What is the safest amount of alcohol to drink?

Medical News Bulletin

By Raymond Quan, MASc, MBA

February 3, 2019

In a massive international study, researchers investigated the level that constitutes the safe amount of alcohol to drink.

The general belief of many in society is that drinking alcohol in moderation has no negative health effects, and may even have a positive effect on one’s well being. But the research on this subject is inconclusive, especially as even light alcohol intake may have the potential to harm the body. Organs can be damaged by long-term alcohol use, or a one-time intoxication event can lead to harm through an accident.

With this research gap in mind, scientists from over 100 countries conducted a comprehensive analysis of existing alcohol studies to establish the safe amount of alcohol to drink. They published their results in The Lancet in August 2018.

The Global Burden of Disease Study

Global Burden of Disease Study (GBD) is an international research program that quantifies the impact from premature death and disability of more than 350 diseases and injuries.  The data covers 195 countries, from 1990 to the present, and is compiled and analyzed by 3,600 researchers in more than 145 countries.  The GBD is based out of the Institute for Health Metrics and Evaluation at the University of Washington, in Seattle, WA, USA, and is funded by the Bill & Melinda Gates Foundation.

For this particular study, GBD researchers analyzed 694 data sources of individual and population-level alcohol consumption, as well as 592 prospective and retrospective studies on the risk of alcohol use.  From these analyses, they estimated alcohol use, alcohol-attributable deaths, and disability-adjusted life years (DALY).  The data analyzed covered the years 1990 to 2016 and was further broken down for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.

Some of the major aspects of the researchers’ methodology were:

1. Alcohol sales estimates were adjusted to take into account both tourist and unrecorded consumption.
2. A new meta-analysis was performed of relative risks for 23 health outcomes associated with alcohol use.
3. A new method was created to quantify the level of alcohol intake that minimizes overall risk to people’s health.

The safe level of drinking is … zero

The major results of the study were as follows:

1. Alcohol use was the 7th leading risk factor around the world for both deaths and disability-adjusted life years in 2016.
2. For the population aged 15–49 years, alcohol use was the leading risk factor globally in 2016, accounting for 3.8% of female deaths and 12.2% of male deaths.
3. The three leading causes of alcohol-attributable deaths in this age group were tuberculosis, road injuries, and self-harm.
4. For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27.1% of total alcohol-attributable female deaths and 18.9% of male deaths.
5. The level of alcohol consumption that minimized harm across all health outcomes was zero drinks per week.

The authors noted that the level of alcohol consumption that would minimize health loss is zero, suggesting that alcohol control policies need to be revised globally. They suggest refocusing on efforts that will lower population-level consumption overall.

Major limitations noted by the study authors included a lack of data for both illicit alcohol production and unrecorded alcohol consumption, given that sales data was the primary source of the authors’ estimations. There was also a lack of data to determine the effect of drinking patterns on health.

Previous research has shown that drinking patterns may add a significant dimension to the level of harm produced by alcohol. The data for motor vehicle harm due to alcohol consumption was also only available for the United States. Further, there was no significant data to quantify the relationship between alcohol consumption and person-to-person violence.  Given these limitations, the study authors additionally concluded that their results likely underestimated the harm produced by alcohol consumption.

Abstention should be a consideration

To say that the safe amount of alcohol to drink is zero is a dramatic statement. But with a study this large, such a conclusion cannot be ignored. The application to both individuals and public health policymakers is that the common view that moderate drinking is healthy should be questioned and that a healthy lifestyle should include the consideration of abstaining from alcohol.

Reference: GBD 2016 Alcohol Collaborators “Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016” The Lancet Published Online August 23, 2018 http://dx.doi.org/10.1016/S0140-6736(18)31310-2