52 Comments
User's avatar
Constantine Kanargelidis's avatar

Very interesting! I had an uncle in Greece who was in his 90's who had a tiny amount of Tsipouro (kinda like grappa) every morning and he was never sick. He accredited his good health to having the tiny amount of alcohol daily. He would always say "ligo!" meaning "a little!" when talking about having the Tsipouro (which was also likely moonshine).

Expand full comment
Chris Masterjohn, PhD's avatar

Interesting!

Expand full comment
Seek Truth's avatar

I wonder whether he was so healthy because or despite the alcohol. Living in a clean environment with natural foods, plenty of sunshine, and low stress probably kept his mitochondria healthy such that his daily poison did not cause noticeable damage.

Expand full comment
Michael Barr, DAOM, IFMCPC's avatar

"Tiny amount" (and small batch/locally producted, I am imagining) being the key here. Same applies in Chinese medical theory (with rice wine). 1-2 ounces, and you're done!

Expand full comment
Mary's avatar

This makes total sense! As a biochemist myself, I’ve often wondered if there was a hormetic effect to a little bevvy now and again...especially given the low levels of consumption across blue zones. My body seems to want to stop after about half a drink these days - maybe this is why!

I’d be curious the effect of ethanol on female hormones, given the huge role the liver plays in their metabolism...and how this may change later in life. (my peri/menopausal female clients always say, “at 45, I stopped being able to drink at all!”)

Once again, thank you Chris 🙏🏻🙏🏻🙏🏻 for your incredible expertise, excellent writing, and for digging up all this fascinating data for us!

Expand full comment
Michael Hood's avatar

I noticed your Facebook post sharing Dr. Mark Hyman MD’s post that a systemic review and meta-analysis of over 100 studies of nearly 5 million subjects found there is no level of alcohol consumption that is beneficial. This seems to contradict your pursuasive analysis proposing that 0.3-0.5 servings per day is likely beneficial.

Expand full comment
Chris Masterjohn, PhD's avatar

I commented on it. They grouped together 0-25 grams, which takes away the precision needed to see the lowest risk at 4-7 grams.

Expand full comment
Rachael's avatar

Thank you for delving into this! I noticed a year or two ago teetotaling became popular, with "mocktails" and "dry January" etc. gaining publicity. Lately it's seemed to be trendy to disavow ANY amount of alcohol despite its near-ubiquity among Blue Zones and general production and use among humans for millennia. I was skeptical of this recent anti-alcohol fad, so I appreciate your in-depth analysis of the research. It seems like the latest wave of teetotaling is rooted more in the classic American sentiment of "if it's pleasurable, it must be bad," similar to why veganism is viewed as so "healthy."

Expand full comment
Ministry of Truth's avatar

I think "Dry January" is more common in cultures where binge drinking is also common. Disavowing ANY alcohol is usually a good strategy for people with problematic drinking habits, even if it's only temporary. If the pleasure comes from inebriation it might actually not be good, but you don't need a PhD to figure that out, one tends to notice the day after. Most people who want to quit or are quitting aren't quitting a 2 drinks a week habit, and it's a helpful belief for them that any amount of alcohol is bad even if it isn't entirely accurate.

Expand full comment
David Wooderson's avatar

Great read! Never thought to compare it to an effect like exercise

Expand full comment
Michael Barr, DAOM, IFMCPC's avatar

Comparing Etoh to exercise is a bridge too far.

Expand full comment
Seek Truth's avatar

Liver cancer is down, too. I always felt that my liver is working better on a little bit of alcohol.

Yours, Jim Beam

Expand full comment
Charles Richardson's avatar

The thing is when you provide some number of drinks per day, a glass of whiskey has more alcohol than a glass of wine. So is a "drink" a glass of whiskey or a glass of wine? How much ethanol are we talking about so we can make a conversion? (Of course, if I'm drinking wine I drink more volume than whiskey so the total ethanol is maybe equal to a shot of whiskey?)

Expand full comment
Chris Masterjohn, PhD's avatar

In addition to the correct comments from others, the "Nutrients" tab has an ethanol target now in grams per day average:

https://chrismasterjohnphd.substack.com/p/nutrient-targets

Expand full comment
RDM's avatar

you nailed it.

a "drink" of wine is 4-6 oz. at 30 proof,

a "drink" of whisky is 1.5 oz. 80 proof.

The first is 0.75oz alcohol, but the second is ...the same! :-)

Expand full comment
Don's avatar

Here's a quick and easy chart for a "standard" drink:

https://www.niaaa.nih.gov/alcohols-effects-health/overview-alcohol-consumption/what-standard-drink

Expand full comment
Don's avatar

I was just about to ask the same question.

Expand full comment
Michael Hood's avatar

This is the most comprehensive analysis I’ve ever seen on finding the right level of alcohol consumption, far exceeding Peter Attia and Huberman.

Expand full comment
R U Kidding me.'s avatar

Hmmmmm.

I can’t stand having a drink /day. It just makes me feel hungry and I swear it makes me eat more than I normally would.

I’m more the “ weekend warrior “ type. For example I might have 2-4 drinks cleaning house or wherever guests come over. Music. Dance. Laugh. Have a great time. Lol. In the summer this could be twice per week.

I guess I will die sooner than the daily drinkers. Dang. Lol. Oh well. At least it was more fun. Lol.

Expand full comment
Chris Masterjohn, PhD's avatar

It's an average, not a daily commitment.

Expand full comment
R U Kidding me.'s avatar

Yeah.

Sometimes twice a week in the summers puts me over the limits. Lol.

Expand full comment
Steph's avatar

I believe the effect of alcohol on appetite has been studied, and you are right. People who drink alcohol with a meal tend to eat more than those who don't.

I experience this myself so if I'm drinking and eating I try not to drink too much before the food.

Expand full comment
Rich's avatar

While I believe that this is plausible, unless the studies differentiate between never drinkers and former drinkers for the 0 drinks level the studies don't really tell you anything.

Expand full comment
Chris Masterjohn, PhD's avatar

The observational studies will always be in danger of confounding, but the experimental evidence shows hormetic effects at doses consistent with the curve bottoms from the observational literature.

Expand full comment
Michael Barr, DAOM, IFMCPC's avatar

Epidemiological studies in observant Mormon, observant Muslim, and the famed Loma Linda, CA Seventh Day Adventist populations would seem to strengthen the case against rather than for Etoh. Although of course there are multiple variables in each.

Expand full comment
Chris Masterjohn, PhD's avatar

In that case people who adhere to the tenets of their religion live longer than those who don’t?

Expand full comment
Ministry of Truth's avatar

Does this only apply to Abrahamic religions or also polytheistic?

Expand full comment
Jim Marlowe's avatar

minor typo = "thing" should be "think"

This makes me thing any alcohol increases the risk of accidents while a hormetic benefit mediates protection against osteoporosis.

Expand full comment
Chris Masterjohn, PhD's avatar

Fixed! Thanks.

Expand full comment
Matthias Kaye's avatar

This is a great article, but have you accounted for the limitation of many of these epidemiological alcohol use studies, where their methodology fails to account for PAST alcohol use? This can lead to a 'j-curve' effect, where the no alcohol consumption group (sick quitters) looks worse than low to moderate alcohol consumption (normal individuals with no past alcohol abuse).

Expand full comment
Steph's avatar

I really appreciate this detailed analysis. One thing I note is that in your summary at the end of the article, you neglecte to reiterate the increased risk of breast cancer at any dose. As this is a big concern for many women, I think it needs to be highlighted and taken strongly into consideration when determining whether or how much alcohol to consume.

Expand full comment
Chris Masterjohn, PhD's avatar

I fixed this, thanks!

Expand full comment
required's avatar

I conclude that people with poor health avoid alcohol.

Expand full comment
Jennifer Depew, R.D.'s avatar

Very nice. I have a webpage with a simpler text, but similar message that alcohol in moderation can be a health benefit. A third of a serving was also what I found recommended/research based as a minimal serving that shows health benefits. - Maybe like a snifter of brandy to 'calm the nerves'.

Expand full comment
jr vildmarks's avatar

Hi, enjoyed your summary. If the consumption goes too high up, the ADH process is not enough, but Microsomal system steps in (MEOS). See picture https://themedicalbiochemistrypage.org/wp-content/uploads/2020/04/cyp2e1-activities.jpg the source of which is https://themedicalbiochemistrypage.org/ethanol-alcohol-metabolism-acute-and-chronic-toxicities/

This may explain why the bigger dose becomes possible, with the expense of e.g. glutathione expletation, since we find ourselves in the detox center of the liver. My point is though, that the same detoxification happens to lipid peroxides, 4-hne, etc poisons derived exclusively from overly omega-6 consumption. I wonder if those heavy users with liver decease, actually are those with a combination of alcohol and omega-6? And those heavy users without liver problems, have enough "olive oil" and "sat fats" in their diet, protecting their liver.

This is definately the case with mice. Make them alcoholics with 40E% alcohol energy share. Divide them into three groups; tallow & coconut (sat fat), lard (omega-6 + olive oil), corn oil (omega-6). After a couple of months, the omega-6 group lost their livers, second group with minor defects, and sat fat group is perfectly fine. Wonder if anyone has looked into this with humans?

A continued topic for the future?

JR

Expand full comment