There’s a lot of contradictory research on alcohol and life expectancy.

One the one hand we all know how bad heavy drinking is for you: from liver disease to weight gain to skin aging, alcoholics suffer a lot of pain and misery before dying earlier than non-drinkers.

But on the other hand, the media loves reporting on studies that seem to suggest moderate drinking of alcohol, or drinking of certain types of alcohol (like red wine) is associated with a longer lifespan than not drinking any alcohol at all.

So how is a spanner who’s interested in human life extension supposed to make any sense of all this?

Well, as just such a person, I decided I wanted an answer to the question of alcohol and aging for myself, so I dug into as much research as I possibly could until I had a conclusion I was satisfied with.

Below I’ll walk you through what I came up with.

(I’m not a doctor, none of this is medical advice, please do your own research to supplement anything you read here).

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The positive: moderate alcohol increases life expectancy

I’m sure you’ve seen all those mainstream media articles touting the newest study that shows a small amount of alcohol is good for you, containing headlines tailor-made for you to share on Facebook with a comment like, “See? Beer is a health food haha!”

Unfortunately, most of the studies cited in those breathless articles are epidemiological population studies which, while sometimes directionally helpful, can never really show causation, only correlation. Such studies may suffer from lots of issues—like selection bias and confounding—that could cause the results to not be accurate (an argument the critics of moderate alcohol make in the section after this one).

Basically, you need to be really careful when drawing conclusions if epidemiological studies are the only evidence you have.

But luckily—and surprising to me as I dug deeper into the research—is that there are actual in vivoLatin meaning 'within a living organism.' Used in science to describe a study on a whole living organism, instead of just on a cell culture (which is instead called an 'in vitro'--Latin for 'in glass'--study). animal studies showing life extension from moderate amounts of alcohol. Since animal studies can be done in controlled environments there are many fewer variables that could confound the results compared to epidemiological studies on human populations.

Granted, a lot of these in vivo studies are older (some from the 70s, 80s, and 90s). For example, fruit flies appear to live longer when a moderate amount of ethanol is introduced to their atmosphere, according to two separate studies conducted in 1989 and 1977, respectively. 

But several more recent examples support those findings. A 2021 study we mentioned in our article on the Mediterranean Diet found moderate red wine consumption increased the average lifespan of fruit flies by 7%.

Also in fruit flies, a 2009 study found, “For survival measured by longevity, acetaldehyde [an alcohol byproduct] is beneficial at low and stressful at high concentrations in Drosophila [fruit flies] utilizing ethanol as a major resource.” This is known as a “J curve” because when you graph death rates against alcohol consumption you get something that looks like a big “J,” with the lowest death rates at a moderate (nonzero) intake. 

(Remember the J curve since we’ll see a lot of it in the epidemiological studies below.)

Continuing on with animals and alcohol life expectancy, several studies have also shown mice live longer with a little bit of alcohol compared to none at all.

For instance, a 1987 paper found, “There was no difference between the survival curves of the low alcohol and water-drinking singly housed controls. The medium alcohol mice had the longest mean lifespan of the five groups and the high alcohol mice had the shortest.” (There’s that J curve again!)

A 1992 paper found alcohol increased the lifespan of mice by 16%, while a 1999 study found daily low alcohol intake lowered blood pressure in hypertensive rats.

And again in mice, a 2020 study found a low-dose of ethanol improved their healthspan as measured by obesity resistance, thermogenic activity, physical performance, mitochondrial function, elevated insulin sensitivity, and subdued inflammation.

Red wine was found to reduce progression of atherosclerosis in mice, and also in rabbits. (Though, interestingly, this also worked with dealcoholized red wine, suggesting other red wine components like quercetin, catechin, or resveratrol may contribute to its health benefits.)

Beyond animal studies, and before we get into the possibly problematic epidemiological studies, there are some controlled human studies I found that showed positive health benefits of light-to-moderate alcohol consumption.

For instance, a 2008 study showed that, in men, a moderate alcohol intake of 20-70 grams daily improved inflammation biomarkers compared to both no intake and high intake.

A 2013 randomized controlled trial (the gold standard of studies and considered by many as more accurate than epidemiological studies) found a daily glass of red wine (100ml for women and 200ml for men) improved the LDL/HDL ratio by 13% over the course of 20 weeks.

A two-year controlled trial on red wine drinking in people with type-2 diabetes found that red wine improved a whole host of biomarkers and concluded that, “[I]nitiating moderate wine intake, especially red wine, among well-controlled diabetics as part of a healthy diet is apparently safe and modestly decreases cardiometabolic risk.”

In addition to the animal studies and human trials suggesting a health benefit to moderate alcohol consumption, there are mountains of epidemiological studies and meta analyses showing the same. While, again, these types of studies have their own issues (which we’ll cover in the “negative” section below), there are so many of them that come to similar conclusions that I think they’re still worth considering.

Several recent meta analyses and reviews of lots of different epidemiological studies on alcohol consumption have concluded low-to-moderate alcohol consumption is associated with health benefits ranging from reduced colon cancer risk to decreased risk for heart disease (at less than 30g of alcohol per day) to improved cardiovascular health (for red wine).

A 2021 meta analysis of 48,423 people “found J-curve relationships between alcohol consumption and mortality in those with cardiovascular disease, with the greatest risk reduction being observed at 7 g/day for all-cause mortality and 8 g/day for cardiovascular mortality relative to current non-drinkers.”

A 2020 epidemiological study in the Netherlands indicated people who drank between 5-15 grams of alcohol per day were more likely to reach 90 years old than people who abstained from drinking completely and also than those who binge drank. (For context, one “standard” drink in the U.S. is roughly 14 grams of alcohol.)

A 2018 cohort study of 99,654 adults concluded, “In comparison to lifetime light alcohol drinkers (1–3 drinks per week), lifetime never or infrequent drinkers (<1 drink/week), as well as heavy (2–<3 drinks/day) and very heavy drinkers (3+ drinks/day) had increased overall mortality and combined risk of cancer or death.”

Another 2018 study found, “Relative to nondrinkers, moderate and heavy drinkers (up to 3 drinks/day for women and for men 65 years and older, up to 4 drinks/day for men under 65 years) had significantly higher adjusted odds of survival to age 85 without cognitive impairment.” 

While I didn’t find a ton of studies on why low alcohol intake may have health benefits, a couple theories did show up in my search:

• Alcoholic beverages like red wine and beer may be high in polyphenol compounds like quercetin and resveratrol that have beneficial effects.
• Alcohol may suppress mTOR which, if you remember our article on protein and longevity, could slow down aging.
• Small amounts of alcohol may trigger hormesis responses in the body (small stresses that make the body as a whole stronger, like lifting weights to create micro-tears in your muscles that are then rebuilt stronger than before).
• Evolution may have made small amounts of alcohol good for us to attract us to ripe, fermenting fruits.

Of course, alcohol can also be really terrible for you, and a lot of scientists think all the above research showing a positive association between alcohol and life expectancy is bunk.

The negative: alcohol reduces life expectancy

Obviously heavy alcohol drinking is associated with just about every negative health outcome under the sun, including higher rates of cancer, heart disease, dementia, and premature death, but could lower alcohol consumption also be harmful?

Turns out there’s some good research suggesting that’s the case.

While I could find fewer controlled trials demonstrating negative health impacts of low-doses of alcohol, I still did find a couple.

For instance, a 2011 study found that low amounts of red wine (0.5 mg/kg of ethanol) in healthy, young subjects impaired some measures of heart function like ventricular performance over the course of just 60 minutes.

A 2019 study found no positive benefit of even moderate alcohol consumption on telomereThe 'caps' on the ends of chromosomes that tell a cell where to stop transcribing DNA during division and that shorten with age. length (a possible measure of biological age) and concluded, “Binge drinking may reduce telomere length. Using telomere length as a marker of age and health, these data fail to demonstrate any benefits of alcohol consumption, even when consumed in moderation”

A 2003 review of experimental studies found that even just one binge drinking episode can damage the gut lining and lead to “leaky gut” symptoms. 

As in the health benefits section above, however, there’s a lot more epidemiological research (compared to controlled trials) on the possible negative consequences of low and moderate alcohol consumption and life expectancy.

Several meta analyses and reviews have criticized the epidemiological studies showing a health benefit of moderate alcohol consumption.

A 2016 meta analysis looked at 87 epidemiological studies on drinking and, after adjusting for unhealthy abstainers, concluded, “Meta-analyses adjusting for these factors find that low-volume alcohol consumption has no net mortality benefit compared with lifetime abstention or occasional drinking.”

A 2015 meta analysis of 38 epidemiological studies came to a less strict conclusion, but also shed doubt on the health effects of moderate drinking, saying, “Reductions in risk among moderate alcohol drinkers may be confined to women and non-Asian populations. Although based on a minority of studies, there is also the possibility that reductions in risk may have been overestimated by studies using a referent group contaminated by less healthy former drinkers.”

A 2019 review also cast doubt on the study design of epidemiological studies promoting low alcohol consumption, noting, 

“For example, the average age at enrollment in cohort studies was over 50 years in recent meta-analyses and therefore participants had to have survived to that age in order to be included in the cohort studies. We recently found that more than one third of deaths caused by alcohol occur among individuals younger than age 50, whereas the vast majority of ‘deaths prevented’ [in cohort studies] accrued to those over 50.” 

This means those positive alcohol studies could be vastly under-counting alcohol-related deaths since they’re not including enough younger subjects.

Also casting doubt on the results of the positive epidemiological studies are concerns that a lot of them may be funded by the alcohol industry itself and could be biased in their findings.

Two different meta analyses, one in 2018 and another in 2020, found “extensive” involvement by alcohol companies and related organizations in “supporting scientific research” as well as significant concerns in the scientific community about the bias of such research.

And at least one trial, specifically designed to look at the health benefits of low and moderate drinking, had to be scrapped in 2018 because of ties to the alcohol industry, with the director of the NIH saying, “The early and frequent engagement with industry representatives calls into question the impartiality of the process and thus, casts doubt that the scientific knowledge gained from the study would be actionable or believable.”

Beyond the meta analyses are several recent epidemiological studies finding even moderate and low alcohol consumption has negative consequences for health and longevity.

For example, even moderate long-term alcohol intake is associated with an increase in breast cancer risk according to a 2011 epidemiological study.

According to a 2021 population study even moderate drinking (less than 20 grams of alcohol per day) contributed to 13.9% of total alcohol-related cancers.

Another 2021 paper (this one not yet peer-reviewed) looked at over 25,000 people and concluded there is “no safe level of alcohol consumption for brain health” markers like brain volume and gray matter density.

A 2018 epidemiological paper also concluded there was no safe dose of alcohol, saying, “We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero.”

Plus, contra the studies showing a positive cardioprotective effect of low drinking, a 2016 review found, “There appears to be a consistent finding of an immediately higher cardiovascular risk following any alcohol consumption but by 24 hours, only heavy alcohol intake conferred continued risk.”

Should you drink alcohol if you want to live longer?

Honestly, after wading through all of the above, I’m not that sure about the following conclusion. It’s a weak enough opinion that I could be swayed away from it pretty easily if new significant evidence popped up contradicting it, so take the below with a big grain of salt.

For myself (a 34-year-old male with no genetic predisposition to alcoholism and healthy liver ALT biomarker levels), I’ve decided a low level consumption of alcohol (1-3 drinks a week at most, and primarily red wine) seems to make sense given the totality of the scientific evidence on moderate alcohol intake.

Longevity Advice’s cofounder, Rachel (a 32-year-old female with a genetic predisposition to alcoholism and healthy liver ALT biomarker levels), chooses to consume two drinks a month or fewer.

While the epidemiological studies for and against alcohol for healthy aging pretty much balance out in my mind, I found the actual controlled animal experiments showing life extension effects from moderate amounts of alcohol and red wine were much more persuasive. Those types of studies, in more controlled environments and with far fewer variables, are much easier to get right than massive human population studies with tons of possible confounding factors.

Plus, there are enough of the positive animal trials that I’m not willing to write them off as some fluke caused by a lab error. The effects seem to have been replicated across several species as well.

Now, if some big new experimental studies show either that those results are bunk, or that they don’t translate to humans for some reason, obviously I’d have to change my opinion. But for now I’m convinced a little alcohol may actually be healthy.

Especially if that alcohol contains good polyphenols like red wine and beer do, which some studies have shown are both better than spirits for cardiovascular disease and cancer.

As to what a “moderate amount” of alcohol actually looks like, the studies I read seem to be all over the place, and also vary by gender.

For instance:

• “Other studies performed in women have observed that daily doses of 15–20 g of alcohol as red wine are sufficient to elicit protective effects similar to those observed in men who consumed higher doses of wine.” from https://content.iospress.com/articles/nutrition-and-aging/nua039
• “Daily alcohol intake showed an apparent U-shaped association with hs-CRP and fibrinogen values in men, with lowest levels at an alcohol intake of 20-70 g daily” from https://pubmed.ncbi.nlm.nih.gov/18372583/
• “Maximum potential benefit occurs at 0.5 to one standard drinks (7-14 g pure ethanol) per day for women (18% lower all-cause mortality, 95% confidence interval (CI) = 13-22%) and one to two standard drinks (14-28 g ethanol) per day for men (17% lower all-cause mortality, 95% CI = 15-19%).” from https://pubmed.ncbi.nlm.nih.gov/31309639/

Taking all those together (and the others I skimmed) I think I’ll err on the low side, just to be safe, and say probably around 10-20 grams of alcohol daily should be my max as a guy, while my wife should probably be closer to a maximum of 5-10 grams per day. And as I don’t find it hard to skip drinking I’ll probably average even lower than that, since on most days I don’t drink any alcohol at all.

What’s your take on alcohol and aging?

Thoughts? Any recommendations for good, high-polyphenol content red wine? 

Give me your favorites in the comments!

J.P.

I’m the co-founder of Longevity Advice and have been passionate about radical life extension ever since I was a teenager. Formerly I was a content marketing director in the B2B software space. I’m also a sci-fi novelist, wargame rules writer, and enthusiast for cooking things in bacon fat. My sister once called me “King of the Nerds” and it’s a title I’ve been trying to live up to ever since.