It’s Called Happy Hour for a Good Reason

For most of my career as a cardiologist, the advice around alcohol was fairly straightforward: everything in moderation. In recent years, however, that message has shifted dramatically. We now hear, with growing certainty, that all alcohol is harmful—and that the only truly healthy choice is complete abstinence.

I understand where this perspective comes from. Alcohol misuse is common and often devastating. I see its consequences regularly in clinical practice. Still, I worry that this increasingly rigid, all-or-nothing narrative may be “throwing the baby out with the bathwater”.

Because after decades of caring for patients—and observing the lives of the people I love most—I’ve come to believe something more nuanced is true: for many people, light and responsible drinking, especially in a social setting, can be safe and may even support health and longevity.

I saw this play out vividly in my own family. My mother, grandmothers and great grandmothers lived well into their 90s. One of them, my grandmother Dorothy O’Keefe, made it all the way to 103. These women shared a simple, steady ritual: one small drink at happy hour before dinner, nearly every evening. A modest glass of wine or a small cocktail, enjoyed slowly, usually in the company of others.

Their husbands, on the other hand, tended to drink more—sometimes much more. And almost without exception, their lives were shorter. We used to joke that Dorothy’s nightly Manhattan was really a “Man-hooten,” because about ten minutes into happy hour she and her friends would be hooting with laughter. But beneath the humor was an important truth: this was never about alcohol alone—it was about connection, joy, and relaxation.

That distinction matters.

We are living through an era of unprecedented social isolation. Even before the pandemic, many people were drifting apart. Afterward, the trend accelerated. We spend more time alone, more time on screens, and less time in face-to-face conversation than any generation before us.

Happy hour, at its best, is a deliberate pause in the day. It’s an invitation to sit down with loved ones—friends, family, neighbors, new acquaintances—to talk, listen, laugh, and tell stories, get to know and emotionally support one another after a long day of work. It’s not about escaping life; it’s about reconnecting with it.

And the science on social connection is striking. Study after study shows that having a few strong, loving, supportive relationships is the single most powerful predictor of healthy longevity. More predictive than cholesterol levels. More important than exercise alone. Even more influential than genetics or any other factor.

Seen through that lens, it’s not surprising that large, well-conducted observational studies consistently show that people who consume about two to seven alcoholic drinks per week have fewer heart attacks (still the most common cause of death in America) compared with those who drink none at all. This is one of the most reproducible findings in cardiovascular epidemiology.

Is alcohol itself the magic ingredient? Probably not. In fact, alcohol is a carcinogen and cardio-toxin that can also cause strokes and dementia. However, it’s a dose-dependent poison. In small doses alcohol is virtually harmless, and its pro-social effects can be a tonic for improving health and wellbeing. Alcohol, used responsibly, often acts as a social lubricant—one that helps people slow down, open up, and connect. I worry that if you’re someone who drinks socially and in moderation and you give up alcohol entirely, you may not live longer, but it will just feel longer because you’re not having much fun. 

Here's another key point: the more you drink, the more you will need to drink to get that euphoric “buzz”. But the opposite is also true—the less you drink, the less it takes to get you buzzed. So, when you keep your drinking in the light range, you get all the emotional and longevity benefits and none of the downside. 

That said, alcohol has a dark side, and it would be irresponsible to ignore it. Alcohol is the fourth leading cause of premature death in America. It is undeniably a slippery slope. For many people, one drink can quickly become several. I know this personally: alcohol dependence runs in my own family, reflecting my Irish and French heritage. I’ve seen how destructive it can be.

That’s why this conversation demands humility and honesty. Not everyone can drink safely. And I never advise someone who doesn’t drink to start. If alcohol has ever been a problem for you—or for those close to you—abstinence is a wise, life-affirming choice.

But for those who can drink responsibly, moderation truly matters. In practical terms, that usually means one drink, occasionally two, but never routinely more than that. It also means being intentional about timing.

I generally recommend enjoying alcohol with or just before dinner. One drink, especially non-sweet (dry) red wine, compared to drinking water before dinner, reduces the post-meal glucose spike. As the Glucose Goddess Jessie Inchauspe emphasizes, blunting this post-meal spike confers myriad health benefits. Also, having that drink with or before your evening meal allows more time for your body to metabolize the alcohol prior to bedtime—important for preserving high-quality sleep.

In my own life, I’ve settled into a rhythm that feels both enjoyable and sustainable. I’ll have a happy hour four to six days a week, but only if I’m with a family member or a friend. I never drink alone. I rarely ever exceed six ounces of wine, and often it’s closer to three or four. That small amount allows me to relax and be present without disturbing my sleep or giving me a headache the next morning.

This approach isn’t about indulgence. It’s about ritual. About creating protected time for conversation, laughter, storytelling, and human warmth. And animal warmth—my mother Leatrice in her final years would often have happy hour with her little dog Henri on her lap, feeding him cheese and carrots while she chatted on the phone. 

So when I hear sweeping declarations that all alcohol is harmful, I worry about unintended consequences. If we eliminate the ritual without replacing the connection, we may inadvertently worsen the very loneliness and stress that can make us miserable and shorten our lives.

Health is not just about avoiding risks. It’s also about cultivating meaning, joy, and relationships. For some people, light alcohol consumption—used thoughtfully and responsibly—can be part of that equation.

At its best, happy hour reminds us to show up and let ourselves be seen, to slow down, and savor time with people we cherish. So, here’s to your health. May your glass be half-empty and your heart be full of laughter and love.

Rules for a Healthy Happy Hour

• Keep it light. One drink is ideal; occasionally two. More than that, and the benefits fade quickly.

• Never drink alone. Happy hour is about connection, not consumption. Save it for time with friends, family, or loved ones.

• Pair it with food. Enjoy your drink with or just before dinner to blunt blood sugar spikes and slow alcohol absorption.

• Mind the pour. A “standard” drink is smaller than most people think—about 4–5 oz of wine or 1–1.5 oz of spirits.

• Go early. Drinking earlier in the evening allows your body time to metabolize alcohol before sleep. If alcohol disrupts your sleep, scale back—or skip it altogether.

• Choose a dry red wine. This is without question the healthiest option. But honestly, the dose of alcohol is the most important feature of a healthy drinking habit. Dorothy made it to 103 drinking 1.5 oz of whiskey, not red wine, each night before dinner. 

• Know yourself. If moderation is difficult or alcohol has ever been a problem, abstinence is the healthiest choice.

• Relish the ritual. Sip slowly, laugh freely, and focus on the people—not the glass.