Alcohol consumption recommendations explained
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.
General recommendations
These guidelines apply to men, and women who don't belong to the specific populations.
Teetotalism advocacy by organization
- 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"'.[1]
- 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.[2] [3]
- 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."[4]
- 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.[5] [6]
Recommended alcohol intake limitations
By country
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.[7] [8] |
---|
Austria | | 24 g | 16 g | | | | | | | |
---|
Canada | "Not drinking has benefits, such as better health, and better sleep." | | | 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".[9] |
---|
Czech Republic | | 24 g | 16 g | | | | | | | |
---|
Denmark | | 48 g | 120 g | | | | | Reference.[10] |
---|
Finland | | | | 168 g | 84 g | | | | | Reference.[11] |
---|
Germany | Alcoholic beverages pose health risks and ideally should be avoided completely. | | | | | | | | | The German Centre for Addiction Issues recommends everyone to reduce alcohol consumption, regardless of the amounts consumed.[12] |
---|
Hong Kong | | 20 g | 10 g | | | | | | | Reference.[13] |
---|
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.[14] |
---|
Ireland | | | | 170 g | 140 g | | | | | Reference.[15] |
---|
Italy | | 24 g | 12 g | | | | | | | Reference.[16] |
---|
Japan | | 40 g | 20 g | | | | | | | Reference.[17] |
---|
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. |
---|
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[18] 50 g for men, 40 g for women On any single occasion, to reduce risk of injury. |
---|
Norway | | 20 g | 10 g | | | | | | | Reference.[19] |
---|
Portugal | | 37 g | 18.5 g | | | | | | | Reference.[20] |
---|
Spain | | 30 g | 20 g | | | | | | | Also suggests a maximum of no more than twice this on any one occasion. |
---|
Sweden | "Not possible to specify a limit for risk-free alcohol consumption." | | | | | 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.[21] |
---|
Switzerland | | 30 g | 20–24 g | | | | | | | Reference. |
---|
United Kingdom | "There's no completely safe level of drinking." | | | 112 g a week, spread across 3 days or more. | | | | | Reference.[22] |
---|
USA | "People who do not drink should not start drinking for any reason." | 28 g | 14 g | 196 g | 98 g | | | | | Reference.[23] | |
---|
=Pregnant women
=
See main article: Alcohol and pregnancy.
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,[24] [25] most guidelines state that no safe amount of alcohol consumption has been established and recommend that pregnant women abstain entirely from alcohol.[26] [27] 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[28] [29]
- Canada: "Don't drink if you are pregnant or planning to become pregnant."[30]
- France: Total abstinence
- Hong Kong: "Abstinence from alcohol during pregnancy is the safest choice."[31]
- Iceland: Advise that pregnant women abstain from alcohol during pregnancy because no safe consumption level exists.
- Israel: Women should avoid consuming alcohol before and during pregnancy[32]
- The Netherlands: Abstinence
- New Zealand: "Women who are pregnant or planning to become pregnant should avoid drinking alcohol."[33]
- Norway: Abstinence[34]
- Sweden: Abstinence.[35]
- UK: Abstinence during pregnancy[36]
- US: Total abstinence during pregnancy and while planning to become pregnant[37]
=Breastfeeding women
=
"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."[38] "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."[39] "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."
- Australia: Total abstinence advised[28] [29]
- Hong Kong: "Avoid alcohol and alcoholic drinks."[40]
- 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.[33]
- 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.[39]
=Minors
=
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.[41] [42] [43]
=Elderly
=
- Italy: 12 g/day for men over 65.
- Japan: Less than 29 g/day for the elderly (and women).
By study
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.[44]
Binge drinking
By country
- 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.[45] 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.[46]
Specific populations
Youths
Caveats
See also: Alcohol and health.
Risk factors
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,[48] 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
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.[49] [50]
Moreover, studies suggest even moderate alcohol consumption may significantly impair – neurobiologically beneficial and -demanding – exercise (possibly including the recovery and adaptation).[51] [52] [53] [54]
Daily consumption, habituation and addiction
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[55] as it may lead to habituation, desensitization (consumption-induced tolerance), progressively increasing average dosages and addiction.
According to the CDC, it would be important to focus on the amount people drink on the days that they drink. However, few studies or guidelines distinguish between or compare "moderate consumption" patterns (i.e. frequency, timing and dosage/intensity[56] per session) of occasional drinking and daily drinking. 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.[57]
Harmful physiological effects
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.[58] 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".[59]
Alcohol promotion recommendations
- Polymeal recommends 150 mL of red wine (about one glass) every day, in combination with other several food items.
Controversy
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.[60]
Units and standard drinks
See main article: Standard drink. 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 . 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.[61] [62] 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.[63]
See also
References
Explanatory notes
Citations
External links
Notes and References
- Web site: No level of alcohol consumption is safe for our health. www.who.int. 2023-09-25. 12 January 2023. https://web.archive.org/web/20230112022159/https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health. live.
- 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. . The Impact of Alcohol Consumption on Cardiovascular Health: Myths and Measures . Global Heart . 17 . 1 . 2022-07-22 . 2211-8179 . 36051324 . 9306675 . 10.5334/gh.1132 . free .
- Web site: Salamon . Maureen . Want a healthier heart? Seriously consider skipping the drinks . Harvard Health . en . 1 May 2022 . 31 May 2024 . 31 May 2024 . https://web.archive.org/web/20240531181810/https://www.health.harvard.edu/heart-health/want-a-healthier-heart-seriously-consider-skipping-the-drinks . live .
- Web site: Less meat, more plant-based: Here are the Nordic Nutrition Recommendations 2023. www.norden.org. 2023-09-25. 22 September 2023. https://web.archive.org/web/20230922192903/https://www.norden.org/en/news/less-meat-more-plant-based-here-are-nordic-nutrition-recommendations-2023. live.
- Book: Mechanick. Jeffrey I.. Kushner. Robert F.. Lifestyle Medicine: A Manual for Clinical Practice. 21 April 2016. Springer Science. en . 978-3-319-24687-1. 153. 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..
- Web site: Deedwania . Prakash . 12 January 2015 . Alcohol and Heart Health . https://web.archive.org/web/20160121160534/http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/Alcohol-and-Heart-Health_UCM_305173_Article.jsp#.VqEB3bLP32c . 21 January 2016 . 4 August 2016 . American Heart Association (AHA) . en.
- Web site: Managing your alcohol intake . 21 February 2024 . 13 March 2024 . 13 March 2024 . https://web.archive.org/web/20240313091056/https://www.healthdirect.gov.au/managing-your-alcohol-intake . live .
- Web site: Australian guidelines to reduce health risks from drinking alcohol . Nhmrc.gov.au . 2020 . 2021-06-10 . 16 June 2021 . https://web.archive.org/web/20210616210628/https://www.nhmrc.gov.au/about-us/publications/australian-guidelines-reduce-health-risks-drinking-alcohol . live .
- Web site: Canada's Guidance on Alcohol and Health. ccsa.ca. 2023-09-25. 11 September 2023. https://web.archive.org/web/20230911192545/https://www.ccsa.ca/canadas-guidance-alcohol-and-health. live.
- Web site: Anbefalinger om alkohol . Sundhedsstyrelsen . da . 2024-06-12 . 22 March 2024 . https://web.archive.org/web/20240322191457/https://sst.dk/da/borger/en-sund-hverdag/alkohol/anbefalinger-om-alkohol . live .
- Web site: Alkoholin riskirajat . Alko . fi . 2024-06-12 . 24 February 2024 . https://web.archive.org/web/20240224035156/https://www.alko.fi/vastuullisesti/alkoholi-ja-terveys/alkoholin-riskirajat . live .
- Web site: Empfehlungen zum Umgang mit Alkohol . 2023-10-30 . Deutsche Hauptstelle für Suchtfragen . de . 24 October 2023 . https://web.archive.org/web/20231024045224/https://www.dhs.de/fileadmin/user_upload/WK_der_DHS_-_Empfehlungen_zum_Umgang_mit_Alkohol.pdf . live .
- Department of Health Action Plan to Reduce Alcohol-related Harm in Hong Kong September 2011
- Web site: Recommendations from the Directorate of Health . Ísland.is . 2024-06-12.
- Web site: Health chiefs cut limits on safe drinking. 2012-06-26. Alcohol Action Ireland. en-US. 2020-03-01. 1 March 2020. https://web.archive.org/web/20200301162130/https://alcoholireland.ie/health-chiefs-cut-limits-on-safe-drinking/. live.
- https://www.salute.gov.it/portale/alcol/dettaglioContenutiAlcol.jsp?lingua=italiano&id=5526&area=alcol&menu=vuoto Alcol, zero o il meno possibile
- Web site: 2024-06-12. Japan draws up guidelines on alcohol consumption. 19 February 2024. The Japan Times. 24 March 2024. https://web.archive.org/web/20240324194731/https://www.japantimes.co.jp/news/2024/02/19/japan/science-health/japan-alcohol-consumption-guideline/. live.
- Alcohol Advisory Council of New Zealand (ALAC) What's in a Standard Drink
- Web site: Anbefaling angående inntak av alkohol ved forebygging av hjerte- og karsykdom . Helsedirektoratet . 2018-03-05 . no . 2024-06-12 . 22 March 2024 . https://web.archive.org/web/20240322192021/https://www.helsedirektoratet.no/retningslinjer/forebygging-av-hjerte-og-karsykdom/kartlegging-av-levevaner-og-rad-om-livsstilstiltak-som-forebygging-av-hjerte-og-karsykdom/anbefaling-angaende-inntak-av-alkohol-ved-forebygging-av-hjerte-og-karsykdom . live .
- Drinking and You Drinking guidelines — units of alcohol
- Web site: Nya gränsvärden för riskbruk av alkohol till hälso- och sjukvården . www.socialstyrelsen.se . 2023-09-13 . 12 September 2023 . sv . 30 September 2023 . https://web.archive.org/web/20230930100841/https://www.socialstyrelsen.se/aktuellt/nya-gransvarden-for-riskbruk-av-alkohol-till-halso--och-sjukvarden/ . live .
- Web site: Drink less - Better Health . nhs.uk . en . 6 July 2021 . 14 March 2024 . 14 March 2024 . https://web.archive.org/web/20240314135215/https://www.nhs.uk/better-health/drink-less/ . live .
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- NICE, Routine antenatal care for healthy pregnant women March 2007
- BBC 'No alcohol in pregnancy' advised 25 May 2007
- National Health and Medical Research Council 2020 Australian Guidelines to Reduce Health Risks from Drinking Alcohol
- National Health and Medical Research Council 2009 Australian Guidelines to Reduce Health Risks from Drinking Alcohol: Frequently Asked Questions
- Canadian Center on Substance Abuse Canada's Low-Risk Alcohol Drinking Guidelines
- Web site: Department of Health . 16 September 2020 . 17 September 2020 . https://web.archive.org/web/20200917120757/https://www.change4health.gov.hk/en/alcohol_aware/facts/women_and_alcohol/index.html . live .
- Web site: Proper Nutrition during Pregnancy. Ministry of Health. State of Israel. 23 June 2016. 28 June 2021. https://web.archive.org/web/20210628231751/http://www.health.gov.il/english/topics/pregnancy/during/pages/proper_nutrition_during_pregnancy.aspx. live.
- New Zealand Ministry of Health Manatū Hauora Food and Nutrition Guidelines for Healthy Pregnant and Breastfeeding Women
- Web site: Alkovett for den lille. avogtil.no/. AV OG TIL. 23 June 2016. 15 December 2017. https://web.archive.org/web/20171215195616/https://avogtil.no/content/uploads/2015/09/Folder-brosjyre-gravidiet.pdf. live.
- Web site: Ej längre bruk av alkohol vid graviditet. roi.socialstyrelsen.se. 2023-09-24. sv.
- Web site: New recommended drinking guidelines welcomed by NICE . www.nice.org.uk . 2023-09-17 . 8 January 2016 . 17 January 2024 . https://web.archive.org/web/20240117021859/https://www.nice.org.uk/news/article/new-recommended-drinking-guidelines-welcomed-by-nice . live .
- 'USDA, Dietary Guidelines for Americans 2005, Chapter 9: Alcoholic Beverages
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- http://www.dh.gov.uk/en/News/Recentstories/DH_110305 Parents back alcohol free childhood
- BBC 'No alcohol' urged for under-15s 29 January 2009
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- Centre for Addiction and Mental Health / Centre de toxicomanie et de santé mentale Low-Risk Drinking Guidelines
- Alcohol Advisory Council of New Zealand (ALAC) Low Risk Drinking
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