Sarah Wakeman: Most Replayed Moment: Is There A Safe Amount Of Alcohol? What Happens To The Body When You Drink!

The host opens by noting that alcohol has "been on the journey" in terms of society's opinion of it. They ask the guest to trace how views of its health benefits have changed and to say what people still get wrong. The guest starts by challenging the idea that drinking is a modern habit. Archaeologists, the guest says, have found beer-making equipment in hunter-gatherer cave dwellings from 13,000 years ago.

The guest adds that in China 9,000 years ago, alcohol was about a spiritual journey or a social activity and "was never really about health." The health framing came later, with messages like drinking red wine to improve your health. The guest calls this the point "where I think we got wrong," and puts the error down to how researchers were reading the data.

The guest makes two points about the old evidence. First, if you look at only one health condition, there are some conditions where a moderate amount of alcohol does improve health. Second, the way the studies were designed mattered. Typical studies followed very large populations, tens of thousands of people, who reported how much alcohol they drank. Researchers then tracked their health risks over time and sorted them into non-drinkers, light drinkers, moderate drinkers and heavy drinkers.

These studies found that people drinking up to the moderate level seemed to do better than people who did not drink at all. That finding is where the idea of drinking for health came from. The pattern is often described as a J-shaped curve. Moderate drinkers appear to have lower risk of health problems, and only at very high levels of drinking does risk rise above that of non-drinkers.

The flaw, according to the guest, was in the comparison group. Many people who do not drink at all are unhealthy for some other reason. Someone might have heart failure and avoid alcohol so it does not interact with their medication. Others might have a history of alcohol use disorder and be in recovery, so alcohol has already done them some damage. Including these people in the non-drinker group makes drinkers look healthier by comparison.

When researchers change the reference group to people who drink very rarely, at very light levels, rather than people who do not drink at all, the apparent health benefits start to disappear. The guest says this is especially true when you look across all conditions together rather than just one.

The host asks directly whether there is no healthy level of alcohol consumption. The guest agrees, with a careful qualification.

I would never say drinking alcohol is good for your health.

The guest also says this does not mean drinking at what they call low risk levels cannot be part of a healthy lifestyle. They describe it as "a slight shift." The advice is "don't fool yourself into thinking that drinking that glass of wine is like going to exercise for 30 minutes," because alcohol does not promote health. The guest compares it to having dessert, eating bacon or going out in the sun. All of these carry risks, and the guest would not say you can never do any of them. The point is to understand the risks and then make your own choices.