WASHINGTON — A report on alcohol’s health effects, commissioned by the federal government but unreleased under President Trump, came out Tuesday — in a scientific journal. The study finds even low levels of drinking may increase the risk of various diseases or even death.
The Alcohol Intake and Health Study began in 2023 and was run by the federal Substance Abuse and Mental Health Services Administration as part of an update to the United States’ dietary guidelines. However, the panel’s work was quickly embroiled in controversy, with some members of Congress and alcohol industry trade groups alleging scientists on the project held an anti-alcohol bent.
The group’s final study was not released by the Trump administration. A House Oversight Committee report in January called it “irretrievably flawed” and recommended dietary guideline authors ignore its conclusions. Some authors of the study, who work outside the U.S. government, say their findings were politicized and suppressed because they are unfavorable to powerful special interests, including the beer, wine, and liquor lobbies.
Scorned by Trump officials, researchers took their review to the Journal of Studies on Alcohol and Drugs, which published it — without reference to SAMHSA funding. Among the findings is that even low levels of consumption, or about one drink per day, raises Americans’ chances of dying or becoming seriously ill.
“These findings are not radical. They are rigorous — and commercially threatening,” Robert Vincent, who helped oversee the study as a former associate administrator for alcohol prevention and treatment policy at SAMHSA, wrote in an accompanying editorial. Vincent lost his job last year as part of sweeping cuts across federal health agencies.
Emily Hilliard, a spokesperson for the Department of Health and Human Services, said federal officials reviewed the alcohol study “alongside the broader body of available scientific evidence” when updating the nation’s dietary advice.
New guidelines — and a flipped pyramid— were unveiled in January and surprised some by dropping decades-old messaging on alcohol. Instead of telling Americans to stick to one or two drinks per day, they advised Americans simply to “consume less alcohol for better overall health.”
“The guidelines are informed by the totality of the scientific record, not any single report or analysis,” Hilliard told STAT. A scientific appendix published alongside the dietary guidelines, however, noted that officials relied on a different study, not the SAMHSA-led report, as the basis for their alcohol recommendation.
Historically, suggested drinking limits for men have been double that of women due to biological differences in how quickly the body processes alcohol.
However, available scientific evidence supports a gender-neutral recommendation in order to reduce men’s risks, the SAMHSA report found: no more than one alcoholic beverage per day for adults who drink. Another panel shaping the dietary guidelines arrived at the same conclusion in 2020, but the proposal was not adopted.
Science on alcohol’s health effects is particularly resonant at a time when Americans are drinking less and thinking more about their health, but when alcohol-related harms remain at high levels. Alcohol contributes to an estimated 178,000 deaths each year in this country. Drinking, especially heavy use, has been associated with a panoply of ailments and increased risk of death.
But the science is mixed on how small amounts of alcohol impact health. Just last week, a large review in the journal Nature Health found evidence that low-to-moderate drinking was tied to a reduced risk of some cardiovascular diseases, type 2 diabetes, and dementias. On the other hand, even very low levels of drinking were associated with increased cancer risk, the study found. “Current evidence does not support sex-specific thresholds” for federal alcohol guidance, the authors wrote.
Trump officials’ decision to withhold a taxpayer-funded alcohol report has implications for public health, but it also raises fresh questions about scientific independence under the administration. Officials have already clawed back or threatened research funding on topics they consider illegitimate, such as gender diversity and racial inequality. Most recently, the administration proposed changing the way scientific grants are awarded so political appointees retain tighter control of research conducted with federal funds.
“The public health consequences of sidelining evidence-based alcohol policy are immediate and cumulative,” Vincent wrote in his editorial.
In the end, Trump officials relied on a study of alcohol led by the National Academies of Sciences, Engineering, and Medicine at the request of Congress. That review by 14 outside researchers found mid-grade evidence that moderate drinking was associated with lower all-cause mortality. The group’s analysis was not specific to causes of death driven by alcohol. The review also found moderate drinking increased the risk of breast cancer. (The NASEM panel was criticized by watchdogs and outside researchers for including people with financial ties to the beverage alcohol industry.)
The SAMHSA panel, in contrast, found there was no net health benefit from alcohol, and that even moderate amounts carry risk. One drink per day is associated with “elevated risks of death from liver cirrhosis, esophageal and oral cancers, and injury-related deaths. Among females, these risks extend to liver cancer,” the paper says.
Researchers used meta-analyses and data modeling to estimate alcohol-specific risks for various diseases and injuries, and then compared those hazards to risks in people who never drank. (Former drinkers were left out in order to control for a potential bias in those who stopped drinking after becoming ill.) The study focused on U.S. data that were representative of the national population, including from surveys, injury surveillance systems, and vital statistics repositories.
While the lifetime risk of death from one drink per day is about 1 in 1,000, it climbs with consumption. At 14 drinks per week, men face a 1-in-25 chance of dying due to alcohol over the course of their life, data suggest. Women’s risks increase sharply the more they drink: At two drinks per day, women’s relative risk of dying from severe liver disease was more than twice that of men who drank the same amount, the analysis found.
Small protective effects researchers observed at up to three drinks per week were not statistically significant. They did, however, find a lowered risk of diabetes in women who drank up to one alcoholic beverage per day — a finding echoed in some other research — but said risks were “not evenly distributed across individuals.”
Binge drinking, which is defined as five or more drinks in one sitting for men, or four or more for women, raises the risk of heart attack, heart disease, stroke, and injury, the review found.
STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.