December 17th was a good day for wine drinkers. A new report from the National Academies of Sciences, Engineering and Medicine (NASEM) unveiled evidence that moderate alcohol consumption can lower risks of cardiovascular disease and all-cause mortality. It went even further to suggest that (responsible) drinking may be better for you than not drinking at all.
Three weeks later, the record scratched. On January 3rd, United States Surgeon General Dr. Vivek Murthy recommended cancer warning labels on alcohol.
Consumers, understandably, are feeling the whiplash. On one end of the spectrum, many of the country’s leading scientists are firmly stating alcohol consumption is tied to lower mortality. On the other: the surgeon general scorning alcohol.
So, who should we be listening to?
The National Academies’s Stance
NASEM’s review, which looked at recent research on the impact of moderate alcohol consumption on health, was commissioned by Congress, directed by the USDA and led by top scientists. The report is one of two that will inform the 2025 edition of the U.S. Dietary Guidelines, which sets the recommended limits of drinking.
“We ended up with three conclusions that reached the level of moderate certainty, meaning there was sufficient evidence to support an association,” says NASEM committee chair Dr. Ned Calonge, associate dean for public health practice at the Colorado School of Public Health.
The first: Responsible alcohol consumption can lower all-cause mortality (defined as death by any cause). The second takeaway is that moderate alcohol consumption can lower one’s risk of cardiovascular disease.
Remember the French paradox? “The report reawakened this discussion that there is a slight cardio-protective effect of alcohol consumption,” explains Dr. Robert Kaplan, an adjunct professor of medicine at Stanford University School of Medicine and a member of NASEM.
The other takeaway isn’t so great—women who consume alcohol have a slightly higher risk of breast cancer than women who have never drank.
Additional health issues, such as weight change, other forms of cancer and cognitive health, were analyzed, but Calonge and team could not find sufficient evidence to make a firm conclusion on negative or positive relations to alcohol.
The Surgeon General’s Report
A few weeks after NASEM released its report, the surgeon general, Dr. Murthy, released an advisory report on his stance on alcohol. It was, quite literally, sobering.
His report, which is his summary of current literature, linked seven types of cancer to casual drinking. “What we know with a high degree of confidence is that there is a causal link between alcohol and cancer risk,” writes Dr. Murthy in the report.
Dr. Murthy called out alcohol as being the third-leading preventable cause of cancer in the United States, following tobacco and obesity. There are roughly 20,000 alcohol-related cancer deaths in the country annually—more than drunk driving fatalities.
It’s important to note that both studies are arguing over the consequences of a glass or two a day, in line with the current Dietary Guidelines for Americans—one drink a day for women, two for men. Excessive drinking is detrimental, hard stop.
To lower alcohol-related deaths, Dr. Murthy recommends cancer warning labels be added to all alcoholic products, joining warnings against drinking while pregnant or operating heavy machinery.
Any mandatory label change would need to be approved by Congress. It’s unclear if it will happen—Dr. Murthy will be leaving the office on January 20th. President-elect Donald Trump has chosen Janette Nesheiwat to replace him.
Understanding the Research
Studies can have contradictory results for a number of reasons. Some use too small a subject group; others are swayed by Big Alcohol dollars or other biased agencies. Some studies don’t separate light-to-moderate and heavy drinkers, a.k.a. the casual wine drinkers versus the hard-core liquor consumers.
In the surgeon general’s report, Dr. Kaplan noticed a tendency to lump together moderate and heavy drinkers. “They didn’t do a good job of toggling back and forth between the occasional and the high-risk drinkers,” he explains. “It sounds as if every swallow you take increases your risk, and evidence is not that way.”
It gets murkier when you consider that many study respondents aren’t transparent about how much they drink (ever round your weekly glasses down to your family doctor?), which can further skew results.
Other studies went awry when comparing drinkers with people who do not currently drink. “There’s a worry that past drinkers may stop drinking for health-related reasons, such as an alcohol-related illness or alcohol use disorder,” explains Dr. Calonge. “They quit for a reason, and have worse health status than a moderate drinker.”
To combat flawed data, the National Academies put a heavy emphasis on transparency. They only consider studies comparing drinkers versus lifetime abstainers.
Additionally, the Academies look for experts who are well known and respected to issue its reports, explains Dr. Kaplan. “They post those names on their website. They look carefully to determine whether people can look at evidence objectively. Anybody can challenge the membership of the committee for conflicts of interest, be it intellectual or financial.”
Two proposed members were booted from the committee because of ties to the alcohol industry.
Once the committee is formed, data is gathered in open sessions. “Anybody can look at the materials,” Dr. Kaplan says. “And testimonies before the committee are public. It’s not a big crowd, but people show up.”
The final report is peer reviewed by ten experts in the field, along with professors and senior academics from across North America.
The Fall Out
Both reports are the newest additions to a dog pile of confusing claims, both in favor of and against alcohol consumption.
It started in 1991, when journalist Morley Safer went on 60 Minutes and—wine glass in hand—put forward the concept of the “French paradox.” If the French drink wine and feast on buttery foods, why are heart disease levels low in that country? Should Americans follow suit?
Similar studies and stories singing the benefits of Burgundy and Barolo began popping up over the ensuing decades.
In 1997, the prestigious New England Journal of Medicine reported that found that “overall death rates were lowest among men and women reporting about one drink daily.” Nearly 15 years later, Glamour posed the idea of a Champagne diet, hailing its ability to reduce alcohol consumption while benefitting the heart, brain and libido.
But wine’s health halo has gone crooked over the last few years.
A 2018 study in The Lancet declared that alcohol—in any amount—is not safe for consumption. In 2023, the World Health Organization (WHO) co-signed The Lancet’s claim.
Then, the International Journal of Epidemiology announced that the 2018 Lancet study was flawed. And just this month, two researchers at Harvard’s School of Public Health and Medical School revisited the idea that alcohol in limited amounts could potentially extend lives.
Scientists are divided. Some demonize drinking. Others argue that wine is fine; a glass or two with meals will do no wrong. Some others are blaming a new neo-prohibitionist movement, out to villainize booze.
“The surgeon general’s announcement is unwelcome, but not surprising,” says Dave Parker, founder of Benchmark Wine Group. “It’s a broad-sweeping response based on incomplete data, and aligns with the neo-prohibitionist or anti-alcohol movements that have been trending lately.”
Some industry members, like journalist Jessica Dupuy, who covers wine, spirits and travel for publications like Decanter, Forbes and Texas Monthly, take issue with the surgeon general targeting alcohol. If obesity is the second-leading cause of cancer (and contributes to 7% of cancer cases annually in the U.S., compared to wine’s 4 to 5%), why not target ultra-processed foods?
What Does This Mean for Your Daily Glass?
Unfortunately amidst this rigamarole, the burden lies on each drinker to decipher their own risks.
Alcohol can slightly raise your risk for breast cancer, but smoking, diet, genetics and other environmental factors are also at play. The health risks of alcohol will also depend on frequency and amount. The more you drink, the higher the risk.
“If I continue to have wine with dinner, my probability of getting cancer may go up,” explains Dr. Kaplan. “But it’s a small percentage point, not a big accelerated risk. If someone is drinking four drinks a day, it’s a completely different story.”
The social and cultural impact of wine is also important to consider.
“Alcohol, especially wine, has deep ties to people's culture, community and history,” says Parker. “Using verbiage such as ‘cancer-causing’—based on frankly murky intentions—risks ripping these bonds apart.’”
Like so many other aspects of life, it’s all about weighing risk with reward.
“It’s complicated,” says Dr. Kaplan. “Like anything in life, we make choices. We put our kids into competitive athletics, even though it’s one of the most common reasons for emergency room visits among children. We may be taking a small risk with occasional wine consumption, but it’s not a big risk. It’s a trade, for enjoyment of food, wine and life.”
More Health Coverage
- Is tasting 3,000 wines a year hazardous to your health?
- Warning labels on alcohol are coming. Will drinkers even care?
- Is a glass of wine a day good for you? We investigate.
- Is Dry January the healthy move? Blue Zones’ Dan Buettner weighs in.
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Published: January 8, 2025
