In 1991, Sixty Minutes ran a segment that tackled the so-called “French paradox” — the phenomenon in which French folks had better heart health than Americans even though both countries consumed high-fat diets. The conclusion: French people had better heart health because they drank wine with dinner.
After the one-hour special, red wine sales in the United States spiked by almost 50 percent. And for more than thirty years, that was the truth we lived with; that not only is a glass of wine in celebration or a drink in commiseration harmless, but it’s even beneficial. Generations of women never had a reason to question the glass in their hands.
As it turns out, that particular truth is not exactly true, and maybe we should bat an eye. Or both. More research has been coming out on the dangers of alcohol, with some debunking previous claims that it’s good for longevity.
As our understanding of alcohol and its impacts on our bodies and minds evolves, it’s becoming harder to justify the pervasiveness of alcohol’s role in women’s lives under the umbrella of health. But does that mean it’s time to quit drinking alcohol? The answer isn’t as cut and dry as we may want.
In March 2023, the Journal of the American Medical Association (JAMA) published a review that analyzed four decades of alcohol research. The review authors found flaws in how the studies conducted their research and ultimately concluded that alcohol was associated with no positive health benefits.
The main flaw the authors identified related to how those studies categorized drinkers versus nondrinkers. Many of the folks in the non-drinking group were actually former drinkers who’d given up alcohol after developing health issues. The review authors found that when they compared former drinkers to “lifetime abstainers” the former drinkers had “significantly elevated mortality risks compared with lifetime abstainers.”
The review authors also noted that former studies did not account for the fact that their sample group of nondrinkers was largely made up of older men. Many might have been previous drinkers who may have given up alcohol for health reasons. They also did not factor in that light and occasional drinkers are “systemically healthier than current abstainers.” In other words, the light and moderate drinking group was made up of folks who were more likely to practice healthy habits such as dental hygiene and exercise routines to support healthier lifestyles. Meanwhile, abstainers geared more towards older age and were more “biased toward ill health.”
Taken all together, it means prior studies were wrong to simply look at both groups as if the only variable was alcohol consumption. When reviewers adjusted for all other factors, they found no benefit to alcohol consumption.
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In fact, they found that higher levels of alcohol consumption were associated with negative health consequences, an idea echoed by Dr. Greg Hobelmann, M.P.H., co-CEO and president of Ashely Addiction Treatment. According to Dr. Hobelmann, “There’s no physiological benefit” to drinking alcohol, and in fact, the overall health impact is a “net negative.”
For women, those negative consequences start at lower levels of alcohol consumption than they do for men. Just two glasses of wine or two standard cocktails with 1.5 ounces of liquor a night actually had a negative impact on women’s health. Moreover, when comparing female drinkers to female lifetime abstainers, the review authors found “significantly larger risks of mortality among female drinkers compared with female lifetime non-drinkers.”
Dawn Sugarman, Ph.D., a research psychologist at McLean Hospital, was not surprised by the recent findings, nor by the fact that women are more susceptible to alcohol’s negative health impacts. In an email to Flow, Dr. Sugarman wrote that sex differences make women more vulnerable than men to the negative health impacts of alcohol — including cirrhosis, cardiomyopathy, and nerve damage — after fewer years of heavy drinking than do men. The recent JAMA review adds to this growing list of concerns. Unlike previous findings, both men and women were not protected from premature death even if they drank one or two glasses a week.
Damage To The Brain
Over six million Americans live with Alzheimer’s, and almost two-thirds are women. For a long time, researchers explained the high number of women living with Alzheimer’s by pointing to the fact that women generally live longer than men. However, other factors, such as alcohol, may also be at play. A 2020 review of the link between alcohol and dementia found that excessive alcohol use — more than 14 drinks per week — was “certainly linked to an increase in dementia risk.”
Dr. Sugarman confirmed this finding, noting that excessive alcohol use — eight or more drinks per week for women — can lead to brain damage. This may increase the risk of developing dementia.
While it’s worth being aware of the increased risk of dementia, it may not be a reason to empty your wine cabinet. Kellyann Niotis, MD, a preventive neurologist at Early Medical and Flow Advisory Council member, helped put it into perspective. In an email to Flow, Dr. Niotis noted that excessive alcohol use is a risk factor for dementia, and “is thought to account for about 1% of dementia cases. As a comparison, social isolation is estimated to account for 4% of dementia cases.”
Impact On Sleep
By now, most of us are aware of the importance of a good night’s sleep. We’ve been told countless times how sleep has a positive impact on our bodies, minds, and immune systems.
Most of us know also that alcohol is a sleep disrupter, and even if you’re logging in the hours at night, consuming alcohol may ruin the quality of that sleep. “Although alcohol might help you fall asleep faster, you are likely to wake up again as the alcohol leaves your body and the quality of sleep you get is poor,” writes Dr. Sugarman.
For women, the effects of alcohol on sleep seem to be even more pronounced. A 2011 study found that “total sleep time, sleep efficiency, nighttime awakenings, and wake after sleep onset were more disrupted in women than men.” Essentially, women had a worse night of sleep than men, despite going to sleep at comparable levels of intoxication.
Increased Cancer Risk
There is a strong link between alcohol and breast cancer. A pooled analysis of more than fifty studies found that each alcoholic drink can increase a woman’s breast cancer risk by approximately 7 percent. When the number of drinks rises to 2 or 3 per day, the risk was 20 percent higher when compared to women who don’t drink alcohol at all.
Unfortunately, even though breast cancer accounts for approximately 30 percent of all new cancer cases in women each year in the United States and is the most commonly diagnosed cancer globally, researchers still don’t know exactly why alcohol consumption increases breast cancer risk. They do have theories, however, involving an increase in levels of estrogen or folic acid, both of which are associated with breast cancer.
Breast cancer isn’t the only cancer risk alcohol increases. The National Toxicology Program of the US Department of Health and Human Services considers alcohol a human carcinogen, and its consumption has been linked to an increased risk of other cancers, including head and neck, esophageal, colorectal, and liver cancer. The “evidence indicates that the more alcohol a person drinks—particularly the more alcohol a person drinks regularly over time — the higher his or her risk of developing an alcohol-associated cancer.”
Therese Bevers, MD, medical director of MD Anderson’s Cancer Prevention Center, urges caution in understanding the information available, particularly for moderate drinkers. “You need to be more concerned if it becomes a routine in which you drink more than one drink each day.”
What Happens When You Stop Drinking
“When you stop drinking, in very short order, you will start to feel the beneficial effects,” notes Dr. Hobelmann. Most people can expect to see positive changes in their concentration, improved mood and sleep, and an increase in energy within days.
Abstaining from alcohol can even impact brain health in a positive way. According to Dr. Sugarman, “most alcohol-related cognitive impairment shows at least some improvement in brain structure and functioning within a year of abstinence from alcohol, though some people take much longer.”
Considering the potential risks and without the premise of believing there’s a health benefit to alcohol, many women are choosing to quit drinking alcohol altogether. The “sober curious” movement has grown in popularity in the last few years.
Being sober-curious means being more intentional about the decision to drink alcohol, and it’s a trend that Jami Mayo, the lead research associate at Ashley Addiction Treatment celebrates. “It gives the power back by defining our own boundaries, and breaking down these historical social norms that have been ongoing for thousands of years.”
Is It Time To Quit?
Quitting alcohol is a personal choice. For those drinking specifically for alcohol’s health benefits, the science might make it easier to quit since it actually leads to more health problems.
For others, the choice to quit or not is less easy. Alcohol is rooted in our social norms and habits, and that’s okay. Drinking to socialize or because you enjoy a beer or glass of wine with dinner isn’t the end of the world. But it requires some intentionality because when it comes to alcohol, moderation is key.
“A person can consume alcohol responsibly, at a dose that doesn’t hit the level of toxicity, without any serious costs to their health,” says Dr. Niotis, who urges her female patients to limit themselves to one drink at a time. “[O]ccasionally enjoying a glass or two of chardonnay with your girlfriends isn’t going to negatively impact your health. In fact, that social interaction can benefit brain health!”
Above all, whatever choice feels right to you, the best thing you can do is pay attention to your body and stay informed so that you can show up in your life as the best version of yourself.
