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eWellness: Alcohol: Benefits vs. Risks

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Dr K K Aggarwal    03 May 2020

  • There is consensus that non-drinkers should not start and the ones who drink can continue provided they do so in moderation and in absence of contraindications.
  • Persons who have been lifelong abstainers cannot be easily compared with moderate or even rare drinkers. Recommending alcohol intake to non-drinkers, even if they would agree to drink, is not justified.
  • The diseases that moderate alcohol use prevents (such as coronary heart disease, ischemic stroke, and diabetes) are most prevalent in the elderly, men, and people with coronary heart disease risk factors. For these groups, moderate alcohol use is associated with a considerable mortality benefit relative to abstention or rare drinking.
  • For young to middle-aged adults, especially women, moderate alcohol use increases the risk of the most common causes of death (such as trauma and breast cancer).
  • Women who drink alcohol should also take supplemental folate to help decrease the risk of breast cancer.
  • Men below 45 years of age may also experience more harm than benefit from alcohol consumption. In this age group, moderate alcohol use is not likely to provide any mortality benefit, but consumption of less than one drink a day appears to be safe if temporally removed from operation of dangerous equipment. For individuals with established contraindications to alcohol use, even this level of alcohol use is dangerous.
  • Men can tolerate more alcohol than women. The ideal therapeutic dose of alcohol is around 6 g per day. Medically safe limits are 10 g in one hour, 20 g in a day and 70 g in a week (50% for women).

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