Pleasure or risk? Alcohol from a longevity perspective

For many people, alcohol is part of a social get-together, but for others it is an underestimated health risk. But what does science really say? Peter Attia, doctor and longevity expert, provides clarity. His analysis is based on hard evidence, but his recommendations remain pragmatic. Those who drink should do so consciously and in moderation.
Alcohol is no ordinary nutrient
Alcohol is not just another food. While fats, carbohydrates and proteins are essential macronutrients, alcohol mainly provides empty calories. At seven kilocalories per gram, it is almost as high in calories as fat. But the real danger lies in how it is metabolised. The liver produces acetaldehyde, a toxic intermediate product that is associated with various diseases.
What does research really say
Attia emphasises that many findings are based on epidemiological studies. In other words, on observations, not on controlled experiments. While the health risks of tobacco are undisputed, the situation with alcohol is more complex. The often-cited J-shaped curve, according to which small amounts are even said to be healthy, is deceptive. Many ‘non-drinkers’ in studies are former alcoholics or people with pre-existing conditions. A statistical distortion effect.
A comprehensive JAMA meta-analysis from 2023 with over five million participants showed that people who consume less than one drink per week or up to one and a half drinks per day had no increased risk of mortality compared to lifelong teetotallers. But as soon as consumption increases to three or more drinks per day, the risk of cardiovascular disease, dementia and cancer increases significantly. Women are particularly sensitive because their bodies produce less alcohol dehydrogenase, the enzyme that breaks down alcohol.
Attia's conclusion: set clear limits
The bottom line is clear. At no level of consumption is alcohol beneficial to health. Nevertheless, Attia is not advocating total abstinence. Those who occasionally drink a glass of wine or beer should be aware that the benefits are purely social and not health-related. He believes that the critical limit is a maximum of one drink per day. But even then, it is worth asking whether alcohol is disrupting your sleep, promoting unhealthy eating habits or affecting your fitness in the long term.
The pragmatic solution is to enjoy it with strategy
Attia advocates a conscious approach. Quality over quantity. Those who drink should make sure that alcohol does not become an unnoticed habit. His pragmatic advice is clear. Two drinks a month with friends is not a problem. Twelve beers in one evening is.
Ultimately, alcohol is a personal decision. But if you value longevity, you should know that the healthiest glass is the one you don't drink.
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