It’s true that moderate drinking can offer substantial health benefits across all age brackets, the most striking of which is a finding by Harvard’s School of Public Health that alcohol can protect against heart disease. But giving undue attention to the benefits masks alcohol’s many pitfalls, says Bob Wright, who’s spent 30 years as director of education at Hilton Head Health, a health and weight-loss facility in the coastal South Carolina resort town.

“If you drink and meet the definition of moderate, it might be nice to know that you’re shielding yourself against some things,” Wright says. “But there are no public health guidelines that say you should start drinking.” Short version: If you’re looking to shield yourself against heart disease, start with exercise and diet, not merlot.

The CDC’s Dietary Guidelines for Americans identify “moderate” alcohol intake as one drink a day for women and two for men, with “one drink” being:

  • 12 ounces of beer
  • 5 ounces of wine
  • 1 1/2 ounces (roughly a shot) of 80-proof distilled spirits or liquor

And when they say “per day” they mean it — you can’t have seven drinks on a Tuesday and call it moderate intake. Also, the rules change when you hit 65: “Moderate” intake after that age is one drink per day for everybody. (Sorry.)

Most importantly, remember that everyone has individualized benefits, risks, genes, behaviors, and backgrounds that can influence how alcohol affects them, and you should talk to your doctor about yours. Actually, he or she may start the conversation for you: The CDC in early January began urging physicians to become more aggressive about talking to their patients about drinking. (The Affordable Care Act requires new plans to cover alcohol screening and brief counseling without a co-pay.)

4 Benefits of Drinking Alcohol

1. It protects your heart.

More than 100 studies have confirmed that alcohol — again, in moderation — can decrease risk of death by cardiovascular causes by a startling 25 to 40 percent. Andrea Paul, chief medical officer of boardvitals.com, says that’s because alcohol raises a person’s HDL, or “good” cholesterol. (The Mayo Clinic agrees, as does Harvard.) That slashes the risk of heart attacks, ischemic strokes and death from all cardiovascular causes.

2. It cuts down on other risks as well.

Paul says moderate consumption has been linked to a decreased risk of type 2 diabetes and gallstones and a study from Loyola University in Chicago indicates that it could reduce the risk of dementia and cognitive impairment as well. (Interestingly, Wright says these benefits originate from all forms of alcohol; there’s no added benefit from red wine, for example, over other kinds of drinks. “Some suggest that the benefit from red wine comes from resveratrol,” he says, “The real contributing factor is the alcohol.”)

3. It could offer benefits for breast cancer survivors.

Drinking is widely recognized as a breast cancer risk; a study of more than 320,000 women found that those who drank more than moderately increased their chances of developing the cancer by up to 41 percent. But a study published in the Journal of Clinical Oncology in April suggests that moderate drinking may improve chances of surviving the disease, in part because of those cardiovascular benefits.“”Women consuming moderate levels of alcohol, either before or after diagnosis, experienced better cardiovascular and overall survival than nondrinkers,” wrote Polly A. Newcomb, Ph.D., head of the Cancer Prevention Program at Fred Hutchinson Cancer Research Center and the study’s principal investigator. But more research needs to be done to confirm the findings.

4. It might make you live longer.

A study released just last December suggested that people who drink regularly live longer lives than those who don’t. The report, which appeared in the journal Alcoholism: Clinical and Experimental Research, connected moderate drinking with the lowest mortality rate. By percentage, 69 percent of nondrinkers died prematurely, but only 41 percent of moderate drinkers did. (Heavy drinkers had a surprising 60 percent mortality rate.)

5 Negative Effects of Alcohol

1. Alcoholism and overdoing it.

Let’s get some ugly facts out of the way: The CDC estimates at least 38 million adults in the United States drink too much, but only 1 in 6 of those ever discuss their drinking with a health professional. (Most of those 38 million? Not diagnosed as alcoholics, but do drink way too much.) Overconsumption of alcohol causes about 88,000 deaths in the U.S. every year, and one in every three cases of violent crime involves alcohol.

2. Increase cancer risk and other diseases

Many of the effects of alcohol are too well-known: Heavy drinking can cause hepatitis and cirrhosis, both of which are very serious. It can increase blood pressure and damage the muscles of the heart. It is the cause of drinking and driving accidents, lessens inhibitions, creates a potential for addiction and can make people act inappropritely. Moreover, the World Cancer Research Fund and American Institute for Cancer Research have linked alcohol to cancers of the mouth, pharynx, larynx, esophagus, and colon, as well as the breast cancer risk mentioned above.

3. It does a number on your skin.

Alcohol does three pretty terrible things to your skin, says Dr. Ariel Ostad, dermatologist, author and clinical assistant professor in the Department of Dermatology at New York University Medical Center. First, alcohol is a notorious dehydrator and diuretic, which explains many of your hangover symptoms and why your skin is dull and dry. It beats up your liver, of course, which can make your skin look sallow and pasty. And it’s a vasodilator, which means it widens the blood vessels, particularly in your face, which makes you look red and puffy. The good news, says Ostad, is that this one has an easy fix: Drink water, which will cycle out the alcohol and restore hydration to your body.

4. Alcohol has calories.

Wright, who counts weight gain as a hidden effect of drinking too much, has a saying. “Resolve dissolves in alcohol.” A few drinks in, he says, and you’ll be less likely to turn down that dessert, or rack of ribs or third or fourth drink. Individual drinks aren’t calorie-rich: one standard 12-oz. 5% alcohol beer is about 150 calories, a 5-oz. glass of wine is about 100, and an ounce-and-a-half shot about 100 calories (it doesn’t matter if it’s gin, vodka, whiskey or bourbon, and all those “clear liquor” myths have been busted). But if you go over that moderate level of two drinks (or 300 calories) a day, things can start to add up.

5. Alcohol affects your thinking.

Moreover, Wright says, alcohol gets in the way of you making smart decisions. “I don’t say this judgmentally,” he says, “But it gets in the way of people behaving in a healthful way.”

•December 20, 2017