Alcohol consumption and cardiovascular risk guidelines
INTERHEART trial had shown moderate alcohol intake is associated with decreased cardiac risk. Why did they change the current recommendations about alcohol use ?
Early observational studies, including the INTERHEART trial, suggested that moderate alcohol consumption lowered heart disease risk, but newer, higher‑quality research has shown that this apparent benefit was largely due to residual confounding and bias (healthier lifestyle, higher socioeconomic status, and the “sick‑quitter” effect). Mendelian randomization studies and large prospective cohorts that separate lifelong abstainers from former drinkers do not demonstrate a true cardioprotective effect. At the same time, evidence of harm even at low levels is stronger: increased risk of atrial fibrillation, hypertension, hemorrhagic stroke, several cancers (especially breast), injuries, dependence, and adverse effects on sleep and weight. Consequently, major guidelines (AHA/ACC, WHO, U.S. Dietary Guidelines, India’s FSSAI) now recommend not starting to drink for heart health; if alcohol is consumed, it should be light and infrequent—generally ≤1 standard drink per day with several alcohol‑free days—and less is better.