Drink: ... and a few drinks can be a good medicine, too

Christmas drinkers can celebrate - modestly. Britain's most famous medical researcher has concluded that alcohol is good medicine. Jeremy Laurance, Health Editor, explains how it can prevent disease.

There is now "massive evidence" that a couple of drinks a day is good for health, according to Sir Richard Doll, the UK's most eminent epidemiologist.

It does not matter whether the drink is beer, wine or spirits - it is the alcohol that confers the protective effect, principally by reducing heart disease and stroke. Two or three drinks a day is the ideal - cutting heart disease in men over 45 by a third - after which mortality starts to rise again because of an increase in diseases associated with alcohol, such as cirrhosis of the liver and oral cancer. But only when consumption rises to seven drinks a day does mortality for the drinker exceed that for a teetotaller.

The optimum level of drinking for women is somewhat lower, partly because of their smaller size but also because they have a lower risk of heart disease, greater susceptibility to liver damage and a higher risk of breast cancer, which increases by 10 per cent for each drink additional to the optimum taken on average each day. A drink is equivalent to a half pint of beer, small glass of wine or single measure of spirits.

There is no evidence that drinking reduces mortality in people under 45 who are at lower risk of dying from heart disease. Since drinking at all levels increases the risk of accidents, in younger people, this outweighs any benefit to the heart.

Sir Richard, whose work 20 years ago established the link between smoking and lung cancer, says in the British Medical Journal , that there is no greater benefit from drinking wine, despite what some studies have shown.

The apparent benefit derives from different styles of drinking. Wine drinkers tend to drink small amounts regularly, gaining the greatest benefit, while beer and spirit drinkers tend to binge on one or two days a week.

Sir Richard concludes: "People should be treated as adults and should be told the facts. These still need to be refined in detail but in broad outline they are quite clear.

"In middle and old age, some small amount of alcohol within the range of one to four drinks each days reduces the risk of premature death, irrespective of the medium in which it is taken."