C.Be it raft beer in Melbourne, pinot noir in Paris or mojitos in Havana, alcohol is part of almost every culture in the world. As evidence of harm accumulates, the message from health authorities around the world is that we need to drink less, or even abstain altogether. Is not … why?
Professor Kate Conigrave, an expert in addiction medicine and public health physician at the University of Sydney, knows better than anyone the damage caused by alcohol. She chaired the group that produced Australia’s latest guidelines for reducing the health risks of alcohol, and by 2020 healthy adults should drink no more than 10 drinks a week and no more than 4 drinks a day. This is a reduction from the 2009 guidelines that recommended no more than two drinks per day for men and women.
“The more we learn about alcohol, the more we realize the risk of harm from drinking less,” she says.
The message that alcohol is a social and physical poison is being repeated around the world with increasing confidence as evidence of harm from its consumption continues to mount. Why are there so many different guidelines on what constitutes low-risk drinking?
For example, in Belgium a maximum of 21 drinks per week for men and 14 drinks per week for women is considered low risk, whereas in Ireland a maximum of 17 drinks per week for men and 11 drinks per week for women, two abstinence days per week. increase. France, like Australia, recommends no more than 10 standard drinks per week, but no more than 2 standard drinks per day and abstinence at least one day per week. I’m here. The UK recommends no more than 14 units per week for at least 3 days and “some” sobriety days, while the US recommends no more than 2 drinks per day for men and 1 drink for women. Recommended.
To further confuse things, countries have different definitions of what constitutes a standard drink.In the United States, a standard drink contains 14 grams of alcohol. 10 grams in Australia and about 8 grams in the UK.
Some countries have separate advice for men and women, but not others, including Australia. states that it is the same. The higher the consumption, the more vulnerable women are to harm.
There is also the problem of different age groups being affected differently by alcohol. “It’s generally accepted that as you get older, especially when you start to feel frail, you want to drink less,” she says. It also clarifies that no one under the age of 18 may consume any alcohol.
However, the guidelines do not tailor advice to subsets of adult age groups, even though risks are likely to differ based on age. “At 24, your brain is still developing…so maybe you should drink a little less in a year’s time,'” says Conigrave. It’s a trade-off between being able to do that and having guidelines that you can use.”
Draw a line
The biggest question for those making these recommendations is where to set the threshold between what is perceived as low-risk drinking and what is moderate or high-risk drinking. There are many harmful effects of alcohol, such as heart disease, liver disease, brain damage, cancer, and high blood pressure. If alcohol consumption increases linearly or curvilinearly upwards, how do we identify low-risk ones? should I choose to
Associate Professor Michael Livingston, an alcohol policy researcher at Curtin University’s National Institute of Medicine, said: “There are no easy answers.”
In Australia, the guidelines committee chose the low risk threshold as a 1 in 100 risk of dying from alcohol-related causes. The reason is that this is about the same level of risk associated with driving a car, according to professor Robin Loom, a sociologist at the Center for Alcohol Policy Research at La Trobe University who has worked on previous alcohol recommendations. “If you look at what comes closest to alcohol in terms of being a risky behavior that many people engage in on a regular basis … the easiest thing to come close to in Australia is the government’s commitment to driving. That’s what we’re doing,” says Room.
Canada has adopted an evidence-based approach that suggests health benefits, primarily of heart disease, in relation to very low levels of alcohol consumption. there is. This is because people who drink low levels of alcohol are more likely to engage in other healthy habits, whereas those who never drink are more likely to have pre-existing poor health or previous alcohol abuse.
However, Canadian guidelines take this effect into account. “The point where the risk crosses beyond abstinence — that is, as soon as the risk is higher than not drinking at all — is where they drew the line,” Livingston says.
How low can you go?
Overall, the number of weekly drinks considered low-risk has steadily decreased over the years as evidence of increased adverse health effects, particularly cancer risk, has increased. How low can you go?
Alcohol is “our drug,” Room said, so zero alcohol guidelines are unlikely. “Everywhere you look, there are people who basically expect to consume alcohol as part of their lives, and that’s very different from what’s true for cigarettes at this point,” he says.
The Netherlands has pushed the bar for low-risk drinking the most. That guideline recommends not drinking alcohol at all to begin with, but if you choose to drink, you should not exceed one glass per day. “It kind of seems like a bottoming out,” Livingston says. “It’s hard to imagine a lower guideline than that.”
The elephant in the room is the question of whether alcohol consumption guidelines actually make a difference in drinking behavior. There’s little evidence that it does. But it’s not strong evidence, he says.
“They could work in a more nuanced way and gradually change the norms about alcohol,” he says. But changing drinking guidelines won’t solve the country’s alcohol problem .
“While it won’t lead to dramatic behavioral changes, it can be a means of potentially making an impact if well promoted and incorporated into general health promotion.”