Moderate Drinking Has No ‘Protective’ Effects for Blacks

For most people, alcohol is a pleasant accompaniment to social activities. Moderate alcohol use—up to two drinks per day for men and one drink per day for women and older people (A standard drink is a one 12-ounce bottle of beer or wine cooler, one 5 ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits)—is not harmful for most adults.

Many have heard about the protective health effects of moderate alcohol consumption, usually in relation to red wine. This association is part of what researchers call a “J-shaped” relationship: moderate drinkers show a lower mortality risk than lifetime abstainers, and heavy drinkers show a higher mortality risk than either of the other groups.

A study in the journal Alcoholism: Clinical & Experimental Research finds that alcohol consumption does not seem to have protective effects for African Americans, and its authors suggest this may be due to different drinking patterns, specifically binge drinking.

“One of the most discussed findings in alcohol epidemiology is the J-shaped curve,” said Christopher T. Sempos, professor and director of graduate studies in the department of social and preventive medicine at the University of Buffalo, and corresponding author for the study.

“Essentially, what it tells us is that some kind of drinking is beneficial to health. In our study, however, this beneficial effect could not be found in African Americans, even when using the same study where the beneficial effect had been found for whites.”

Sempos’ research show that patterns of drinking—that is, the style of how alcohol is consumed—explain the differences between African Americans and whites. For example, somebody can have an average moderate volume by drinking heavily once or twice a week.

From 1971 to 1975, the first National Health and Nutrition Examination Survey (NHANES I) collected data on 14,407 adults who were 25 to 75 years of age during this time. Follow-up surveys were conducted in four waves: 1982 to 1984, 1986, 1987 and 1992. Researchers focused in particular on data collected for 2,054 African Americans (768 men, 1,286 women).
“This study clearly demonstrates an absence of a protective effect at lower volumes of consumption in a large sample of African Americans followed over a long period of longitudinal follow up,” said Tom Greenfield, center director at the Alcohol Research Group.

“The absence of this effect in the African Americans is striking. The study also confirms that African Americans evidenced drinking less often but in larger amounts than the white respondents – a biologically less protective pattern.” African Americans binge drink more than whites and such a drinking style has no beneficial health outcomes.
 Other researchers have found evidence that because of larger containers and higher alcohol content products marketed to African Americans, these surveys may underestimate the heavy quantities consumed by ethnic minorities.

These factors are just some of those that help explain the higher risks of liver cirrhosis, among African American and Hispanic populations compared to whites.
Both Sempos and Greenfield recommend that alcohol policy, which currently focuses on reducing average volume of drinking, instead should focus on drinking patterns among certain populations.
“For African Americans in particular,” said Greenfield, “we need to develop evidence-based interventions, health messages and prevention programs that will reinforce the acceptability of drinking in smaller amounts while emphasizing the health and social harms of drinking larger amounts.”