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Alcohol Presents Only Health Risks for the Young, But May Benefit Over 40s

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New research published in The Lancet shows that alcohol poses much higher health risks in young people than in older adults, and that consumption of a small amount of alcohol in adults over aged 40 may provide some health benefits. This study is the first to investigate the theoretical minimum risk of alcohol consumption based on factors such as geographical region, age, sex and year taking into consideration the background rates of disease in the population. This study suggests that guidelines for alcohol consumption should vary based on age and location.

To guide policies and guidelines on alcohol consumption, researchers looked at the risk of alcohol on 22 health outcomes such as injury, cardiovascular disease and cancer. They used data from the 2020 Global Burden of Disease dataset, examining datapoints for males and females aged 15–95 in 204 countries between the years 1990 and 2020. Researchers aimed to determine the average daily alcohol intake that poses minimal risk to a population, as well as the amount a person can drink before taking on excess health risks compared to someone who does not drink at all.

What is a “standard drink”?

One standard drink is defined as 10 grams of pure alcohol. Examples include:

  • A small glass of red wine (100 ml or 3.4 fluid ounces) at 13% alcohol by volume
  • A can or bottle of beer (375 ml or 12 fluid ounces) at 3.5% alcohol by volume
  • A shot of whiskey or other spirits (30 ml or 1.0 fluid ounces) at 40% alcohol by volume

The findings indicate that people aged 15–39 were recommended to drink 0.136 standard drinks per day (i.e., just over one-tenth of a standard drink) before risking adverse health effects. Looking only at females aged 15–39, this amount was slightly higher at 0.273 standard drinks.

The strictest guidelines have been aimed at males aged 15–39 worldwide, who were calculated to be at the greatest risk from dangerous levels of alcohol consumption. According to the researchers, 1.34 billion people consumed harmful amounts of alcohol in 2020, and that males aged 15–39 were the largest demographic within this group in every region. Harmful alcohol use among young males was particularly concentrated in Australasia and western and central Europe. Additionally, 60% of alcohol-related injuries occur within this age group – including motor vehicle accidents, suicides and homicides – with no evidence for any health benefits.

“Although the risks associated with alcohol consumption are similar for males and females, young males stood out as the group with the highest level of harmful alcohol consumption. This is because a larger proportion of males compared to females consume alcohol and their average level of consumption is also significantly higher,” said Dr. Emmanuela Gakidou, senior author of the study and professor of health metrics sciences at the Institute for Health Metrics and Evaluation at the University of Washington’s School of Medicine.

Small amounts of alcohol may provide benefits to over 40s

Nevertheless, the research does indicate that adults over the age of 40 with no underlying health conditions may benefit from a small amount of alcohol consumption – estimated as one to two standard drinks per day. The proposed benefits from this small alcohol consumption include reduced risks of cardiovascular disease, stroke and diabetes.

Researchers estimated that in 2020, safe alcohol consumption levels for those aged 40–64 ranged from half to almost two standard drinks per day for both males and females. For those aged over 65, risk of loss of health was reached at just over three standard drinks per day. Overall, these findings suggest that small amounts of alcohol consumption in people aged 40 years or older with no underlying health conditions may be associated with improved health outcomes.

“Our message is simple: young people should not drink, but older people may benefit from drinking small amounts. While it may not be realistic to think young adults will abstain from drinking, we do think it’s important to communicate the latest evidence so that everyone can make informed decisions about their health,” explained Dr. Gakidou.

Risk varies across regions

The researchers also found that risk of disease burden between age groups also varied significantly across different regions, particularly for over 40s. For example, among those 55–59 years of age in north Africa and the Middle East, 30.7% of alcohol-related health effects were due to cardiovascular disease, 12.6% due to cancer and 1% due to tuberculosis. When looking at the same age group in sub-Saharan Africa, this changed to 20% to cardiovascular disease, 9.8% to cancer, and 10.1% to tuberculosis. This meant that the level of alcohol consumption before health risks in these groups were estimated to be 0.876 standard drinks in north Africa and the Middle East and 0.596 standard drinks in sub-Saharan Africa.

Limitations to the study

The authors of the paper also address some limitations to the analysis, stating that factors such as the patterns of drinking were not examined. Therefore, the study did not make distinctions between people who infrequently consume large amounts of alcohol over short periods and those who consume a consistent amount of alcohol over several days. Additionally, levels of alcohol consumption from the study were self-reported by the participants, potentially introducing bias, and that data collection was delayed due to the COVID-19 pandemic.

Overall, the researchers found that the recommended alcohol intake for adults was low – between 0 and 1.87 standard drinks per day – regardless of geography, age, sex or year.

Reference: Bryazka D, Reitsma MB, Griswold MG, et al. Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020. The Lancet. 2022;400(10347):185-235. doi: 10.1016/S0140-6736(22)00847-9

This article is a rework of a press release issued by The Lancet. Material has been edited for length and content.