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Alcohol and Health: 15 Effects of Excess Alcohol Intake and 4 Benefits of Moderate Drinking

by Lindsay Christensen, MS, CNS, LDN, A-CFHC

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Alcohol has been a part of the human diet since before the dawn of agriculture, when our hominid ancestors began to consume rotting, fermenting fruit that fell on the forest floor. The fermenting fruit naturally contained alcohol and likely prompted the evolution of human liver enzymes designed to break down alcohol molecules. (1, 2)

alcohol health
Excessive alcohol has several negative effects on your health. iStock/franckreporter

Traditional cultures around the world have long enjoyed the occasional alcoholic beverage. Cauim, an alcoholic beverage made from the manioc root, has been enjoyed by indigenous people of South America for millennia. The Japanese have been making sake for at least 2,000 years, while winemaking began nearly 8,000 years ago. (3, 4) The earliest known fermented beverage, which most likely contained alcohol, hailed from China and consisted of a mixture of rice, honey, and hawthorn or grapes. One anthropological theory postulates that the dawn of agriculture was initiated by humans’ discovery of beer, which persuaded them to give up their nomadic ways and settle into societies where they could cultivate grain for their newfound favorite beverage. (5)

While alcohol is inarguably a long-standing part of the human diet, it can be problematic for our health when consumed in excess. Just as humans have evolved to love sugar as a survival mechanism, but suffer poor health when it is consumed in excess, so too have humans evolved to enjoy alcohol, yet suffer when we consume it chronically in large quantities. (6) In essence, excess alcohol intake represents another form of evolutionary mismatch! Read on to learn 15 ways in which excess alcohol intake adversely affects your health, and four health benefits of moderate alcohol consumption.  

Moderate alcohol consumption has some well-publicized benefits, but excess drinking has clear drawbacks. Check out this article for more on the health effects of alcohol (and for three mocktail recipes to help you reduce drinking). #nutrition #healthylifestyle #wellness

15 Health Effects of Excessive Alcohol Intake

While alcoholic beverages consumed in moderation are linked to good health, excessive consumption of alcohol triggers an array of adverse health consequences. What constitutes “excessive” alcohol intake? According to the most recent definition established by the Centers for Disease Control and Prevention, excessive alcohol intake is defined as the consumption of five or more drinks in one sitting or 15 or more drinks in a week for men and four drinks in one sitting or nine drinks in a week in women. (7) This pattern of alcohol intake is associated with the following adverse health effects.

Please note that the list of health effects described here applies to excessive alcohol consumption, not alcoholism. The general health effects of excessive alcohol intake are distinct from the impact of chronic, high alcohol intake, such as in alcoholism, which includes severe conditions ranging from cirrhosis to loss of cerebral gray matter.

1. Excessive Alcohol Intake Triggers Unhealthy Eating and Fat Gain

Have you ever noticed that after having a few drinks, your desire to stick to your nutrient-dense, whole foods diet goes out the window? If you have, you’re not alone! Heavy alcohol use lowers our inhibitions, leading to poor decision-making in many areas, including our food choices. This finding helps to explain why a night of heavy drinking often ends in a trip to the nearest fast-food joint. (8) This phenomenon—a desire for processed foods after excessive drinking—is colloquially referred to as the “drunchies” (drunk munchies). (9) In addition to lowering inhibitions, heavy alcohol use may cause unhealthy eating by triggering dramatic blood sugar fluctuations and by inhibiting leptin and glucagon-like peptide-1, hormones that reduce appetite.

Given the impact of excessive alcohol intake on appetite, it’s no surprise that it can cause you to pack on pounds. Most alcoholic beverages are a source of empty calories, filling your body with calories but minimal nutrients:

  • A 12-ounce can of beer contains approximately 150 calories.
  • A five-ounce glass of wine totals 125 calories.
  • Mixed drinks containing fruit juices and soda contain even more calories.

To make matters worse, intake of these calories doesn’t appear to induce satiety; rather, it ramps up hunger signals, increasing food intake and possibly promoting fat gain. (10) Conversely, light to moderate drinking does not appear to have any adverse effects on body composition and fat gain. (11)

2. Most Commercial Alcohol Is Highly Processed and Full of Additives

While alcoholic beverages have been around for millennia, it is only quite recently that they became processed foods. For example, while wine used to be a simple mixture of grapes and yeast, the modern-day commercialization process has turned most wines into unhealthy processed beverages, filled with synthetic purple coloring, white sugar, phthalates, mycotoxins, and herbicides such as glyphosate. (12, 13) You can learn more about the pitfalls of commercial wine, and why you should choose organic additive-free wines instead, in Chris’s article “All About Wine, Part 2: The Health Benefits and Risks.”

Modern-day beer is often equally processed and contains a plethora of unhealthy ingredients, including genetically modified corn syrup, genetically modified yeast, and monosodium glutamate.

3. Excessive Alcohol Decreases Micronutrient Status

Alcohol acts acutely as a diuretic, meaning it triggers increased elimination of urine. Magnesium, a vital micronutrient required for over 300 biochemical processes in your body, is eliminated with that urine. Heavy alcohol use over time may, therefore, deplete your magnesium status. (14)

Moderate alcohol consumption has been found to decrease vitamin B12 status in postmenopausal women, whereas heavy alcohol use depletes zinc and folate. (15, 16, 17) Concerningly, one small randomized controlled trial suggests that moderate alcohol intake reduces folate and vitamin B12 in healthy males. (18) It appears that if you are a moderate alcohol drinker, you’ll want to make sure that you are also eating a nutrient-dense diet to keep your micronutrients at optimal levels. 

4. Heavy Alcohol Use Inhibits Immune Function

Heavy alcohol intake may inhibit optimal immune function by reducing the activity of macrophages, critical cells involved in the innate immune response, your body’s front-line defense against pathogens. (19) It also decreases phagocytosis, the process by which white blood cells called neutrophils engulf and destroy harmful microbes, such as bacteria and viruses. (20) Heavy alcohol consumption also promotes a pro-inflammatory state and suppresses the immune system’s ability to target and clear pathogens via the antibody-dependent cell-mediated immune response. (21) If you are suffering from any sort of chronic infectious illness, such as Lyme disease, you should definitely avoid heavy alcohol consumption and may be better off avoiding alcohol entirely until your health is back on track.

5. Heavy Alcohol Use Disrupts Hormone Balance

Are you a woman dealing with polycystic ovary syndrome (PCOS)? If you are, you should definitely avoid excessive alcohol consumption. Drinking alcohol can acutely increase androgens in females; since many women with PCOS already have elevated androgens, this may cause a worsening of PCOS symptoms such as acne. (22) Preclinical research indicates that heavy drinking induces whole-body insulin resistance; insulin resistance plays a central role in PCOS, so heavy drinking may exacerbate PCOS symptoms.

In men, heavy alcohol intake actually decreases testosterone and increases estrogen by stimulating the conversion of androgens into estrogens. (23) This biochemical process explains why males who drink excessively frequently suffer from fat gain and low sex drive.

6. Excessive Drinking Impacts Fertility

If you are a woman looking to get pregnant, excessive drinking may hinder your progress toward this goal. Heavy alcohol consumption diminishes ovarian reserve, or the capacity of the ovary to produce healthy egg cells capable of being fertilized and creating a baby. Preliminary research also suggests that women undergoing infertility treatment should minimize alcohol consumption, as even moderate levels may reduce their ability to conceive. (24)

Controversially, some research suggests that even moderate drinking could reduce sperm quality in men. (25) However, other research reports no adverse effects of alcohol consumption on male reproductive health. (26) Factors such as the frequency and type of alcohol consumed by men, combined with their current health status, may ultimately converge to determine the impact of moderate alcohol consumption on their sperm quality and other reproductive health markers.

7. Heavy Alcohol Intake Impacts Blood Sugar Control

Preclinical research suggests that excessive alcohol intake may promote insulin resistance by impairing insulin signaling in the hypothalamus, a part of the brain that regulates numerous physiological functions, including hormonal balance and blood sugar control. (27) Conversely, moderate alcohol consumption may support healthy fasting insulin and hemoglobin A1c levels in individuals without diabetes. (28)

8. Excess Alcohol Impacts Athletic Performance

Does alcohol adversely affect athletic performance? Again, the research is conflicting. On the one hand, the consumption of alcohol immediately post-workout may impair protein synthesis, impairing muscle growth in response to exercise. (29) Acute alcohol intake also decreases power output during endurance activity, possibly by reducing muscle uptake of glucose or disturbing lactate metabolism, which contributes to muscle fatigue. (30)

Importantly, excessive alcohol intake may also hurt athletic performance indirectly by reducing sleep quality. Poor-quality sleep reduces anabolic factors needed for building and maintaining muscle and may thus compromise athletic performance by decreasing muscle function. (31) If you are an athlete and a fitness enthusiast, you may want to limit your alcohol intake if you have performance goals in mind.

9. It Can Lead to Dependence

Do you feel like you need a glass of wine every night to wind down after a busy day? If you do, this may be a sign that you are relying too heavily on alcohol in your life and need to find healthier ways of managing stress, such as a mindfulness practice. You may find that reducing your alcohol intake is empowering, as author Judi Ketteler did in an article for The New York Times.

10. It Disrupts the Gut Microbiota and Intestinal Barrier

Excessive alcohol intake has some concerning effects on gut health. It decreases beneficial gut bacteria while promoting the growth of harmful oral bacteria. It also increases the permeability of the intestinal barrier to endotoxin, a pro-inflammatory bacterial byproduct. (32, 33, 34, 35) If you are struggling with gastrointestinal issues such as leaky gut, small intestinal bacterial overgrowth, IBS, or gastroesophageal reflux disease, you may be better off avoiding alcohol entirely.

11. Excess Alcohol Increases Histamine

If you’ve ever become flushed or developed a headache after drinking a glass of red wine, then you’ve experienced firsthand the effects of alcohol on histamine production. Histamine is a compound released by cells in response to injury, allergic mediators, and other inflammatory substances. It causes contraction of smooth muscle and dilation of capillaries, contributing to redness and swelling, among other symptoms. Alcohol and its metabolite, acetaldehyde, liberate histamine from mast cells, where it is stored. They also inhibit an enzyme called diamine oxidase, which is required to break down histamine in the liver and gut. (36, 37)

Alcohol is also fermented, and the fermentation process creates histamine, further worsening the histamine-releasing effects of alcoholic drinks. If you deal with seasonal allergies, histamine intolerance, or mast cell disorders, you are better off avoiding alcohol, especially heavy alcohol consumption.

12. It Bogs Down Detox Pathways

If you are undergoing any sort of detox program, such as for heavy metals or mold toxins, or are experiencing symptoms of impaired detoxification pathways such as hormonal imbalance, it may be best to avoid alcohol. Acute alcohol consumption decreases glutathione, your body’s premier antioxidant, and a critical cofactor in various detoxification pathways. (38) Intestinal barrier integrity is essential for successful detoxification. Reduced barrier integrity compromises the detoxification of bacterial endotoxin; the adverse effect of alcohol on the intestinal barrier may, therefore, also impair detox by disrupting the gut barrier. (39)

13. Heavy Drinking May Exacerbate Skin Issues

Alcohol has acute diuretic effects, increasing water elimination and inducing dehydration. One study found that in women with a variety of racial backgrounds, heavy alcohol use detracted significantly from their skin appearance; female drinkers demonstrated increased upper facial lines, under-eye puffiness, and visible facial blood vessels. (40)

Alcohol consumption is also linked to a worsening of rosacea in women. (41) This effect may be mediated by the adverse impact of excessive alcohol on the gut microbiome, which is linked to rosacea pathogenesis. Rosacea is also triggered by vasodilating chemicals (like alcohol). (42)

Heavy alcohol consumption may worsen existing acne by disrupting the intestinal barrier, which is a critical component of the gut-skin axis. It may also exacerbate acne in women by increasing testosterone production, which in turn increases sebum production, causing inflammation of the sebaceous glands.

14. It Impairs Sleep

Some of the most concerning effects of excessive alcohol intake have to do with its impact on sleep. If you wear any sort of sleep tracker, like an Oura ring, then you have probably observed a significant decrease in your sleep quality after drinking alcohol in the evening. Alcohol intake decreases the restorative quality of sleep by disturbing autonomic nervous system activity, as evidenced by low heart rate variability. (43) It also suppresses restorative REM sleep. (44) Even though alcohol may help you fall asleep, alcohol-induced sleep is more like anesthesia than real sleep, according to sleep expert Dr. Matthew Walker. Just one drink per day may be enough for you to sleep poorly at night, mainly if it is consumed very close to bedtime.

15. Excess Alcohol Intake May Accelerate Aging

Heavy alcohol use may lead you to age less gracefully compared to your peers with moderate alcohol intake. Chronic alcohol consumption accelerates aging visibly by dehydrating the skin and enhancing the appearance of fine lines and wrinkles. While moderate alcohol intake may support or have a neutral effect on longevity, excessive alcohol consumption has an inverse relationship with longevity, unsurprisingly, given its adverse impact on mechanisms that contribute to aging, such as disruption of glycemic control and sleep. (45)

Try a 30-Day No Alcohol Challenge

If you feel that you are consuming more alcohol than is healthy, you may want to try a 30-day no alcohol challenge. The premise of the challenge is simple: Avoid alcohol altogether for 30 days. After 30 days, try adding back organic wine or whatever organic alcohol you enjoy, and see how you feel. You may find that regular alcohol consumption is no longer something you want or need in your life, or that you really only want it once or twice per week or on special occasions.

Four Benefits of Moderate Alcohol Consumption

Moderate alcohol consumption is defined as the consumption of one drink per day for women and two drinks per day for men.

An abundance of epidemiological research suggests that moderate alcohol consumption offers benefits for brain and cardiometabolic health. Many of the studies suggesting benefits of moderate alcohol consumption have looked at red wine.

1. Red Wine Is a Good Source of Health-Promoting Polyphenols

The alcoholic beverage that is most often linked to good health in studies of moderate drinkers is red wine, and for good reason: Red wine is rich in polyphenols, phytochemicals that reduce oxidative stress in the body and combat free radical damage. Oxidative stress and free radical damage underlie many pathological processes in the body, including the development of heart disease and cognitive dysfunction. Moderate consumption of wine-based polyphenols bolsters the body’s antioxidant defenses and may thus help combat disease-causing oxidative damage.

Interestingly, red wine polyphenols also act as prebiotics, promoting the growth of beneficial gut bacteria. (46) Red wine has more polyphenols than white wine, so if you are going to imbibe, red wine is the more nutritious wine option. (47)

2. Moderate Alcohol Consumption May Benefit Brain Health

Moderate alcohol consumption, and particularly wine consumption, may have beneficial effects on brain health. Fascinatingly, low-level alcohol consumption may boost the activity of the glymphatic system, a network of lymphatic vessels in the brain responsible for clearing away neurotoxic wastes such as misfolded proteins. (48) The verdict appears to be that if you are generally healthy, moderate alcohol consumption is just fine for your brain and may offer some benefits. (49) However, if you are currently suffering from neurocognitive issues such as brain fog, anxiety, or depression, moderate alcohol consumption may actually make you feel worse.

3. It Could Help Your Gut Health, Too

As I mentioned above, moderate red wine consumption may promote the growth of beneficial gut bacteria due to its high polyphenol content. However, not all forms of alcohol offer gut health benefits; in one study where the gut health effects of red wine consumption were compared to those of gin, red wine increased beneficial gut bacteria while gin did not. (50)

Interestingly, moderate beer consumption may also promote the growth of beneficial gut bacteria, provided you aren’t sensitive to the gluten in beer. (51) The plant ingredients used to create beer—grains and hops, primarily—can also act as prebiotics in the gut.

4. Moderate Drinkers Have a Lowered Incidence of Chronic Disease

Moderate alcohol consumption is associated with a lowered incidence of chronic disease, particularly cardiovascular disease. (52) However, these health benefits are likely pretty small once we take into account the other health factors that distinguish moderate alcohol drinkers from abstainers and heavy alcohol drinkers.

Finally, I want to mention that there may be some issues with the way we study drinking, including two statistical phenomena—confounding and selection bias—that may inflate the purported health benefits of moderate drinking.

For a clear, succinct summary of these factors, I recommend you read this article. However, in the meantime, I think it’s safe to say that moderate drinking is probably harmless, but it remains to be seen whether it offers significant health benefits.

If you are feeling confused by the conflicting research on alcohol and health, here are a few key takeaways:

  • If you are going to drink, red wine is likely the best option from a health perspective.
  • Your current health status must be considered when determining whether alcohol is a healthy addition to your diet. For example, if you are currently struggling with gut issues, alcohol is best avoided. However, if you are generally healthy, you can probably include it without any problems.
  • A variety of lifestyle factors, including how much sleep you get, your stress level, and your age, likely play crucial roles in your body’s response to moderate alcohol consumption.

How to Enjoy Alcohol in Moderation

So, you’ve determined that drinking in moderation is fine for you—but what alcohol should you choose? Fortunately, a bunch of healthier alcohol options are emerging on the market as demand for these beverages rises! For wine, I recommend Dry Farm Wines; they meticulously test their wine for problematic ingredients such as gluten and contaminants such as mycotoxins. If you are a kombucha fan, KYLA Hard Kombucha is a delicious option that I think you’ll enjoy. Finally, if you love fruity, bright flavors, I think you’ll like Wild Tonic, a beverage that is similar to kombucha but fermented with honey instead of cane sugar, thus imparting it with prebiotic benefits!

Three Mocktail Recipes to Help with Your 30-Day No Alcohol Challenge

If you’re interested in doing a 30-day no alcohol challenge, or simply want to switch out the occasional glass of wine for a non-alcoholic option, I suggest Curious Elixirs, Kin Euphorics, Lagunitas Hoppy Refresher, or one of the homemade mocktail recipes here.

1. Balsamic-Infused Mocktail

Serves 1 


  • 1 ounce of natural flavor-infused balsamic vinegar
  • 4 ounces of unsweetened sparkling water/tonic water (such as San Pellegrino or Topo Chico)
  • 4 large ice cubes
  • Fresh leafy herbs or fruit to garnish


  1. Place the four ice cubes in a tumbler glass.
  2. Pour the balsamic vinegar in the bottom of the glass.
  3. Pour the sparkling water on top.
  4. Garnish with fresh fruit or herbs and enjoy!

2. Pomegranate Orange Mocktail

Serves 1 


  • ¼ cup of unsweetened pomegranate juice
  • 1 orange; cut one half into 2 orange slices and juice the second half of the orange
  • 8 ounces of sparkling water
  • 4 ice cubes


  1. Chill the sparkling water in the refrigerator.
  2. Place the ice cubes in a tall glass.
  3. Juice half of the orange, carefully removing any seeds that fall into the juice.
  4. Pour the pomegranate juice and orange juice into a glass. Stir with a spoon.
  5. Pour the sparkling water over the pomegranate and orange juice. Garnish the glass with two orange slices. Enjoy!

3. Ginger Lemon Kombucha Mocktail

Serves 1 



  1. Chop the fresh ginger until it is finely minced and add it to a cocktail shaker.
  2. Juice the lemon and add the juice to the cocktail shaker. Add a handful of ice and shake well.
  3. Pour into a martini glass and pour the kombucha on top.
  4. Garnish with fresh fruit of choice, such as sliced pears or berries.
Lindsay Christensen professional photo
Lindsay Christensen, MS, CNS, LDN, A-CFHC

Lindsay Christensen is a research assistant and contributing writer for Chris Kresser. She has a B.S. in Biomedical Science and an M.S. in Human Nutrition and is a clinical nutritionist, freelance writer, and the newly minted author of The Lyme Disease 30-Day Meal Plan, a practical science-based guide on dietary and lifestyle changes that support recovery from Lyme disease. She currently sees clients through her nutrition consulting business, Ascent to Health, and has completed a 1,000-hour internship to obtain the Certified Nutrition Specialist (CNS) credential, a prestigious credential for nutrition professionals. Lindsay has also passed the Certified Ketogenic Nutrition Specialist exam developed by the American Nutrition Association earning her the CKNS credential.

When Lindsay is not writing and seeing clients, she can be found hiking, skiing, and trail running in the beautiful outdoor spaces surrounding her home in Broomfield, Colorado. You can learn more about Lindsay’s writing and nutrition consulting services at Ascent to Health, stay up-to-date on the latest nutrition science on her Facebook and Instagram accounts, and find her new book, The Lyme Disease 30-Day Meal Plan, on Amazon.


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