The ongoing debate over the health impacts of alcohol has taken a significant turn, raising questions about what advice Americans should follow regarding alcohol consumption. A recent report from the National Academies of Sciences, Engineering, and Medicine, commissioned to shape the next edition of the U.S. Dietary Guidelines, has revived a long-standing but increasingly controversial claim: moderate drinking might offer health benefits. This report, released in December, is at odds with an emerging consensus in the scientific community that alcohol poses more harm than good.
The National Academies’ review suggests that moderate drinking may lower the risk of heart attack, stroke, and overall mortality, sparking renewed debate among health experts. This hypothesis was once a cornerstone of public health advice, but recent studies have raised concerns about alcohol’s carcinogenic effects and its links to a range of serious health issues.
While the report acknowledges the link between alcohol and an increased risk of breast cancer, it concludes that the evidence supporting alcohol’s role in causing other cancers is insufficient. This conclusion contradicts the position of numerous scientific bodies, including the National Cancer Institute, which argues that alcohol consumption is a known carcinogen.
As the U.S. prepares to revise its Dietary Guidelines, due later this year, critics fear that the National Academies’ conclusions could undermine public health efforts and delay addressing alcohol’s growing harms. Diane Riibe, co-founder of the U.S. Alcohol Policy Alliance, which advocates for stricter alcohol policies, expressed concern that the report could serve the interests of the alcohol industry rather than public health.
Alcohol industry representatives, including those from the Distilled Spirits Council of the United States, maintain that the guidelines should reflect “sound science.” In a joint statement, alcohol trade organizations urged the U.S. government to preserve the integrity of the guidelines, advocating for informed decision-making around alcohol consumption.
However, critics argue that the report’s conclusions, particularly its portrayal of moderate drinking as a potential benefit, overlook growing evidence about alcohol’s dangers. Dr. Marion Nestle, a prominent nutritionist, criticized the report for its failure to adequately address the latest scientific findings. “The alcohol industry is pushing to halt progress in understanding alcohol’s harms,” she said, referencing the industry’s past resistance to warnings about alcohol-related cancers.
Internationally, health organizations have increasingly emphasized the risks of alcohol, advocating for reduced consumption or complete abstinence. The World Health Organization, Canada, the United Kingdom, and other countries have adopted the stance that no level of alcohol consumption is truly safe. Some scientists are even suggesting that the health risks of alcohol may begin with the very first drink.
In contrast, the U.S. guidelines have remained largely unchanged, despite evidence suggesting that even moderate drinking carries significant risks. The 2020 update to the U.S. Dietary Guidelines, for instance, acknowledged the risks associated with alcohol but still upheld the advice that moderate consumption—up to one drink per day for women and two for men—was considered safe.
The National Academies’ report is just one piece of the puzzle, with another governmental analysis expected soon. This second report, produced by the Interagency Coordinating Committee on the Prevention of Underage Drinking, will likely focus on the direct health consequences of alcohol use, such as its role in liver disease, heart disease, and various cancers.
Scientists who are critical of alcohol’s health benefits, like Dr. Tim Stockwell from the University of Victoria, argue that the National Academies’ review was selective in its inclusion of studies. Many studies documenting alcohol’s harms were excluded from the panel’s analysis, raising questions about the completeness of its findings. As the government moves toward issuing new guidelines, there are hopes that the second report will address these concerns, providing a clearer picture of alcohol’s risks and prompting necessary changes in public health policy.
As the U.S. continues to grapple with the implications of alcohol consumption on public health, it’s clear that the conversation is far from settled. With rising concerns about alcohol-related diseases, the role of the alcohol industry, and differing global health guidelines, the U.S. is at a crossroads in determining how best to advise its citizens about alcohol.
The upcoming revisions to the Dietary Guidelines will play a crucial role in shaping how American
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