Madeline Heim
In the first edition of the U.S. dietary guidelines, published in 1980, the authors wrote: "One or two drinks daily appear to cause no harm in adults. If you drink you should do so in moderation."
Though our scientific understanding of alcohol has sharpened since then, every edition up through 2020 has included such limits: moderate drinking is defined as one standard drink or less per day for women and two or less per day for men.
In the newest edition, however, they're gone. Americans should "consume less alcohol for better overall health," the 2025 guidelines say, adding that pregnant women, people with alcohol use disorder, and those on certain medications should avoid it entirely.
The change is perplexing to health experts nationally and in Wisconsin, which ranks among the worst states for excessive drinking, and where alcohol contributes to more than 3,000 deaths each year. Though drinking less is certainly the right approach, people appreciate clear and specific guidelines about alcohol, said Maureen Busalacchi, director of the Wisconsin Alcohol Policy Project at the Medical College of Wisconsin.
"One of the most visited parts of our website talks about serving sizes ... how much people can drink and what the risk is," she said. "By not putting that out there, that changes things. There's no reason we should back away from the research that has been coming, certainly for the last decade, in terms of health harms from alcohol."
The link between alcohol and health is complex and often cherry-picked for headlines – like the notion that drinking red wine is good for the heart. (Experts say red wine drinkers could have better heart health outcomes for other reasons.)
Excessive alcohol use is linked to a number of health concerns, with liver problems the most well-known among them. In Wisconsin, alcohol-related liver disease deaths escalated dramatically between 2019 and 2023, and liver problems due to alcohol are showing up in younger people.
In recent years, awareness has also grown regarding the link between cancer and alcohol, even at moderate levels. Drinking alcohol raises a person's risk of cancers of the mouth, throat, voice box, esophagus, colon and rectum, and liver cancer, as well as breast cancer in women, according to the U.S. Centers for Disease Control and Prevention.
In January 2025, former U.S. Surgeon General Vivek Murthy called on Congress to require health warning labels on alcohol products detailing the risk of cancer, saying many Americans were unaware of them. Even women who consumed one drink daily had about a 10% higher breast cancer risk than women who did not drink, according to Murthy's advisory.
Busalacchi said now that more specific criteria about alcohol have been removed from the dietary guidelines, she and other public health entities will need to fill the gap. She said she wants people to understand that a pint of beer or full pour of wine is more than one serving size of alcohol – defined as 12 ounces of beer, 5 ounces of wine or 1.5 ounces of distilled spirits.
Addressing the changes to alcohol guidance in the dietary guidelines, Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, said in a press conference that alcohol is a "social lubricant," and while "in the best case scenario, I don't think you should drink alcohol," it can bring people together to bond and socialize. It hit home for some, particularly as the U.S. struggles with a loneliness epidemic.
Busalacchi said she doesn't disagree but did point to the number of events in Wisconsin – from watching sports to weekends at a cabin – that are based around alcohol, "a mindset that's hard to break," she said.
"The challenge is, you don't need that in order to socialize," she said.
She did say she sees a turning tide across the state in terms of residents' relationships with alcohol, particularly this month, when many abstain from alcohol as part of Dry January – and bars and restaurants make efforts to cater to them.
"If you haven't started yet, jump into Dry January," Busalacchi said. "Give yourself a week or two without alcohol, and see if you don't feel better."
