There is no safe level of alcohol consumption, new global study confirms

Imperial researchers are among a team of international scientists to suggest there is no safe level of alcohol – the health risks outweigh benefits.

The findings were published in The Lancet medical journal.

Previous research has suggested low levels of consumption can have a protective effect against heart disease and diabetes. These findings however show that alcohol only had a protective effect against heart disease, and that the adverse effects of developing other health problems, particularly cancers, increased with the number of alcoholic drinks consumed each day.

Listen above for an audio clip about the research (or listen to the whole interview on the Imperial College Podcast)

No safe level

Any protective effect of 1-2 units of alcohol per day on ischaemic heart disease was offset by the risks, and overall the health risks associated with alcohol rose in line with the amount consumed each day. Therefore, the authors concluded that there is no safe level of alcohol.

Professor Sonia Saxena from Imperial’s School of Public Health is one of the authors on the paper. Speaking to the BBC, she said: “One drink a day does represent a small increased health risk, but adjust that to the UK population as a whole and it represents a far bigger number, and most people are not drinking just one drink a day.” 

Professor Saxena told the BBC that the study was the most comprehensive study ever conducted on the subject. She explained: "This study provides more robust estimates by combining alcohol sales data, self-reported data on the amount of alcohol consumed, abstinence, tourism data and estimates of the levels of illicit trade and home brewing.”

The authors also found that globally one in three people drink alcohol (equivalent to 2.4 billion people), including 25% of women (0.9 billion women) and 39% of men (1.5 billion men). On average, each day women consumed 0.73 alcoholic drinks, and men drank 1.7 drinks.

Which countries drink the most?

Drinking patterns varied globally. The highest number of current alcohol drinkers was in Denmark (97.1% of men and 95.3% of women) while the lowest were in Pakistan for men (0.8%) and Bangladesh for women (0.3%).

Drinking patterns also vary. Men in Romania drank the most with eight drinks per day, while women in Ukraine drank the most with four. UK women were in the top ten highest consumers with three alcoholic drinks per day. 

Health risks

It was also reported that 2.2% of women and 6.8% of men die from alcohol-related health problems each year. Alcohol has a complex association with health, affecting it in multiple ways. Regular consumption has adverse effects on organs and tissues, acute intoxication can lead to injuries or poisoning, and alcohol dependence may lead to frequent intoxication, self-harm or violence.

Alcohol use was ranked as the seventh leading risk factor for premature death and disability worldwide in 2016, and was the leading cause for people aged 15-49 years old. In this age group, it is associated with tuberculosis, road injuries, and self-harm.

They estimate that, for one year, in people aged 15-95 years, drinking one alcoholic drink a day increases the risk of developing one of the 23 alcohol-related health problems by 0.5%, compared with not drinking at all (from 914 people in 100,000 for one year for non-drinkers aged 15-95 years, to 918 in 100,000 people a year for 15-95 year olds who consume one alcoholic drink a day).

The study used data from 694 studies to estimate how common drinking alcohol is worldwide and used 592 studies including 28 million people worldwide to study the health risks associated with alcohol between 1990 to 2016 in 195 countries. In the study, a standard alcoholic drink is defined as 10g alcohol.

The authors note some limitations, including that it is difficult to estimate illicit alcohol production and unrecorded consumption so their results may not fully capture this. The study also does not include drinking data for people under the age of 15 years, and does not include links to health problems such as dementia and psoriasis where evidence suggests alcohol could be a risk factor. The wider harms to other individuals incurred while under the influence of alcohol on others for example from interpersonal violence or road traffic injuries were not assessed.

See the press release of this article