The dilemma surrounding the recommended daily amount of alcohol has been a subject of debate for decades, but it seems that the scientific consensus is slowly but surely changing. Former guidelines that suggested a glass or two a day could be acceptable, and even beneficial, are now being increasingly questioned under the weight of new evidence about health risks. Federal agencies in the United States are reportedly considering a complete change of course and abandoning recommendations for specific daily limits, which follows earlier positions from reputable organizations like the American Heart Association, which emphasized the need for additional, higher-quality research to determine the actual effects of alcohol on cardiovascular health.

Experts warn that it is too early to draw conclusions about whether one glass a day is necessarily unhealthy, but at the same time, they emphasize that guidelines must be based on solid and irrefutable evidence. Unfortunately, the long-standing lack of rigorous scientific research on alcohol consumption has left the public in a kind of limbo, balancing between potential benefits and proven harms.

How (un)safe is it? A revision of old recommendations

There is strong and consistent evidence that consuming more than two alcoholic drinks per day is almost certainly harmful to heart health, regardless of the type of heart disease studied. For individuals with a predisposition to addiction, and especially those with a history of alcohol use disorder, complete abstinence is the safest and most prudent choice. Most people who consume alcohol do so in moderation, but it is precisely for this group that the scientific community still does not have a definitive answer about the long-term health risks or possible benefits of one drink per day.

Traditional recommendations, such as those promoted for decades by the American Heart Association, generally set the limit at no more than two drinks per day for men and one drink per day for women. However, it is important to emphasize that the data suggesting a possible protective effect of alcohol were mainly related to the consumption of exclusively one drink per day. The quality of these studies is now considered insufficient for making firm and reliable recommendations. The need for more rigorous, methodologically sound research on the actual health consequences of that one glass a day has never been greater.

Alcohol and the heart: The complex relationship of a double-edged sword

The impact of alcohol on heart health is extremely complex and multifaceted. Excessive drinking, also known as binge drinking (consuming a large amount of alcohol in a short time), is proven to increase the risk of a range of serious conditions. These include high blood pressure (hypertension), heart failure, heart attack, and dangerous arrhythmias, or heart rhythm disorders. On the other side of the coin, there is a possibility that one drink per day may reduce some heart-related risks, including the risk of heart attack, heart failure, and even some arrhythmias. However, this thesis also requires confirmation through higher-quality studies that will exclude other lifestyle factors.

The so-called "J-curve," a theory according to which moderate drinkers have a lower risk of heart disease than those who do not drink at all and those who drink excessively, is now under a large question mark. Newer analyses suggest that older studies may have had methodological flaws; for example, the "abstainers" group often included former heavy alcoholics who had stopped drinking due to already compromised health, which artificially created the impression that moderate drinkers were healthier.

Impact on other organs and overall health

The story of alcohol does not end with the heart. Its impact extends to almost every organ system in the body. The liver, as the central organ for metabolism, is the first to be hit. Long-term consumption can lead to the accumulation of fat in the liver (alcoholic fatty liver), inflammation (alcoholic hepatitis), and ultimately, cirrhosis – irreversible scarring of the liver tissue that can end in complete organ failure. The World Health Organization (WHO) is clear: there is no safe amount of alcohol that does not carry a certain health risk.

Equally concerning is the link between alcohol and cancer. The International Agency for Research on Cancer (IARC) has classified alcohol in Group 1 of carcinogens, alongside tobacco, asbestos, and radiation. It has been proven that alcohol consumption increases the risk of developing cancer of the oral cavity, pharynx, esophagus, liver, colon, and breast. The risk increases with the amount of alcohol consumed, but it is important to note that even moderate consumption carries an elevated risk compared to complete abstinence.

The brain is also extremely sensitive to the toxic effects of alcohol. Chronic consumption is associated with a reduction in brain volume, cognitive decline, and an increased risk of dementia. The effect on sleep is paradoxical: although a nightcap may help you fall asleep faster, it significantly impairs its quality. Alcohol disrupts the architecture of sleep, reducing the proportion of the crucial REM phase, which leads to feelings of fatigue and exhaustion the next day, regardless of the number of hours slept.

Individual factors: Why is there no universal rule?

It is crucial to understand that the effects of alcohol, even when consumed in moderation, vary significantly from person to person. Genetics plays an important role in how our body metabolizes alcohol. Gender is also a significant factor; women generally have lower levels of the enzyme responsible for breaking down alcohol and a smaller proportion of water in their bodies, which is why the same amount of alcohol results in a higher blood concentration and a greater risk of organ damage. Body weight, general health status, and the presence of chronic diseases further modify the individual response to alcohol.

In one and the same person, alcohol can simultaneously show both harmful and potentially beneficial effects. For example, moderate consumption may slightly raise blood pressure but at the same time help prevent type 2 diabetes or lower "bad" cholesterol levels. Understanding how to identify individuals who are more prone to the harmful consequences of alcohol is one of the priorities for future research.

Practical advice and recommendations for a healthier life

So, what should be done while we wait for definitive scientific answers? For those who do not drink, experts are unanimous: there is not enough strong evidence to justify starting to consume alcohol for health reasons. The potential benefits are far outweighed by the proven risks. For those who enjoy an occasional glass of a drink, the safest approach is moderation, which would ideally mean avoiding the consumption of more than one standard drink within 24 hours.

It seems that the healthiest way to consume alcohol is with a meal, such as dinner, and choosing drinks with a lower alcohol content and a higher polyphenol content, such as red wine or dark beer. Higher concentrations of alcohol, achieved by drinking spirits or consuming on an empty stomach, are significantly more harmful. It is important to know what a "standard drink" is - it is approximately 1.25 dcl of wine, 2.5 dcl of beer, or 0.3 dcl of spirits.

It is important for the public to understand that not all studies on alcohol are equal and that some methods, such as randomized clinical trials, are far more reliable in determining cause-and-effect relationships. It is precisely the lack of such trials, which would directly compare a group that consumes one drink per day with a group that abstains, that is the main obstacle to formulating final guidelines.

In the end, health care is a holistic story. Regular physical activity, avoiding tobacco products, maintaining a healthy body weight, and avoiding excessive alcohol consumption are the foundations of a healthy and long life. Further high-quality research is needed to discover whether occasional or daily consumption of one drink per day is ultimately better or worse for overall health.