Moderate Drinking Has No Health Benefit, US-Funded Alcohol Review Finds
12 November 2026, New York, US: A large evidence review commissioned by the US government has found no level of drinking that delivers an overall health benefit. It estimates that the lifetime risk of dying from alcohol-attributable causes reaches about one in 25 for people who drink 14 standard drinks a week. The study, published in the Journal of Studies on Alcohol and Drugs and publicised in late October by researchers at Columbia University’s Mailman School of Public Health, challenges the long-held view that light or moderate drinking protects the heart.
The work, titled the Alcohol Intake and Health Study, is not a new clinical trial. The 25-author team reviewed more than 7,200 scientific articles on alcohol-related diseases and injuries, then combined the resulting risk estimates with large national US health datasets to model the lifetime chance of dying or falling ill from alcohol at different levels of consumption. The figures are population-level estimates rather than predictions for any individual.
Among the conditions modelled were cancers of the oesophagus, mouth and breast, cardiovascular disease, liver disease and injuries. The authors flagged pancreatic cancer as an emerging association that was not yet included in the calculations.
The central finding is that the protective effect often credited to modest drinking did not hold up overall. The review found possible reductions in the risk of ischaemic heart disease (caused by narrowed arteries) and stroke at low intakes, but those gains were outweighed by increases in cancer and other harms, even at seven drinks a week. Up to seven drinks a week, the researchers reported only small increases in risk for most conditions. Above one drink a day, risk rose for both men and women. At two drinks a day, or about 14 a week, lifetime alcohol-attributable mortality reached roughly one in 25.
The researchers used a standard drink of 12 ounces of beer, 5 ounces of wine or 1.5 ounces of spirits.
Who did the work, and why it matters for guidance
The lead author is Kevin Shield, an associate professor at the University of Toronto and senior scientist at the Centre for Addiction and Mental Health, where he leads a World Health Organization and Pan American Health Organization collaborating centre on addiction and mental health. Co-authors include Katherine Keyes, professor of epidemiology at Columbia Mailman, and Timothy Naimi of the University of Victoria’s Canadian Institute for Substance Use Research. The study was funded by the US Substance Abuse and Mental Health Services Administration (SAMHSA) through the contractor Synergy Enterprises.
According to the researchers, the federal government originally commissioned the review to help shape updated national dietary advice. Their release notes that the current Dietary Guidelines for Americans tell people to limit alcoholic beverages without setting a numeric ceiling. Earlier editions advised no more than two drinks a day for men and one for women. The study’s results point to a lower threshold, with risk rising above one drink a day regardless of sex.
The debate over alcohol advice has direct consequences well beyond medicine. Beer, wine and spirits are major outlets for barley, hops, grapes, maize and other crops, and dietary guidance on drinking feeds into labelling rules, public health campaigns and long-term consumer demand.
The journal published an accompanying editorial by Robert Vincent, a former associate administrator at SAMHSA, who wrote that the report had been invited to inform the 2025 to 2030 guidelines but that its findings “were sidelined.” That view is the author’s own assessment rather than an official account of how the guidelines were drafted.
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