Moderate Drinking and Women's Health: Highlights from the Research Literature

Abstract

In 1996, for the first time, the U.S. government recognized in its Dietary Guidelines for Americans that moderate drinking may have health benefits.’ It is understandable that some nurses and other health professionals may find the dissemination of information about the health benefits of moderate drinking to be at odds with the federal government’s longstanding policy to educate the public about the health hazards associated with drinking. Although not without controversy, the policy decision to include information about the possible health benefits of moderate drinking in the Guidelines is a direct result of an increasing body of scientific evidence supporting a positive relationship between moderate consumption of alcohol and some standard indicators of health. Most research on moderate drinking and health has been conducted with men as subjects. However, recent studies have demonstrated differences in men’s and women’s response to alcohol. The purpose of this article is to identify and review major studies that elucidate the relationship between moderate drinking and women’s health. The nursing responsibility to provide women with health counseling relevant to alcohol use and abuse is best informed by a familiarity with the research literature. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines social drinkers as “those for whom drinking produces no serious longterm health or social consequences and cessation of alcohol use poses no problem”2, p. 1. Moderate drinking is usually defined as a form of social drinking that is regulated by a self-imposed drinking limit. Moderate drinking was defined by the Dietary Guidelines for Americans as not more than one drink per day for women and two drinks per day or less for men. ’ Several researcher^^-^ also define moderate drinking for women as one drink or 14 g or less of alcohol per day. The lower level of alcohol consumption recommended for women as compared with men is based on typical differences in body weight, indications that women are more susceptible than men to toxic effects, and concerns regarding the possible increased risk of breast cancer. Pregnant women and those who are breast-feeding are advised not to drink at aL6 Women’s alcohol use varies according to age, marital status, educational level, and number of social roles a woman fulfills. Married women drink less than divorced, separated, or single women. Widows also consume less than these group^.^^^ Women in the 21 to 34 age group have the highest rates of alcohol consumption, with higher rates of episodic drinking, intoxication, and drinking-related problem~.~*~-’~ Although more women with higher educational levels are moderate drinkers, women with lower educational levels are at higher risk for drinking-related problem^.^*^*^^^ The number of social roles a woman fulfills affects drinking behavior. Multiple roles may reduce alcohol intake, as family roles and employment increase self-esteem and social support while decreasing opportunity. 14* l5 Studies indicate that there are numerous risks and benefits associated with moderate drinking in women. The cardiovascular effects, effects on estradiol levels, bone marrow density, and breast cancer are the main points of interest of the studies reviewed.