empty stomach, it's immediately transported to the liver through what's called the portal vein. And the liver sees alcohol before the rest of the body, including the brain. And when alcohol hits uh the liver rapidly, it gets a bit overwhelmed.

[00:16:29]And uh while it's it's working overtime, that's what leads to fatty liver disease and eventually cerosis. As you probably know, women are biologically more sensitive to alcohol uh than men are. If you take a man and a woman of the same weight and give them the exact same drink, a woman's going to have a higher blood alcohol level. And that's because women have less total body water than men do. So the uh and blood and alcohol is soluble in water. So there's less area to dilute the alcohol. And the other thing is women just uh have less of the stomach enzyme alcohol dehydrogenase which helps metabolize the alcohol while it's still in the stomach before it gets sent to the liver.

[00:17:17]>> Okay. If you're a woman watching this, I can feel your next question. What about breast cancer? Every time I see a headline about alcohol and cancer, it's aimed at women. So, I wanted to understand what the actual numbers say, not the headlines. Let's start with the big picture. Out of 100 women, 35 will die of cardiovascular disease. That's heart disease. and three will die of breast cancer.

[00:17:49]Heart disease kills more than 10 times as many women as breast cancer and moderate drinking appears to protect against heart disease. That doesn't erase the breast cancer question, but it puts it into perspective that the headlines don't. Now, the breast cancer risk from moderate drinking. At zero drinks per day, a woman's lifetime risk of developing breast cancer is approximately 12%.

[00:18:15]And at one drink per day, it rises to approximately 12.8%.

[00:18:21]That's a 8 percentage point increase.

[00:18:24]It's real, but small in absolute terms.

[00:18:28]We've gone from 12 to 12.8.

[00:18:32]Now, here's where the headlines can be misleading. Instead of saying your risk goes up by8 percentage points, they say your risk increases by 10%. Both descriptions are technically talking about the same change, but one is relative, 10% higher than 12, and the other is absolute, 8 percentage points more. A 10% increase in risk sounds really big. An increase from 12 to 12.8 feels very, very different. Now, let me put that number next to some other things that increase breast cancer risk.

[00:19:12]being overweight 12 to 17% absolute risk having your first child after 30 14 to 15%.

[00:19:22]So this doesn't mean we ignore the increase of risk with drinking. It means we see it clearly. And two studies found that women who take a standard multivitamin with folate, which is basically every multivitamin, suggests that this mitigates the cancer risk associated with moderate alcohol intake altogether. I'm not dismissing the cancer argument. I want to be really clear about that. But when I see the actual numbers and I compare them to risks around me that I accept in my daily life, I can make an informed choice instead of a panicked one. And that is exactly what I wanted.

[00:20:00]>> For someone like me, I'm a woman. I think I'm technically midlife now. Uh, and no major high-risisk genetics that I can see. Uh, how do you personally weigh the breast cancer data against the heart benefit?

[00:20:18]>> An excellent question because all the talk lately seems to be about cancer and cardiovascular disease. We're talking heart attack and stroke kill literally 10 times more women than breast cancer does. Literally. Uh I think the breast cancer association with alcohol also based on observational data is probably real. But it's important to keep that perspective. Um, so for a healthy midlife woman like yourself without strong breast cancer risk factors, I think the potential cardiovascular benefit of moderate intake significantly outweighs the relatively small potential increase in breast cancer.

[00:21:02]The one area where I'd be more cautious is if your mother or sister first-degree relatives have a history of breast cancer or if you have a known BRCA genetic mutation.

[00:21:16]>> How do you can you just take a test for that?

[00:21:18]>> Yeah, that's a blood test.

[00:21:20]>> Oh, that's really helpful.

[00:21:26]I've spent all this time making the case for why my wine habit may be passable, but I'd be dishonest if I didn't say this isn't true for everyone. And we don't have the full picture yet. There are groups where the science is clear and it's a clear no. If you're pregnant, if you're recovering from alcohol use disorder, or if you know you can't control your intake, if you're on medications that interact with alcohol, if you're younger and are afraid of accidental binge drinking, if you've had certain liver conditions, or if you have a family history of alcoholism, be very mindful. One thing that surprised me, for most types of heart disease, moderate alcohol is actually protective. So, a family history of heart disease probably shouldn't be on the scare list, but that's a conversation for your doctor, your actual doctor, not your Instagram feed, and certainly not me. Now, here's what I think is the most important thing anyone's told me in this whole process.

[00:22:29]The single biggest risk from moderate drinking is the moderate drinking part.

[00:22:35]Binge drinking turns out to be very bad for you, even if it's burgundy. And one of the tricky things about when you talk about alcohol and health is that when people hear it might be good for them, they validate unhealthy behavior. And that's not what I'm talking about today.

[00:22:52]One more honest thing about nearly every big study used to assess wine and health is that they're mostly one kind of study. It's called an observational study. Researchers watch large groups of people over many years and record how much they drink and then see what happens to them. Observational studies are powerful for spotting patterns. They can tell us that moderate drinkers tend to have better health outcomes, but they have big limitation. They can't prove what's causing those differences. Many moderate wine drinkers also eat better.

[00:23:26]They exercise more. They have higher incomes and more stable lives. And those things could be driving that lower risk.

[00:23:34]But there is another kind of study, the gold standard. It's called a randomized trial. That's where researchers actually assign people to groups. You drink this much, you don't, and then they compare what happens. And right now, there is a massive randomized trial happening designed to answer exactly this question for alcohol.

[00:23:56]It's called UNATI, Unati. And the results are expected in 2029.

[00:24:04]We are funding huge experiments right now because we don't have the answer to everything yet, but we still have to live in our bodies right now with the best evidence that we do have. And I'll be honest with you, I have friends and colleagues in the wine world who've looked at all of this info and have stopped drinking. And I respect that completely. This is not a one-sizefits-all kind of answer. That's the whole point.

[00:24:30]>> What red flags in someone histories or labs would make you say, "Hey, your nightly glass needs to go to zero."

[00:24:39]>> To me, um I think the biggest risk factor would be loss of control. If people are drinking more than they intended, if they have failed attempts to cut back, >> if they've had blackouts, uh or alcohol is becoming very emotionally necessary in their life. A healthy relationship with wine still involves the human remaining in charge.

[00:25:04]Pregnancy is obviously another situation where I'd advise avoiding alcohol.

[00:25:09]Um, medically I'm concerned about elevated liver enzymes, >> whether it's hepatitis, fatty liver, alcohol consumption, um, statin drugs.

[00:25:25]Uh, those those are all potentially challenging to the liver and the liver enzymes are one of is the most common way we assess liver health.

[00:25:37]So, here is what I'm actually going to do about all of this.

[00:25:42]Step one, I'm building a new weekly calendar. Not because I think my old one was terrible, but because I actually know what the numbers mean and I can be smarter about it. Step two, I'm going to perfect my 2.5 ounce halfpour. It's easy to learn your pore line with a Sharpie marker. It washes off. Step three, save those second glasses for social nights.

[00:26:07]Maybe Friday, Saturday, a dinner party, nights where the wine is just part of the experience, not a habit. Step four, I will take an alcohol-free night after a wine party for sure. And step five, drink my wine with food, preferably with friends. I revise my week.

[00:26:36]All this research and studying has made me, you know, I want to take a proactive approach. Does this look like a pattern as a doctor that you'd be comfortable with for a woman of my age? Assuming that my labs and my family history is okay.

[00:26:56]Yes, I'd be very comfortable with it. Uh the the the intentionality of it all.

[00:27:01]You're you're actively addressing your alcohol consumption, smaller pores, alcohol-free nights, saving larger intake for genuinely social events, uh rather than just routine habit. Um I think that's excellent what you've come up with.

[00:27:21]After months of investigating this, here's where I land. For me, right now, the evidence says that moderate wine with meals inside a healthy life is roughly neutral to maybe mildly protective for my health. And it's clearly positive for my joy, my culture, and my connection to other people. And those things matter, too. What's interesting is we've been here before with coffee. In 1991, the WHO's cancer agency ARC even classified coffee as possibly carcinogenic and the headlines told people to quit drinking it. Then the research matured. Scientists did better studies and controlled for things like smoking. And in 2016, the WHO reviewed over a thousand studies, removed coffee from the carcinogen list, saying there was no conclusive evidence it causes cancer. I am not saying that wine story will pan out the same way.

[00:28:20]But I am saying I've seen this panic cycle before. For a lot of moderate wine drinkers, especially in midlife, the harms and benefits roughly balance out.

[00:28:30]The biggest risk to manage isn't the glass, it's making sure the glass doesn't quietly become a bottle. And we'll know more in a few years when the UNATI unit trial reports. Until then, we'll make the best informed choice we can. What's your advice to a wine lover who wants to be honest with themselves and still enjoy wine?

[00:28:54]>> Yeah, I would I would say uh keep it moderate, keep it social, and ideally uh connected to a meal rather than an escape, you know, on an empty stomach type of thing. If tonight you pour a glass of wine with dinner, I hope it's because you've looked into the evidence, made your own call, and you genuinely enjoy wine. I looked, I decided, and I'm still drinking.

[00:29:22]And because this topic is a heavy hitter with a lot of scientific studies behind it, I'll be posting them along with some of the doctor's commentary from this video on winefolley.com. There's a lot to go through and I encourage you to do your own research. And until next time, happy tasting. Peace out.