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A federally commissioned study intended to inform the 2025-2030 US Dietary Guidelines showed that alcohol consumption — even at levels considered moderate — increases the risk for death and a range of health problems.

The investigators said these findings support limiting alcohol consumption to no more than one drink per day for adults who choose to drink, regardless of sex. Current Dietary Guidelines recommend up to two drinks per day for men and one drink per day for women.

The study, which was published online on June 9 in the Journal of Studies on Alcohol and Drugs, has become a flashpoint in the debate over federal alcohol guidance.

“Even low levels of alcohol use come with health risks. And that risk continues to increase the more someone drinks,” lead author Kevin Shield, PhD, of the University of Toronto and the Centre for Addiction and Mental Health, both in Toronto, Ontario, Canada, said in a news release.

Despite being commissioned to help inform the 2025-2030 Dietary Guidelines for Americans, the study’s conclusions were not reflected in the final federal recommendations released earlier this year, a decision that has drawn criticism from some public health experts and the author of an accompanying editorial.

“The Alcohol Intake and Health report was explicitly invited to inform alcohol guidance during development of the Dietary Guidelines for Americans, 2025-2030. Despite the study’s adherence to its mandate, its findings were sidelined,” editorialist Robert M. Vincent, former associate administrator for alcohol prevention and treatment policy at the Substance Abuse and Mental Health Services Administration, wrote.

Commissioned by the federal Interagency Coordinating Committee on the Prevention of Underage Drinking, the Alcohol Intake and Health Study estimated lifetime risks for alcohol-attributable mortality and morbidity according to average weekly alcohol consumption over a person’s lifetime.

The researchers found no net protective effect of alcohol consumption on health at any level. Instead, alcohol consumption starting at relatively low levels was associated with elevated mortality and morbidity risks.

Among men, consuming more than 6.5 drinks per week was associated with a lifetime alcohol-attributable mortality risk exceeding 1 in 1000; for women, the threshold was about seven drinks per week. At consumption levels above 8.5 drinks weekly, the risk exceeded 1 in 100 for both sexes.

At 14 drinks per week — the upper limit previously recommended for men under the 2020-2025 Dietary Guidelines — the estimated risk for an alcohol-attributable death was approximately 1 in 25 (4%).

Drinking patterns also influenced the risk. The authors reported that consumption of more than one drink per occasion was associated with progressively higher risks for breast cancer, cardiovascular disease, and injury.

‘Ambiguous’ Guidance

However, when the 2025-2030 Dietary Guidelines were released in January, they did not incorporate the report’s findings or recommended consumption thresholds. Instead, the guidelines advised Americans to “consume less alcohol for better overall health” without specifying quantitative limits.

Study co-author Priscilla Martinez-Matszczyk, PhD, MPhil, said she supported the guidelines’ overall recommendation to reduce alcohol consumption but added that it doesn’t go far enough.

“It’s good to tell people that drinking less is better for your health. That’s what our findings show. But it’s unhelpful not to have specific guidance because when people are told that alcohol isn’t good for them, they very reasonably, say — well, how much? We need to be able to answer that question,” said Martinez-Matszczyk of the Alcohol Research Group, Public Health Institute in Emeryville, California.

Marion Nestle, PhD, MPH, professor emerita of nutrition, food studies, and public health at New York University in New York City, agreed that the final guideline language does not provide consumers with enough information to make informed decisions about alcohol-related risk.

The recommendation to “limit alcoholic beverages” is open to interpretation because it does not define what constitutes a safe or appropriate level of consumption, said Nestle, who was not involved in the study.

An Unusual Omission

Nestle said it is highly unusual for a government-commissioned review intended to inform national dietary guidelines not to be reflected in the final recommendations.

The public, she added, should be “hugely” concerned about the alcohol industry’s influence in the development of public health policy.

She also agreed that the final guideline language does not provide consumers with enough information to make informed decisions about alcohol-related risk.

The recommendation to “limit alcoholic beverages” is open to interpretation because it does not define what constitutes a safe or appropriate level of consumption, said Nestle, who was not involved in the study.

In his editorial, Vincent argued that the findings were sidelined amid what he described as a broader pattern of alcohol-industry influence on science and policy.

He asserted that the findings were excluded not because of shortcomings in the science but because they conflicted with powerful commercial interests and became entangled in political and procedural battles.

Vincent noted that sidelining evidence-based alcohol policy carries real “immediate and cumulative” consequences across prevention, treatment, and recovery systems.

He added that the debate is no longer about scientific uncertainty but whether evidence will inform policy when it conflicts with commercial interests.

Department of Health and Human Services (HHS) Responds

In a statement, HHS said the Alcohol Intake and Health Study was one of several resources considered in developing the 2025-2030 Dietary Guidelines for Americans.

The agency said the guidelines were based on a broad review of scientific evidence and expert input and emphasized that recommendations are informed by the “totality of the scientific record, not any single report or analysis.”

The study had no commercial funding. The authors, Martinez-Matszczyk, and Vincent reported having no relevant disclosures.