Mai tai: 21 grams of alcohol in a fruit glass

A meta-analysis of 36 trials with 2865 adults, nearly all of them men, found that cutting down on alcohol lowered systolic blood pressure by 3.13 mm Hg on average (95% CI 2.32 to 3.93), with large differences between trials. In people who drank two or fewer drinks a day, drinking less brought no significant change in blood pressure, a finding about blood pressure alone and not a safe amount of alcohol. That matters for a mai tai because one is not a small drink. A 180 g glass made to the USDA survey recipe carries about 21.4 g of alcohol, 29.7 g of carbohydrate and 268 calories. That is one standard recipe, and bar versions vary in how much rum and syrup go in. We found no study of the mai tai itself, so everything below is about alcohol in general. At 21.4 g, one glass is about one and a half US standard drinks of 14 g each. The WHO Regional Office for Europe says there is no safe amount of alcohol that does not affect health and classes alcohol as a Group 1 carcinogen.

As people eat it, per 3.5 oz (100 g)

How much is actually in it

• One 180 g mai tai carries about 268 calories, 21.4 g of alcohol and 29.7 g of carbohydrate in USDA survey data. — FNDDS Mai Tai, FDC 2710677, WWEIA Liquor and cocktails (n = 1 record) Evidence E source
  Per 100 g: energy 149 calories, alcohol 11.9 g, carbohydrate 16.48 g; per drink (180 g): 268.2 calories, alcohol 21.4 g, carbohydrate 29.7 g; per fl oz (30 g): 44.7 calories, alcohol 3.6 g

What a real portion looks like

• The US alcohol institute (NIAAA) defines one standard drink as about 14 g of pure alcohol, the amount in a 1.5-ounce shot of 40% spirits, and warns that standard drink amounts may not reflect customary serving sizes. — US drinkers Evidence E source
  One standard drink = about 14 g pure alcohol = 1.5 fl oz of 40% spirits; standard drink amounts may not match customary serving sizes

What your body absorbs

• In a randomized crossover trial in 12 adults, vodka mixed with diet cola gave a higher peak breath alcohol than the same dose mixed with sugar-sweetened cola, 38.3 versus 34.8 ug/100 mL. — 12 healthy volunteers (8 men, 4 women) aged 19-64; 0.5 g/kg alcohol as vodka with regular or diet cola, two sessions (n = 12) Evidence B source
  Peak BrAC 38.3 +/- 9.45 (diet) vs 34.8 +/- 6.82 ug/100 mL (regular); AUC 0-180 min 45249 vs 40439 ug.min/L; gastric half-emptying 100 vs 111 min

What it does to your health

• The WHO Regional Office for Europe says there is no safe amount of alcohol that does not affect health, and that alcohol is a toxic, dependence-producing substance classed as a Group 1 carcinogen. — general population Evidence E source
  No safe amount of alcohol that does not affect health; alcohol is an IARC Group 1 carcinogen
• By a meta-analysis of 36 trials with 2865 adults, cutting down on alcohol lowered systolic blood pressure by 3.13 mm Hg on average. — 2865 participants (2464 men, 401 women) in 36 trials, 1 week to 2 years (median 4 weeks), high-income countries (n = 2865) Evidence A source
  Systolic BP -3.13 mm Hg (95% CI -3.93 to -2.32), diastolic -2.00 mm Hg (95% CI -2.65 to -1.35); I2 82.0% and 79.5%
• By the same meta-analysis of 36 trials, cutting back lowered blood pressure only in people drinking more than two drinks a day, with a drop of 0.91 mm Hg systolic per drink removed. — 2865 participants in 36 trials, stratified by baseline intake (two or fewer, three, four to five, six or more drinks per day) (n = 2865) Evidence A source
  No significant effect at two or fewer drinks/day; meta-regression beta -0.91 mm Hg systolic and -0.75 mm Hg diastolic per one drink/day of baseline intake (p<0.0001)

Safety, limits and interactions

• The US alcohol institute (NIAAA) warns that mixing alcohol with certain medicines can cause fainting, loss of coordination, internal bleeding, heart problems and breathing difficulties, and that small amounts of alcohol already make driving dangerous, more so with such medicines. — people who drink while taking medicines Evidence E source
  Nausea, vomiting, headaches, drowsiness, fainting, loss of coordination, internal bleeding, heart problems, breathing difficulties; greater driving risk
• The US alcohol institute (NIAAA) lists slowed or difficult breathing, impaired motor control and memory problems when alcohol is mixed with sleep medicines such as zolpidem, and an increased risk of overdose with anxiety drugs such as lorazepam or alprazolam. — people taking sleep medicines (zolpidem and others) or anxiety and epilepsy medicines (lorazepam, alprazolam, diazepam and others) Evidence E source
  Drowsiness, dizziness, slowed or difficult breathing, impaired motor control, memory problems; overdose risk with anxiety and epilepsy drugs
• The US alcohol institute (NIAAA) lists fast heartbeat, sudden changes in blood pressure, vomiting, headache and flushing as possible reactions when alcohol is mixed with infection medicines such as metronidazole, and liver damage with isoniazid or ketoconazole. — people taking antibiotics and antifungals listed under Infections, including metronidazole (Flagyl) Evidence E source
  Fast heartbeat, sudden blood pressure changes, stomach pain, vomiting, headache, flushing; liver damage with isoniazid or ketoconazole
• The US alcohol institute (NIAAA) lists stomach bleeding and ulcers, and liver damage with acetaminophen, as possible reactions when alcohol is mixed with pain relievers, and abnormally low blood sugar when it is mixed with diabetes medicines. — people taking pain relievers (including acetaminophen) or diabetes medicines (including metformin, glipizide) Evidence E source
  Pain relievers: stomach upset, bleeding and ulcers, liver damage with acetaminophen. Diabetes medicines: abnormally low blood sugar, flushing reaction
• The CDC says most US states set the legal blood alcohol limit for driving at 0.08 g/dL and Utah at 0.05 g/dL, that impairment starts at lower levels, and that 13,524 people were killed in 2022 in crashes involving alcohol-impaired drivers. — US drivers Evidence E source
  Legal BAC limit 0.08 g/dL in most states, 0.05 g/dL in Utah; impairment starts below these limits; 13,524 deaths in alcohol-impaired crashes in 2022
• Pooled observational data from 12 studies of 5510 patients with Wernicke encephalopathy name alcohol as the main risk factor, present in 90.7% of cases. — 5510 patients with Wernicke encephalopathy in 12 studies, searched to April 2025 (n = 5510) Evidence C source
  Alcohol main risk factor 90.7%; overall mortality 5.1% (95% CI 2.3-8.8%); classic triad in 32.7%

Who this works differently for

• The CDC says there is no known safe amount of alcohol during pregnancy and no safe time to drink, that liquor is as able to cause harm as wine or beer, and that drinking in pregnancy is linked to miscarriage, preterm birth and stillbirth. — pregnant women and women trying to get pregnant Evidence E source
  No known safe amount, no safe time; all types of alcohol including liquor can harm; linked to FASDs, miscarriage, preterm birth, stillbirth
• The 2025-2030 Dietary Guidelines for Americans say to consume less alcohol for better overall health, and that pregnant women, people recovering from alcohol use disorder or unable to control how much they drink, and people on medicines that interact with alcohol should avoid it completely. — US adults, with named groups who should not drink at all Evidence E source
  Drink less. Avoid completely if pregnant, recovering from alcohol use disorder or unable to control intake, or on interacting medicines
• The US alcohol institute (NIAAA) says older people are at particularly high risk of harmful alcohol and medicine interactions, because aging slows the breakdown of alcohol and they more often take interacting medicines, and that such combinations can lead to falls. — older people Evidence E source
  Higher risk of harmful alcohol-medication interactions; alcohol stays in the system longer; more likely to take interacting medicines; falls and injuries
• The US alcohol institute (NIAAA) notes that the US minimum legal drinking age is 21, that the brain keeps developing into the 20s and alcohol can alter this, and that people who start drinking before 15 have a higher risk of alcohol use disorder later. — people under 21 in the United States Evidence E source
  Legal drinking age 21; brain develops into the 20s and alcohol can alter it; drinking before 15 linked to higher risk of alcohol use disorder
• According to the NIH Office of Dietary Supplements, up to 80% of people with chronic alcoholism develop thiamin deficiency because ethanol reduces its absorption and storage. — People with chronic alcohol use disorder Evidence E source
  Up to 80% develop thiamin deficiency
• According to the NIH Office of Dietary Supplements, low zinc status is seen in 30% to 50% of people with alcohol use disorder, as ethanol cuts zinc absorption and raises urinary losses. — People with alcohol use disorder Evidence E source
  Low zinc status in 30-50%
• Observational data from 1565 Japanese adults with type 2 diabetes link more alcohol to lower intake of most micronutrients in younger men, but not in women. — 1565 outpatients with type 2 diabetes aged 30-89, Japan, 2014-2019; younger men aged 65 or under (n = 1565) Evidence C source
  Younger men: potassium beta -0.299 (95% CI -0.510 to -0.088), also calcium, vitamins A and C; older men: vitamin C only; women: no associations

The bottom line

Sugar in the glass may change how fast the alcohol arrives. In a randomized crossover trial in 12 adults, vodka with diet cola gave a higher peak breath alcohol than the same dose with sugared cola, 38.3 against 34.8 ug/100 mL. That was an open-label study with cola, and nobody has tested the juices and syrups of a mai tai, so treat it as a hint about mixers. Who should not drink it. The CDC says there is no known safe amount of alcohol during pregnancy and no safe time to drink. The 2025-2030 Dietary Guidelines for Americans say pregnant women, people recovering from alcohol use disorder or unable to control how much they drink, and people on medicines that interact with alcohol should avoid it completely. The US alcohol institute (NIAAA) lists harmful reactions when alcohol is mixed with sleep and anxiety medicines, pain relievers including acetaminophen, diabetes medicines and infection medicines such as metronidazole, and says older people are at particularly high risk. The US legal drinking age is 21. The CDC notes that driving impairment starts below the legal blood alcohol limit of 0.08 g/dL in most states. Heavy, long-term drinking adds its own harms. According to the NIH Office of Dietary Supplements, up to 80% of people with chronic alcoholism develop thiamin deficiency, and low zinc status is seen in 30% to 50% of people with alcohol use disorder. Pooled observational data on 5510 patients with Wernicke encephalopathy, the brain disorder of thiamin deficiency, name alcohol as the main risk factor in 90.7% of cases. Among 1565 Japanese adults with type 2 diabetes, younger men who drank more also reported lower intake of potassium, calcium and vitamins A and C, an association from one survey, and women showed no such link.

Sources

1. mtai-r5-01 · USDA FNDDS, dataset
   Mai Tai (FNDDS, FDC 2710677, WWEIA Liquor and cocktails): 1 drink = 180 g; 1 fl oz = 30 g; per 100 g: Energy 149 kcal; Alcohol, ethyl 11.9 g; Carbohydrate, by difference 16.48 g; per 1 drink: 268.2 kcal, alcohol 21.4 g, carbohydrate 29.7 g
   USDA FNDDS 2021-2023, Mai Tai (FDC 2710677) · checked 2026-10-02
2. hf2-mtai-11 · agency definition
   In the United States, one standard drink contains about 14 grams, or about 0.6 fluid ounces, of pure alcohol. That is the amount of alcohol in: A 12-ounce can of regular beer at 5% alcohol by volume A 5-ounce glass of wine at 12% alcohol by volume A 1.5-ounce shot glass of distilled spirits at 40% alcohol by volume ... Although the standard drink amounts are helpful for following health guidelines, they may not reflect customary serving sizes.
   NIAAA, What Is A Standard Drink? · checked 2026-10-08
3. mtai-r5-02 · randomized crossover trial
   Diet coke increased both the peak BrAC (38.3 ± 9.45 vs. 34.8 ± 6.82 μg/100 mL) and the area under the breath ethanol curve between 0 and 180 minutes (45249.0 ± 95.7 vs. 40439.25 ± 72.5 μg·min/L).
   Toxicol Lett, 2025 · checked 2026-10-02
4. hf2-mtai-10 · agency position
   The World Health Organization has now published a statement in The Lancet Public Health: when it comes to alcohol consumption, there is no safe amount that does not affect health. ... Alcohol is a toxic, psychoactive, and dependence-producing substance and has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer decades ago
   WHO Regional Office for Europe, news release: No level of alcohol consumption is safe for our health (4 January 2023) · checked 2026-10-08
5. mtai-r5-03 · meta-analysis of trials
   The overall effect of a reduction of alcohol consumption across all trials was −3·13 mm Hg (95% CI −3·93 to −2·32) for systolic blood pressure and −2·00 (−2·65 to −1·35) for diastolic blood pressure with substantial between-study heterogeneity (I2 82·0% and 79·5%, respectively).
   Lancet Public Health, 2017 (Roerecke et al.) · checked 2026-10-02
6. mtai-r5-04 · meta-analysis of trials
   For people who drank two or fewer drinks per day, we recorded no significant effect of lower alcohol intake on pooled blood pressure (figures 2 and 3, table 2).
   Lancet Public Health, 2017 (Roerecke et al.) · checked 2026-10-02
7. hf2-mtai-3 · agency advice
   Mixing alcohol with certain medications can cause nausea and vomiting, headaches, drowsiness, fainting, or loss of coordination. It also can put you at risk for internal bleeding, heart problems, and difficulties in breathing. ... Small amounts of alcohol can make it dangerous to drive, and when you mix alcohol with certain medicines you put yourself at even greater risk.
   NIAAA, Harmful Interactions: Mixing Alcohol with Medicines (brochure, revised 2014) · checked 2026-10-08
8. hf2-mtai-4 · agency advice
   Sleep problems Ambien® Zolpidem Drowsiness, sleepiness, dizziness; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems ... Anxiety and epilepsy Ativan® Lorazepam Drowsiness, dizziness; increased risk for overdose; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems
   NIAAA, Harmful Interactions: Mixing Alcohol with Medicines (brochure, revised 2014) · checked 2026-10-08
9. hf2-mtai-5 · agency advice
   Fast heartbeat, sudden changes in blood pressure; stomach pain, upset stomach, vomiting, headache, or flushing or redness of the face; liver damage (isoniazid, ketoconazole) Flagyl® Metronidazole
   NIAAA, Harmful Interactions: Mixing Alcohol with Medicines (brochure, revised 2014) · checked 2026-10-08
10. hf2-mtai-6 · agency advice
    Stomach upset, bleeding and ulcers; liver damage (acetaminophen); rapid heartbeat ... Abnormally low blood sugar levels, flushing reaction (nausea, vomiting, headache, rapid heartbeat, sudden changes in blood pressure); symptoms of nausea and weakness may occur (metformin)
    NIAAA, Harmful Interactions: Mixing Alcohol with Medicines (brochure, revised 2014) · checked 2026-10-08
11. hf2-mtai-9 · agency advice
    Most states have set the legal BAC limit for driving at 0.08 grams of alcohol per deciliter (g/dL) ... the limit is 0.05 g/dL in Utah. However, impairment starts at lower BAC levels. ... In 2022, 13,524 people were killed in motor vehicle crashes involving alcohol-impaired drivers
    US CDC, Impaired Driving: About (page reviewed January 28, 2026) · checked 2026-10-08
12. mtai-r5-07 · meta-analysis of observational studies
    Alcohol consumption was the main risk factor (90.7%); among non-alcohol-related cases, the most frequent clinical settings were malnutrition (30.2%), infections (25.1%), and psychiatric disorders (15.4%).
    Neuroepidemiology, 2026 · checked 2026-10-02
13. hf2-mtai-1 · agency advice
    There is no known safe amount of alcohol use during pregnancy. ... There is no safe time during pregnancy to drink alcohol. ... All types of alcohol can be harmful, including red or white wine, beer, and liquor. ... Alcohol use during pregnancy is associated with an increased risk of miscarriage, preterm birth, stillbirth, and
    US CDC, About Alcohol Use During Pregnancy (page reviewed August 14, 2026) · checked 2026-10-08
14. hf2-mtai-2 · dietary guideline
    Consume less alcohol for better overall health. ... People who should completely avoid alcohol include pregnant women, people who are recovering from alcohol use disorder or are unable to control the amount they drink, and people taking medications or with medical conditions that can interact with alcohol.
    Dietary Guidelines for Americans, 2025-2030 (HHS, USDA), January 2026 · checked 2026-10-08
15. hf2-mtai-7 · agency advice
    Combining alcohol with some medicines can lead to falls and serious injuries, especially among older people. ... Older people are at particularly high risk for harmful alcohol–medication interactions. Aging slows the body’s ability to break down alcohol, so alcohol remains in a person’s system longer. Older people also are more likely to take a medication that interacts with alcohol
    NIAAA, Harmful Interactions: Mixing Alcohol with Medicines (brochure, revised 2014) · checked 2026-10-08
16. hf2-mtai-8 · agency advice
    Research shows that people who start drinking before the age of 15 are at a higher risk for developing alcohol use disorder (AUD) later in life. ... Research shows that people’s brains keep developing well into their 20s. Alcohol can alter this development, potentially affected structure and function. ... keeping the U.S. Minimum Legal Drinking Age at 21
    NIAAA, Underage Drinking (fact sheet) · checked 2026-10-08
17. mtai-r5-05 · fact sheet
    Up to 80% of people with chronic alcoholism develop thiamin deficiency because ethanol reduces gastrointestinal absorption of thiamin, thiamin stores in the liver, and thiamin phosphorylation [3,19].
    NIH Office of Dietary Supplements, Thiamin Fact Sheet for Health Professionals · checked 2026-10-02
18. mtai-r5-06 · fact sheet
    Low zinc status has been observed in 30% to 50% of people with alcohol use disorder [1,50]. Ethanol consumption decreases intestinal absorption of zinc and increases urinary zinc excretion [1,50,51,52].
    NIH Office of Dietary Supplements, Zinc Fact Sheet for Health Professionals · checked 2026-10-02
19. mtai-r5-08 · cross-sectional study
    In younger men, higher alcoholic beverage intake was linked to higher smoking rates and lower intake of all assessed micronutrients except iron, with the strongest association observed for potassium (β = -0.299, 95 % CI: -0.510, -0.088), followed by calcium, and vitamins A and C.
    Clin Nutr ESPEN, 2026 · checked 2026-10-02