Sober Curious: How Alcohol Impacts Your Health
By Lauren Chan, PhD, RD, C2ST Intern, University of Chicago
At the beginning of the year, I always hear about friends or family doing “Dry January”, or choosing not to drink alcohol for the month of January. This trend does not stop with January, also spanning to “Sober October” or other months. Some people are even exploring the Sober Curious movement and experimenting with abstaining from alcohol entirely. But are people actually changing their drinking habits, and how does alcohol intake impact health?
Dry January or Sober October can be considered ‘Temporary Alcohol Abstinence Challenges’ (TAAC), where someone commits to stop drinking alcohol for a set period of time. People may have a variety of reasons for doing a TAAC, which may or may not include a desire to become fully sober. Interestingly, these types of challenges may actually reduce alcohol intake after the challenge ends. One research study looking at drinking rates in young adults after completing a TAAC reported that 15% of participants chose to remain sober after the challenge and that half of the participants reported drinking less afterwards.
Decreasing consumption of alcohol is becoming a trend in the United States, with a recent Gallup poll indicating lower alcohol usage for Americans across age brackets. In the 2025 poll, just over half of Americans reported thinking drinking alcohol in moderation is “bad for one’s health”. Is alcohol truly bad for you?
From a nutrition perspective, alcohol is considered a toxic substance, which is why it causes drinkers to feel inTOXICated. The World Health Organization (WHO) has stated that no level of alcohol consumption is healthy. The type of alcohol found in alcoholic beverages is called ethanol. Once ingested, ethanol is primarily absorbed in the small intestine, where it quickly enters the bloodstream and is transported to the liver. In the liver, the ethanol is broken down by multiple enzymes to metabolize it.
The two major enzymes in the liver that facilitate ethanol metabolism are called alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH2). The first step in the process is metabolizing ethanol with ADH, which converts it into acetaldehyde. Acetaldehyde is a toxic waste product that can damage tissues, which means the body wants to break it down further as quickly as possible. For the second step of this process, acetaldehyde is metabolized by ALDH2 to make acetate. Acetate is not as toxic as acetaldehyde, but it can depress the central nervous system. Acetate can also travel from the liver to the heart and lungs, where it is metabolized into carbon dioxide. This may cause tissue damage, especially with high levels of alcohol intake. Individuals have different quantities of ADH and ALDH2, meaning everyone processes alcohol at a different rate. What is particularly concerning is when low enzyme levels or high alcohol intake lead to the buildup of toxic byproducts that damage cells and organs.
One of the most significant negative effects of alcohol consumption is an increased risk of cancer. Alcohol is considered a Group I carcinogen, meaning there is substantial evidence linking alcohol consumption to cancer. The most prominent cancers associated with alcohol intake are mouth, esophagus, colon, liver, and breast (in women). Red wine has received attention in recent years for its resveratrol content and the potential to decrease cancer risk. However, this claim is not supported by research, and red wine intake has not been associated with lower cancer risk. Further, one meta-analysis indicated that both heavy and light alcohol consumption of alcohol increases cancer risk. Consistent with the WHO, these authors indicate that no level of alcohol consumption is safe from a cancer risk standpoint.
Alcohol can also have other health risks, including liver damage, alcohol use disorder, and negative impacts on mental health.
In the 2025-2030 Dietary Guidelines for Americans (DGA), the recommendation for alcohol is to “consume less alcohol for better overall health”, and there are no noted limits of alcohol intake. This is different from previous iterations of the DGA, in which the 2020-2025 version stated that for people who choose to drink alcohol, limit intake to two drinks or fewer per day for men and one drink or fewer per day for women. Removing all “recommended” quantities in the latest DGA further stresses how the guidelines are promoting the reduction and elimination of alcohol from the diet.
With changes in public health recommendations and more individuals considering alcohol to be bad for their own health, there may be continued growth in participation in TAAC, the sober curious movement, and sober lifestyles. Given the science supporting alcohol abstinence, this might be a move in the right direction for public health.