Is there a safe dose of alcohol? Headlines say no. The biggest meta-analysis on alcohol and death says something more nuanced. Dr Cliff Harvey sits down with longtime collaborator Dr Mikki Williden to separate "no healthy dose" from "no safe dose", and to work out what a sensible, evidence-based drinking pattern looks like for people who enjoy the odd drink.

In this episode we cover:

• Why alcohol is such a divisive topic, and why both apologists and absolutists get the evidence wrong
• What the Zhao et al. (2023) meta-analysis of 107 cohort studies found on all-cause mortality
• Why cancer risk is where the case for "no safe dose" is strongest
• Relative vs absolute risk, and how to read a 3% or 20% increase
• Abstainer bias: why non-drinkers once looked less healthy than light drinkers
• How diet, exercise and a Mediterranean-style drinking pattern change the picture
• Why zero-tolerance messaging can erode trust
• The practical take-home: a drinking pattern that sits well inside the risk thresholds

Chapters:

• 00:00 Why alcohol is such a polarising health topic
• 01:25 Why Mikki is the right person to discuss the evidence
• 03:17 Tracking health metrics without obsession
• 07:39 Why steps and movement matter more than fitness dogma
• 09:02 Do strength training and jiu-jitsu count as cardio?
• 12:53 Why more carbs improved Mikki's running and recovery
• 15:47 Why low carb and high carb can both work
• 20:34 Horses for courses: matching diet to the goal and season
• 23:30 Why "what if they did even better?" is a weak argument
• 25:25 Back to alcohol and mortality
• 30:07 Why mortality is the right place to start
• 32:11 What the major meta-analysis found on all-cause mortality
• 35:09 Why cancer changes the conversation
• 38:01 How alcohol-related cancer risk is usually presented
• 40:19 Relative risk vs absolute risk explained
• 42:13 Why cancer studies often use broad intake categories
• 43:46 Drinking frequency and binge patterns
• 44:46 Abstainer bias: why non-drinkers looked worse
• 47:11 Residual confounding and why no study is perfect
• 49:07 How physical activity and Mediterranean habits reduce risk
• 50:43 No healthy dose, but maybe a safe dose
• 55:56 How drinking culture has shifted
• 58:16 Functional drinking and underestimated intake
• 1:02:36 Why zero-tolerance messaging erodes trust
• 1:04:51 Alcohol with food, and why culture affects outcomes
• 1:08:13 Personal tolerance, nickel sensitivity and congeners
• 1:10:11 Social lubrication, behaviour and context
• 1:12:07 The biggest health levers may not be alcohol
• 1:14:03 How mindfulness, sleep and behaviour ripple across health
• 1:15:31 The practical middle ground on alcohol
• 1:17:09 Where to find Mikki and the Holistic Performance Institute

About Dr Mikki Williden

Dr Mikki Williden is a New Zealand nutritionist with a PhD in nutrition, a former AUT lecturer, and host of the Mikkipedia podcast. She runs coaching and programmes for people who want evidence-based nutrition that fits real life, and is a long-term contributor to the Holistic Performance Institute.

Find Mikki: Website https://mikkiwilliden.com · Instagram https://www.instagram.com/mikkiwilliden/ · Facebook https://www.facebook.com/mikkiwillidennutrition · Mikkipedia https://podcast.mikkiwilliden.com

Studies mentioned in this episode

• Zhao et al. (2023), daily alcohol intake and all-cause mortality, JAMA Network Open: https://doi.org/10.1001/jamanetworkopen.2023.6185
• Health effects associated with alcohol consumption: a Burden of Proof study (2026), Nature Health: https://www.nature.com/articles/s44360-026-00139-5
• Sarich et al. (2026), alcohol-attributable cancer risk in the 45 and Up Study, British Journal of Cancer: https://doi.org/10.1038/s41416-026-03403-3
• Perreault et al. (2017), physical activity and alcohol-related mortality, British Journal of Sports Medicine: https://doi.org/10.1136/bjsports-2016-096194
• Campanella et al. (2024), Mediterranean alcohol-drinking pattern, diet and mortality, Nutrients: https://doi.org/10.3390/nu16010059
• Kassaw et al. (2024), Mendelian randomisation of alcohol and mortality, International Journal of Epidemiology: https://academic.oup.com/ije/article/53/2/dyae046/7632292
• Nutripaedia living review: alcohol and mortality (link to add when live)

HPI links

• Roadmap: https://www.holisticperformance.institute/pages/roadmap
• Podcast page: https://www.holisticperformance.institute/pages/podcast
• Instagram: https://www.instagram.com/holisticperformancenutrition/
• Facebook: https://www.facebook.com/HolisticPerformanceNutrition/
• LinkedIn: https://nz.linkedin.com/company/holistic-performance-institute
• YouTube: https://www.youtube.com/@holisticperformance

Want the full evidence review? Cliff's living review on alcohol and mortality is going up in Nutripaedia, HPI's database of evidence reviews. Thinking about a career in nutrition? Grab the free Practitioner's Roadmap: https://www.holisticperformance.institute/pages/roadmap.

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