International study supports low UK alcohol guidelines

The UK’s comparatively low threshold for recommended safe drinking levels has been supported by a major new study.

As international low-risk drinking guidelines vary substantially, Risk thresholds for alcohol consumption – published in the Lancet – studied almost 600,000 people without previous cardiovascular disease across 19 countries, to attempt to define ‘thresholds associated with lowest risk for all-cause mortality and cardiovascular disease’.

The ‘minimum mortality risk’ was found to be around, or below, 100g of alcohol per week – or 12.5 units, as one UK unit is defined as 8g. Drinking above that level was found to increase the risk of heart failure, stroke, fatal hypertensive disease and fatal aortic aneurysm.

In the US, an upper limit of almost 200g per week is recommended for men – roughly twice the UK level – while guidelines in Italy, Portugal and Spain are almost 50 per higher still. Many national guidelines, however, recognise that drinkers are willing to accept some level of risk.

‘These data support limits for alcohol consumption that are lower than those recommended in most current guidelines,’ the study states. ‘Exploratory analyses suggested that drinkers of beer or spirits, as well as binge drinkers, had the highest risk for all-cause mortality.’

People drinking at the current UK guideline levels – which were revised just over two years ago to 14 units per week for both men and women (DDN, February 2016, page 4) – would face little increased risk. However, drinking above two units a day means the ‘death rates steadily climb’, according to Winton Professor for the Public Understanding of Risk at Cambridge University, Prof David Spiegelhalter. ‘This is a massive and very impressive study,’ he said. ‘The paper estimates a 40-year-old drinking four units a day above the guidelines has roughly two years lower life expectancy, which is around a twentieth of their remaining life. This works out at about an hour per day. So it’s as if each unit above guidelines is taking, on average, about 15 minutes of life, about the same as a cigarette.’

The widely reported study – which acknowledges that ‘self-reported alcohol consumption data are prone to bias’ – has led to headlines such as ‘Glass of wine a day could shave years off your life’ (Independent) and ‘Deadly cost of that extra drink’ (Mail).

‘This research adds to a growing number of studies supporting current UK guidelines for lower risk drinking,’ said Dr Tony Rao of the Institute of Psychiatry, Psychology and Neuroscience at King’s College, London. ‘It also highlights the need to reduce alcohol-related harm in baby boomers, an age group currently at highest risk of rising alcohol misuse.’

Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599,912 current drinkers in 83 prospective studies at www.thelancet.com

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