A comprehensive worldwide study of alcohol use and its impact on health concludes that the safest level of consumption is zero.
The Global Burden of Disease Study 2016 has calculated levels of alcohol use and its effects on health during 1990–2016 in 195 countries.
The research, which now features in the journal The Lancet, notes that in 2016, alcohol use was responsible for almost 3 million deaths globally.
Alcohol use was the main cause of death for people aged 15–49 that year, accounting for 12 percent of deaths in men of that age.
"Our findings," says senior study author Dr. Emmanuela Gakidou, who currently works at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle, "are consistent with other recent research, which found clear and convincing correlations between drinking and premature death, cancer, and cardiovascular problems."
She and her colleagues conclude that the "safest level of drinking is none." They explain that this is "in conflict with most health guidelines, which espouse health benefits associated with consuming up to two drinks per day."
Large variations in drinking patterns
More than 500 researchers, academics, and other collaborators from over 40 countries worked on the study.
To estimate global alcohol consumption, they used data from 694 studies and then used another 592 studies covering 28 million people to examine impact on health.
The results revealed that 32.5 percent of people worldwide drink alcohol. Among women, the proportion of those who drink is 25 percent, whereas for men it is 39 percent.
On average, women drink 0.73 alcoholic beverages per day, whereas men drink 1.7. The study defines a standard alcoholic drink as one that contains 10 grams of "pure ethyl alcohol."
This measure is somewhat less than that used in United States guidelines on alcohol consumption. These state that a standard drink has around "14 grams of pure alcohol."
U.S guidelines typically give 14 grams, or 0.6 fluid ounces, as the amount to be found in a 12-ounce can of 5 percent beer, or 5 fluid ounces of 12 percent wine, or a 1.5 fluid ounce shot of 40 percent whisky, rum, and other spirits.
The study found large variations in drinking patterns among different countries. Denmark had the highest proportion of drinkers (97.1 percent of men and 95.3 percent of women), while Bangladesh and Pakistan had the lowest (0.3 percent and 0.8 percent, respectively).
Average levels of drinking were revealed to be the highest in Romania for men (8.2 drinks per day) and in Ukraine for women (4.2 drinks per day).
The lowest levels were in Pakistan for men (0.0007 drinks per day) and in Iran for women (0.0003 drinks per day).
'We need to act urgently'
The researchers calculated the health risk in people aged 15–95 years of consuming one alcoholic drink per day for 1 year compared with abstaining.
They revealed that this raised the risk of developing or experiencing 1 of the 23 "health problems" mentioned in the study by 0.5 percent.
At population level, this means that the number of individuals developing or experiencing 1 of the 23 problems over the course of a year is 918 out of every 100,000 for those who drink one alcoholic beverage per day, compared with 914 out of every 100,000 for those who don't drink.
The health problems covered in the study include:
- cardiovascular disorders such as stroke and heart disease
- several cancers, such as of the breast, liver, and parts of the digestive tract
- diabetes, pancreatitis, and other non-infectious diseases
- tuberculosis, respiratory, and other infections
- unintentional injury
- self harm
- traffic-related injury
"Previous studies," notes lead study author Dr. Max Griswold, who also works at the IHME, "have found a protective effect of alcohol on some conditions, but we found that the combined health risks associated with alcohol increase with any amount of alcohol."
'Change emphasis in alcohol guidelines'
Dr. Gakidou urges that governments need to alter policies so that they emphasize either "lowering people's levels of alcohol consumption or abstaining entirely."
In countries such as the U.S., public health information on alcohol and health tends to focus either on the dangers of excessive alcohol consumption or on keeping drinking to moderate levels.
There is often little mention of the fact that no consumption at all is the safest. For instance, the fact sheet on alcohol and health from the Centers for Disease Control and Prevention (CDC) starts with "[d]rinking too much can harm your health."
It then cites statistics about the effects of excessive drinking. During 2006–2010, excessive alcohol consumption in the U.S. resulted in around 88,000 deaths per year, cutting the lifespan of those who died by an average of 30 years. Among adults aged 20–64 years, it led to 1 in 10 deaths.
The 2015–2020 Dietary Guidelines for Americans advice on alcohol use opens with "[i]f alcohol is consumed, it should be in moderation" and then goes on to define moderate drinking as no more than two drinks per day for men and no more than one for women.
That being said, there is mention that the guidelines do "not recommend that individuals who do not drink alcohol start drinking for any reason."
"We now understand," says Richard C. Horton, who is editor-in-chief of The Lancet, "that alcohol is one of the major causes of death in the world today."
"We need to act urgently to prevent these millions of deaths," he adds.
"The myth that one or two drinks a day are good for you is just that — a myth. This study shatters that myth."
Dr. Emmanuela Gakidou