The purported health benefits of drinking alcohol in moderation continue to be the subject of study and debate.
Researchers keep finding some positives — an association with a lower risk of heart disease because of the way alcohol impacts the brain’s response to stress, for example.
But negatives keep showing up, too.
Even light drinking was associated with a higher cancer mortality in older adults, a 2024 study found.
Drinking, then falling asleep on a plane can be bad for heart health because the combination of alcohol and cabin pressure can lower a passenger’s blood oxygen level and increase their heart rate, according to a separate 2024 study.
“It’s kind of gone back and forth as to whether it’s healthy for you or not to have that light to moderate drinking. Some of the studies have said yes, some have said no,” NBC News medical correspondent Dr. John Torres said on TODAY.
“What a lot of experts are saying is: No. 1, don’t start drinking just because you think it’s going to help with your heart health.”
How much alcohol is healthy?
No level of alcohol consumption is safe for health, the World Health Organization warns, noting alcohol causes at least seven types of cancer.
The current Dietary Guidelines for Americans recommend skipping alcohol altogether or drinking it in moderation, defined as two drinks maximum a day for men, one drink or less a day for women. Women’s drinking has been of particular concern.
Still, if people choose to drink alcohol in moderation, there are some preferred go-to options, experts say.
“This is a fun indulgence, so choose wisely for taste, serving size and calories,” says NBC News Health and Nutrition Editor Madelyn Fernstrom, Ph.D., certified nutrition specialist.
“If you’re going to drink, there are better choices than others,” adds Ginger Hultin, a Seattle-based registered dietitian nutritionist who once worked as a bartender.
Could alcohol be healthy?
There’s not enough documented health benefit from any type of alcohol to impact short- or long-term health, even red wine, Fernstrom says. The small amount of mixer, such as kombucha, orange juice or tomato juice, people add to some drinks is also not enough to justify a “health benefit,” she adds.
So within the limits of moderation, choose the alcohol you enjoy, but keep in mind the calories in drinks, Fernstrom notes. For example, a bottle of beer can have up to 350 calories; a piña colada has more than 500.
“They go into your body like any other calories and get processed as such,” Hultin, author of “Meal Prep for Weight Loss 101,” tells TODAY.com.
Top healthiest alcoholic drinks
Given all the warnings about alcohol, think of this category as the least unhealthy alcoholic drinks:
A glass of champagne or sparking white wine
A glass of sparkling white wine has about 100 calories. You can even add a splash of orange juice for a refreshing mimosa, Fernstrom says.
“Wine is a go-to for many people, but not of particular health benefit,” she notes. “A ‘spritzer’ is always a good choice — club soda and wine. The bubbles slow down your pace of drinking and cut the calories in half. So you can enjoy another glass for the same alcohol serving size.”
The standard serving size for wine is 5 ounces.
Dry red or white wines, or dry sparkling wine, also don’t have added sugar like a lot of other drinks, Hultin adds.
Light beer
Specifically, beer with lower alcohol by volume, such as Guinness. A standard 12-ounce serving of the smooth dark beer has almost same alcohol content as many light beers, “but (is) very satisfying,” Fernstrom says. “And fermented, which supports gut health.”
Pilsners and lagers also tend to be lower in alcohol and are less calorically dense, Hultin says.
Beer drinking in the U.S. actually fell to the lowest level in a generation in 2023, as beer competes with “sugar-forward alcohol beverages,” NBC News reported.
Spirits
This includes tequila, rum or vodka, “which are pretty pure,” Hultin notes. “On their own or mixed with soda water, those can actually be a good choice in the right portion.”
The problem comes when people pour too much or add a sugary mixer. The standard size for spirits is 1.5 ounces. It’s under 100 calories, and you can keep it there with a club soda mixer, low-calorie tonic water or low-calorie soda, Fernstrom advises.
She suggests drinks such as vodka and club soda with a twist of lemon or orange; rum and diet cola, gin and low-sugar tonic, or a small martini.
Canned hard seltzer or hard kombucha
It contains about 100 calories and the can offers good portion control — just make sure to choose a product without added sugar, Fernstrom says.
Which alcohol is least damaging to the liver?
They all have the same impact because the liver has to process alcohol no matter what form it comes in, “so that’s a volume situation,” Hultin says.
What is the healthiest alcohol for your heart?
It appears any alcohol consumed in small to moderate amounts can be healthy for your heart.
Having a drink a day reduces stress signaling in the brain, which then has a “downstream” effect on the cardiovascular system, a 2023 study published in the Journal of the American College of Cardiology found.
The authors wanted to explain why multiple other studies showed light to moderate drinking reduces cardiovascular disease.
The mechanism seems to be that alcohol dampens the response of the amygdala, the part of the brain that reacts to stress, and triggers higher blood pressure and increased heart rate, they noted.
“It’s about lowering your body’s response to stress,” Torres said. “The alcohol is helping your brain moderate that response.”
So it’s not the flavonoids or resveratrol in red wine that’s protective, as previously thought — it’s the alcohol itself, according to this study. You can have bourbon, red wine, beer or another drink and the benefit is the same, Torres noted.
Of course, there are other ways to relieve stress other than drinking alcohol, including exercise, meditation and spending time with pets.
“We are not advocating the use of alcohol to reduce the risk of heart attacks or strokes because of other concerning effects of alcohol on health,” Dr. Ahmed Tawakol, study co-author and a cardiologist at Massachusetts General Hospital, said in a statement.
In a contrarian 2024 study, more than one alcoholic drink a day increased the risk for heart disease, especially in women.
A 2022 study found drinking any amount of alcohol was associated with increased risk of heart disease.
What is the lowest calorie alcohol?
Light beer has about 100 calories per a 12-ounce bottle, according to the National Library of Medicine.
A 1.5 ounce serving of gin, rum, vodka and whiskey also contains about 100 calories.
For mixed drinks, stick with a Bloody Mary at 120 calories, a rum and Diet Coke at 100 calories, or a Mojito at 143 calories.
Tips for healthier drinking
The experts had this advice:
Don’t drink on an empty stomach
Alcohol is unique in that it gets absorbed right through the stomach, which can hit people faster, Hultin says. “I really recommend that people drink alcohol while eating food, because it’s going to slow the absorption of alcohol and how fast it gets into your bloodstream,” she notes.
Alcohol is dehydrating, so it’s always a good idea to have a glass of water to sip on hand, especially in hot weather, Fernstrom adds.
Skip fruit juice mixers
They’re loaded with extra sugar. That includes drinks like Long Island iced tea made with multiple types of spirits and juices, which can contain 500 calories or more, Fernstrom says.
Be careful with tropical drinks
They’re also full of calories and can contain saturated fat if coconut cream is added in, Hultin notes. The alcohol in fruity, sweet tropical drinks is well masked and goes down so easily that people can drink them too quickly and overdo it, Fernstrom adds.
This article was originally published on TODAY.com
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