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*Excess intake is associated with increased mortality and other medical morbidities. However, alcohol can be used safely, and moderate alcohol consumption has been associated with decreased mortality and may have cardiovascular benefits.
An overview of the risks and benefits of alcohol consumption will be discussed in this topic. Specific issues related to alcohol use in pregnancy and the cardiovascular benefits and risks of alcohol are discussed in detail separately. (See "Alcohol intake and pregnancy" and "Cardiovascular benefits and risks of moderate alcohol consumption".)
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DEFINITIONSLevel of drinking — Definitions of "moderate" and "heavy" drinking also vary.
●Moderate drinking: low risk for alcohol problems
•Women: <2 drinks per day
•Men: <3 drinks per day
•People age ≥65: <2 drinks per day
●Heavy drinking: at risk for alcohol problems
•Women: >7 drinks per week or 3 drinks per occasion
•Men: >14 drinks per week or 4 drinks per occasion
●Binge drinking:
•Women: 4 or more drinks in one drinking occasion
•Men: 5 or more drinks in one drinking occasion
ALCOHOL AND SPECIFIC ILLNESSES
Cancer — Alcohol use has been associated with increased risk for cancer, with heavy use being associated with the highest risk. ... regardless of smoking history [43]. However, for women who had never smoked, there was an increased risk of alcohol-related cancer (defined as colorectum, female breast, oral cavity, pharynx, larynx, liver, and esophagus) even with one alcoholic drink a day (Relative risk [RR] 1.13, 95% CI 1.06-1.20), mainly driven by an increased risk for breast cancer.
Breast cancer — There is consistent evidence that breast cancer risk is higher for women consuming both low (<1 drink/day) to high (≥3 drinks/day) levels of alcohol compared with abstainers [43-46]. There appears to be a significant dose response relationship beginning with intakes as low as three to six drinks per week.
A hormonal basis for the effect of alcohol on breast cancer is possible,...
Gastrointestinal cancer — Several types of gastrointestinal cancer are linked to alcohol consumption, even at low levels of intake.
Esophageal — The risk of squamous cell esophageal cancer is related to alcohol use . However, alcohol does not appear to be associated with increased risk for esophageal adenocarcinoma .
Observational studies have suggested that alcoholics do not appear to be at increased risk for developing colorectal cancer [66,67]. However, a 2014 systematic review and meta-analysis of 23 case control and cohort studies found a dose-response relationship between alcohol consumption and colorectal cancer [72].
Pancreatic — Pancreatic cancer is not clearly related to alcohol intake.
Hepatocellular — Hepatocellular carcinoma has been linked to alcohol use.
Lung cancer — Data are unclear whether alcohol intake increases risk for lung cancer.
Head and neck cancer — Alcohol consumption is a risk factor for head and neck cancer.
Liver cirrhosis — Many epidemiological studies have found that liver disease is unusual among moderate drinkers
Cholelithiasis — Moderate alcohol intake lowers the risk of gallstones [88,89].
Pancreatitis — Heavy alcohol use predisposes to both acute and chronic pancreatitis.
Renal dysfunction — Moderate alcohol consumption does not appear to be substantially associated with higher or lower risk of renal dysfunction.
Osteoporosis — Heavy alcohol use predisposes to hip fracture by causing both osteoporosis and falls [102,103], although the data on moderate use are mixed.
Diabetes mellitus — The risk of diabetes mellitus is decreased in people with moderate alcohol consumption [119,120].
Violence — Alcohol use increases the risk of violence. Alcohol is involved in one-half to two-thirds of all homicides, at least one-half of serious assaults, and more than one-quarter of all rapes [144].
Suicide — Alcohol abuse is associated with an increased risk of suicide [145]. However, moderate drinking does not appear to increase suicide risk [146]. .
Acute alcohol use is often a factor in
suicide attempts. In a case-crossover study of 102 patients seen in seven emergency departments for suicide attempt, the relative risk for suicide attempt in the six hours following acute ingestion, compared with each patient's usual alcohol consumption, was 9.6 (95% CI 5.7-16.3) [151].
Dementia — Data on alcohol use and risk of dementia are mixed.
Several studies have demonstrated either a lower risk of dementia or a lesser decline in cognitive function over time with mild to moderate alcohol consumption, compared with abstention [153-158]. One study found this relationship for .