Recommendations for consumption of the drug alcohol (also known formally as ethanol) vary from recommendations to be alcohol-free to daily or weekly drinking "safe limits" or maximum intakes. Many governmental agencies and organizations have issued guidelines. These recommendations concerning maximum intake are distinct from any legal restrictions, for example countries with drunk driving laws or countries that have prohibited alcohol. To varying degrees, these recommendations are also distinct from the scientific evidence, such as the short-term effects of alcohol consumption and long-term effects of alcohol consumption. [1]
These guidelines apply to men, and women who don't belong to the specific populations.
Some governments set the same recommendation for both sexes, while others give separate limits. The guidelines give drink amounts in a variety of formats, such as standard drinks, fluid ounces, or milliliters, but have been converted to grams of ethanol for ease of comparison.
The daily limits range from 10-30 g per day for men and 10-24 g per day for women. Weekly limits range from 27-252 g/week for men and 27-168 g/week for women. The weekly limits are lower than the daily limits, meaning intake on a particular day may be higher than one-seventh of the weekly amount, but consumption on other days of the week should be lower. The limits for women are often but not always lower than those for men.
Country (or region) | Teetotalism recommended | Low risk | Medium to high risk | Details | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Day | Week | Day | Week | |||||||
Men | Women | Men | Women | Men | Women | Men | Women | |||
Australia | 40 g | 100 g | Reference. [7] [8] | |||||||
Austria | 24 g | 16 g | ||||||||
Canada | "Not drinking has benefits, such as better health, and better sleep." [9] | 27 g | The Canadian Centre on Substance Use and Addiction has a sliding scale of intakes. The scale states that at 27 g or less per week, "you are likely to avoid alcohol-related consequences for yourself or others". [9] | |||||||
Czech Republic | 24 g | 16 g | ||||||||
Denmark | 48 g | 120 g | Reference. [10] | |||||||
Finland | 168 g | 84 g | Reference. [11] | |||||||
Germany | Alcoholic beverages pose health risks and ideally should be avoided completely. [12] | The German Centre for Addiction Issues recommends everyone to reduce alcohol consumption, regardless of the amounts consumed. [12] | ||||||||
Hong Kong | 20 g | 10 g | Reference. [13] | |||||||
Iceland | 32 g | "Stop drinking before reaching five drinks on the same occasion". 1 standard drink in Iceland = 8 g ethanol. 8 g x 4 drinks = 32 g. [14] | ||||||||
Ireland | 170 g | 140 g | Reference. [15] | |||||||
Italy | 24 g | 12 g | Reference. [16] | |||||||
Japan | 40 g | 20 g | Reference. [17] | |||||||
Netherlands | Recommends an alcohol consumption level of zero grams. | 10 g | The Health Council of the Netherlands recommends an alcohol consumption level of zero or no more than 10 g per day. [18] | |||||||
New Zealand | 30 g | 20 g | 150 g | 100 g | 50 g | 40 g | At least two alcohol-free days every week. 30 g for men, 20 g for women To reduce long-term health risks [19] 50 g for men, 40 g for women On any single occasion, to reduce risk of injury. [19] | |||
Norway | 20 g | 10 g | Reference. [20] | |||||||
Portugal | 37 g | 18.5 g | Reference. [21] | |||||||
Spain | 30 g | 20 g | Also suggests a maximum of no more than twice this on any one occasion. [21] | |||||||
Sweden | "Not possible to specify a limit for risk-free alcohol consumption." [22] | 48 g | 120 g | The National Board of Health and Welfare defines risky consumption as 10 (Swedish) standard drinks per week (120 g), and 4 standard drinks (48 g) or more per occasion, once per month or more often. Alcohol intervention is offered for people who exceed these recommendations. [22] | ||||||
Switzerland | 30 g | 20–24 g | Reference. [18] | |||||||
United Kingdom | "There's no completely safe level of drinking." [23] | 112 g a week, spread across 3 days or more. | Reference. [23] | |||||||
USA | "People who do not drink should not start drinking for any reason." [24] | 28 g | 14 g | 196 g | 98 g | Reference. [24] |
Excessive drinking during pregnancy, especially in the first eight to twelve weeks, is associated with fetal alcohol spectrum disorders such as abnormal appearance and behavioral problems. Although low-to-moderate drinking of less than 12g/day is not known to significantly increase the chance of such disorders, [1] [25] most guidelines state that no safe amount of alcohol consumption has been established and recommend that pregnant women abstain entirely from alcohol. [26] [27] As there may be some weeks between conception and confirmation of pregnancy, most guidelines also recommend that women trying or likely to become pregnant should avoid alcohol as well.
"Alcohol passes to the baby in small amounts in breast milk. The milk will smell different to the baby and may affect their feeding, sleeping or digestion. The best advice is to avoid drinking shortly before a baby's feed." [38] "Alcohol inhibits a mother's let-down (the release of milk to the nipple). Studies have shown that babies take around 20% less milk if there's alcohol present, so they'll need to feed more often – although infants have been known to go on 'nursing strike', probably because of the altered taste of the milk." [39] "There is little research evidence available about the effect that [alcohol in breast milk] has on the baby, although practitioners report that, even at relatively low levels of drinking, it may reduce the amount of milk available and cause irritability, poor feeding and sleep disturbance in the infant. Given these concerns, a prudent approach is advised." [40]
Countries have different recommendations concerning the administration of alcohol to minors by adults.
According to a 2024 systematic review and meta-analysis, even at 20 g/day (1 large beer), the risk of developing an alcohol use disorder (AUD) is nearly 3 times higher than non-drinkers, and the risk of dying from an AUD is about 2 times higher than non-drinkers. [45]
The recommended limits for daily or weekly consumption provided in the various countries' guidelines generally apply to the average healthy adult. However, many guidelines also set out numerous conditions under which alcohol intake should be further restricted or eliminated. They may stipulate that, among other things, people with liver, kidney, or other chronic disease, cancer risk factors, smaller body size, young or advanced age, those who have experienced issues with mental health, sleep disturbances, alcohol or drug dependency or who have a close family member who has, or who are taking medication that may interact with alcohol, [49] or suffering or recovering from an illness or accident, are urged to consider, in consultation with their health professionals, a different level of alcohol use, including reduction or abstention.
Furthermore, the maximum amounts allowed do not apply to those involved with activities such as operating vehicles or machinery, risky sports or other activities, or those responsible for the safety of others. [40] [50] [51]
Moreover, studies suggest even moderate alcohol consumption may significantly impair – neurobiologically beneficial and -demanding – exercise (possibly including the recovery and adaptation). [52] [53] [54] [55]
As of 2022, moderate consumption levels of alcoholic beverages are typically defined in terms of average consumption per day. However, when drinking becomes a chronic daily activity the consumption puts individuals at an increased health risk [56] [ medical citation needed ][ additional citation(s) needed ] as it may lead to habituation, desensitization (consumption-induced tolerance), progressively increasing average dosages and addiction.[ citation needed ]
According to the CDC, it would be important to focus on the amount people drink on the days that they drink. [57] However, few studies or guidelines distinguish between or compare "moderate consumption" patterns (i.e. frequency, timing and dosage/intensity [58] per session) of occasional drinking and daily drinking.[ citation needed ]One review showed that among drinkers (not limited to moderate consumption levels), daily drinking in comparison to non-daily drinking was associated with incidence of liver cirrhosis. [59]
Emerging evidence suggests that "even drinking within the recommended limits may increase the overall risk of death from various causes, such as from several types of cancer". Better health outcomes among moderate drinkers that some studies reported may be due to the moderate alcohol consumption itself but they may also instead be caused by "other differences in behaviors or genetics between people who drink moderately and people who don't". According to the CDC, recent studies indicate moderate consumption may not have the protective health benefits. [57] A systematic analysis found that "The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0–0·8) standard drinks per week". [60]
Guidelines generally give recommended amounts measured in grams (g) of pure alcohol per day or week. Some guidelines also express alcohol intake in standard drinks or units of alcohol. The size of a standard drink varies widely among the various guidelines, from 8g to 20g, as does the recommended number of standard drinks per day or week. [18] [61] The standard drink size is not meant as recommendations for how much alcohol a drink should contain, but rather to give a common reference that people can use for measuring their intake, though they may or may not correspond to a typical serving size in their country. [62]
The long-term effects of alcohol have been extensively researched. The health effects of long-term alcohol consumption on health vary depending on the amount consumed. Even light drinking poses health risks, but atypically small amounts of alcohol may have health benefits. Alcoholism causes severe health consequences which outweigh any potential benefits.
Drinking culture is the set of traditions and social behaviours that surround the consumption of alcoholic beverages as a recreational drug and social lubricant. Although alcoholic beverages and social attitudes toward drinking vary around the world, nearly every civilization has independently discovered the processes of brewing beer, fermenting wine, and distilling spirits, among other practices. Many countries have developed their own regional cultures based on unique traditions around the fermentation and consumption of alcohol, which may also be known as a beer culture, wine culture etc. after a particularly prominent type of drink.
Oily fish are fish species with oil (fats) in soft tissues and in the coelomic cavity around the gut. Their fillets may contain up to 30% oil, although this figure varies both within and between species. Examples of oily fish include small forage fish such as sardines, herring and anchovies, and other larger pelagic fish such as salmon, trout, tuna, swordfish and mackerel.
Breast milk or mother's milk is milk produced by the mammary glands in the breast of human females. Breast milk is the primary source of nutrition for newborn infants, comprising fats, proteins, carbohydrates, and a varying composition of minerals and vitamins. Breast milk also contains substances that help protect an infant against infection and inflammation, such as symbiotic bacteria and other microorganisms and immunoglobulin A, whilst also contributing to the healthy development of the infant's immune system and gut microbiome.
A standard drink or unit of alcohol is a measure of alcohol consumption representing a fixed amount of pure alcohol. The notion is used in relation to recommendations about alcohol consumption and its relative risks to health. It helps to educate alcohol users. A hypothetical alcoholic beverage sized to one standard drink varies in volume depending on the alcohol concentration of the beverage, but it always contains the same amount of alcohol and therefore produces the same amount of drunkenness. Many government health guidelines specify low to high risk amounts in units of grams of pure alcohol per day, week, or single occasion. These government guidelines often illustrate these amounts as standard drinks of various beverages, with their serving sizes indicated. Although used for the same purpose, the definition of a standard drink varies from country to country.
Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person who is exposed to alcohol during gestation, as a result of their mother drinking alcohol during pregnancy. The several forms of the condition are: fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS), alcohol-related neurodevelopmental disorder (ARND), and neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE). Other terms used are fetal alcohol effects (FAE), partial fetal alcohol effects (PFAE), alcohol-related birth defects (ARBD), and static encephalopathy, but these terms have fallen out of favor and are no longer considered part of the spectrum.
In a 2018 study on 599,912 drinkers, a roughly linear association was found with alcohol consumption and a higher risk of stroke, coronary artery disease excluding myocardial infarction, heart failure, fatal hypertensive disease, and fatal aortic aneurysm, even for moderate drinkers. The American Heart Association states that people who are currently non-drinkers should not start drinking alcohol.
Alcohol and cancer have a complex relationship. Alcohol causes cancers of the oesophagus, liver, breast, colon, oral cavity, rectum, pharynx, and larynx, and probably causes cancers of the pancreas. Cancer risk, can occur even with light to moderate drinking. The more alcohol is consumed, the higher the cancer risk, and no amount can be considered completely safe. Alcoholic beverages were classified as a Group 1 carcinogen by the International Agency for Research on Cancer (IARC) in 1988. An estimated 3.6% of all cancer cases and 3.5% of cancer deaths worldwide are attributable to consumption of alcohol. 740,000 cases of cancer in 2020 or 4.1% of new cancer cases were attributed to alcohol.
Nutrition and pregnancy refers to the nutrient intake, and dietary planning that is undertaken before, during and after pregnancy. Nutrition of the fetus begins at conception. For this reason, the nutrition of the mother is important from before conception as well as throughout pregnancy and breastfeeding. An ever-increasing number of studies have shown that the nutrition of the mother will have an effect on the child, up to and including the risk for cancer, cardiovascular disease, hypertension and diabetes throughout life.
Alcohol has a number of effects on health. Short-term effects of alcohol consumption include intoxication and dehydration. Long-term effects of alcohol include changes in the metabolism of the liver and brain, several types of cancer and alcohol use disorder. Alcohol intoxication affects the brain, causing slurred speech, clumsiness, and delayed reflexes. There is an increased risk of developing an alcohol use disorder for teenagers while their brain is still developing. Adolescents who drink have a higher probability of injury including death.
The health effects of wine are mainly determined by its active ingredient – alcohol. Preliminary studies found that drinking small quantities of wine, particularly of red wine, may be associated with a decreased risk of cardiovascular diseases, cognitive decline, stroke, diabetes mellitus, metabolic syndrome, and early death. Other studies found no such effects.
A diabetic diet is a diet that is used by people with diabetes mellitus or high blood sugar to minimize symptoms and dangerous complications of long-term elevations in blood sugar.
The Dietary Guidelines for Americans (DGA) provide nutritional advice for Americans who are healthy or who are at risk for chronic disease but do not currently have chronic disease. The Guidelines are published every five years by the US Department of Agriculture, together with the US Department of Health and Human Services. Notably, the most recent ninth edition for 2020–25 includes dietary guidelines for children from birth to 23 months. In addition to the Dietary Guidelines per se, there are additional tools for assessing diet and nutrition, including the Healthy Eating Index (HEI), which can be used to assess the quality of a given selection of foods in the context of the Dietary Guidelines. Also provided are additional explanations regarding customization of the Guidelines to individual eating preferences, application of the Guidelines during pregnancy and infancy, the USDA Nutrition Evidence Systematic Review, information about the Nutrition Communicators Network and the MyPlate initiative, information from the National Academies about redesigning the process by which the Dietary Guidelines for Americans are created, and information about dietary guidelines from other nations.
Binge drinking, or heavy episodic drinking, is drinking alcoholic beverages with an intention of becoming intoxicated by heavy consumption of alcohol over a short period of time, but definitions vary considerably.
Women should speak to their doctor or healthcare professional before starting or stopping any medications while pregnant. Non-essential drugs and medications should be avoided while pregnant. Tobacco, alcohol, marijuana, and illicit drug use while pregnant may be dangerous for the unborn baby and may lead to severe health problems and/or birth defects. Even small amounts of alcohol, tobacco, and marijuana have not been proven to be safe when taken while pregnant. In some cases, for example, if the mother has epilepsy or diabetes, the risk of stopping a medication may be worse than risks associated with taking the medication while pregnant. The mother's healthcare professional will help make these decisions about the safest way to protect the health of both the mother and unborn child. In addition to medications and substances, some dietary supplements are important for a healthy pregnancy, however, others may cause harm to the unborn child.
Alcohol is commonly consumed and available at pubs and liquor stores in Australia – all of which are private enterprises. Spirits can be purchased at liquor stores and pubs, whereas most grocery stores do not sell them, although they may have separate liquor stores on their premises. Alcohol consumption is higher, according to WHO studies, than in most European countries and several Central Asian and African countries, although consumption is just as high in Australia as in North America. After tobacco, alcohol is the second leading preventable cause of death and hospitalisation in Australia.
Prenatal nutrition addresses nutrient recommendations before and during pregnancy. Nutrition and weight management before and during pregnancy has a profound effect on the development of infants. This is a rather critical time for healthy development since infants rely heavily on maternal stores and nutrient for optimal growth and health outcome later in life.
Alcohol, sometimes referred to by the chemical name ethanol, is a depressant drug found in fermented beverages such as beer, wine, and distilled spirit — in particular, rectified spirit. Ethanol is colloquially referred to as "alcohol" because it is the most prevalent alcohol in alcoholic beverages. But technically all alcoholic beverages contain several types of psychoactive alcohols, that are categorized as primary, secondary, or tertiary. Primary, and secondary alcohols, are oxidized to aldehydes, and ketones, respectively, while tertiary alcohols are generally resistant to oxidation. Ethanol is a primary alcohol that has unpleasant actions in the body, many of which are mediated by its toxic metabolite acetaldehyde. Less prevalent alcohols found in alcoholic beverages, are secondary, and tertiary alcohols. For example, the tertiary alcohol 2M2B which is up to 50 times more potent than ethanol and found in trace quantities in alcoholic beverages, has been synthesized and used as a designer drug. Alcoholic beverages are sometimes laced with toxic alcohols, such as methanol and isopropyl alcohol. A mild, brief exposure to isopropyl alcohol is unlikely to cause any serious harm. But many methanol poisoning incidents have occurred through history, since methanol is lethal even in small quantities, as little as 10–15 milliliters. Ethanol is used to treat methanol and ethylene glycol toxicity.
Contraindications to breastfeeding are those conditions that could compromise the health of the infant if breast milk from their mother is consumed. Examples include galactosemia, untreated HIV, untreated active tuberculosis, Human T-lymphotropic virus 1 or II, uses illicit drugs, or mothers undergoing chemotherapy or radiation treatment.
Sober curious is a cultural movement and lifestyle of practicing none or limited alcohol consumption that started spreading in the late 2010s, in particular among people from the millennials generation, and was coined by Ruby Warrington in her 2019 book Sober Curious. It differs from traditional abstinence in that it is not founded on asceticism, religious condemnation of alcohol or previous alcohol abuse, but motivated by a curiosity of a sober lifestyle. Markets have reacted by offering a wider selection of non-alcoholic beverages.
Explanatory notes
Citations
However, even light alcohol use (≤1 drink daily) increases the risk of developing cancer, and heavier use (≥2-4 drinks daily) significantly increases morbidity and mortality. Given these and other risks, the American Heart Association cautions that, if they do not already drink alcohol, people should not start drinking for the purported cardiovascular benefits of alcohol.
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