RESPONSIBLE DRINKING GUIDELINES
How alcohol effects us depends on many factors such as our age, size, sex and health. How quickly we drink, and whether it is with food or on an empty stomach, also effects how quickly we absorb alcohol.
The US Government looks at the risks and benefits of drinking alcohol and has been able to draw up guidelines for safe or low risk drinking with input from the Department of Agriculture and Department of Health & Human Services.
The US has one national set of dietary guidelines that includes advices on low-risk alcohol drinking, which are supported by health specialists, as well as many respected US organizations. 2015–2020 Dietary Guidelines for Americans are for healthy adults.
The guidelines state that ‘These guidelines are intended for Americans of legal drinking age who choose to drink alcohol and are informed by the most recent and best available scientific research and evidence. They are intended to provide consistent information across the country to help Americans moderate their alcohol consumption and reduce their immediate and long-term alcohol-related harm.
If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and two drinks per day for men—and only by adults of legal drinking age.
One drink is defined as 12 fluid ounces of regular beer (5% alcohol), 5 fluid ounces of wine (12% alcohol), or 1.5 fluid ounces of 80 proof (40% alcohol) distilled spirits. One drink contains 0.6 fluid ounces of alcohol.’'
It is important to remember that the alcoholic content of drinks will vary depending on the size of the pour. Also, home pours and cocktails may contain significantly more than these standard drink averages.
This level of intake appears to pose few health risks for most people and may be beneficial to health for some people, especially men over 40 and post menopausal women due to alcohol's cardiovascular protective effects. Generally, those adults who choose to drink should do so in a sensible manner as part of a healthy diet and lifestyle and preferably around mealtimes or with food.
The consumption of small amounts of alcohol on a regular basis is more healthful than binge drinking large amounts of alcohol occasionally. Episodes of heavy intake (e.g. weekend bingeing alternating with weekday abstinence) is associated with health and safety risks. Saving up drinks should not be regarded as moderate or healthful, even if your total weekly alcohol intake is within the limits of moderation.
Why are there different guidelines for men and women?
Women's bodies are generally smaller and have less body water, so alcohol concentrations rise more quickly. Sorry ladies, but you can’t drink as much as men. That’s not a male conspiracy theory but a biological fact! Women have less body water than men so the concentration of alcohol in their blood stream is proportionally higher. So, if a woman weighing 60 kgs drinks a double vodka then a man of the same size will need to drink a triple in order to reach the same blood alcohol level. There is also some evidence that women break down alcohol slightly differently. The enzyme ADH breaks down alcohol in the liver and in the lining of the stomach; and women have less of it, so alcohol is broken down more slowly.
When not to drink
Official drinking guidelines are issued by governments and public health to advise on levels of alcohol consumption considered 'safe', 'responsible,' or 'low risk'. They do not apply to those under the legal drinking age or to pregnant women. Those on medication or with a history of illness should consult their general practitioner or specific advice. For religious or health reasons nearly half of adults around the world choose not to drink (45%). Responsible drinking means drinking enjoyably, sociably and moderately and includes not drinking at all in situations when the effects of alcohol will put your own or someone's safety or health at risk
The US Dietary Guidelines 2015-20 identify some circumstances in which people should not drink alcohol, including "individuals who are taking certain over-the-counter or prescription medications or who have certain medical conditions, those who are recovering from alcoholism or are unable to control the amount they drink, and anyone younger than age 21 years. Individuals should also not drink if they are driving, planning to drive, or are participating in other activities requiring skill, coordination, and alertness. Women who are or who may be pregnant should not drink. Drinking during pregnancy, especially in the first few months of pregnancy, may result in negative behavioral or neurological consequences in the offspring. No safe level of alcohol consumption during pregnancy has been established. Women who are breastfeeding should consult with their health care provider regarding alcohol consumption.
How much do Americans Drink?
In the US in 2012, 87.6% of people aged 18 or older reported that they drank alcohol at some point in their lifetime; 71% reported that they drank in the past year; 56.3% reported that they drank in the past month.
In 2012, 24.6% of people ages 18 or older reported that they engaged in binge drinking (defined as drinking 5 or more alcoholic drinks on the same occasion) in the past month; 7.1% reported that they engaged in heavy drinking in the past month (defined as drinking 5 or more drinks on the same occasion on each of 5 or more days).
Potential Health Benefits of Moderate Alcohol UseWhen most people talk about the benefits of alcoholic beverages, they're usually referring to the pleasant, relaxed feeling and enhanced sociability that often result from drinking. When scientists and health professionals talk about the benefits of alcohol use, however, they are primarily referring to the fact that moderate drinking may reduce the risk of certain diseases, especially coronary heart disease. Among middle-aged and elderly people, moderate drinkers have lower mortality rates than abstainers - this is known as the 'J' shaped curve, or French paradox. In simple terms, alcohol stimulates the liver to produce 'good' HDL cholesterol and 'thins' the blood, helping prevent the build up of harmful clots or hardening of the arteries. In contrast, among younger adults alcohol consumption appears to provide little, if any, health benefit, and excess alcohol consumption among young adults is associated with a higher risk of traumatic injury and death. Consumers should enjoy drinking in moderation as one element of the 'healthy lifestyle' choices of regular exercise, not smoking, staying slim and a diet rich in fruit and vegetables and low in saturated fat. If you can manage this and enjoy drinking in moderation, your risk of chronic diseases reduce by more than 50%.
Advice For Today
The US Dietary Guidelines2015-20 state that
If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age.
Excessive (i.e., heavy, high-risk, or binge) drinking has no benefits, and the hazards of heavy alcohol intake are well known. Excessive drinking increases the risk of cirrhosis of the liver, hypertension, stroke, type 2 diabetes, cancer of the upper gastrointestinal tract and colon, injury, and violence. Excessive drinking over time is associated with increased body weight and can impair short-and long-term cognitive function. For the growing percentage of the population with elevated blood pressure, reducing alcohol intake can effectively lower blood pressure, although this is most effective when paired with changes in diet and physical activity patterns. Alcohol is not a component of the USDA Food Patterns. Thus, if alcohol is consumed, the calories from alcohol should be accounted for so that the limits on calories for other uses and total calories are not exceeded.
In comparison to moderate alcohol consumption, excessive drinking is responsible for 88,000 deaths in the United States each year, including 1 in 10 deaths among working age adults (age 20-64 years). In 2006, the estimated economic cost to the United States of excessive drinking was $224 billion.Binge drinking accounts for over half of the deaths and three-fourths of the economic costs due to excessive drinking.
Key definitions for alcohol
What is moderate alcohol consumption? Moderate alcohol consumption is defined as up to 1 drink per day for women (14g) and up to 2 drinks per day for men.
What is heavy of high risk drinking?high-risk drinking is the consumption of 4 or more drinks on any day or 8 or more drinks per week for women and 5 or more drinks on any day or 15 or more drinks per week for men.
What is binge drinking?Binge drinking is the consumption within about 2 hours of 4 or more drinks for women and 5 or more drinks for men.
The bottom line message
Most people who drink do so moderately and responsibly as part of a healthy diet and lifestyle. Common sense tells us to drink responsibly at any time and especially if you are planning to drive or undertake other activities that require skills. Alcohol can be enjoyed as part of a healthy lifestyle in moderation, but it is not recommended that anyone begin drinking or drink more frequently on the basis of their health. Enjoyment of wine, beer and spirits has formed part of a pleasurable part of many traditions, cultures and some religions around the globe since civilization began.
Further sources of information
Foundation for Advancing Alcohol Responsibility responsibility.org
Rethinking Drinking rethinkingdrinking.niaaa.nih.gov/WhatCountsDrink/WhatsAstandardDrink.asp
Dietary Guidelines for Americans health.gov/dietaryguidelines/2015/
Executive Summary health.gov/dietaryguidelines/2015/guidelines/executive-summary/
Questions and answers health.gov/dietaryguidelines/2015/qanda.asp
National Institute on Alcohol Abuse and Alcoholism Health and Social Issues Research Information niaaa.nih.gov/research
National Library of Medicine: www.nlm.nih.gov/
American Heart Association:
American Cancer Society: www.cancer.org/cancer/news/expertvoices/2013/06/default.aspx
American Academy of Family Physicians: www.aafp.org/
American Medical Association: www.ama-assn.org/
American Diabetes Association: www.diabetes.org/home.jsp
American Stroke Association: www.stroke.org/
© 2000 Alcohol in Moderation. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.