SOURCE: Goulden R. Moderate alcohol consumption is not associated with reduced all-cause mortality. Am J Med 2016;129:180-186.

Conventional and clinical wisdom says alcohol in moderation benefits one’s health. Plenty of observational data show those who are non-drinkers and those who drink excessively have higher mortality than those who drink in moderation. But observational studies can only generate hypotheses because such studies cannot prove causation. Have we jumped the gun on causation?

Goulden reported on 206,966 person-years of follow-up from the Health and Retirement Study, a cohort study comprised of a nationally representative sample of adults > 50 years of age (n = 24,029). When adjusted for sociodemographic variables, health status, and functional status, there was no difference in all-cause mortality associated with moderate alcohol intake compared to other groups.

The relationship between moderate alcohol use and health benefits may have nothing to do with alcohol. Might those who drink in moderation also practice moderation in other aspects of their lives, such as smoking, exercise, diet, and relationships, which could lead to better outcomes regardless of alcohol intake? As usual, there are no simple answers.