Action on alcohol: Experts propose limits as US dietary guidelines omit specific numbers

Statistical analysis has found that even moderate drinking raises the risk of death and chronic diseases, such as cancer and heart conditions. The research seeks to offer more concrete guidelines than the new US dietary guidelines. 

The study, initially commissioned by the US government to inform the guidelines, reveals that people consuming 14 alcoholic drinks per week on average have a mortality risk of one in 25 (4%), while seven drinks per week have minimal risks.

Study co-author Timothy Naimi, M.D., M.P.H., director of the University of Victoria’s Canadian Institute for Substance Use Research, tells Nutrition Insight that when it comes to alcohol, “the less is best” message in the new dietary guidelines is only good as a summary of the evidence.

“But it is not very effective without providing more concrete quantity scaffolding — otherwise it sounds like industry messaging ‘know when to say when’ or ‘drink in moderation,’ which doesn’t convey much information because there is very little information.”

The study results indicate that men drinking over 6.5 drinks and women over seven per week have a chance of dying from alcohol-related causes greater than one in 1,000. At over 8.5 drinks per week for men and women, the risk rose to greater than one in 100.

Additionally, it matters how the alcohol consumption is spread. The study finds that drinking over one drink in one sitting is linked to higher breast cancer risk, heart disease, and injury.

Alcohol limits per sex

The updated guidelines currently advise people to “limit alcohol” for “better overall health.” It removed the 2020–2025 specifications that, for those who choose to drink, women can drink one while men can drink two or fewer alcoholic beverages per day.

New research urges clear, quantified alcohol limits instead of vague “moderation” advice.According to Naimi, who is also an adjunct professor at Boston University in the US, the study aimed at providing a qualitative framework across the drinking spectrum, saying that even two drinks per day are associated with a substantially elevated risk of premature death caused by alcohol.

“The previous one or two [drinks] for men suggested a range of consumption that was quite risky, and though some might consider it moderate socially, it’s not moderate risk-wise,” warns Naimi. “In recent years, you’ve seen a couple of countries make recommendations the same for men and women at a drink per day or less, for example, the Netherlands.”

He states that the new guidelines, which do not quantify alcohol limits, are a “missed opportunity.” He adds: “I think our study helps fill that gap.”

Lead study author Kevin Shield, Ph.D., associate professor at the University of Toronto in Canada, adds: “Even low levels of alcohol use come with health risks. And that risk continues to increase the more someone drinks.”

Large data review

The medical experts reviewed over 7,200 scientific articles’ statistical analyses to uncover the risk level for each condition. These risks were then applied to national health datasets, as outlined in the Journal of Studies on Alcohol and Drugs.

In addition to uncovering mortality risk, the researchers also analyzed drinking patterns’ influence on chronic and acute alcohol-related conditions such as cancers, including esophageal, oral, and breast cancer, as well as cardiovascular and liver disease, and injury.

Moreover, the study challenges the common misconception that alcohol can protect health, such as the social belief that a glass of red wine is good for the heart. The study authors reveal that no protective overall effect of alcohol on health was observed.

Naimi details: “We do model some protective effects at low levels as was found in the best meta-analysis.” However, he notes the limitations of observational studies. 

Shield adds that low levels might be associated with reduced ischemic heart disease and stroke, but when comparing the health outcomes of chronic disease, the potential benefits are outweighed by risks.

Alcohol research and news 

Growing research on alcohol is increasingly warning of health impacts. One study warns that consuming alcohol can stimulate cravings for salty ultra-processed foods, which may fuel excess energy and weight gain. Another study found that any amount of alcohol consumption raises dementia risk.

To make it easier for health professionals to approach patients about alcohol use, Canada updated guidelines for alcohol screening and detecting early misuse. The WHO sought another solution, urging tax reforms as alcohol and sugary drinks are becoming too affordable.

Meanwhile, researchers of another study found that alcoholic beverage warning labels may encourage reduced drinking.