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How much alcohol is too much alcohol?

New research is completely changing the way we should look at the effects of drinking alcohol. Here's what you need to know

How much alcohol should you drink?
How much alcohol should you drink? (Istockphoto)

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Who doesn’t like raising a toast to one’s health, when enjoying a drink? Ironically though, you may be doing a disservice to your health by having that drink! A comprehensive, though ongoing, study, conducted by the University of Washington, Seattle is studying this exact same thing. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), tracks the effects of alcohol on respondents from 204 countries, ranging from the 19-95 years in age. So far, the study has found that even a small quantity of alcohol is harmful and carries no benefits at all for people under 40.

The GBD has found that, globally, 1.03 billion males and 312 million females, aged 15 and over, consumed alcohol in amounts exceeding safe limits in 2020. The same study also found that harmful consumption was predominantly concentrated among individuals aged 15–39 years (59.1%)—75.5% of this number are men. Australasia, Western Europe and Central Europe had the highest percentages of males aged 15–39 years consuming harmful amounts of alcohol. Among women in the same age group, Australasia, Western Europe and southern Latin America had the highest rates of harmful alcohol consumption. By contrast, only 6·55% of individuals consuming harmful amounts of alcohol were older than 65 years. 

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“Drinking alcohol in any quantity at any stage of life is harmful for the health,” says Dr. Vikas Deswal, senior consultant for internal medicine at Medanta Hospital, Gurugram. “It can cause several issues like carcinomas, chronic kidney disease, cirrhosis, and other acute and dangerous health conditions. So, at any age drinking alcohol is not recommended. There are no benefits one can associate with it.” 

Despite the study's new findings, Dr. Pankaj Puri, director of gastroenterology and hepatobiloary sciences at Fortis Escorts Hospital in Okhla, New Delhi, warns that it would be incorrect to recommend alcohol even to older adults. "In fact, older adults may have liver fibrosis and scarring due to other insults like obesity related fatty liver, viral hepatitis, etc. and may be prone to liver damage even with lower amounts of alcohol," Puri points out. Alcohol use accounted for 1·78 million deaths in 2020 and was the leading risk factor for mortality among males aged 15–49 years, according to the study which was published in the Lancet last month. 

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GBD researchers also found that people over the age of 40, who don't have any underlying health conditions, could possibly benefit from small amounts of alcohol, ranging from 0.1 to 1.87 standard drinks, leading to a reduced risk in ischaemic heart disease, diabetes and stroke. However, the most significant finding of the study was that the amount that could lead to such benefits is much lower than the current drinking guidelines prevalent across the world.

"A drink of 30ml of whisky, 100ml of wine or 250ml of beer, is equivalent to 10gm alcohol. The safe limits for the liver are 2-3 standard drinks per day in males and 1-2 standard drinks per day in women," says Puri. However, that advice might need a rethink after this study, including current guidelines that suggest different quantities by gender. The GBD study found that instead of gender, the alcohol limits should be set by age and location. The maximum safe limits for those aged 40 and beyond was 1.87 standard drinks, the researchers found.

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"There has been some data about the protective effect of alcohol intake in moderation especially red wine. However, the deleterious effects of alcohol on other organs must be kept in mind," warned Puri. People with co-existing liver diseases can suffer further damage even with current safe levels of alcohol intake, he added. Doctors advise that alcohol should not be consumed more than five days a week to allow the liver to recover. Pancreatitis can occur even with small amount of alcohol intake and can be a life threatening illness. Hence care should be taken before recommending that alcohol is good for health, they warn.

Deswal acknowledges the presence of moderate and social drinkers, who believe they aren't consuming harmful amounts of alcohol. "Again, any amount at any age is harmful," he emphasises. 

Shrenik Avlani is a writer and editor and the co-author of The Shivfit Way, a book on functional fitness.

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