Low-carb beer? Low-sugar wine? A drink a day keeps the doctor away? When it comes to alcohol there is no shortage of advice – so it pays to know the facts.

There are a lot of misconceptions about alcohol and health. For a start, we’re often hearing it’s healthy to drink a little; especially things like red wine. Don’t those people who live to 100 in the Mediterranean quaff it daily? If it’s good enough for them, we reason, it’s good enough for us.

In which case, what drink to choose? Should we be worried about the sugar and carbs in alcohol too? With some alcohol marketing campaigns promising low-carb and low-sugar products, you could be forgiven for thinking this was a real issue.

Sadly, the devil is often in the detail, and the detail is seldom delved into in media reports. Most health experts agree the benefits of drinking alcohol are fairly regularly overstated. And the harms – perhaps because we don’t really want to know about them – are routinely understated.

Similarly, many people believe beer is high in sugar and carbs. In fact, beer does not contain much sugar – and it never has. A 330ml bottle of beer can contain as little as one gram or less of sugar.

Nor are carbs a huge issue in beer; most beers are relatively low in carbohydrate. Low-carb beers are a triumph of marketing over substance. A ‘75% fewer carbs’ beer I tried recently, for example, does indeed contain two grams of carbs versus eight grams in a standard beer. But this saves a negligible amount of calories: 27 calories or 113 kilojoules in a bottle. Hardly enough to shrink a beer belly.

It’s not the carbs or sugar in beer or wine that makes us fat and causes us harm. It’s the alcohol.

Most wine, similarly, contains very little sugar – less than a teaspoon in a glass. Spirits are similar; it’s the mixers we have with these that add sugar to the drink.

It’s not the carbs or the sugar in beer, wine, whiskey – or any alcohol – that make us fat and causes us harm – and it has never been. It’s the alcohol.

Alcohol has nearly twice the energy of sugar: one gram of alcohol provides 7 calories (29kJ) compared to one gram of sugar with 4 calories (17kJ).

Alcohol is also a toxin; it’s strongly linked with increased risk for six types of cancer. Alcoholic drinks are classified by the International Agency for Research on Cancer (IARC) as a Group 1 carcinogen – that’s the same as asbestos and tobacco. The IARC classifies alcohol as “a cause of female breast, colorectum, larynx, liver, esophagus, oral cavity, and pharynx cancers; and as a probable cause of pancreatic cancer”.

So what about those Mediterranean centenarians then? How come they don’t have cancer?

It’s likely to be because of the context of their drinking. They drink very small amounts, and they drink it in the context of a super-healthy, plant-based diet combined with a low-stress lifestyle which includes incidental exercise and strong community engagement. In other words: lead a brilliantly healthy lifestyle and a little bit of wine won’t kill you.

From this we could easily draw that it’s better to give up alcohol. It’s fair to say that if you don’t drink, don’t start. You won’t miss any health benefits by not drinking. But that’s not to say we can’t drink safely. If you do drink, there are some things you can do to lower your risk of alcohol-related harm.

Be aware, a ‘standard’ drink is probably less than you think it is.

First, drink consciously. Try not to mindlessly quaff through thirst or nervousness; drink water at the same time as your wine. Drinking every day can mean it’s pretty easy to overdo it, so think about having some alcohol-free days in your week. And don’t ‘save up’ and binge at the weekend. Binge drinking is associated with its own set of health risks, including injury.

When you do drink, try and keep it to three drinks or fewer in a session, and be aware a ‘standard’ drink is probably less than you think it is.

Finally, when you’re choosing your drink, don’t be fooled by the marketing claims. Don’t forget to look at the most important thing on the label. When it comes to health, we are far better off ignoring claims of low sugar or low carbs, and going for low- or no-alcohol options.


  • Avoid mindlessly sipping through thirst or nervousness
  • Drink water at the same time as alcohol
  • Have alcohol-free days
  • Try not to binge drink – it opens up a whole new set of risks, including injury
  • Keep it to three drinks or less each session
  • Choose ‘low alcohol’ options over ‘low sugar’ ‘low carb’

The bottom line: enjoy moderate drinking, with an emphasis on the moderation.

Niki Bezzant

Niki Bezzant is a New Zealand-based food writer, editor and commentator. She is the founding editor (now editor-at-large) of Healthy Food Guide magazine, and is currently president of Food Writers New Zealand and a proud ambassador for the Garden to Table program which helps children learn how to grow, cook and share food. She is a member of the Council of Directors for the True Health Initiative, a global coalition of health professionals dedicated to sharing a science-based message of what we know for sure about lifestyle and health.