Alcohol consumption recommendations
From Wikipedia the free encyclopedia
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. These recommendations are (often) also distinct from the scientific evidence, such as the short-term effects of alcohol consumption and long-term effects of alcohol consumption.
These guidelines apply to men, and women who are neither pregnant nor breastfeeding.
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."
Alcohol intake recommendations 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.
|Australia||40 g/day, 100 g/week (Both sexes)|| (New guidelines were adopted in 2020.)|
|Austria||24 g/day||16 g/day|
|Canada||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".
|Czech Republic||24 g/day||16 g/day|
|Denmark||168 g/week||84 g/week||For low risk of disease|
|252 g/week||168 g/week||For high risk of disease.|
|Finland||165 g/week||110 g/week.|||
|Germany||The German Centre for Addiction Issues recommends everyone to reduce alcohol consumption, regardless of the amounts consumed. Alcoholic beverages pose health risks and ideally should be avoided completely.|
|Hong Kong||20 g/day||10 g/day.|||
|Ireland||170 g/week||140 g/week.|||
12g/day if over 65
|Japan||29 g/day||Less for women and the elderly|||
|Netherlands||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/day and 150 g/week||20 g/day and 100 g/week (women)||At least two alcohol-free days every week. To reduce long-term health risks|
|50 g||40 g||On any single occasion, to reduce risk of injury.|
|Portugal||37 g/day||18.5 g/day|||
|Spain||30 g/day||20 g/day||Also suggests a maximum of no more than twice this on any one occasion.|
|Sweden||The National Board of Health and Welfare defines risky consumption as 120 g per week, and 48 g or more per occasion, once per month or more often.|
Alcohol intervention is offered for people who exceed these recommendations.
108 g per week, and 36 g per occasion, is not considered risky according to the new guideline.
|United Kingdom||112 g/week||112 g/week|||
|USA||Up to 28 g/day |
not to exceed 196 g/week
|14 g/day |
not to exceed 98 g/week
Overall, the daily limits range from 10–37 g per day for men and 10-16 g per day for women. Weekly limits range from 27–170 g/week for men and 27–140 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 consistently lower than those for men.
Excessive drinking in pregnancy is the cause of fetal alcohol syndrome (BE: foetal alcohol syndrome), especially in the first eight to twelve weeks of pregnancy. Therefore, pregnant women receive special advice. It is not known whether there is a safe minimum amount of alcohol consumption, although low levels of drinking are not known to be harmful. As there may be some weeks between conception and confirmation of pregnancy, most countries recommend that women trying to become pregnant should follow the guidelines for pregnant women.
- Australia: Total abstinence during pregnancy and if planning a pregnancy
- Canada: "Don't drink if you are pregnant or planning to become pregnant."
- France: Total abstinence
- Hong Kong: "Abstinence from alcohol during pregnancy is the safest choice."
- 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
- The Netherlands: Abstinence
- New Zealand: "Women who are pregnant or planning to become pregnant should avoid drinking alcohol."
- Norway: Abstinence
- Sweden: Abstinence.
- UK: Abstinence during pregnancy
- US: Total abstinence during pregnancy and while planning to become pregnant
In short, all countries listed above now recommend that women abstain from alcohol consumption if they are pregnant or likely to become pregnant.
"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." "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." "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
- Hong Kong: "Avoid alcohol and alcoholic drinks."
- 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.
- 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.
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.
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, 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.
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.
Moreover, studies suggest even moderate alcohol consumption may significantly impair – neurobiologically beneficial and -demanding – exercise (possibly including the recovery and adaptation).
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[medical citation needed][additional citation(s) needed] 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 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.
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. 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".
Units and standard drinks
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. 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.
- "No level of alcohol consumption is safe for our health". www.who.int. Retrieved 25 September 2023.
- "Less meat, more plant-based: Here are the Nordic Nutrition Recommendations 2023". www.norden.org. 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). Retrieved 4 August 2016.
- "Canada's Guidance on Alcohol and Health". ccsa.ca. Retrieved 25 September 2023.
- 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
- "Australian guidelines to reduce health risks from drinking alcohol". Nhmrc.gov.au. 2020. Retrieved 10 June 2021.
- "Anbefalinger". www.sst.dk (in Danish). Retrieved 16 November 2018.[permanent dead link]
- Drinking and You Drinking guidelines — units of alcohol Archived 8 February 2007 at the Wayback Machine
- "Empfehlungen zum Umgang mit Alkohol" (PDF). Deutsche Hauptstelle für Suchtfragen (in German). Retrieved 30 October 2023.
- Department of Health Action Plan to Reduce Alcohol-related Harm in Hong Kong September 2011
- "Health chiefs cut limits on safe drinking". Alcohol Action Ireland. 26 June 2012. Retrieved 1 March 2020.
- Alcol, zero o il meno possibile January 2022
- "Drinking Guidelines: General Population". IARD.org. International Alliance for Responsible Drinking. Retrieved 23 June 2016.
- Alcohol Advisory Council of New Zealand (ALAC) What's in a Standard Drink
- "Nya gränsvärden för riskbruk av alkohol till hälso- och sjukvården". www.socialstyrelsen.se (in Swedish). Retrieved 13 September 2023.
- "What's low-risk drinking? - Rethinking Drinking - NIAAA".
- NICE, Routine antenatal care for healthy pregnant women March 2007
- BBC 'No alcohol in pregnancy' advised 25 May 2007
- Canadian Center on Substance Abuse Canada's Low-Risk Alcohol Drinking Guidelines
- Department of Health
- "Proper Nutrition during Pregnancy". Ministry of Health. State of Israel. Retrieved 23 June 2016.
- New Zealand Ministry of Health Manatū Hauora Food and Nutrition Guidelines for Healthy Pregnant and Breastfeeding Women
- "Alkovett for den lille" (PDF). avogtil.no/. AV OG TIL. Retrieved 23 June 2016.
- "Ej längre bruk av alkohol vid graviditet". roi.socialstyrelsen.se (in Swedish). Retrieved 24 September 2023.
- "New recommended drinking guidelines welcomed by NICE". www.nice.org.uk. 8 January 2016. Retrieved 17 September 2023.
- 'USDA, Dietary Guidelines for Americans 2005, Chapter 9: Alcoholic Beverages Archived 1 July 2007 at the Wayback Machine
- Alcohol and pregnancy
- Alcohol and breastfeeding (2009) - Retrieved 23 May 2014
- Australian Guidelines 2009
- Family Health Service, Department of Health
- "Consultation on children, young people and alcohol". Dcsf.gov.uk. Archived from the original on 14 June 2013. Retrieved 30 March 2014.
- Parents back alcohol free childhood 17 December 2009
- BBC 'No alcohol' urged for under-15s 29 January 2009
- Weathermon R, Crabb DW (1999). "Alcohol and medication interactions" (PDF). Alcohol Res Health. 23 (1): 40–54. PMC 6761694. PMID 10890797.
- 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 Archived 9 January 2008 at the Wayback Machine
- El-Sayed, Mahmoud S.; Ali, Nagia; Ali, Zeinab El-Sayed (1 March 2005). "Interaction Between Alcohol and Exercise". Sports Medicine. 35 (3): 257–269. doi:10.2165/00007256-200535030-00005. ISSN 1179-2035. PMID 15730339. S2CID 33487248.
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- Lakićević, Nemanja (September 2019). "The Effects of Alcohol Consumption on Recovery Following Resistance Exercise: A Systematic Review". Journal of Functional Morphology and Kinesiology. 4 (3): 41. doi:10.3390/jfmk4030041. ISSN 2411-5142. PMC 7739274. PMID 33467356.
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- "Mayo Clinic Q and A: Is daily drinking problem drinking?". Mayo Clinic News Network (in Spanish). 16 February 2018. Retrieved 24 April 2022.
- "Facts about moderate drinking | CDC". CDC. 19 April 2022. Retrieved 24 April 2022.
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- Mongan, Deirdre; Long, Jean (22 May 2015). "Standard drink measures throughout Europe; peoples' understanding of standard drinks and their use in drinking guidelines, alcohol surveys and labelling" (PDF). Reducing Alcohol Related Harm. p. 8. Retrieved 26 September 2017.
- 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