Recommended maximum intake of alcoholic beverages

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There is no global consensus on recommended maximum intake (or safe limits) of the drug alcohol.[1] The guidelines provided by health agencies of governments are varied and are shown below. These recommendations concerning maximum intake are distinct from any legal restrictions (e.g. driving after consuming alcohol) that may apply in those countries. The American Heart Association recommends that those who do not already consume alcoholic beverages should not start doing so because of the negative long-term effects of alcohol consumption.[2][3]

Caveats[edit]

The guidelines are general guidelines applying to a typical person. However, there are some people who should not consume alcohol, or limit their use to less than guideline amounts. These are:

  • "People with chronic hepatitis C (or other forms of chronic hepatitis infection) who drink heavily [and exceed maximum recommended consumption levels] have poorer health outcomes than those who drink less." That is, they have poorer health outcomes than do those who drink within the guidelines.[4][5]
  • Thin people — those below average body weight (60 kilograms (130 lb) for men, 50 kilograms (110 lb) for women)[6]
  • People with a relative who has, or has had, a problem with alcohol. First-degree relatives are parents and siblings; second-degree relatives are grandparents, uncles, aunts, and cousins.[4] These individuals "are urged to be careful about how much they drink."
  • People with a mental health problem (such as anxiety or depression) or sleep disturbances [4][5] Individuals with a mental health problem "should take particular care to stay within the levels set in Guideline 1" (i.e. no more than 2 standard drinks a day).
  • People taking medications or other drugs, if contraindicated,[4] "Numerous classes of prescription medications can interact with alcohol, including antibiotics, antidepressants, antihistamines, barbiturates, benzodiazepines, muscle relaxants, non-narcotic pain medications and anti-inflammatory agents, opioids, and warfarin. In addition, many over-the-counter and herbal medications can cause negative effects when taken with alcohol."[7] Others include analgesics, aspirin, insulin, and oral contraceptives. "The list of medications that may interact with alcohol is so long that you should always consult a pharmacist or physician before drinking while using any medicine."[8]
  • Older people because their bodies may be less able to handle the effects of alcohol.[4] Older people are urged "to consider drinking less than the levels set in Guideline 1" (i.e. no more than 2 standard drinks a day).
  • Young adults (aged about 18–25 years) are urged to drink no more than 2 standard drinks a day.[4]
  • Young people (up to about 18 years) "should not drink to become intoxicated."[4]
  • People who are or have been dependent on other drugs[6]
  • People who have a poor diet, or are under-nourished[6]
  • People who have a family history of cancer or other risk factors for cancer[5] (see Alcohol and cancer for details of how alcohol affects the risk of various cancers)
  • People who are told not to drink for legal, medical or other reasons[5]
  • "People who choose not to drink alcohol should not be urged to drink to gain any potential health benefit, and should be supported in their decision not to drink. … Non-drinkers can use other strategies, such as regular exercise, giving up smoking, and a healthy diet, to gain protection against heart disease."[4]

The standard guidelines may be too high when:

  • undertaking activities that involve risk or a degree of skill such as flying, scuba diving, water sports, ski-ing, using complex or heavy machinery or farm machinery, and driving.[4][5][6][9]
  • suffering an acute or chronic physical disease such as heart and lung disease, influenza, diabetes, epilepsy or acute infections[6]
  • recovering from an accident, injury or operation[6]
  • taking sleeping pills or tranquillisers, anti-depressants or narcotics[6]
  • responsible for the safety of others at work or at home[5]

Units and standard drinks[edit]

See also: Standard drink

Countries express alcohol intake in units or standard drinks when recommending maximum alcohol intake. In increasing order of unit size a unit or standard drink is defined as:

Country Grams of pure alcohol millilitres Ref
Austria 20 [10]
United Kingdom 8 10 [11][10]
Iceland 9.5 [12]
Netherlands 10 [10]
Australia 10 12.7 [13]
Ireland 10 12.7 [14]
Italy 10 12.7 [citation needed]
New Zealand 10 12.7 [15]
Poland 10 12.7 [citation needed]
Spain 10 12.7 [citation needed]
Finland 11 [16]
Denmark 12 [citation needed]
France 12 [citation needed]
South Africa 12 [citation needed]
Canada 13.6 [5]
Portugal 14 [16]
United States 14 [16]
Hungary 17 [citation needed]
Japan 19.75 25 [citation needed]
Hong Kong 10 [17]

Men[edit]

The standard drink size is given in brackets.

Daily maximum drinks (no weekly limits recommended)[edit]

  • Australia: 2/day; 14/week (@10 g = 20 g/day, 140 g/week)[18][19] (New guidelines were adopted on 6 March 2009.[20])
  • Austria: 24 g
  • Czech Republic: 24 g
  • Germany: 24 g/day
  • Hong Kong: 2/day (20 g) [21]
  • Italy: 40 g (30 g for the elderly)[12]
  • Japan: 1–2 (@19.75 g = 19.75–39.5 g)
  • Netherlands: 3 (@9.9 g = 29.7 g)
  • Portugal: 37 g[16]
  • Spain: 3 (@10 g = 30 g) Also suggests a maximum of no more than twice this on any one occasion.[16]
  • Sweden: 10 g for women and 20 g for men[22]
  • Switzerland: 3 (@10g =30g) for men and 2 (@10g =20g) for women [10]
  • United Kingdom: 3–4 units/day (@ 8g = 24-32g/day); Advice on weekly consumption is avoided[23]

Therefore, these countries recommend limits for men in the range 20–40 g per day.

Daily/weekly maximum drinks[edit]

These countries recommend a weekly limit, but intake on a particular day may be higher than one-seventh of the weekly amount.

  • Canada: 2/day; 14/week (@13.6 g = 27.2 g/day, 190 g/week)[5]
  • New Zealand: To reduce long-term health risks, 3/day (30 g/day); 15/week (150 g/week); At least two alcohol-free days every week[15] To reduce risk of injury per occasion: 5 standard drinks (50 g) on any single occasion.[15]
  • USA: 1–2 units/day (14–28 g/day)(½-1 fl. oz./day), not to exceed 14 units/week (196 g/week)(6.5 fl. oz./wk)

Therefore, these countries recommend limits for men in the range 27.2–32 g of ethanol per day and 168–210 g of ethanol per week.

Weekly maximum drinks[edit]

  • Denmark: 168 g[24]
  • Finland: 15 units (@11 g = 165 g/week)[16]
  • Ireland: 21 units (@10 g = 210 g/week)
  • United Kingdom: Advice on weekly consumption is avoided[23]

Women who are neither pregnant nor breastfeeding[edit]

Women trying to become pregnant should look at the guidelines for pregnant women given in the next section.

Daily maximum drinks (no weekly limits recommended)[edit]

  • Australia: 2/day; 14/week (@10 g = 20 g/day, 140 g/week)[18][19]
  • Austria: 16 g
  • Czech Republic: 16 g
  • Germany: 12 g/day
  • Hong Kong: 1/day (10 g)[21]
  • Italy: 30 g (25 g for elderly women)[12]
  • Netherlands: 2 (@9.9 g = 19.8 g)
  • Portugal: 18.5 g[16]
  • Spain: 2 (@10 g = 20 g) Also suggests a maximum of no more than twice this on any one occasion.[16]
  • Sweden: 20 g
  • Switzerland: 2 (@10–12 g = 20–24 g)[10]
  • United Kingdom: 2–3/day. Advice on weekly consumption is avoided[23]

Therefore, these countries recommend limits for women in the range 16–30 g per day.

Daily/weekly maximum drinks[edit]

These countries recommend a weekly limit, but your intake on a particular day may be higher than one-seventh of the weekly amount.

  • Canada: 2/day; 9/week (@13.6 g = 27.2 g/day, 122.4 g/week)[5][25]
  • New Zealand: To reduce long-term health risks - 2/day (20 g/day); 10/week (100 g/week); At least two alcohol-free days per week[15] To reduce risk of injury per occasion, 4 standard drinks (40 g) on any single occasion[15]
  • USA: 1/day; 7/week (@14g = 14 g/day, 98 g/week)

Therefore, these countries recommend limits for women in the range 14–27.2 g per day and 98–140 g per week.

Weekly maximum drinks[edit]

  • Denmark 84 g[24]
  • Finland: 10 units (@11 g = 110 g/week)[16]
  • Ireland: 14 units (@10 g = 140 g/week)
  • United Kingdom: Advice on weekly consumption is avoided[23]

Pregnant women[edit]

Excessive drinking in pregnancy is the cause of Fetal alcohol syndrome (BE: foetal alcohol syndrome), especially in the first eight to twelve weeks of pregnancy. Therefore, pregnant women receive special advice. It is not known whether there is a safe minimum amount of alcohol consumption, although low levels of drinking are not known to be harmful.[26][27] As there may be some weeks between conception and confirmation of pregnancy, most countries recommend that women trying to become pregnant should follow the guidelines for pregnant women.

  • Australia: Total abstinence during pregnancy and if planning a pregnancy[18][19]
  • Canada: "Don't drink if you are pregnant or planning to become pregnant."[5]
  • France: Total abstinence[10]
  • Iceland: Advise that pregnant women abstain from alcohol during pregnancy because no safe consumption level exists.[10]
  • Israel: Women should avoid consuming alcohol before and during pregnancy [10][28]
  • The Netherlands: Abstinence[10]
  • New Zealand: "Women who are pregnant or planning to become pregnant should avoid drinking alcohol."[29]
  • Norway: Abstinence[10][30]
  • UK: Previously, UK government advice was to avoid alcohol for first 3 months of pregnancy.[27][31][32][33] NICE guidelines (2007) stated, "If you are pregnant or planning to become pregnant, you should try to avoid alcohol completely in the first 3 months of pregnancy because there may be an increased risk of miscarriage. If you choose to drink while you are pregnant, you should drink no more than 1 or 2 UK units of alcohol once or twice a week. There is uncertainty about how much alcohol is safe to drink in pregnancy, but at this low level there is no evidence of any harm to the unborn baby. You should not get drunk or binge drink (drinking more than 7.5 UK units of alcohol on a single occasion) while you are pregnant because this can harm your unborn baby."[26] However the draft UK Health Department guidelines, released in January 2016 now advise to avoid alcohol altogether if pregnant or planning a pregnancy.
  • US: Total abstinence during pregnancy and while planning to become pregnant[34]

In short, all countries listed above now recommend that women abstain from alcohol consumption if they are pregnant or likely to become pregnant.

Breastfeeding women[edit]

"Alcohol passes to the baby in small amounts in breast milk. The milk will smell different to the baby and may affect their feeding, sleeping or digestion. The best advice is to avoid drinking shortly before a baby’s feed."[35] "Alcohol inhibits a mother’s let-down (the release of milk to the nipple). Studies have shown that babies take around 20% less milk if there’s alcohol present, so they’ll need to feed more often – although infants have been known to go on ‘nursing strike’, probably because of the altered taste of the milk."[36] "There is little research evidence available about the effect that [alcohol in breast milk] has on the baby, although practitioners report that, even at relatively low levels of drinking, it may reduce the amount of milk available and cause irritability, poor feeding and sleep disturbance in the infant. Given these concerns, a prudent approach is advised."[4]

  • Australia: Total abstinence advised[18][19]
  • Iceland: Total abstinence advised because no safe consumption level exists.
  • New Zealand: Abstinence recommended, especially in the first month of breastfeeding so that sound breastfeeding patterns can be established.[29]
  • United Kingdom: Total abstinence advised by some, such as the Royal College of Midwives; others advise to limit alcohol to occasional use in small amounts not exceeding the recommended maximums for non-breastfeeding woman as this is known to cause harm, and that daily or binge drinking be avoided.[36]

Minors[edit]

Countries have different recommendations concerning the administration of alcohol to minors by adults.

  • United Kingdom: Children aged under 15 should never be given alcohol, even in small quantities. Children aged 15–17 should not be given alcohol on more than one day a week — and then only under supervision from carers or parents.[37][38][39]

See also[edit]

References[edit]

  1. ^ "Sussex uni finds "no consensus" on safe drink limits". Theargus.co.uk. 2013-01-27. Retrieved 2014-03-30. 
  2. ^ Mechanick, Jeffrey I.; Kushner, Robert F. (21 April 2016). Lifestyle Medicine: A Manual for Clinical Practice. Springer Science. p. 153. ISBN 9783319246871. However, even light alcohol use (≤1 drink daily) increases the risk of developing cancer, and heavier use (≥2-4 drinks daily) significantly increases morbidity and mortality. Given these and other risks, the American Heart Association cautions that, if they do not already drink alcohol, people should not start drinking for the purported cardiovascular benefits of alcohol. 
  3. ^ Deedwania, Prakash (12 January 2015). "Alcohol and Heart Health". American Heart Association (AHA). Retrieved 4 August 2016. 
  4. ^ a b c d e f g h i j Australian Guidelines 2009, p. 39
  5. ^ a b c d e f g h i j Centre for Addiction and Mental Health / Centre de toxicomanie et de santé mentale Low-Risk Drinking Guidelines
  6. ^ a b c d e f g Alcohol Advisory Council of New Zealand (ALAC) Low Risk Drinking
  7. ^ Weathermon R, Crabb DW (1999). "Alcohol and medication interactions" (PDF). Alcohol Res Health. 23 (1): 40–54. PMID 10890797. 
  8. ^ Prevention Source BC Alcohol and Drug Interactions Winter 2000
  9. ^ Sheldrake, Sean; Pollock, Neal W. "Alcohol and Diving". In: Steller D, Lobel L, eds. Diving for Science 2012. Proceedings of the American Academy of Underwater Sciences 31st Symposium. Dauphin Island, AL: AAUS; 2012. Retrieved 2013-03-06. 
  10. ^ a b c d e f g h i j "Drinking Guidelines: General Population". IARD.org. International Alliance for Responsible Drinking. Retrieved 23 June 2016. 
  11. ^ PRODIGY Knowledge (Department of Health) Alcohol and Sensible Drinking
  12. ^ a b c Worldwide Recommendations on Alcohol Consumption Archived 26 May 2006 at the Wayback Machine.
  13. ^ Department of Health and Ageing The Australian Standard Drink
  14. ^ Hope, A. (2009). A Standard Drink in Ireland: What strength? (PDF). Health Service Executive. Retrieved 2 February 2015. 
  15. ^ a b c d e Alcohol Advisory Council of New Zealand (ALAC) What's in a Standard Drink
  16. ^ a b c d e f g h i Drinking and You Drinking guidelines — units of alcohol
  17. ^ Department of Health Alcohol and Health: Hong Kong Situation
  18. ^ a b c d National Health and Medical Research Council 2009 Australian Guidelines to Reduce Health Risks from Drinking Alcohol
  19. ^ a b c d National Health and Medical Research Council 2009 Australian Guidelines to Reduce Health Risks from Drinking Alcohol: Frequently Asked Questions
  20. ^ "New alcohol guidelines say reduce drinking to reduce risk". Nhmrc.gov.au. 2009-03-06. Retrieved 2014-03-30. 
  21. ^ a b Department of Health Action Plan to Reduce Alcohol-related Harm in Hong Kong September 2011
  22. ^ [1] Archived 7 January 2013 at the Wayback Machine.
  23. ^ a b c d Archive copy at the Wayback Machine
  24. ^ a b Navn (påkrævet). "Sundhedsstyrelsen anbefaler at vi drikker mindre alkohol | Alkoholbehandling's Weblog". Alkoholbehandling.wordpress.com. Retrieved 2014-03-30. 
  25. ^ Low-Risk Drinking Guidelines (LRDG) (goes live September 2006)
  26. ^ a b NICE, Routine antenatal care for healthy pregnant women March 2007
  27. ^ a b BBC 'No alcohol in pregnancy' advised 25 May 2007
  28. ^ "Proper Nutrition during Pregnancy". Ministry of Health. State of Israel. Retrieved 23 June 2016. 
  29. ^ a b New Zealand Ministry of Health Manatū Hauora Food and Nutrition Guidelines for Healthy Pregnant and Breastfeeding Women
  30. ^ "Alkovett for den lille" (PDF). http://avogtil.no/. AV OG TIL. Retrieved 23 June 2016.  External link in |website= (help)
  31. ^ Department of Health Alcohol Advice
  32. ^ NHS Alcohol and pregnancy
  33. ^ Rosemary Bennett Zero – the new alcohol limit in pregnancy The Times 25 May 2007
  34. ^ 'USDA, Dietary Guidelines for Americans 2005, Chapter 9: Alcoholic Beverages
  35. ^ Alcohol and pregnancy
  36. ^ a b Alcohol and breastfeeding (2009) | Retrieved 23 May 2014
  37. ^ "Consultation on children, young people and alcohol". Dcsf.gov.uk. Retrieved 2014-03-30. 
  38. ^ Parents back alcohol free childhood 17 December 2009
  39. ^ BBC 'No alcohol' urged for under-15s 29 January 2009

External links[edit]