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Overview of the risks and benefits of alcohol consumption

Author
Kenneth J Mukamal, MD
Section Editor
Joann G Elmore, MD, MPH
Deputy Editor
Richard Hermann, MD

INTRODUCTION

Alcohol use represents an unusual paradox for the clinician. Excess intake is associated with increased mortality and other medical morbidities [1]. 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".)

The implications of excessive alcohol use and screening for unhealthy use of alcohol are also discussed in detail separately. (See "Risky drinking and alcohol use disorder: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis" and "Screening for unhealthy use of alcohol and other drugs in primary care".)

LIMITATIONS IN STUDIES OF ALCOHOL CONSUMPTION

No long-term randomized trials of alcohol administration exist. Our knowledge of the effects of moderate alcohol consumption in humans is derived primarily from two sources: short-term trials analyzing the effect of alcohol on physiological measures and observational studies comparing moderate drinkers with abstainers. Both of these sources have limitations.

While short-term trials of alcohol intake are more easily controlled, they focus on intermediate measures (such as hemostatic parameters, lipid levels, or cognitive function) rather than disease outcome [2-4]. They also do not inform about the balance between alcohol's long-term risks and benefits since alcohol use extends over decades. Furthermore, these trials tend to be performed using healthy, young, white male subjects and the results cannot necessarily be extrapolated to other populations.

                                 

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Literature review current through: Nov 2016. | This topic last updated: Tue Feb 16 00:00:00 GMT+00:00 2016.
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