Drink less or no alcohol

19. Drink less or no alcohol

Cost: There is no cost at all — it saves money and time. The only difficulty is handling social pressure to drink.

In plain terms: After consuming 100 g of pure alcohol per week, the more one drinks, the earlier they tend to die. 100 g of pure alcohol is roughly equivalent to 2.5 L of beer. At age 40, people who drink 100–200 g per week lose about half a year of life expectancy; those drinking 200–350 g lose 1–2 years; and those drinking over 350 g lose 4–5 years. Overall, the healthiest amount to consume is none at all.

Benefit: A combined analysis of 83 longitudinal studies involving 600,000 drinkers showed that the lowest mortality risk occurs at consumption levels of no more than 100 g of pure alcohol per week — roughly 2.5 L of beer at 5% alcohol content, or 300 mL of 40% alcohol spirits. At age 40, drinking 100–200 g per week shortens life expectancy by about 6 months; 200–350 g shortens it by 1–2 years; and over 350 g shortens it by 4–5 years. The Global Burden of Disease Study 2016 also concluded that zero alcohol consumption per week carries the lowest overall health risk. One adjusted analysis found that daily consumption of 1.3–24 g of alcohol was linked to a 7% lower mortality risk (RR 0.93) compared to lifelong abstainers, though this difference was not statistically significant. Daily consumption of 45–64 g raised risk by 19% (RR 1.19), and 65 g or more raised it by 35% (RR 1.35).

Evidence grade: A

Sources: Wood AM et al. (2018). Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. Lancet. <https://doi.org/10.1016/S0140-6736(18)30134-X>; GBD 2016 Alcohol Collaborators (2018). Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. <https://doi.org/10.1016/S0140-6736(18)31310-2>; Zhao J et al. (2023). Association Between Daily Alcohol Intake and Risk of All-Cause Mortality: A Systematic Review and Meta-analyses. JAMA Network Open. <https://doi.org/10.1001/jamanetworkopen.2023.6185>; Di Castelnuovo A et al. (2006). Alcohol dosing and total mortality in men and women: an updated meta-analysis of 34 prospective studies. Archives of Internal Medicine. <https://doi.org/10.1001/archinte.166.22.2437> (disputing party)

Notes: This topic remains debated. Proponents of the “moderate drinking is beneficial” view cite a meta-analysis of 34 long-term studies showing that light drinkers have up to 17–18% lower overall mortality rates; they define “light” as up to 4 drinks per day for men and 2 for women. However, critics argue that abstainer groups often include people who stopped drinking due to illness or those with pre-existing health issues. After adjusting for such factors, the protective effect of moderate drinking disappears. Given this uncertainty, the safest conclusion is that drinking less does not meaningfully extend life, while drinking more definitely shortens it. There is no evidence supporting the idea of “starting to drink for health reasons.” Practical advice on cutting back is provided in Section 21, and guidance on quitting daily drinking is given in Section 20.