Your Brain and Alcohol

You know you shouldn’t drink too much alcohol, but you’ve probably heard that one or two drinks a day (especially wine) is no big deal and may even have health benefits. Right? Not so fast.

“There’s always been a story that moderate drinking, particularly red wine, might be good​ ​… for you or good for your heart. It’s quite controversial, and a lot of people dispute that now,” says Anya Topiwala, a senior clinical researcher in the department of population health at the University of Oxford in England.

A growing body of research, including ​Topiwala’s, suggests not only that moderate drinking may not be beneficial but that it could, in fact, do harm. These studies suggest that no amount of alcohol is ​good​ for your brain.

AARP’s Global Council on Brain Health (GCBH), an independent collaborative of scientists, health professionals, scholars and policy experts convened by AARP, reviewed the existing research and in 2018 published its findings that even moderate amounts of alcohol may harm the brain.

“One theory that I have, and others as well, is that if you look at the kind of people drinking moderate amounts of red wine, they tend to be better educated, high-income individuals that probably do better on memory tests to start with,” Topiwala says. “They may also be doing all sorts of other healthy things, like watching their diet, exercising and looking after their medical health in general.”

Some people who have just a glass of wine ​each​ night do so as a part of the Mediterranean and MIND diets, which allow for that. Both these eating plans emphasize nutrients that have proven positive effects on brain health. So it may be the diet rather than the daily glass of wine that is good for the brain.

Could even a little alcohol do harm?

Recent research suggests that even a little imbibing every week, over time, can take a toll on the brain. A research team reviewed alcohol intake and brain structure images from 36,678 healthy middle-aged and older adults from the U.K. Biobank. Those who drank an average of one to two drinks a day had smaller brain volume than abstainers, as reported in 2022 Nature Communications.

Topiwala and colleagues did their own work. Looking at the drinking patterns of 20,729 adults in their mid 40s to mid 60s, they reported their results in 2022 in PLOS Medicine. The researchers used MRI to measure iron levels in participants’ brains and tested their thinking skills over time. What they found was that any drinking over 56 grams a week — that’s just under two ounces — was linked to higher iron levels in the brain, which was linked to worse cognitive function. 

The study is among the largest to show that even moderate — in fact, ​even ​quite modest — drinking has measurable negative effects on the brain. It adds to earlier studies that have shown that as little as a bottle and a half of wine every week for 30 years is connected to loss of brain mass. Even less, ​drinking ​just 17.5 ounces (about 5 glasses of wine) a week​, is tied to a dip in memory and thinking skills. 

Recent studies aren’t only calling into question drinking’s benefits for brain health. Evidence that it’s good for the heart may be weak, too. 

In a study of 371,463 adults, average age 57, researchers compared the overall health of moderate drinkers, heavy drinkers and teetotallers. The scientists concluded, in 2022 in JAMA Network Open, that there is no amount of drinking, however little, that benefits heart health. It was data like this that led the WHO to take the position in 2023 that “No level of alcohol consumption is safe for health.”

The Centers for Disease Control and Prevention is taking a harder line on drinking now, too. The agency notes that past research that might have suggested moderate drinking was healthier than not drinking is now outweighed by newer evidence that no amount of drinking brings health benefits.

“If I were advising my own parents,” says neurologist Brad Klein, M.D., “presuming they wanted to have a drink, then they would have one or two at most in a night, and preferably only once or twice a week. And I’d hope that it would be one to two glasses of wine — not shots of whiskey.” Just 1.5 ounces of whiskey and other spirits — a standard drink — is 40 percent alcohol. Compare that with a standard 5-ounce glass of wine with 12 percent alcohol. Klein sees patients with stroke, dementia and memory disorders at Abington Neurological Associates in Abington, Pennsylvania.

Topiwala’s studies have shown that if you do drink a full 35 ounces of alcohol a week (about 1.5 bottles of wine), it’s best to spread them out across the week and not drink them all at once.

But ultimately, she says, everyone must decide for himself or herself whether to drink — and how much. Your doctor can help you weigh your personal risk.

“Everyone accepts a different level of risk. It’s a very personal decision,” Topiwala says. “But I want people to know this is a myth that drinking is ​good​ for your brain health. People should be knowledgeable about that if they choose to drink.”