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. The US Dietary Guidelines 2010 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.

A drink is defined as:

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.

Why not try the UNIT CALCULATOR to see how many units your favourite drinks contain? Or download an app for your phone

NIAAA drink calculator

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 2010 identify some circumstances in which people should not drink alcohol:

• Individuals who cannot restrict their drinking to moderate levels.
• Anyone younger than the legal drinking age. Besides being illegal, alcohol consumption increases the risk of drowning, car accidents, and traumatic injury, which are common causes of death in children and adolescents.
• Women who are pregnant or who may be pregnant. 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.
• Individuals taking prescription or over-the-counter medications that can interact with alcohol.
• Individuals with certain specific medical conditions (e.g., liver disease, hypertriglyceridemia, pancreatitis).
• Individuals who plan to drive, operate machinery, or take part in other activities that require attention, skill, or coordination or in situations where impaired judgment could cause injury or death (e.g., swimming).

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 Use

When 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 Guidelines state that

“The consumption of alcohol can have beneficial or harmful effects, depending on the amount consumed, age, and other characteristics of the person consuming the alcohol. Alcohol consumption may have beneficial effects when consumed in moderation. Strong evidence from observational studies has shown that moderate alcohol consumption is associated with a lower risk of cardiovascular disease. Moderate alcohol consumption also is associated with reduced risk of all-cause mortality among middle-aged and older adults and may help to keep cognitive function intact with age. However, it is not recommended that anyone begin drinking or drink more frequently on the basis of potential health benefits because moderate alcohol intake also is associated with increased risk of breast cancer, violence, drowning, and injuries from falls and motor vehicle crashes”.

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.

Excessive alcohol consumption is estimated to be responsible for an average of 79,000 deaths in the US each year. More than half of these deaths are due to binge drinking. Binge drinking also is associated with a wide range of other health and social problems, including sexually transmitted diseases, unintended pregnancy, and violent crime.

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? Heavy or high-risk drinking is the consumption of more than 3 drinks on any day or more than 7 drinks a week for women and more than 4 drinks on any day or more than 14 drinks per week for men.

What is binge drinking? Binge drinking is the consumption within 2 hours of more than 4 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

Drinksmart      www.drinksmart.com/

Dietary Guidelines for Americans  www.cnpp.usda.gov/dietary-guidelines-2010

Executive Summary  www.cnpp.usda.gov/sites/default/files/dietary_guidelines_for_americans/ExecSumm.pdf

Questions and answers www.cnpp.usda.gov/sites/default/files/dietary_guidelines_for_americans/QandA.pd

National Library of Medicine: www.nlm.nih.gov/

American Heart Association:

www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Alcohol-and-Heart-Disease_UCM_305173_Article.jsp

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/