Alcohol consumption recommendations
Recommendations for consumption of the drug alcohol (also known formally as ethanol) vary from recommendations to be alcohol-free to daily or weekly drinking "safe limits" or maximum intakes. Many governmental agencies and organizations have issued guidelines. These recommendations concerning maximum intake are distinct from any legal restrictions, for example countries with drunk driving laws or countries that have prohibited alcohol. To varying degrees, these recommendations are also distinct from the scientific evidence, such as the short-term effects of alcohol consumption and long-term effects of alcohol consumption.[1]
General recommendations
[edit]These guidelines apply to men, and women who don't belong to the specific populations.
Teetotalism advocacy by organization
[edit]![](http://upload.wikimedia.org/wikipedia/commons/thumb/3/33/Share_of_adults_who_have_not_drank_alcohol_in_last_year%2C_OWID.svg/290px-Share_of_adults_who_have_not_drank_alcohol_in_last_year%2C_OWID.svg.png)
- The World Health Organization published a statement in The Lancet Public Health in April 2023 that "there is no safe amount that does not affect health"'.[2]
- The World Heart Federation (recognized by the World Health Organization as its leading NGO partner) (2022) recommends against any alcohol intake for optimal heart health.[3][4]
- The 2023 Nordic Nutrition Recommendations state "Since no safe limit for alcohol consumption can be provided, the recommendation in NNR2023 is that everyone should avoid drinking alcohol."[5]
- 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.[6][7]
Recommended alcohol intake limitations
[edit]By country
[edit]![](http://upload.wikimedia.org/wikipedia/commons/thumb/8/8b/AlcoholPerCapita.jpg/400px-AlcoholPerCapita.jpg)
Some governments set the same recommendation for both sexes, while others give separate limits. The guidelines give drink amounts in a variety of formats, such as standard drinks, fluid ounces, or milliliters, but have been converted to grams of ethanol for ease of comparison.
The daily limits range from 10-30 g per day for men and 10-24 g per day for women. Weekly limits range from 27-252 g/week for men and 27-168 g/week for women. The weekly limits are lower than the daily limits, meaning intake on a particular day may be higher than one-seventh of the weekly amount, but consumption on other days of the week should be lower. The limits for women are often but not always lower than those for men.
Country (or region) | Teetotalism recommended | Low risk | Medium to high risk | Details | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Day | Week | Day | Week | |||||||
Men | Women | Men | Women | Men | Women | Men | Women | |||
Australia | 40 g | 100 g | Reference.[9][10] | |||||||
Austria | 24 g | 16 g | ||||||||
Canada | "Not drinking has benefits, such as better health, and better sleep."[11] | 27 g | The Canadian Centre on Substance Use and Addiction has a sliding scale of intakes. The scale states that at 27 g or less per week, "you are likely to avoid alcohol-related consequences for yourself or others".[11] | |||||||
Czech Republic | 24 g | 16 g | ||||||||
Denmark | 48 g | 120 g | Reference.[12] | |||||||
Finland | 168 g | 84 g | Reference.[13] | |||||||
Germany | Alcoholic beverages pose health risks and ideally should be avoided completely.[14] | The German Centre for Addiction Issues recommends everyone to reduce alcohol consumption, regardless of the amounts consumed.[14] | ||||||||
Hong Kong | 20 g | 10 g | Reference.[15] | |||||||
Iceland | 32 g | "Stop drinking before reaching five drinks on the same occasion". 1 standard drink in Iceland = 8 g ethanol. 8 g x 4 drinks = 32 g.[16] | ||||||||
Ireland | 170 g | 140 g | Reference.[17] | |||||||
Italy | 24 g | 12 g | Reference.[18] | |||||||
Japan | 40 g | 20 g | Reference.[19] | |||||||
Netherlands | Recommends an alcohol consumption level of zero grams. | 10 g | The Health Council of the Netherlands recommends an alcohol consumption level of zero or no more than 10 g per day.[20] | |||||||
New Zealand | 30 g | 20 g | 150 g | 100 g | 50 g | 40 g | At least two alcohol-free days every week. 30 g for men, 20 g for women To reduce long-term health risks[21] 50 g for men, 40 g for women On any single occasion, to reduce risk of injury.[21] | |||
Norway | 20 g | 10 g | Reference.[22] | |||||||
Portugal | 37 g | 18.5 g | Reference.[23] | |||||||
Spain | 30 g | 20 g | Also suggests a maximum of no more than twice this on any one occasion.[23] | |||||||
Sweden | "Not possible to specify a limit for risk-free alcohol consumption."[24] | 48 g | 120 g | The National Board of Health and Welfare defines risky consumption as 10 (Swedish) standard drinks per week (120 g), and 4 standard drinks (48 g) or more per occasion, once per month or more often. Alcohol intervention is offered for people who exceed these recommendations.[24] | ||||||
Switzerland | 30 g | 20–24 g | Reference.[20] | |||||||
United Kingdom | "There's no completely safe level of drinking."[25] | 112 g a week, spread across 3 days or more. | Reference.[25] | |||||||
USA | "People who do not drink should not start drinking for any reason."[26] | 28 g | 14 g | 196 g | 98 g | Reference.[26] |
Specific populations
[edit]Pregnant women
[edit]![](http://upload.wikimedia.org/wikipedia/commons/thumb/c/cc/Zero_alcool_pendant_la_grossesse.svg/220px-Zero_alcool_pendant_la_grossesse.svg.png)
Excessive drinking during pregnancy, especially in the first eight to twelve weeks, is associated with fetal alcohol spectrum disorders such as abnormal appearance and behavioral problems. Although low-to-moderate drinking of less than 12g/day is not known to significantly increase the chance of such disorders,[1][27] most guidelines state that no safe amount of alcohol consumption has been established and recommend that pregnant women abstain entirely from alcohol.[28][29] As there may be some weeks between conception and confirmation of pregnancy, most guidelines also recommend that women trying or likely to become pregnant should avoid alcohol as well.
- Australia: Total abstinence during pregnancy and if planning a pregnancy[30][31]
- Canada: "Don't drink if you are pregnant or planning to become pregnant."[32]
- France: Total abstinence[20]
- Hong Kong: "Abstinence from alcohol during pregnancy is the safest choice."[33]
- Iceland: Advise that pregnant women abstain from alcohol during pregnancy because no safe consumption level exists.[20]
- Israel: Women should avoid consuming alcohol before and during pregnancy[20][34]
- The Netherlands: Abstinence[20]
- New Zealand: "Women who are pregnant or planning to become pregnant should avoid drinking alcohol."[35]
- Norway: Abstinence[20][36]
- Sweden: Abstinence.[37]
- UK: Abstinence during pregnancy[38]
- US: Total abstinence during pregnancy and while planning to become pregnant[39]
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."[40] "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."[41] "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."[42]
- Australia: Total abstinence advised[30][31]
- Hong Kong: "Avoid alcohol and alcoholic drinks."[43]
- 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.[35]
- 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.[41]
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.[44][45][46]
Elderly
[edit]By study
[edit]According to a 2024 systematic review and meta-analysis, even at 20 g/day (1 large beer), the risk of developing an alcohol use disorder (AUD) is nearly 3 times higher than non-drinkers, and the risk of dying from an AUD is about 2 times higher than non-drinkers.[47]
Binge drinking
[edit]By country
[edit]- USA: The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines the term "binge drinking" as a pattern of drinking that brings a person's blood alcohol concentration (BAC) to 0.08 percent or above.[48] Whatever the numerical definition used, heavy drinking or rapid consumption over a short period of time with the intention of becoming intoxicated is often implied when the term is used colloquially, since four or five drinks consumed over the course of a whole day and as an accompaniment to meals will not have the same effects as the same amount consumed over a couple of hours on an empty stomach.[49]
Specific populations
[edit]Youths
[edit]- USA
- Get Your Sexy Back: A recurring message of the campaign is that consuming 5 or more units of alcohol (70 g pure ethanol) at a single sitting constitutes binge drinking.[50]
Caveats
[edit]Risk factors
[edit]The recommended limits for daily or weekly consumption provided in the various countries' guidelines generally apply to the average healthy adult. However, many guidelines also set out numerous conditions under which alcohol intake should be further restricted or eliminated. They may stipulate that, among other things, people with liver, kidney, or other chronic disease, cancer risk factors, smaller body size, young or advanced age, those who have experienced issues with mental health, sleep disturbances, alcohol or drug dependency or who have a close family member who has, or who are taking medication that may interact with alcohol,[51] or suffering or recovering from an illness or accident, are urged to consider, in consultation with their health professionals, a different level of alcohol use, including reduction or abstention.
Activities
[edit]Furthermore, the maximum amounts allowed do not apply to those involved with activities such as operating vehicles or machinery, risky sports or other activities, or those responsible for the safety of others.[42][52][53]
Moreover, studies suggest even moderate alcohol consumption may significantly impair – neurobiologically beneficial and -demanding – exercise (possibly including the recovery and adaptation).[54][55][56][57]
Daily consumption, habituation and addiction
[edit]As of 2022, moderate consumption levels of alcoholic beverages are typically defined in terms of average consumption per day. However, when drinking becomes a chronic daily activity the consumption puts individuals at an increased health risk[58][medical citation needed][additional citation(s) needed] as it may lead to habituation, desensitization (consumption-induced tolerance), progressively increasing average dosages and addiction.[citation needed]
According to the CDC, it would be important to focus on the amount people drink on the days that they drink.[59] However, few studies or guidelines distinguish between or compare "moderate consumption" patterns (i.e. frequency, timing and dosage/intensity[60] per session) of occasional drinking and daily drinking.[citation needed] One review showed that among drinkers (not limited to moderate consumption levels), daily drinking in comparison to non-daily drinking was associated with incidence of liver cirrhosis.[61]
Harmful physiological effects
[edit]Emerging evidence suggests that "even drinking within the recommended limits may increase the overall risk of death from various causes, such as from several types of cancer". Better health outcomes among moderate drinkers that some studies reported may be due to the moderate alcohol consumption itself but they may also instead be caused by "other differences in behaviors or genetics between people who drink moderately and people who don't". According to the CDC, recent studies indicate moderate consumption may not have the protective health benefits.[59] A systematic analysis found that "The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0–0·8) standard drinks per week".[62]
Alcohol promotion recommendations
[edit]- Polymeal recommends 150 mL of red wine (about one glass) every day, in combination with other several food items.
Controversy
[edit]In 2023, the World Health Organization (WHO) stated that there is currently no conclusive evidence from studies that the potential benefits of moderate alcohol consumption for cardiovascular disease and type 2 diabetes outweigh the increased cancer risk associated with these drinking levels for individual consumers.[63]
Units and standard drinks
[edit]Guidelines generally give recommended amounts measured in grams (g) of pure alcohol per day or week. Some guidelines also express alcohol intake in standard drinks or units of alcohol. The size of a standard drink varies widely among the various guidelines, from 8g to 20g, as does the recommended number of standard drinks per day or week.[20][64] The standard drink size is not meant as recommendations for how much alcohol a drink should contain, but rather to give a common reference that people can use for measuring their intake, though they may or may not correspond to a typical serving size in their country.[65]
See also
[edit]References
[edit]Explanatory notes
Citations
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- ^ "No level of alcohol consumption is safe for our health". www.who.int. Archived from the original on 12 January 2023. Retrieved 25 September 2023.
- ^ Arora, Monika; ElSayed, Ahmed; Beger, Birgit; Naidoo, Pamela; Shilton, Trevor; Jain, Neha; Armstrong-Walenczak, Kelcey; Mwangi, Jeremiah; Wang, Yunshu; Eiselé, Jean-Luc; Pinto, Fausto J.; Champagne, Beatriz M. (22 July 2022). "The Impact of Alcohol Consumption on Cardiovascular Health: Myths and Measures". Global Heart. 17 (1). doi:10.5334/gh.1132. ISSN 2211-8179. PMC 9306675. PMID 36051324.
- ^ Salamon, Maureen (1 May 2022). "Want a healthier heart? Seriously consider skipping the drinks". Harvard Health. Archived from the original on 31 May 2024. Retrieved 31 May 2024.
- ^ "Less meat, more plant-based: Here are the Nordic Nutrition Recommendations 2023". www.norden.org. Archived from the original on 22 September 2023. Retrieved 25 September 2023.
- ^ Mechanick, Jeffrey I.; Kushner, Robert F. (21 April 2016). Lifestyle Medicine: A Manual for Clinical Practice. Springer Science. p. 153. ISBN 978-3-319-24687-1.
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.
- ^ Deedwania, Prakash (12 January 2015). "Alcohol and Heart Health". American Heart Association (AHA). Archived from the original on 21 January 2016. Retrieved 4 August 2016.
- ^ "Alcohol consumption per person". Our World in Data. Archived from the original on 16 March 2020. Retrieved 15 February 2020.
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- ^ "Australian guidelines to reduce health risks from drinking alcohol". Nhmrc.gov.au. 2020. Archived from the original on 16 June 2021. Retrieved 10 June 2021.
- ^ a b "Canada's Guidance on Alcohol and Health". ccsa.ca. Archived from the original on 11 September 2023. Retrieved 25 September 2023.
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- ^ Department of Health Action Plan to Reduce Alcohol-related Harm in Hong Kong Archived 24 October 2019 at the Wayback Machine September 2011
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- ^ a b Drinking and You Drinking guidelines — units of alcohol Archived 8 February 2007 at the Wayback Machine
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- ^ a b "Drink less - Better Health". nhs.uk. 6 July 2021. Archived from the original on 14 March 2024. Retrieved 14 March 2024.
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- ^ NICE, Routine antenatal care for healthy pregnant women Archived 11 July 2009 at the Wayback Machine March 2007
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- ^ "Proper Nutrition during Pregnancy". Ministry of Health. State of Israel. Archived from the original on 28 June 2021. Retrieved 23 June 2016.
- ^ a b New Zealand Ministry of Health Manatū Hauora Food and Nutrition Guidelines for Healthy Pregnant and Breastfeeding Women Archived 26 December 2010 at the Wayback Machine
- ^ "Alkovett for den lille" (PDF). avogtil.no/. AV OG TIL. Archived (PDF) from the original on 15 December 2017. Retrieved 23 June 2016.
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- ^ "New recommended drinking guidelines welcomed by NICE". www.nice.org.uk. 8 January 2016. Archived from the original on 17 January 2024. Retrieved 17 September 2023.
- ^ 'USDA, Dietary Guidelines for Americans 2005, Chapter 9: Alcoholic Beverages Archived 1 July 2007 at the Wayback Machine
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- ^ a b Australian Guidelines 2009
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- ^ Carr, Tessa; Kilian, Carolin; Llamosas‐Falcón, Laura; Zhu, Yachen; Lasserre, Aurélie M.; Puka, Klajdi; Probst, Charlotte (2024). "The risk relationships between alcohol consumption, alcohol use disorder and alcohol use disorder mortality: A systematic review and meta‐analysis". Addiction. 119 (7): 1174–1187. doi:10.1111/add.16456. ISSN 0965-2140. PMC 11156554. PMID 38450868.
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- ^ Heckley, Gawain; Jarl, Johan; Gerdtham, Ulf-G (2017). "Frequency and intensity of alcohol consumption: new evidence from Sweden". The European Journal of Health Economics. 18 (4): 495–517. doi:10.1007/s10198-016-0805-2. ISSN 1618-7598. PMC 5387029. PMID 27282872.
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External links
[edit]- National Health and Medical Research Council (2020). Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Commonwealth of Australia. ISBN 978-1-86496-071-6.
- The Brilliant Breastfeeding Alcohol and Breastfeeding Archived 17 December 2007 at the Wayback Machine page describes pros and cons of drinking alcohol while breastfeeding.
- Drinking Guidelines: General Population by Country IARD.org
- Drinking Guidelines: Pregnancy and Breastfeeding by Country IARD.org