VA study: Moderate alcohol use linked to lower rates of hospitalization, death

A VA study finds that hospitalization or death from any cause was higher in older Veterans who were nondrinkers or “harmful use” drinkers, compared with moderate drinkers. All of the nearly 10,000 Veterans in the study were defined as “high risk” for being hospitalized within one year.

The results appeared in the journal “Alcoholism Clinical & Experimental Research” in June 2021.

The study’s principal investigator, Dr. Dan Blalock, says one possible explanation for the finding is that healthier patients in the study sample liked to drink in moderate amounts.

Dr. Dan Blalock is a clinical research psychologist at the Durham VA.

Researcher doubtful that alcohol benefits a person’s health

But even though the findings support prior literature showing that drinking a moderate amount of alcohol is linked with reduced risk later in life for hospitalization or death, Blalock expresses skepticism that even a small amount of alcohol is beneficial to one’s health.

“A lot of people in the medical community are talking about that theory right now,” says Blalock, a clinical research psychologist at the Durham VA Health Care System in North Carolina. “There are hypothesized mechanisms for why a little bit of alcohol would be good for your health, like alcohol actually helps your good cholesterol [HDL] a little bit. That’s one of the mechanisms that’s been proposed, especially for heart health.

“But people are starting to steer away from the idea that moderate amounts of alcohol are better for your health overall,” he adds. “That’s because a lot of work is coming out that any amount of alcohol increases your risk for a lot of different things considered detrimental to your health, from certain cancers to certain cardiac abnormalities. A lot of that research is pretty new, especially regarding cancers. But it’s making people step away from the idea that alcohol has beneficial effects for you on the whole.”

In recent years, studies have challenged the theory that alcohol has health benefits, concluding that no alcohol use is the most universally recommended way to minimize health risks linked to drinking. Most health experts advise people who don’t drink to not start.

Study produces surprising finding on heart disease and drinking

In their research, Blalock and his colleagues also reached a surprising conclusion. They found that the rate of hospitalizations or deaths specifically related to heart disease was similar in the four categories of drinking evaluated in the paper. In other words, drinking, even at hazardous levels, didn’t appear to make things worse. But only 184 of the Veterans in the study had hospitalizations that could be attributed to heart disease, so the results might not be valid or might need to be replicated with a larger sample.

“When we started to look at how the numbers broke down, it became clear that our sample [of nearly 10,000 Veterans] was relatively small given the relatively rare event of heart disease hospitalizations at six months past baseline,” says Blalock, who is also an assistant consulting professor at Duke University in North Carolina. “Once you break those 184 patients down into our four categories of alcohol use—nondrinker, moderate, hazardous, and harmful—there weren’t enough data points to confidently conclude anything about the link between alcohol consumption and heart disease hospitalizations.

“That is why we have to be very careful with how we discuss these findings and non-findings,” he adds. “We’re not saying that alcohol consumption has no relationship with heart disease hospitalizations. We’re simply saying that our findings did not support an association one way or another, and that additional work is needed in survey samples larger than ours.”

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