Is moderate drinking actually ok?

For years, a glass of red wine was seen as a health tonic.

Most of us now know that's not quite accurate.

Still, plenty of people drink. And a lot of them believe a moderate amount is fine. Maybe even good for them.

But is it?

A new risk-modeling study, assembled by an expert panel convened to inform the next Dietary Guidelines, pressure-tested that belief—and found it doesn't quite hold up.[1]

Let's find out more.

How the study worked

A common approach in alcohol research is to count how many drinkers die from any cause and compare that to non-drinkers.

This study approached it differently. Researchers went condition by condition—liver disease, specific cancers, car crashes—and added up the alcohol-related risk from each one.

To do this, they pulled together research reviews on diseases and injuries causally linked to alcohol, then applied those risks to U.S. drinking, mortality, and population data. Sixteen reviews informed the final model.

Also of note: researchers compared drinkers to lifetime abstainers, rather than lumping former drinkers in with people who had never drunk.

That matters because of something called “sick quitter bias.” People sometimes stop drinking because they've developed health problems. When they're counted alongside lifelong non-drinkers, it can make drinking look healthier by comparison.

Separating those groups helps researchers get a clearer picture.

These are estimates built from existing research, rather than an experiment following people through a lifetime of assigned drinking. That's a useful way to study a question we can't realistically test under perfectly controlled conditions.

What the study found

The researchers found no convincing overall protection against dying from alcohol-related causes, even at low-to-moderate levels such as one drink per day.

Tiny protective signals showed up at up to three drinks per week, but they weren't statistically meaningful. In other words, they didn't establish a health benefit.

After that, risk climbed.

Researchers also calculated the estimated lifetime risk of dying from an alcohol-related cause at different drinking levels. The review reports these figures:[1]

These are lifetime estimates, not your risk from one week of drinking. They describe population risk rather than predicting an individual's future.

Still, the increase is worth paying attention to. Fourteen drinks per week averages out to two a day—an amount plenty of people would describe as pretty normal.

Normal and harmless don't automatically travel together.

The review also emphasized that how you drink matters alongside how much you drink.

Saving the week's drinks for one big night doesn't make the weekly total a safety guarantee.

Details you don't want to miss

Two other findings stood out.

First, alcohol-related harm among younger adults, especially those under 40, included road crashes and other injuries. The consequences aren't all waiting several decades down the road.

Second, some risks were greater for women, especially at higher intakes. At 14 drinks per week, the estimated risk of death from liver cirrhosis was about 2.1 times that of lifetime abstainers for men and 5.4 times for women.[1]

Those comparisons are each against abstainers of the same sex. The practical point is that the same number of drinks doesn't necessarily carry the same risk for everyone.

What this means for you

1. “It's okay to drink in moderation” isn't accurate anymore.

At least, not as a blanket reassurance that moderate drinking is harmless or good for your body.

Some people still believe their one or two glasses of wine at dinner are doing good things for their health. This research gives us good reason to retire that idea.

You can enjoy wine. It doesn't need a fake medical degree.

The useful message is straightforward: this study found no convincing overall health protection from drinking, and the estimated risk increased as people drank more.

That doesn't mean every person who drinks will develop a serious health problem. It means “moderate” shouldn't end the discussion.

My job as a coach is to help you understand the evidence and decide what tradeoffs you're willing to make. Fear and shame rarely make that conversation more useful.

Speaking of tradeoffs…

2. The tradeoff question

In The Coaching Habit, Michael Bungay Stanier asks:

“If you're saying Yes to this, what are you saying No to?”

That's a useful question to bring to alcohol.

When you say yes to drinking, what else comes with that decision? What might you be giving up? Better sleep? An easier time managing your food? A morning you actually want to participate in?

And what do you enjoy about the drink? The taste? The occasion? The ritual?

The answers matter. I help people examine the trade-offs between alcohol and the goals they hired me to help them achieve.

Some people absolutely can reach their weight and fitness goals with alcohol included in moderation. Achieving those goals doesn't erase alcohol's health risks, but it does mean the conversation needs to account for the person in front of me.

Lately, though, as my client base and I get older, booze is becoming less and less of a draw.

Clients describe the decision this way:

“The cost is simply too much when you start feeling healthy, slept, and sober.”

Their words. And I understand them. I went through the same process when I decided to quit.

Once you've experienced the alternative, you have more than a research headline to compare against. You know what your own mornings feel like.

Three things to try

1. Notice which drinks are worth it to you

One of my longest-running clients used the question “Is this worth the calories?” for years when making decisions on dates and at social events.

It helped her decide what she actually wanted, rather than automatically having whatever was available.

You can use that same pause with alcohol and expand the question beyond calories. Is this worth the money? How I might feel tomorrow? Does the second or third drink add enough enjoyment to justify the cost?

You don't need an elaborate tracking system.

Start by noticing.

2. Choose a specific reduction

A doctor I coach got specific about two occasions when he planned to drink: a college football game and his birthday. Outside those occasions, he committed to no booze.

That gave him something concrete to follow.

“I'll drink less” leaves a lot of room for negotiation once Friday arrives and starts making its case.

Choose the days, occasions, or amount you're going to change. If you're choosing particular occasions, decide how much you'll drink at them, too.

Specificity helps when a general intention keeps falling apart.

3. Call in the troops

Addiction specialists, doctors, therapists, coaches, trainers, family, and friends can all help in different ways.

If cutting back is harder than expected, bring someone into the conversation. You don't have to wait until alcohol has wrecked your life to deserve support.

A coach can help you examine habits and build a plan. A qualified healthcare professional can assess whether you need treatment or medical support.

If you drink heavily and regularly, or have experienced withdrawal, get medical guidance before stopping abruptly; withdrawal can be dangerous. NIAAA guidance

What I've seen in coaching

After roughly 15 years of coaching, the thing that stands out is how often clients are surprised by what improves when they stop drinking.

They tell me their sleep becomes restorative. Their skin looks better. Energy improves.

Mornings become something to look forward to instead of something to survive.

Some describe fewer arguments and less fighting in their relationships. Their confidence goes through the roof.

These are experiences clients have shared with me, and they often matter much more to them than the number on the scale.

One woman I coached had gone to high school with me. She graduated a year ahead of me and told me that, from graduation until we worked together, she'd never gone more than a month without booze.

That was ages 18 to 33. Fifteen years without much opportunity to find out how adult life felt without regular drinking.

She stopped drinking, lost 80 pounds, and met her husband.

Quitting alcohol doesn't come with a complimentary spouse or a guaranteed weight-loss result. She made changes and did the work. But removing alcohol was an important part of her story, and the life she built gave her plenty of reasons to keep going.

That's what I want people to have the chance to examine.

You may decide some drinking still fits the life you want. You may discover you've been accepting a cost that no longer feels worth paying.

Either way, give yourself permission to reconsider. A habit you've had for years doesn't get to make the decision forever.

References

1. George S, Naimi TS, Keyes K, Martinez-Matyszczyk P, Milam AJ, Rehm J, et al. Alcohol Intake and Health Study: No protective effect at low levels, with mortality increasing to 1 in 25 at 14 drinks per week. J Stud Alcohol Drugs. 2026;87(4):621–638. DOI: 10.15288/jsad.25-00435.

2. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med. 2010;7(7). DOI: 10.1371/journal.pmed.1000316. Retained from the original review; the social-health discussion has been removed from this adaptation.

Coaching question: Bungay Stanier M. The Coaching Habit: Say Less, Ask More & Change the Way You Lead Forever. Box of Crayons Press; 2016.

Want help putting this into practice?

Wondering whether alcohol is still worth what it costs you? Reply and tell me what you enjoy about drinking—and what you’re getting tired of. We can talk through the trade-offs and what you’d like to change.