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

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 recommendedLow riskMedium to high riskDetails
DayWeekDayWeek
MenWomenMenWomenMenWomenMenWomen
Australia40 g100 gReference.[7] [8]
Austria24 g16 g
Canada"Not drinking has benefits, such as better health, and better sleep."27 gThe 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 Republic24 g16 g
Denmark48 g120 gReference.[10]
Finland168 g84 gReference.[11]
GermanyAlcoholic 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 Kong20 g10 gReference.[13]
Iceland32 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]
Ireland170 g140 gReference.[15]
Italy24 g12 gReference.[16]
Japan40 g20 gReference.[17]
NetherlandsRecommends an alcohol consumption level of zero grams.10 gThe Health Council of the Netherlands recommends an alcohol consumption level of zero or no more than 10 g per day.
New Zealand30 g20 g150 g100 g50 g40 gAt 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.
Norway20 g10 gReference.[19]
Portugal37 g18.5 gReference.[20]
Spain30 g20 gAlso 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 g120 gThe 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]
Switzerland30 g20–24 gReference.
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 g14 g196 g98 gReference.[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.

=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."

=Minors

=

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

=Elderly

=

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

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

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

  1. 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.
  2. 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 .
  3. 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 .
  4. 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.
  5. 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..
  6. 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.
  7. 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 .
  8. 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 .
  9. 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.
  10. 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 .
  11. 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 .
  12. 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 .
  13. Department of Health Action Plan to Reduce Alcohol-related Harm in Hong Kong September 2011
  14. Web site: Recommendations from the Directorate of Health . Ísland.is . 2024-06-12.
  15. 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.
  16. https://www.salute.gov.it/portale/alcol/dettaglioContenutiAlcol.jsp?lingua=italiano&id=5526&area=alcol&menu=vuoto Alcol, zero o il meno possibile
  17. 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.
  18. Alcohol Advisory Council of New Zealand (ALAC) What's in a Standard Drink
  19. 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 .
  20. Drinking and You Drinking guidelines — units of alcohol
  21. 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 .
  22. 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 .
  23. Web site: What's low-risk drinking? - Rethinking Drinking - NIAAA . 31 August 2018 . 31 August 2018 . https://web.archive.org/web/20180831072002/https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Is-your-drinking-pattern-risky/Whats-Low-Risk-Drinking.aspx . live .
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  25. Flak . Audrey L. . Su . Su . Bertrand . Jacquelyn . Denny . Clark H. . Kesmodel . Ulrik S. . Cogswell . Mary E. . The Association of Mild, Moderate, and Binge Prenatal Alcohol Exposure and Child Neuropsychological Outcomes: A Meta-Analysis . Alcoholism: Clinical and Experimental Research . January 2014 . 38 . 1 . 214–226 . 10.1111/acer.12214. free. 23905882 .
  26. NICE, Routine antenatal care for healthy pregnant women March 2007
  27. BBC 'No alcohol in pregnancy' advised 25 May 2007
  28. National Health and Medical Research Council 2020 Australian Guidelines to Reduce Health Risks from Drinking Alcohol
  29. National Health and Medical Research Council 2009 Australian Guidelines to Reduce Health Risks from Drinking Alcohol: Frequently Asked Questions
  30. Canadian Center on Substance Abuse Canada's Low-Risk Alcohol Drinking Guidelines
  31. 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 .
  32. 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.
  33. New Zealand Ministry of Health Manatū Hauora Food and Nutrition Guidelines for Healthy Pregnant and Breastfeeding Women
  34. 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.
  35. Web site: Ej längre bruk av alkohol vid graviditet. roi.socialstyrelsen.se. 2023-09-24. sv.
  36. 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 .
  37. 'USDA, Dietary Guidelines for Americans 2005, Chapter 9: Alcoholic Beverages
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  42. http://www.dh.gov.uk/en/News/Recentstories/DH_110305 Parents back alcohol free childhood
  43. BBC 'No alcohol' urged for under-15s 29 January 2009
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  50. Alcohol Advisory Council of New Zealand (ALAC) Low Risk Drinking
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