Alcohol Consumption


Alcohol consumption is drinking beverages that contain ethyl alcohol, such as beer and wine, or distilled spirits, such as gin, whiskey, or vodka.

Calories in alcohol


Serving amount (fl. oz.)

Average (calories)








Distilled (80 proof)

Gin, rum, vodka, whisky, tequila



Brandy, cognac



Liqueurs (Drambuie, Cointreau, Kahlúa)







Dry white















Vermouth, sweet



Vermouth, dry













Whiskey sour



Margarita cocktail






SOURCE: National Institute on Alcohol Abuse and Alcoholism. “Alcohol Calorie Counter.” National Institutes of Health, U.S. Department of Health and Human Services. calorie-calculator.aspx (accessed April 9, 2018).



Ethyl alcohol, or ethanol, is produced by yeast fermentation of the natural sugars in plants, such as grapes (wine), hops (beer), sugar cane (rum), agave (tequila), or rice (sake). The process of fermenting plants to produce alcohol is at least 10,000 years old and appears to have developed independently in many cultures.

Alcohol affects almost every system of the body. Research suggests that consuming alcohol in moderation offers some health benefits and some health risks. Heavy use of alcohol has no health benefits and many health risks. The United States federal Dietary Guidelines 2015–2020 define moderate alcohol consumption as one drink per day for women and two drinks per day for men. This difference by gender is based on the fact that women tend to be smaller in body size than men and their bodies contain a lower percentage of water. An equivalent amount of alcohol in a woman's bloodstream would be more concentrated than in a man's. Not all countries have different guidelines for men and women; the United Kingdom, for example, does not. A “drink” according to these guidelines contains about 0.5 oz. (14 g) of alcohol and is defined as:

Using this definition, one regular beer contains about 145 calories. One glass of red wine has 105 calories, and white wine has about 100 calories. One shot of distilled spirits has about 95 calories, plus any calories in the mixer used to make mixed drinks.

Benefits of moderate alcohol consumption

Numerous studies have shown an association between moderate alcohol consumption and a lowered risk of heart attacks, sudden cardiac death, peripheral vascular disease, and strokes caused by blood clots (ischemic stroke). A 2017 study that surveyed two million adults without cardiovascular disease at the start of the study found that, compared to adults who drank moderately, did not drink, and drank heavily, both had a higher risk of diseases such as heart attack, heart failure, and angina. The risk of these diseases is reduced between 25%–40% in both men and women who drink moderately. The reduction is seen in people who have no apparent heart disease, as well as those who are at high risk of heart disease because they have type 2 diabetes, high blood pressure (hypertension), angina (chest pain), or have already had one heart attack. There seem to be some age differences; for example, in women the benefits are seen only after age 55, and the greatest benefit is seen in women who consume less than five units per week. Researchers suggest that this protective effect occurs because alcohol increases the amount of HDL, or “good” cholesterol, and also affects various proteins in ways that make blood clotting less likely. It is possible, however, that this effect is simply a correlation between behaviors and health outcomes, and that alcohol is not itself causing the improvement in health.

In two other large studies, people who drank moderately were also less likely to develop type 2 diabetes and gallstones. Gallstones are hard masses of cholesterol and calcium that form in the gallbladder. Finally, moderate drinking serves a social purpose that can provide psychological benefits. Dr. Malcolm Kendrick has hypothesized that stress, not cholesterol, is actually the main cause of heart disease, and that moderate consumption of alcohol effectively reduces stress, thereby lowering risk.

Risks of moderate alcohol consumption

Moderate alcohol consumption also carries with it some risks. Most organizations now have the view that drinking alcohol should never be encouraged for health reasons. In women, even moderate drinking is associated with a modest increase in the risk of developing breast cancer and other cancers. Some evidence shows that a large intake of folate (folic acid), 400–600 mg daily, might help counteract this increased risk in women. Alcohol consumption may increase the risk of cardiovascular events in the 24 hours immediately following consumption.

Women who are pregnant or breastfeeding should avoid alcohol completely, as even moderate consumption can affect the fetus. Fetal alcohol syndrome is a severe problem that causes the child to have symptoms that can include a small head, poor coordination, learning disabilities, heart problems, and difficulty controlling mood. Alcohol consumption can also alter sleep patterns and interact with many medications. By far the greatest risk of moderate drinking is that for some people it can lead to heavy alcohol consumption, alcohol abuse, and alcohol dependency. Twin and family studies indicate that there is an inherited tendency for some individuals to develop alcohol abuse disorders.

Risks of heavy alcohol consumption

The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) defines heavy drinking as drinking five or more drinks on the same occasion on each of five or more days in the past 30 days. Heavy drinking among Americans rose 17.2 % between 2005 and 2012. About 16.3 million people aged 12 and over in the United States were using alcohol heavily in 2014. A 2017 study found that those who drink heavily have an increased risk of heart attack, cardiac arrest, stroke from a blood clot, peripheral artery disease, and death from any cause.

Between moderate and heavy alcohol consumption is a gray area of potentially problematic drinking that includes binge drinking. Binge drinking is heavy alcohol consumption that occurs intermittently, that is, not on a daily basis, but at least once a month. Bingeing for men means consuming five or more drinks in a period of about two hours. For women, it is consuming four or more drinks in the same time period. According to SAMHSA, in 2014 approximately 60.9 people aged 12 and over engaged in binge drinking. The highest numbers were in the 18–25 age group (37.7%). Binge drinking is linked with accidents, unsafe behaviors, and even death in this age group.

Heavy alcohol consumption is the defining symptom of a disorder renamed alcohol use disorder (AUD) in the Diagnostic and Statistical Manual for Mental Disorders Fifth Edition (DSM-5), published by the American Psychiatric Association. The previous version of this manual, DSM-IV, described two distinct disorders called alcohol dependence and alcohol abuse (alcoholism). The DSM-5, published in 2013, combined these two disorders into one disorder called alcohol use disorder. The term “alcoholism” is no longer used as a medical diagnosis.

The DSM-5 instructs clinicians to look for eleven symptoms:

The presence of at least two symptoms in the past 12 months indicates an alcohol use disorder. Mild disorder is characterized by two or three symptoms. Moderate disorder is diagnosed if four or five symptoms are present. A person who experience six or more symptoms is said to have severe AUD.

As of 2015, experts estimated that 68.5 million American adults suffered from AUD. Less than 20% of those affected ever seek treatment.

Heavy drinking causes many health problems. It increases the risk of stroke and cardiovascular disease and can cause brain damage, loss of judgment, loss of motor skills, and memory loss. Cirrhosis, a disease in which the liver develops scar tissue and stops functioning, is the cause of death in about 32% of people with AUD worldwide. AUD also substantially increases the chance of dying by violence or developing esophageal cancer, mouth cancer, liver cancer, or breast cancer (in women).

People with AUD generally do not eat healthy, balanced diets. An increasing problem in young women, particularly women with body image issues or eating disorders, is the deprivation of food to save calories for alcohol to avoid weight gain. This is a dangerous practice. When 30% or more of an individual's calories come from alcohol, serious nutritional deficiencies develop. Not only do people who drink too much fail to get the protein, vitamins, and minerals they need, but alcohol also interferes with the absorption of the nutrients they do eat. People who abuse alcohol develop malnutrition and deficiencies in essential amino acids, vitamin C, and B-complex vitamins, especially vitamins B1, B2, and B6. They may develop either deficiencies or excesses of vitamin A. Long-term drinking can lower levels of vitamin A in the liver, while creating excesses elsewhere in the body, which may play a role in the development of alcoholic liver disease.


Some people should never drink alcohol. These include:


Alcohol is a central nervous system depressant. More than 150 drugs interact with alcohol. Some of these interactions can be fatal, especially those that involve narcotic drugs that also depress the central nervous system. Alcohol can also lower activity of some drugs such as some antibiotics. Categories of drugs that interact with alcohol include:


One of the best-known treatments for alcohol use disorder is the 12-step program of Alcoholics Anonymous. This program uses social support, rewards, and mentoring to change behavior. For it to succeed, an individual with AUD must want to recover and must be willing to work at achieving sobriety. Relapses are common. Families of people with drinking problems may be helped by Al-Anon and teens by Alateen, whether or not their family member with AUD participates in Alcoholics Anonymous.

Some people with AUD find success through alternative approaches that do not have AA's insistence on lifetime abstinence from alcohol. Cognitive behavioral therapy teaches individuals to control their automatic thoughts and therefore their behavior. Managed moderation is a practice many people use to control their drinking. Smartphone apps allow people to track their alcohol consumption to keep blood alcohol levels within their desired limits.

Alcohol use disorder (AUD)—
A disorder characterized by excessive use of alcohol despite a desire to stop and the fact that this use causes problems in a person's life.
B-complex vitamins—
A group of water-soluble vitamins that often work together in the body. These include thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxine (B6), biotin (B7 or vitamin H), folate/folic acid (B9), and cobalamin (B12).
Binge drinking—
Heavy alcohol consumption that occurs intermittently. Bingeing for men means consuming five or more drinks in a period of about two hours. For women, it is consuming four or more drinks in the same time period.
Essential amino acid—
An amino acid that is necessary for health but that cannot be made by the human body and must be acquired through diet.
Folic acid—
Also called vitamin B9, a stable synthetic form of folate that is found in dietary supplements and is added to fortified foods such as flour and cereal.
High density lipoprotein (HDL)—
One of several proteins in the blood that transport cholesterol to the liver and away from the arteries.
Heavy drinking—
Drinking five or more drinks on the same occasion on each of five or more days in the past 30 days.
An inorganic substance that is necessary in small quantities for the body to maintain good health. Examples include zinc, copper, and iron.
Peripheral vascular disease—
A disease of blood vessels except those that supply blood to the heart.
A measure of alcohol. In the United States, one proof is equal to 0.5% alcohol content.
Adjustment of the body to a drug so that it takes more and more of the drug to produce the same physiological or psychological effect.
Type 2 diabetes—
Sometimes called adult-onset diabetes, this disease prevents the body from properly using glucose (blood sugar).
A nutrient that the body needs in small amounts to remain healthy, but that the body cannot manufacture for itself and must acquire through diet.


In addition to physical complications of moderate and heavy alcohol abuse, alcohol consumption can take an emotional and psychological toll on relationships and families, especially on children who have a parent with alcoholism.

Parental concerns

Alcohol consumption by adolescents substantially increases their risk of being in both fatal and nonfatal motor vehicle accidents. It also increases the chance of participating in risky sexual behavior, failing or dropping out of school, committing suicide, or being a homicide victim. Combining alcohol and energy drinks further increases these risks. Children who begin to drink before age 15 are four times more likely to become alcohol dependent, according to the National Institute on Alcohol Abuse and Alcoholism.

See also Adult nutrition ; Breastfeeding ; Folate ; Gallstones ; Gastroesophageal reflux disease (GERD) ; Hypertension ; Malnutrition ; Minerals ; Vitamins .



Fitzgerald, Hiram E., and Leon I. Puttler. Alcohol Use Disorders: A Developmental Science Approach to Etiology. New York: Oxford University Press, 2018.

Kendrick, Malcolm. The Great Cholesterol Con: The Truth about What Really Causes Heart Disease and How to Avoid It. London: John Blake, 2008.

Kuhar, Michael. The Addicted Brain: Why We Abuse Drugs, Alcohol, and Nicotine. Upper Saddle River, NJ: Pearson, 2015.


Grant, Bridget F., Risë B. Goldstein, Tulshi D. Saha, et al. “Epidemiology of DSM-5 Alcohol Use Disorder.” JAMA Psychiatry 72, no. 8 (August 2015): 757–66.

Kimbrough, Adam, Sarah Kim, Maury Cole, et al. “Intermittent Access to Ethanol Drinking Facilitates the Transition to Excessive Drinking After Chronic Intermittent Ethanol Vapor Exposure.” Alcoholism: Clinical and Experimental Research 41, no. 8 (August 2017): 1502–9.

Motofsky, Elizabeth, Harpreet S. Chahal, Kenneth J. Mukamal, et al. “Alcohol and Immediate Risk of Cardiovascular Events.” Circulation 8, no. 133 (March 2016): 979–87.


Alcoholics Anonymous. “Alcohol Use Disorder.” . (accessed April 2, 2018).

Bazian. “Moderate Drinking May Reduce Heart Disease Risk.” NHS Choices. (accessed April 2, 2018).

Lieber, Charles S. “Relationships Between Nutrition, Alcohol Use, and Liver Disease.” National Institute on Alcohol Abuse and Alcoholism. (accessed April 2, 2018).

Linus Pauling Institute, Micronutrient Information Center. “Folic Acid.” Oregon State University. (accessed April 2, 2018).

MedlinePlus. “Alcohol.” U.S. National Library of Medicine. (accessed April 2, 2018).

Moderation Management. “Moderation Management” . (accessed April 2, 2018).

National Institute on Alcohol Abuse and Alcoholism. “Alcohol Use Disorder: A Comparison between DSMIV and DSM-5.” National Institutes of Health, U.S. Department of Health & Human Services. (accessed April 2, 2018).

Olson, Richard, Kellie Casavale, Colette Rihane, et al. “Dietary Guidelines 2015–2020.” U.S. Department of Health and Human Services; U.S. Department of Agriculture. (accessed April 2, 2018).

World Cancer Research Fund International. “Alcohol and Cancer.” . (accessed April 2, 2018).


Academy of Nutrition and Dietetics, 120 S. Riverside Plaza, Ste. 2190, Chicago, IL, 60606-6995, (312) 899-0040, (800) 877-1600, .

Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd., Atlanta, GA, 30329, (800) CDC-INFO, CDC-INFO, .

National Council on Alcoholism and Drug Dependence, Inc. (NCADD), 217 Broadway, Ste. 712, New York, NY, 10007, (212) 269-7797, Fax: (212) 269-7510, (800) 622-2255, .

National Institute on Alcohol Abuse and Alcoholism, 635 Fishers Ln., MSC 9304, Bethesda, MD, 20892-9304, (301) 443-3860,, .

Tish Davidson, AM
Revised by Amy Blackwell

  This information is not a tool for self-diagnosis or a substitute for professional care.