According to a new analysis published in The Lancet. This is the first study to report alcohol risk by geographic region, age, sex and year. It suggests that global drinking recommendations should be based on age and location, with the strictest guidelines targeting men aged 15-39, who are at greatest risk of harmful drinking. alcohol in the world.
Research also indicates that adults aged 40 and over without underlying health conditions may see some benefits from low alcohol consumption (between one and two standard drinks per day), including a reduced risk of diseases. cardiovascular disease, stroke and diabetes.
Using estimates of alcohol consumption in 204 countries, the researchers calculated that 1.34 billion people had consumed harmful amounts in 2020. In each region, the largest segment of the population drinking dangerous amounts of alcohol was men between the ages of 15 and 39 and for this age group alcohol consumption offers no health benefits and many health risks, with 60% of alcohol-related injuries occurring among people in this age group, including road accidents, suicides and homicides.
Our message is simple: young people shouldn’t drink, but older people can benefit from drinking small amounts. While it may not be realistic to think that young adults will abstain from drinking, we believe it is important to communicate the latest evidence so that everyone can make informed decisions about their health.”
Dr. Emmanuela Gakidou, lead author, professor of health measurement science at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine
Age and region should guide drinking policies
Researchers looked at the risk of alcohol consumption on 22 health conditions, including injury, cardiovascular disease and cancer, using 2020 Global Burden of Disease data for men and women aged 15. aged 95 and over between 1990 and 2020, in 204 countries and territories. . From this, the researchers were able to estimate the average daily alcohol consumption that minimizes risk for a population. The study also estimates another critical quantity; how much alcohol a person can drink before taking an excessive risk to their health compared to someone who does not drink alcohol.
The recommended amount of alcohol for people aged 15 to 39 before risking health loss was 0.136 standard drinks per day (just over a tenth of a standard drink). This amount was slightly higher for women aged 15 to 39 at 0.273 drinks (about a quarter of a standard drink per day). A standard drink is defined as 10 grams of pure alcohol, which is equivalent to a small glass of red wine (100 ml or 3.4 fluid ounces) at 13% alcohol by volume, a can or a bottle of beer ( 375 ml or 12 fluid ounces) at 3.5% alcohol by volume, or one glass of whiskey or other spirits (30 ml or 1.0 fluid ounces) at 40% alcohol by volume.
The analysis also suggests that for adults aged 40 and over without any underlying health conditions, drinking a small amount of alcohol may provide some benefits, such as reduced risk of ischemic heart disease, d stroke and diabetes. In general, for people aged 40 to 64 in 2020, safe levels of alcohol consumption ranged from around half a standard drink per day (0.527 drinks for men and 0.562 standard drinks per day for women ) to nearly two standard drinks (1.69 standard drinks per day for men and 1.82 for women). For people over the age of 65 in 2020, the risks of alcohol-related health loss were reached after consuming just over three standard drinks per day (3.19 drinks for men and 3. 51 for women). Estimates suggest that small amounts of alcohol in populations over 40 without underlying conditions may be associated with better health outcomes, particularly in populations that primarily face a higher burden of cardiovascular disease .
The distribution of disease burden for a given age group varied greatly across regions, leading to variations in alcohol-related risks, particularly among people aged 40 years. and more. For example, among people aged 55-59 in North Africa and the Middle East, 30.7% of alcohol-related health risks were due to cardiovascular disease, 12.6% were due to cancers and less than 1% were due to tuberculosis. In contrast, in this same age group in central sub-Saharan Africa, 20% of alcohol-related health risks were due to cardiovascular diseases, 9.8% to cancers and 10.1% to tuberculosis. As a result, drinking levels for this age group before risking health loss were 0.876 drinks (or almost one standard drink per day) in North Africa and the Middle East and 0.596 drinks (approximately half a standard glass a day) in central sub-Saharan Africa. Africa.
Overall, recommended alcohol consumption for adults remained low, between 0 and 1.87 standard drinks per day, regardless of geography, age, gender or year.
“Even if a cautious approach is taken and the lowest level of safe drinking is used to set policy recommendations, this implies that the recommended level of alcohol consumption is still too high for younger populations. Our estimates, based on currently available evidence, supports guidelines that differ by age and region Understanding variation in the level of alcohol consumption that minimizes the risk of health loss for populations can help establish effective drinking guidelines , to support alcohol control policies, to track progress in reducing harmful alcohol consumption, and to design the public health message of risk,” says lead author Dana Briazka, researcher at IHME .
Young men most at risk of harmful alcohol use
Using these estimates, the proportion of the population consuming alcohol in amounts exceeding these thresholds by location, age, gender, and year was also calculated, serving as a guide for targeting alcohol control efforts.
Of those consuming harmful amounts of alcohol in 2020, 59.1% were aged 15-39 and 76.7% were men, with 1.03 billion men and 0.312 billion women drinking harmful amounts of alcohol. Harmful use of alcohol was particularly concentrated among young men in Australasia, Western Europe and Central Europe.
“Although the risks associated with alcohol consumption are similar for men and women, young men stand out as the group with the highest level of harmful alcohol consumption. Indeed, a greater proportion of men compared to women consume alcohol and their average level of consumption is also significantly higher,” says Dr. Gakidou.
The authors acknowledge some limitations to this article, including the fact that drinking habits were not examined. Therefore, this study did not distinguish between people who rarely drink heavy episodic alcohol and those who drink the same amount of alcohol over multiple days. Alcohol consumption was also self-reported, which could have introduced bias, and the study could not include data on consumption during the COVID-19 pandemic due to pandemic-related delays in reporting. routine data collection, which could also have affected these estimates.
Writing in a linked comment, Robyn Burton and Nick Sheron of King’s College London (who were not involved in the study) say: “These results apparently contradict a previous GBD estimate published in The Lancet, which pointed out that any consumption of alcohol, regardless of the amount, leads to health loss in populations. There are three main differences between the two GBD publications. First, the more recent study uses data from 2020 instead of 2016. Second, the relative risk curves for five alcohol-related outcomes have been updated.However, none of these changes caused the differences in results.Instead, the differences are due to the new method weighting of relative risk curves by levels of underlying disease, alongside the calculation of more disaggregated estimates by sex, age and geographic region. All-cause mortality varies from group to group, which changes the proportional risk of alcohol on mortality. In the latter analysis, injuries accounted for most alcohol-related harm in younger age groups. This led to a minimum risk level of zero, or very close to zero, among individuals aged 15-39 in all geographic regions. This level is lower than the level estimated for the elderly, due to a shift in the burden of alcohol-related diseases towards cardiovascular diseases and cancers. This highlights the need to consider existing disease rates in a population when trying to determine the total harm posed by alcohol.”
GBD 2020 Alcohol Collaborators., (2022) Population-level risks of alcohol consumption by amount, geography, age, sex and year: a systematic review for the Global Burden of Disease Study 2020. The Lancet. doi.org/10.1016/S0140-6736(22)00847-9.