A government alcohol study published Tuesday concluded that the health risks of alcohol start at a single drink a day. The report was caught up in controversy after drawing the ire of the alcohol industry.
At one drink a day, the researchers found, there was an increased risk of premature death from an illness or injury directly attributable to alcohol, though it was small — 1 in 1,000 people. But the risk of premature death jumped to 1 in 25 for those who had two drinks a day, a level long considered safe for men, according to the study, which was published in the Journal of Studies on Alcohol and Drugs.
The Alcohol Intake and Health Study was one of two reports commissioned during the Biden administration to inform an update to the US dietary guidelines.
The second report, from a panel appointed by the National Academies of Sciences, Engineering and Medicine, or NASEM, came to very different conclusions. It suggested that moderate drinking (up to two drinks a day for men and one for women) was healthier than not drinking at all, although it noted that moderate drinking was also linked to a higher breast cancer risk. Some of the panelists behind that report had financial ties to the alcohol industry.
The second report’s finding was more palatable to the alcohol industry, which had called the Alcohol Intake and Health Study ideologically driven and scientifically flawed, and said it had communicated its concerns repeatedly to government officials over a period of several years.
When the Trump administration finally issued the new dietary guidelines in January, they advised Americans to drink less for better health but omitted any recommendation for daily limits, in a departure from previous years.
“The new dietary guidelines say that consuming less is better for your health, but don’t say what consuming less means,” said Priscilla Martinez-Matyszczyk, one of the authors of the new paper and the deputy scientific director of the alcohol research group at the nonprofit Public Health Institute. “This paper does, and it says that having no more than one drink a day is best for health, and that drinking above that comes with significant risks.”
A standard drink is defined as 12 fluid ounces of regular beer, 5 ounces of wine or 1.5 ounces of distilled spirits.
In an editorial accompanying the new paper, Robert M. Vincent, the former government official who commissioned the study, said he believed he was fired because the report produced evidence “at odds with commercial interests.” Vincent lost his job as associate administrator for alcohol prevention and treatment policy at the Substance Abuse and Mental Health Services Administration during a reduction in force last year.
“It was going to cost the alcohol industry money,” Vincent said. “They didn’t like going from two to one for men, and they didn’t like the mention of cancer.”
But ultimately, Vincent wrote, the findings were sidelined and dissemination of the paper was stalled. The authors of the study decided to publish a version of their research independently in a peer-reviewed journal.
A spokesperson for the Department of Health and Human Services did not respond to a request for comment about Vincent’s statement about his firing, but said that “any characterization that the study was ‘shelved’ is inaccurate.”
The new study, which relied exclusively on US health data, assessed relationships between average alcohol consumption and the risk of disease or death from causes that were directly attributed to drinking.
Women who had one drink a day were more likely to die of liver cancer or breast cancer than women who did not drink. And at one drink a day, both men and women were at increased risk of dying from liver cirrhosis, oral and esophageal cancers, and injuries, the paper found. The risks continued to climb with higher levels of consumption.
Consuming more than one drink per occasion was associated with progressively higher risks of breast cancer, cardiovascular disease and injury.
The report did find that one drink a day was associated with a lower risk of diabetes for women and a lowered risk of stroke for both men and women. However, occasional heavy drinking nullified the protective effects against stroke.
One reason the studies reached such different conclusions is that while the new study examined deaths from causes directly attributable to alcohol, the NASEM report commissioned by Congress looked at overall death rates of moderate drinkers, including deaths not causally related to alcohol.
Critics of the NASEM report say that people who drink in moderation often have other healthy lifestyle habits that contribute to their longevity. The moderate drinking group also included many people who consumed less than two drinks a day. Both of these factors could make the health effects of moderate drinking look less significant than they might be.
Dr. Ned Calonge, an epidemiologist at the University of Colorado Anschutz Medical Campus who led the NASEM study, said he stood by its conclusions.
“Alcohol research is complex and I am not surprised by different methods producing different results,” Calonge said, adding that modeling studies like the Alcohol Intake and Health Study, which use data to estimate the lifetime risk of diseases and deaths caused by alcohol, also come with potential biases.
At the same time, he added, “I don’t believe anyone should start drinking for health reasons.”
A newly published government alcohol study concluded that the health risks of alcohol start at a single drink a day. (Cedric Angeles/The New York Times) 
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