If you are even slightly health conscious, the thought of going to a bar and ordering your favourite cocktail might sound tempting, but it often comes with a side of guilt over the harmful impact alcohol can have on your health.
The discourse around how bad alcohol is for your body has several answers, depending on who you ask.
For instance, a study by the American Heart Association suggests that moderate alcohol consumption may contribute to heart health by increasing HDL ("good") cholesterol and reducing plaque buildup in the arteries. Similarly, a Harvard-cited study also noted that moderate drinking - defined as consuming alcohol in quantities that do not negatively affect the body - can be considered acceptable.
'Even Moderate Drinking Is Not Good'
Such studies had made the occasional indulgence in alcohol seem acceptable. But all these studies came with margins of error, and it's important to note that many of these studies are observational in nature. This means that they often rely on self-reported alcohol intake, which can be inaccurate, and typically involve participants who volunteer their health data over specific time periods.
Meanwhile, the World Health Organization classifies alcohol as a toxic, psychoactive, and dependence-inducing substance, as well as a Group 1 carcinogen. According to WHO, alcohol contributes to at least seven types of cancer, including common ones such as bowel cancer and breast cancer in women. A study published in March 2022 further reveals that even low levels of alcohol consumption can increase the risk of high blood pressure and heart disease.
"No type of alcohol is truly 'safe' in excess, whether it's beer, wine, or spirits," says Dr Swapnil Sharma, Consultant and Chief Surgeon, Liver Transplant, Hepatobiliary, Pancreas and GI Surgery, Wockhardt Hospitals, Mumbai Central.
"Once consumed, alcohol enters the bloodstream and is processed by the liver. Excessive intake can damage liver cells, trigger inflammation, and eventually lead to conditions like fatty liver, hepatitis, cirrhosis, and even liver failure," Dr Sharma adds.
WHO classifies alcohol as a Group 1 carcinogen. Photo: Unsplash
That said, we also understand that in social situations, or after one of "those" days, you might find yourself with a glass in hand. So, if that's the case, which drink should you choose? We asked experts.
The 'Healthier' Alcohol
Dr Rajesh Jaria, Consultant, Internal Medicine at PD Hinduja Hospital & MRC, Khar, Maharashtra, points out that while alcohol does not offer genuine health benefits, drink choices may differ in terms of calories, sugar content, hangover potential, and the congener effect.
Just as inactive ingredients in medicines can cause allergic reactions, different alcoholic drinks contain congeners - compounds that impact the body differently despite ethanol being the key intoxicating ingredient.
"A drink with lower alcohol content is always a healthier choice, as is one with higher antioxidant polyphenols. A clear spirit like vodka or light rum would be a better option than a coloured spirit," says Dr Jaria.
Dr Sharad Malhotra, Senior Consultant and Director, Gastroenterology, Hepatology and Therapeutic Endoscopy, agrees. He explains that not all drinks are created equal-neither in their composition nor their impact on the body.
But after speaking to experts, we found a unanimous answer: the least bad alcohol is red wine.
"If we must pick a 'better' alcohol, red wine edges ahead-but with serious caveats. Red wine contains antioxidants such as resveratrol and flavonoids that have shown mild cardiovascular benefits in limited studies. However, the quantity matters. One small glass a day for women, and two for men - that's the maximum," says Dr Sharad.
Red wine production involves harvesting dark-coloured grapes, crushing them, and fermenting the juice. Photo: Unsplash
"Once you cross that threshold, any protective effect vanishes and the damage begins," he adds.
Dr Jaria agrees. He prefers dry red wine, which, according to him, limits sugar and cuts calorie and carbohydrate content. "A drier white wine also offers these benefits, although it contains negligible resveratrol," he says.
He also highlights that grape skin contributes resveratrol but also brings tannins - a type of congener known to cause headaches. Additionally, he recommends that when in doubt, choosing a drink with lower alcohol content (e.g., 5 per cent vs 8 per cent) such as beer is often the better option.
Which Type of Alcohol Is The Worst?
Dr Malhotra warns that
- flavoured spirits,
- sugary cocktails, and
- high-proof liquors like grain alcohol or moonshine top the list of the most harmful drinks.
These not only elevate the risk of liver damage but also lead to severe dehydration, blood sugar spikes, and acid reflux.
"Sugary mixers in cocktails can overload your pancreas and raise triglyceride levels. Similarly, high-concentration spirits burn the gastrointestinal lining and worsen conditions like ulcers or gastritis," he adds.
Dr Manish Dodmani, Consultant, Medical Gastroenterology, KIMS Hospitals, Thane, Maharashtra, notes that in rural parts of India, people often consume country liquor, which can contain as much as 60-70% alcohol.
"The higher the alcohol percentage, the worse the impact. So, drinks with 40-45% alcohol, like whiskey or vodka, are among the worst. Beer, with its relatively lower alcohol percentage, is far less harmful," he explains.
Dr Jaria also suggests considering hard kombucha, a fermented tea-based drink packed with probiotics and often touted as a health elixir. However, he cautions that versions with higher alcohol content come with the same risks as other alcoholic beverages.
How To Pick A Healthier Alcohol
Dr Malhotra notes that while all alcoholic drinks are labelled similarly, a few key details can help you make a better choice:
The most important bit is
Alcohol by Volume (ABV): Opt for lower ABV, especially for casual or regular consumption.
Have a look at the percentages:
- Beer: 4-6%
- Wine: Up to 14%
- Vodka: 40-95%
- Whiskey: 36-50%
- Gin: 36-50%
- Rum: 36-50%
- Tequila: 40-51%
- Brandy: 35-60%
- Liquers: Around 15%
Other factors to keep in mind when you're picking an alcohol:
- Added Sugars or Flavours: Avoid artificially flavoured or sweetened cocktails.
- Sulfites and Preservatives: Those sensitive to sulphites should be cautious when drinking wines or ciders.
- Fermented vs Distilled: Fermented drinks like beer or wine tend to be less harmful than distilled spirits-though moderation is crucial in either case.
The Last Peg
At the end of the day, no alcohol is truly 'healthy'- but some choices are less damaging than others. If you choose to drink, aim for moderation and make informed decisions.
Look out for lower alcohol content, avoid sugary mixers, and perhaps pick that small glass of red wine over a cocktail loaded with sugar and spirits. And always remember, the healthiest choice will always be a glass of water.