The Drinking Dilemma: Healthy, or Not?

The toughest question about alcohol today isn't whether to shake or stir that martini. It's whether that martini is going to hurt or help your health. If you've been following the news about alcohol, it's enough to give you whiplash: One study says alcohol is good, the next says it's bad. It depends on the study's perspective. For instance, alcohol is bad for your liver and increases your risk of diseases like breast cancer. But it's good for your arteries. So there's always a tradeoff.

Still, if you're female, you may wonder if it's ever safe, thanks to recent studies that found that two daily drinks raise your risk for the most common types of breast cancer by a scary 32%. Three drinks a day raise these odds by 50%.

But then there's the healthy side of alcohol: Moderate drinking can cut your risk of cardiovascular disease by 25% to 40%. That's because the ethanol in a 1990 Bordeaux, a Bud, or any other alcoholic drink increases good cholesterol and discourages blood clots. It may also have an anti-inflammatory effect on plaque. True, red wine has special antioxidants (quercetin, catechins, and resveratrol) that combat the inflammation and free radicals that make a mess of blood-vessel walls. But mouse studies suggest it would take about 180 bottles of red wine every day to do your vessels any good. So it's probably the alcohol that benefits your arteries. And healthier arteries mean fewer heart attacks, strokes, wrinkles, senior moments -- plus, better sexual function for men. What about the new study linking a daily glass of wine (wine only; not beer or liquor) to lower risks of nonalcoholic fatty liver disease, the number one liver ailment in the U.S.? It's much too early to toast to that. More studies need to be done to see if the link holds up.

So, should you sample that pinot noir or not? Someday, a genetic test may help you decide that. For now, here are the five best ways to get alcohol's health benefits without the risks:

1. Set your limits and stick to them. That means half to one drink per day for women and one to two for men. Men can safely drink a little more because they have more of an enzyme that metabolizes alcohol in their stomach lining -- when most men have two drinks, only one is absorbed.

2. If you're a woman, weigh and balance. Some docs believe that women who are premenopausal, have a family history of breast cancer or are cancer survivors, or are thinking about becoming pregnant simply shouldn't drink. (Definitely don't drink if you're already expecting.) On the other hand, heart disease, not breast cancer, is the number one killer of women. Balance, ah, that's the key. If you're at average risk for breast cancer but high risk for ticker trouble, a drink a day might be a helpful addition to the other heart-healthy steps we know you're taking.

3. If you don't drink already, don't start. Especially if you have a family history of drug or alcohol abuse. Alcohol's risks range from addiction to overindulging enough to cause high blood pressure, strokes, heart failure, liver problems, and car accidents. There are plenty of other ways to get its protective benefits against heart disease, wrinkles, memory gaps, and erectile dysfunction. The three biggies: Stay active, maintain a healthy weight, and eat smart -- avoid saturated and trans fats; simple sugars and syrups; and any grain that isn't 100% whole.

4. Think small. French fries and clothing sizes aren't the only things that have been supersized. Drinks have gotten huge, too, thanks in part to extra-large barware. Stick to official amounts: 1 glass of wine = 5 ounces (that's little); one beer = 12 ounces; 1 cocktail = 1.5 ounces of 80-proof spirits such as vodka.

5. One a day doesn't mean seven on Saturday. Forget "saving up" your daily drinks for a weekend binge. The benefits vanish and alcohol turns toxic, aging your immune system and stressing your heart. Not to mention scrambling your ability to avoid waking up with someone you don't recognize or on a bus to Vegas.