Beer: Still good for what ‘ales’ you?

As Homer Simpson famously said, “Here’s to alcohol: the cause of, and solution to, all of life’s problems.” Put another way, alcohol has both beneficial and toxic effects on health. The problem that researchers—and individuals like Homer—have had is finding the right balance between the two.

With the celebration of St. Patrick’s Day upon us, now’s a good time to take a closer look at what goes into our beer mug—and what we get out of it, both the pros and the cons.

PRO: Light drinking linked to lower risk of heart failure. In a meta-analysis of 13 prospective studies, which included a total of 355,804 participants, researchers found that light alcohol drinking (0.1 to 7 drinks per week) was associated with a lower risk of heart failure. Moderate (7.1 to 14 drinks per week), high (14.1 to 28 drinks per week), and heavy (> 28 drinks per week) drinking were not associated with heart failure risk. However, former drinking was associated with an increased risk of heart failure compared with never or occasional drinking.

CON:Drinking is linked to premature death. In a major meta-analysis of 83 prospective studies involving nearly 600,000 current drinkers in 19 countries, a panel of 120 researchers concluded that drinking more than 100 g of alcohol per week (about 5 to 6 pints of beer) was associated with premature mortality. As consumption increased, the risk of death from stroke, coronary disease, heart failure, fatal hypertensive disease, and fatal aortic aneurysm also increased.

Further, the researchers estimated that adult men who consume 196 g of alcohol per week (the upper limit recommended in US guidelines) could extend their life expectancy by 1 to 2 years if they halved their alcohol consumption to 100 g per week or below.

On the upside, drinking 100 g or less of alcohol per week was not linked to decreased mortality but was associated with a lower overall risk of cardiovascular diseases, including heart attack, coronary heart disease, and stroke.

PRO: Drinking reduces death from heart attack? Another positive result from the above meta-analysis: Moderate alcohol consumption was associated with a reduced risk of mortality from heart attack. While some studies, such as this one, have shown that further increasing alcohol intake doesn’t correspond with an upward trend in heart attack risk, other studies have shown that binge drinking and heavy drinking do increase heart attack risk.

CON:Heavy drinking is unhealthy. Besides increased risk for heart attack, heavy drinking is also linked to increased risk for stroke, liver disease, dementia, heart disease, and other serious conditions including weight gain.

PRO: Beer reduces the risk for diabetes. When compared with teetotaling, drinking up to two beers (about 24 g alcohol) per day has been associated with an average 30% lower relative risk for type 2 diabetes. The protective effect appears to be greater in women (40%) than in men (13%).

“The biological mechanism is uncertain,” the researchers wrote, “but there are several factors that may explain the relationship, including increases in insulin sensitivity after moderate alcohol consumption, changes in levels of alcohol metabolites, increases in high-density lipoprotein (HDL) cholesterol concentrations, or via the anti-inflammatory effect of alcohol.”

PRO: Beer buoys good cholesterol (in chubby men). In a recent 12-week prospective study of 36 overweight men, researchers reported that moderate beer drinking (30 g alcohol per day) of either regular or non-alcohol beer didn’t induce vascular endothelial dysfunction or stiffness, nor did it increase body weight.

“In contrast, moderate intake of beer was associated with favorable effects on HDL function increasing its capacity to protect against LDL oxidation and to enhance cholesterol efflux, which may prevent lipid deposition in the vessel wall,” the authors concluded. They acknowledged the short duration and small sample size in their study, but suggested that their research lays the groundwork for larger ones.

CON: Drinking beer causes cancer. There’s no uncertainty about it: Drinking alcohol of any type—beer, wine, or liquor—is a definite risk factor for several types of cancer, including breast, colon, esophageal, and head and neck cancers. According to the American Society of Clinical Oncology (ASCO), between 5% to 6% of new cancers and cancer deaths globally are directly attributable to alcohol.

“People typically don’t associate drinking beer, wine, and hard liquor with increasing their risk of developing cancer in their lifetimes,” said former ASCO President Bruce Johnson, MD. Indeed, 70% of Americans aren’t aware that drinking alcohol is a risk factor for cancer, according to ASCO’s National Cancer Opinion Survey.

PRO: Raise a glass, raise your spirits.Drinking beer makes you feel good. “To a greater degree than either abstainers or heavy drinkers, moderate drinkers have been found to experience a sense of psychological, physical, and social well-being; elevated mood; reduced stress (under some circumstances); reduced psychopathology, particularly depression; enhanced sociability and social participation; and higher incomes and less work absence or disability,” concluded mental health/addiction researchers.

They also concluded, in short, that drinking for pleasure in the convivial company of others is good for mental health and is linked to longer life, while drinking alone to drown one’s sorrows is mentally unhealthy and can increase mortality.