Is there a safe dose of alcohol? Headlines say no. The biggest meta-analysis on alcohol and death says something more nuanced. Dr Cliff Harvey sits down with longtime collaborator Dr Mikki Williden to separate "no healthy dose" from "no safe dose", and to work out what a sensible, evidence-based drinking pattern looks like for people who enjoy the odd drink.
In this episode we cover:
Why alcohol is such a divisive topic, and why both apologists and absolutists get the evidence wrong
What the Zhao et al. (2023) meta-analysis of 107 cohort studies found on all-cause mortality
Why cancer risk is where the case for "no safe dose" is strongest
Relative vs absolute risk, and how to read a 3% or 20% increase
Abstainer bias: why non-drinkers once looked less healthy than light drinkers
How diet, exercise and a Mediterranean-style drinking pattern change the picture
Why zero-tolerance messaging can erode trust
The practical take-home: a drinking pattern that sits well inside the risk thresholds
Chapters:
00:00 Why alcohol is such a polarising health topic
01:25 Why Mikki is the right person to discuss the evidence
03:17 Tracking health metrics without obsession
07:39 Why steps and movement matter more than fitness dogma
09:02 Do strength training and jiu-jitsu count as cardio?
12:53 Why more carbs improved Mikki's running and recovery
15:47 Why low carb and high carb can both work
20:34 Horses for courses: matching diet to the goal and season
23:30 Why "what if they did even better?" is a weak argument
25:25 Back to alcohol and mortality
30:07 Why mortality is the right place to start
32:11 What the major meta-analysis found on all-cause mortality
35:09 Why cancer changes the conversation
38:01 How alcohol-related cancer risk is usually presented
40:19 Relative risk vs absolute risk explained
42:13 Why cancer studies often use broad intake categories
47:11 Residual confounding and why no study is perfect
49:07 How physical activity and Mediterranean habits reduce risk
50:43 No healthy dose, but maybe a safe dose
55:56 How drinking culture has shifted
58:16 Functional drinking and underestimated intake
1:02:36 Why zero-tolerance messaging erodes trust
1:04:51 Alcohol with food, and why culture affects outcomes
1:08:13 Personal tolerance, nickel sensitivity and congeners
1:10:11 Social lubrication, behaviour and context
1:12:07 The biggest health levers may not be alcohol
1:14:03 How mindfulness, sleep and behaviour ripple across health
1:15:31 The practical middle ground on alcohol
1:17:09 Where to find Mikki and the Holistic Performance Institute
About Dr Mikki Williden
Dr Mikki Williden is a New Zealand nutritionist with a PhD in nutrition, a former AUT lecturer, and host of the Mikkipedia podcast. She runs coaching and programmes for people who want evidence-based nutrition that fits real life, and is a long-term contributor to the Holistic Performance Institute.
Want the full evidence review? Cliff's living review on alcohol and mortality is going up in Nutripaedia, HPI's database of evidence reviews. Thinking about a career in nutrition? Grab the free Practitioner's Roadmap: https://www.holisticperformance.institute/pages/roadmap.
If this episode was useful, follow Translating Nutrition and leave a rating, it helps other practitioners find the show.
Podden och tillhörande omslagsbild på den här sidan tillhör
Dr Cliff Harvey. Innehållet i podden är skapat av Dr Cliff Harvey och inte av,
eller tillsammans med, Poddtoppen.
