Is There a Safe Dose of Alcohol? | Dr Mikki Williden

**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** (from Riverside's chapter export) - 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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