A drink with friends is often less about the alcohol and more about the vibe. But alcohol comes with its own health concerns, and it is not just limited to being good or bad. So, is there any safe amount, or does having a drink occasionally significantly impact your health? Experts say the answer depends on quantity, frequency, and why you choose to drink.

What does alcohol do to our bodies?

Longevity physician Dr Peter Attia, speaking to 60 Minutes, calls alcohol a “funny molecule”, pointing out that it is surprisingly dense in calories. “It is seven kilocalories per gram and from a density standpoint, it’s closer to fat than it is protein and carbohydrate. So, you have to be mindful of how many calories you’re consuming, as it’s a pretty empty calorie.”

However, the more serious question is whether it’s carcinogenic, and Dr Peter says it “depends a little bit on the dose.”

While he believes the risk has been overstated, especially at very low doses, he says there is a threshold beyond which ethanol probably has carcinogenic properties, and that it probably varies between men and women. “Women would be less tolerant than men, and it’s probably on the order of two to three drinks a day,” he adds.

Dr Seema Dhir, unit head & Sr consultant in internal medicine at Artemis Hospitals, explains the widely discussed WHO perspective. She says, “The WHO’s ‘no safe level’ does not mean that every drink causes a noticeable health problem. This means that the research has not shown a point at which alcohol-related cancer risk is precisely zero.”

Alcohol is a carcinogen, she explains, and so no amount of alcohol is good for health. But the absolute increase in risk may be small at very low intake. “So ‘no safe level’ refers to risk, not an inevitable health problem after drinking,” she says.

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Is there any safe amount?

The answer is no, reiterates Dr Pankaj Khatana, Sr consultant, internal medicine, Marengo Asia Hospitals, Gurugram, adding, “There is no specific amount or time frame in which alcohol becomes dangerous. Alcohol should not be regarded as a safe or a necessary part of a healthy lifestyle.”

The degree of risk, he adds, may relate to the quantity and pattern of drinking, duration, and individual factors. “The best way to avoid alcohol-related harm is to not drink at all, instead of  finding out what is a completely safe amount to drink.”

Difference between having one drink twice a month and having one every day, even though both may be ‘within limits’

Dr Punya Chopra, senior consultant – internal medicine, diabetologist & rheumatologist, The Women’s Hospital says that the cumulative effect of both is very different. “Within limits does not mean equal or zero risk. One drink twice a month adds up to approximately 24 drinks annually, compared with 365 for daily drinking: roughly 15 times the alcohol exposure. Health risks generally rise with the amount and frequency consumed.”

Citing an example, she says, “NIAAA estimates that one drink a day may increase a woman’s breast cancer risk by 5–15% compared with not drinking.”

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She also mentions that the added risk from two drinks a month is likely to be very small for most healthy adults, provided they avoid binge drinking. Talking about other effects of daily drinking, Dr Chopra says that it “carries a greater chance of disrupted sleep, high blood pressure and habit formation.”

What about the social benefits?

This is where it gets a bit dicey. In the chat with 60 Minutes Dr Peter argues that if alcohol has any benefit, it is not because ethanol is good for you. So any advantage of drinking has to come from some other pro-social effect. Whenever you drink, make it really good. Make it worthwhile. “There has to be a reason for you to drink,” he says, adding, “Try to never have more than two drinks in a day, and try to never drink more than three hours before bedtime because it will negatively impact your sleep. And if you can limit yourself to no more than six or seven drinks a week while adhering to those principles, I can’t tell you that it will have no negative effect on your health, but I think the effect is so small that it probably comes out in the wash, especially if you’re getting the pro-social effect.”

Dr Akhil K Rustagi, senior director & HOD, Cardiology at ShardaCare – Healthcity also takes a cautious route while talking about social occasions. He says, “There’s no alcohol that’s completely risk-free for health. For those who choose to drink, I’d say small amounts and moderate drinking would be the approach, taking your time and not binge drinking. For somebody with a heart condition, it’s better to cut down all amounts.”

The benefit of drinking often has a pro social effect Image Source: Pixabay

Is the risk from an occasional drink comparable to stress or loneliness?

It is always tempting to find ways to justify that one glass of drink to your body, but experts continue to remain cautious. Dr Lakshman Ramachandran, consultant physician, at Kailash Deepak Hospital says, “It would not be scientifically accurate to directly compare an occasional drink with everyday stress, as both affect the body differently.” Explaining how each affects the body, Dr Sahil Nohria, consultant gastroenterology, at Fortis Hospital Jalandhar says, “Stress affects the body through hormonal and nervous system pathways that are largely reversible once the stressor passes. But, alcohol works differently. The liver breaks it down into acetaldehyde, which directly damages cells lining the mouth, oesophagus, stomach, and liver, and that damage adds up over time rather than resetting.”

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Loneliness is another missing link. Dr Chandni Tugnait, MD (A.M) psychotherapist, life alchemist, coach & healer, and founder & director, Gateway of Healing says, “Long-term loneliness seems to shorten life by roughly as much as smoking a few cigarettes a day. That number sounds shocking, but it makes sense once you think about how isolation works. It doesn’t just affect one part of the body, but it wears down the immune system, the heart, and the mind all at once, quietly, over years, mixed in with everything else going on in a person’s life. On the other hand, light drinking works differently, as the harm from an occasional drink is smaller, but it’s also more direct and easier to measure. More alcohol usually means more risk, but loneliness doesn’t behave that way.”

The practical point, as Dr Lakshman points out, is that occasional drinking carries less alcohol related risk than frequent drinking. However, lower risk does not mean no risk, and reducing both the amount and frequency remains the best way to minimise alcohol related health risks.

When does occasional social drinking become a problem 

Perhaps the most important aspect is to note when the equation with alcohol is changing. Dr Akhil says that the changes initially begin to appear in the frequency and the quantity of drinks consumed. The reason matters too. He says, “If a person is using alcohol to help them sleep, to relieve stress or to help them relax, then it might be time to step back. If anyone feels a loss of control and continues to escalate their drinking, that also could potentially indicate a serious issue and it might be time to seek help.”