Daily Alcohol is Not OK

June 24, 2025- by Steven Greer, MD

I have heard that there is a trend among people under 30 or so to avoid alcohol. They view it as a poison now. Related, the HHS and its CDC have dropped the guidelines that stated it was healthy and acceptable to have one to two drinks per day.

All of my life, and as a doctor, I have heard this nonsense that it is alright to have one to two drinks a day. It was based on the “French Paradox”, where supposedly the French and Italians consume alcohol every day with meals and yet live long lives. But that was all bogus data promoted by the alcohol industry.

The fact is that alcohol causes cancer, which is the least of the problems really. It causes significant mental illness as well.

I am not advocating for abstinence. However, I do discourage people from consuming daily alcoholic drinks. If you want to enjoy yourself once a week or so, I think that is fine. However, obesity, mental illness, and cancer become problems when one drinks every day with meals.

Grok:

The idea that moderate daily alcohol consumption, particularly wine, is harmless or even beneficial—often tied to the “French Paradox”—has been debated extensively. The French Paradox refers to the observation that France has relatively low heart disease rates despite diets high in saturated fat and regular alcohol consumption, with wine often credited. Similar claims are made about Italy due to its Mediterranean drinking culture. However, the evidence is far more complex and not as rosy as alcohol industry-backed narratives might suggest. Let’s dive into the data, focusing on Italy and France, and critically examine the health impacts of their drinking patterns.

### Alcohol Consumption in Italy and France

– **Consumption Levels**:

– **France**: According to the WHO’s 2019 data, France’s per capita alcohol consumption is around 10.4 liters of pure alcohol annually (down from higher levels in previous decades). This is among the highest in the EU, with wine being a cultural staple, often consumed daily with meals.[](https://www.euronews.com/health/2025/04/05/dry-january-where-in-europe-is-drinking-alcohol-getting-worse-and-which-countries-have-cut)

– **Italy**: Italy’s per capita consumption is lower, at about 7.7 liters of pure alcohol per year in 2020, a significant decline from 12.4 liters in 1990. Daily drinking is common, especially among older adults, with 14% of Italians aged 15+ reporting daily alcohol consumption in 2014.[](https://cancerworld.net/preventing-alcohol-related-cancers-in-europe-lessons-from-three-countries/)[](https://ec.europa.eu/eurostat/statistics-explained/index.php/Alcohol_consumption_statistics)[](https://www.euronews.com/health/2025/04/05/dry-january-where-in-europe-is-drinking-alcohol-getting-worse-and-which-countries-have-cut)

– Both countries have a Mediterranean drinking pattern: regular, moderate consumption (often wine with meals) rather than binge drinking, which is more common in northern Europe.[](https://pmc.ncbi.nlm.nih.gov/articles/PMC3686709/)

– **Cultural Context**: In both nations, alcohol is deeply embedded in social and culinary traditions, with a focus on wine. Public drunkenness is less tolerated, and drinking is often spread across the week rather than concentrated in heavy sessions.[](https://pmc.ncbi.nlm.nih.gov/articles/PMC3686709/)

### Health Impacts: What the Evidence Says The claim that daily drinking in France and Italy is “fine” or even beneficial hinges on studies suggesting moderate alcohol consumption (1-2 drinks/day) reduces cardiovascular disease (CVD) risk. However, recent research and critical analysis cast doubt on this narrative, especially when considering broader health outcomes. Here’s a breakdown:

#### Cardiovascular Disease and the “French Paradox”

– **Historical Claims**: Studies in the 1990s and early 2000s, like those tied to the French Paradox, suggested that moderate wine consumption (especially red wine due to polyphenols like resveratrol) was linked to lower CVD rates. This was attributed to wine’s supposed protective effects on heart health.[](https://x.com/DrSGargMD/status/1937347079980097658)

– **Critical Reassessment**: More recent analyses, including a 2018 Lancet study and WHO statements, challenge this. The protective effect of moderate drinking on CVD is now considered overstated, often confounded by lifestyle factors (e.g., Mediterranean diet, physical activity, not smoking) rather than alcohol itself. For example, a 2018 study found that light/moderate drinkers had healthier habits overall, and when adjusted for these, the CVD benefit diminished.[](https://nutritionsource.hsph.harvard.edu/healthy-drinks/drinks-to-consume-in-moderation/alcohol-full-story/)

– **WHO’s Stance**: The WHO now states there’s no safe level of alcohol consumption for health, as any potential CVD benefits are outweighed by other risks, particularly cancer.[](https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health)[](https://www.who.int/europe/news-room/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health)

#### Cancer Risks

– **Clear Link**: Alcohol is a Group 1 carcinogen, causally linked to cancers of the breast, liver, head and neck, esophagus, and colorectum. In Europe, alcohol causes about 80,000 cancer deaths annually, with France and Italy contributing significantly due to high consumption.[](https://pmc.ncbi.nlm.nih.gov/articles/PMC9557277/)[](https://www.who.int/news-room/fact-sheets/detail/alcohol)[](https://news.un.org/en/story/2024/07/1152516)

– **Italy’s Data**: Despite lower per capita consumption than France, Italy still sees significant alcohol-attributable cancer deaths (around 190 per 100,000 for men, 120 per 100,000 for women in 2016). The decline in consumption from 1990 to 2014 (12.4 to 7.6 liters) has reduced these rates compared to higher-consuming countries like Slovakia, but the risk remains.[](https://cancerworld.net/preventing-alcohol-related-cancers-in-europe-lessons-from-three-countries/)

– **France’s Burden**: France’s higher consumption correlates with elevated cancer risks, with 474,000 alcohol-related cardiovascular deaths and significant cancer mortality in 2019. The WHO notes that even low levels of drinking increase cancer risk, with no safe threshold.[](https://www.who.int/news-room/fact-sheets/detail/alcohol)[](https://www.who.int/europe/news-room/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health)

#### Liver Disease and Other Noncommunicable Diseases

– **Liver Deaths**: France and Italy have seen declining liver death rates since the 1970s due to reduced overall alcohol consumption and cultural shifts toward moderation. For example, Italy’s standard liver death rate (under age 65) dropped three- to fivefold from 1970 to 2008. However, alcohol remains a leading cause of liver cirrhosis, especially in France, where consumption is higher.[](https://pmc.ncbi.nlm.nih.gov/articles/PMC5873553/)

– **Other Conditions**: Alcohol contributes to over 200 health conditions, including heart disease, diabetes, and mental health disorders like depression and anxiety. In France, alcohol is responsible for 7% of deaths, higher than many EU countries, despite the decline in consumption.[](https://pmc.ncbi.nlm.nih.gov/articles/PMC9557277/)[](https://www.who.int/news-room/fact-sheets/detail/alcohol)

#### Alcohol Dependence and Social Harms

– **Prevalence**: In the WHO European Region, 1 in 10 adults has an alcohol use disorder, and 5.9% live with alcohol dependence. France and Italy, while lower than Eastern European countries, still face significant burdens.[](https://news.un.org/en/story/2024/07/1152516)

– **Italy’s Trends**: A 2013 study estimated 5,320 alcohol-attributable deaths in Italy (ages 15-64), with 5.9% of all deaths linked to alcohol. Young Italians are increasingly adopting binge-drinking patterns, particularly men, with a 40% increase in daily risky drinking among young men during the COVID-19 lockdown.[](https://pmc.ncbi.nlm.nih.gov/articles/PMC8934024/)[](https://pmc.ncbi.nlm.nih.gov/articles/PMC3686709/)

– **Social Impacts**: Alcohol contributes to domestic violence, accidents, and mental health issues in both countries. France’s higher consumption amplifies these risks compared to Italy.[](https://news.un.org/en/story/2024/07/1152516)

#### Gender Differences

– **France**: Men drink nearly four times more than women (8.2 vs. 2.2 liters of pure alcohol per capita in 2019), with 6.7% of male deaths and 2.4% of female deaths alcohol-related.[](https://www.who.int/news-room/fact-sheets/detail/alcohol)

– **Italy**: Men also consume more (16.5 liters/year vs. women’s lower rates), with risky drinking patterns more prevalent among young men.[](https://cancerworld.net/preventing-alcohol-related-cancers-in-europe-lessons-from-three-countries/)[](https://pmc.ncbi.nlm.nih.gov/articles/PMC8934024/)

### Critiquing the “It’s OK” Narrative

– **Industry Influence**: The alcohol industry has historically funded studies promoting moderate drinking benefits, particularly for wine in Mediterranean countries. These studies often overemphasize CVD benefits while downplaying cancer and other risks. The WHO and independent researchers now argue that these benefits are negligible or nonexistent when lifestyle factors are controlled for.[](https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health)[](https://nutritionsource.hsph.harvard.edu/healthy-drinks/drinks-to-consume-in-moderation/alcohol-full-story/)

– **Confounding Factors**: The Mediterranean diet (rich in vegetables, fruits, and olive oil), regular physical activity, and social cohesion in Italy and France likely contribute more to health outcomes than alcohol. For instance, folate intake may mitigate some alcohol-related cancer risks, but this is not a justification for drinking.[](https://nutritionsource.hsph.harvard.edu/healthy-drinks/drinks-to-consume-in-moderation/alcohol-full-story/)

– **No Safe Level**: The WHO’s 2023 statement is unequivocal: no level of alcohol consumption is safe, as risks (especially cancer) begin with the first drink. This directly contradicts the “two drinks a day is OK” claim.[](https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health)[](https://www.who.int/europe/news-room/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health)

– **Declining Consumption**: Both countries have reduced per capita alcohol consumption over decades (France more significantly than Italy), correlating with lower rates of alcohol-related diseases. This suggests that even their “moderate” drinking culture has historically carried significant health costs.[](https://cancerworld.net/preventing-alcohol-related-cancers-in-europe-lessons-from-three-countries/)[](https://www.euronews.com/health/2025/04/05/dry-january-where-in-europe-is-drinking-alcohol-getting-worse-and-which-countries-have-cut)

### Counterarguments and Limitations

– **Moderate Drinking Studies**: Some older studies (e.g., Nurses’ Health Study) suggest that 1-2 drinks/day, combined with high folate intake, may not increase breast cancer risk for women without a family history. However, these findings are outdated and contradicted by newer meta-analyses showing no safe threshold.[](https://nutritionsource.hsph.harvard.edu/healthy-drinks/drinks-to-consume-in-moderation/alcohol-full-story/)

– **Cultural Norms**: The Mediterranean pattern of regular, low-dose drinking may reduce some harms compared to binge drinking, but it doesn’t eliminate risks. For example, daily drinking in Italy is linked to lower rates of heavy episodic drinking (HED) compared to northern Europe, but HED is rising among young Italians.[](https://ec.europa.eu/eurostat/statistics-explained/index.php/Alcohol_consumption_statistics)[](https://pmc.ncbi.nlm.nih.gov/articles/PMC5873553/)

– **Data Gaps**: Wastewater-based epidemiology and self-reported surveys may underestimate or overestimate consumption, complicating precise health impact assessments.[](https://www.sciencedirect.com/science/article/abs/pii/S004896972100930X)

### Conclusion

The evidence does not support the claim that daily drinking in France and Italy is “OK” or universally healthy. While their Mediterranean drinking culture—moderate, meal-associated wine consumption—may mitigate some harms compared to binge-drinking patterns, alcohol still contributes to significant health burdens, including cancer, liver disease, and social harms. France’s higher consumption (10.4 liters/year) amplifies these risks compared to Italy (7.7 liters/year), but both nations face measurable alcohol-related mortality and morbidity. The WHO’s position that no level of alcohol is safe aligns with recent data showing risks outweigh benefits, especially for cancer. The “French Paradox” and similar narratives are likely overstated, with lifestyle factors, not alcohol, driving better health outcomes. Claims of safe drinking levels appear influenced by industry narratives rather than robust evidence. For the most accurate information on alcohol policies and health impacts, check WHO’s Global Status Report on Alcohol (https://www.who.int/publications/i/item/9789240095397) or Italy’s Istituto Superiore di Sanità (https://www.iss.it/).[](https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health)[](https://cancerworld.net/preventing-alcohol-related-cancers-in-europe-lessons-from-three-countries/)[](https://www.who.int/news-room/fact-sheets/detail/alcohol)