a glass of red wine
A glass of red wine | via Photl.com

Believe me, I haven’t smoked or drunk anything. At least not so far. Today, that is. This advice comes straight from the scientific literature (and I am not making this up) from the Japanese Justice Ministry.

So the science first. In a paper titled “Late-Life Alcohol Consumption and 20-Year Mortality” published in the journal Alcoholism: Clinical and Experimental Research; Sep, 2010, researchers followed 1,824 individuals between the ages of 55 and 65. The database at baseline included information on daily alcohol consumption, sociodemographic factors, former problem drinking status, health factors, and social-behavioral factors. Abstention was defined as abstaining from alcohol at baseline (meaning not due to medical problems), Mortality was determined by death certificate.

Two questions right off the bat:

1)  What did the researchers drink to survive long enough to conduct a 20-year follow-up study? By my most optimistic calculations, they should be all retired by now.

2)  Why didn’t I think of a 20-year study? Guaranteed tenure and lifetime employment.


The enigma of alcohol’s U-shaped curve

But seriously, this study addresses an enigma that kept countless epidemiologists, public health experts, alcohol researchers gainfully employed even before the government stimulus.

When you plot all-cause mortality of people who abstain from alcohol, drink moderately, or heavily, you get something that intuitively doesn’t make sense: a U-shaped curve, with moderate (2 glasses a day) at the bottom of the U, heavy drinkers at the top of the U on the right (no surprise there), and teetotalers at the top of the opposite side. In other words, non-drinkers died earlier than moderate drinkers. How to account for that?

Many studies have attempted to solve the mystery, but they had a basic flaw that bedevils many longitudinal (looking across time) and cross-sectional (looking across a population) studies: confounding factors. To give only one example: the non-drinkers abstained at the time the study took place, but undoubtedly some of them had been heavy drinkers in the past and then quit. They may still suffer from a damaged heart muscle, fried brain cells, marinated liver, or cell mutations that decades later declare themselves as a  full-fledged cancer. So it is important to delve into the health history, the socioeconomic status, even the psychological state of the person. And then, using statistical formulas, account for these factors so as to obtain as “pure” of a baseline picture as possible. Needless to say, this is hard to do. But to the researchers of this study’s credit: they did it. And what they found is very interesting.

Controlling only for age and gender, compared to moderate drinkers, abstainers had a more than two times increased mortality risk, heavy drinkers had 70% increased risk, and light drinkers had 23% increased risk. A model controlling for former problem drinking status, existing health problems, and key socio-demographic and social-behavioral factors, as well as for age and gender, substantially reduced the mortality effect for abstainers compared to moderate drinkers. However, even after adjusting for all covariates, abstainers and heavy drinkers continued to show increased mortality risks of 51 and 45%, respectively, compared to moderate drinkers.

Bottom line is that abstainers die earlier. But why?

I could think of two broad categories. The first is pure medicine: alcohol in moderation elevates the levels of HDL, the “good” cholesterol. It also contains anti-oxidants and resveratrol. And it reduces blood pressure to some degree.

The second category is just as important, in my not-so-humble opinion. As I long suspected, the study found that moderate drinkers have more friends and higher quality “friend support” than abstainers. They’re also more likely to be married.


Some history

Have you ever seen a picture of Dionysus and his cohorts? They were having a ball! Every time I see these paintings it brings a smile to my heart. I wish I was there with them. Greek Symposia, where they reclined, ate and drank wine, and had elevated discussions was the forerunner of the Jewish Seder. For me, this makes the Passover Seder a joyous occasion, rather than the somber ritual it could have been. And not just wine, any alcoholic drink would do.

The Paleolithic people of 10,000 years ago brewed beer. So did the Mesopotamians, Nubians, the ancient Egyptians, and the Israelites. As psychologists will tell you, alcohol in moderation removes behavioral inhibitions. Just go to any Karaoke club in Tokyo and you will encounter the painfully reserved “salarymen” and CEOs singing their hearts out and mingling as equals – a total breakdown of social barriers and behavioral inhibitions.  As neurobiologists will tell you this is because alcohol inhibits the GABA neurons. These are neurons that put the brakes on our impulses.

To put it in simple terms: abstainers may be more likely to be loners, inhibited, pessimistic and high-strung. This alone can drive one to drink.


If all else fails –move to Japan

Why move to Japan? No, it’s not because the Japanese know how to drink, rather they know how not to die! In today’s NYT (9/11/10), we read that in Japan more than 234,000 people listed on government records as age 100 or older are actually missing and probably dead, in some cases long dead. For ages, scientists looked for explanations for the advanced longevity seen in Japan. They varied from healthy food, eating in moderation, reverence for the parents and grandparents, and active integration of the old in family and society. But all the while those people were dead! Japan, with its legendary long-lived oldsters?

Now the Japanese Justice Ministry revealed that a survey of local records across Japan uncovered about 77,000 missing residents listed as at least 120 years old, and 884 were on the records as 150 or older. That would have made them far more advanced in age than the longest-lived person recorded in modern times, a Frenchwoman who died in 1997 at age 122.

The furor over Japan’s missing centenarians began in July when the authorities in Tokyo discovered the body of Sogen Kato, the man thought to have been the city’s oldest living man at 111, mummified in his bed, dead for more than three decades.

So, if you are a determined abstainer, the least you should do to improve your longevity is to move to Japan. It will make the US gene pool a lot happier. Me? I am staying here, with  2 glasses of wine (Merlot, thank you very much) for dinner. Much more fun – for sure. Cheers!

Reviewed and updated 5/19/17.

Dov Michaeli, MD, PhD
Dov Michaeli, MD, PhD loves to write about the brain and human behavior as well as translate complicated basic science concepts into entertainment for the rest of us. He was a professor at the University of California San Francisco before leaving to enter the world of biotech. He served as the Chief Medical Officer of biotech companies, including Aphton Corporation. He also founded and served as the CEO of Madah Medica, an early stage biotech company developing products to improve post-surgical pain control. He is now retired and enjoys working out, following the stock market, travelling the world, and, of course, writing for TDWI.


  1. Nice blog Dov. Someday the medical community should do some research on cannabis. There are over 200 medical conditions that respond favorably to cannabis. The movie, “The Union-the business behind getting high” is a Canadian film that will open your eyes to the real story behind cannabis. Many friends of mine use it for anxiety and pain relief.

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