Is it safe for women to drink alcohol?

People drinking red wine at Chritamas party at home

Before answering your question, let’s define “one drink”: it’s 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor. And it means having one drink each day of the week, not having seven drinks on Saturday night, sleeping it off Sunday, and begging off until next Saturday night. Now, despite the recent study, we stick with what we’ve said, which reflects the research of outstanding nutrition scientists at Harvard and elsewhere.

But please notice the word “generally” in your question. There are many nutritional practices that may be healthy for most, but not all, people. Why? Because people are different: our age, gender, genes, and lifestyles are different. And because with some types of food, a little is good but a lot is not: in small doses they’re a tonic, but in larger doses they’re toxic. And because some practices affect the risk of one disease very differently from the risk of another. And because, globally, nations are very different in their lifestyles and disease risks. The question of alcohol in women highlights the importance of all these differences.

Your genes and your gender influence whether you might become addicted to alcohol, how efficiently you metabolize alcohol, and the effect of alcohol on your organs. In small doses, alcohol changes body chemistry in ways that reduce heart attacks and strokes. In larger doses, however, it damages many organs, including the heart, brain, and liver, and it damages the fetus in a pregnant woman. Also, alcohol addiction plays a key role in traffic deaths and violent crime. As for global differences, the study you’re probably referring to was heavily influenced by death rates in developing nations, where death from tuberculosis (fueled by alcohol) is much more common than in the United States.

As for the effect of alcohol on different diseases, more than 100 studies show that a woman who has one drink per day, compared with a woman who does not drink, has a reduced risk of having a heart attack and the most common kind of stroke. Yet, many of these same studies also show that even a drink a day increases a woman’s risk of breast cancer. In thinking about this trade-off, it’s important to know that heart attacks are by far the most common cause of death in women, killing 10 times more women than does breast cancer.

So a woman who is pregnant, or who has a personal or family history of breast cancer, liver disease, or alcohol abuse, should generally avoid alcohol. For others, one drink a day is generally healthy.

— by Anthony L. Komaroff, M.D.
Editor in Chief, Harvard Health Letter

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