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Recommended maximum intake of alcoholic beverages

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Alcohol psychology
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Alcohol use
Alcohol abuse
Alcohol consumption and health
Treatment of alcohol problems

This article summarizes the recommended maximum intake (or 'safe limits') of alcohol as recommended by the health agencies of various governments. These recommendations are highly varied, reflecting the fact that they tend to be more political than scientific in nature. The recommendations are distinct from legal restrictions that may apply in those countries. Therefore, consumers need not follow the recommendations of the country in which they happen to live and are free to choose those of another country.

Guidelines are general in nature Edit

The guidelines are general guidelines applying to a 'typical' person. Those who are larger than average may be able to consume more. However, there are some people who should not consume alcohol, or limit their use to less than guideline amounts. These are:

  • "People with chronic hepatitis C (or other forms of chronic hepatitis infection) who drink heavily [and exceed maximum recommended consumption levels] have poorer health outcomes than those who drink less." That is, they have poorer health outcomes than do those who drink within the guidelines. [1][2]
  • Thin people - those below average body weight (60kg for men, 50kg for women)[3]
  • People with a relative who has, or has had, a problem with alcohol. First-degree relatives are parents, siblings and second-degree relatives are grandparents, uncles, aunts, cousins. ([1], p10) These individuals "are urged to be careful about how much they drink."
  • People with a mental health problem (including anxiety or depression) and/or sleep disturbance ([1], p11)[2] Individuals with a mental health problem "should take particular care to stay within the levels set in Guideline 1" (i.e. not drinking more than six standard drinks in any one day for a man and four in any one day for a woman). However, drinking alcohol in moderation can be very useful in reducing anxiety. [4]
  • People taking medications or other drugs, if contraindicated [1], p12) "Numerous classes of prescription medications can interact with alcohol, including antibiotics, antidepressants, antihistamines, barbiturates, benzodiazepines, histamine H2 receptor antagonists, muscle relaxants, nonnarcotic pain medications and anti-inflammatory agents, opioids, and warfarin. In addition, many over-the-counter and herbal medications can cause negative effects when taken with alcohol."[5] Others include analgesics, aspirin, insulin, and oral contraceptives. "The list of medications that may interact with alcohol is so long that you should always consult a pharmacist or physician before drinking while using any medicine."[6]
  • Older people because their bodies may be less able to handle the effects of alcohol([1], p13) Older people are urged "to consider drinking less than the levels set in Guideline1" (i.e., no more than six drinks in any one day for a man or no more than four in any one day for a woman). However, moderate drinking reduces such diseases associated with advanced age as osteoporosis, [7], Alzheimer’s disease, [8] other forms of dementia [9] the major cause of blindness in old age, macular degeneration, [10] and is associated with longevity [11]
  • Young adults (aged about 18–25 years) ([1], p6 & p14)are "urged not to drink beyond the levels set in Guideline 1" (i.e., no more than 6 standard drinks in any one day for a man or 4 in any one day for a woman).
  • Young people (up to about 18 years) ([1], p15))"should not drink to become intoxicated."
  • People who are or have been dependent on other drugs[3]
  • People who have a poor diet, or are under-nourished[3] However, alcohol may be useful to stimulate their appetite.
  • People who have a family history of cancer or other risk factors for cancer[2] However, alcohol can reduce the risk of Hodgkin’s lymphoma, [12] kidney cancer, [13] and non-Hodgkin’s lymphoma. [14] In addition, alcohol is not a risk factor for adenoid cancer, adrenal gland cancer, adult leukemia, anal cancer, appendix cancer, bile duct cancer, bladder cancer, bone cancer, brain cancer, central nervous system cancer (craniopharyngioma), cervical cancer, Ewing's family of tumors, extragonal germ cell cancer, extrahepatic bile duct cancer, eye cancer, Fallopian tube cancer, Kaposi's sarcoma, liver cancer, lung cancer, malignant melanoma, malignant mesothelioma, nasal cavity and paranasal sinus cancer, ovarian cancer, pancreatic cancer, penile cancer, pituitary gland cancer, pleuropulmonary blastoma, prostate cancer, salivary gland cancer, skin cancer, soft tissue cancers, spinal cancer, testicular cancer, thymus cancer, transitional cell cancer of renal pelvis and ureter, urethral cancer or vaginal cancer.
  • People who are told not to drink for legal, medical or other reasons[2]
  • "People who choose not to drink alcohol should not be urged to drink to gain any potential health benefit, and should be supported in their decision not to drink. … Non-drinkers can use other strategies, such as regular exercise, giving up smoking, and a healthy diet, to gain protection against heart disease."([1], p17)

The standard guidelines may be too high when:

  • undertaking activities that involve risk or a degree of skill such as flying, scuba diving, water sports, ski-ing, using complex or heavy machinery or farm machinery, and driving([1], p7)[3][2]
  • suffering an acute or chronic physical disease such as heart and lung disease, influenza, diabetes, epilepsy or acute infections[3]
  • recovering from an accident, injury or operation[3]
  • drinking regularly to relieve stress or get to sleep.[3]
  • responsible for the safety of others at work or at home[2]

A physician can provide additional information.

Units and standard drinks Edit

Countries express alcohol intake in 'units' or 'standard drinks' when recommending alcohol intake. In ascending order of unit size:

  • United Kingdom: A 'unit' is 8g or 10 millilitres of alcohol. A unit is roughly equivalent to half a pint of ordinary strength beer, lager, or cider (3–4% alcohol by volume), or a small pub measure (25 ml) of spirits (40% alcohol by volume), or a standard pub measure (50 ml) of fortified wine such as sherry or port (20% alcohol by volume).[15][16]
  • Iceland: 9.5g[17]
  • Netherlands: A standard drink is 9.9g.[16]
  • Australia, Austria, Ireland, Italy, New Zealand, Poland, Spain[18][17][19],: A standard drink is 10g / 13 millilitres of alcohol. So in these countries, a standard drink is 30ml of straight spirits, a 330ml can of beer, or a 100ml glass of table wine. To calculate standard drinks, use the following formula: Volume of container (litres) x % alcohol by volume (mL/100mL) x 0.789 = The number of standard drinks[20][16]
  • Finland: A standard drink is 11g.[21]
  • Switzerland: A standard drink is 10–12g.
  • Denmark, France, South Africa: A standard drink is 12g.
  • Canada: A standard drink is 13.6g alcohol. Examples of standard drinks are: 5 oz/142 mL of wine (12% alcohol), 1.5 oz/43 mL of spirits (40% alcohol), 12 oz/341 mL of regular strength beer (5% alcohol).[2]
  • Portugal, United States: A standard drink is 14g / 18 millilitres / 0.5 ounces of alcohol.[21]
  • Hungary: 17g[17]
  • Japan: A standard drink is 19.75g / 25 millilitres of alcohol.
  • Hong Kong: 1 unit is a glass of wine or a pint of beer

Men Edit

The standard drink size is given in brackets.

Daily maximum drinks (no weekly limits recommended)Edit

  • Austria: 24g
  • Czech Republic 24g
  • Italy: 40g (30g for the elderly)[17]
  • Japan 1–2 (@19.75g = 19.75–39.5g)
  • Netherlands: 3 (@9.9g = 29.7g)
  • Portugal 37g[21]
  • Spain: 3 (@10g = 30g) Also suggests a maximum of no more than twice this on any one occasion.[21]
  • Sweden: 20g
  • Switzerland: 2 (@10–12g = 20–24g)[22]

Therefore, these countries recommend limits for men in the range 20–40g per day.

Daily/weekly maximum drinksEdit

These countries recommend a weekly limit, but your intake on a particular day may be higher than one-seventh of the weekly amount.

  • Australia: 6/day; 28/week (@10g = 60g/day, 280g/week) Recommends one or two alcohol-free days per week.[23]
  • Canada: 2/day; 14/week (@13.6g = 27.2g/day, 190g/week)[2][24]
  • Hong Kong: 3–4/day; 21/week (glass of wine or a pint of beer)
  • New Zealand: 3/day; 21/week (@10g = 30g/day, 210g/week)[19]
  • UK: 3–4/day; 21/week (@8g = 24–32g day, 168g/week)
  • USA: 4/day; 14/week (@14g = 56g/day, 196g/week)[22]

Therefore, these countries recommend limits for men in the range 24–60g per day and 168–280g per week.

Weekly maximum drinksEdit

  • Denmark: 252g[21]
  • Finland: 15 units (@11g = 165g/week)[21]
  • Ireland: 21 units (@10g = 210g/week)

Women who are neither pregnant nor breastfeeding Edit

Women trying to become pregnant should look at the guidelines for pregnant women given in the next section.

Daily maximum drinks (no weekly limits recommended)Edit

  • Austria: 16g
  • Czech Republic 16g
  • Italy: 30g (25g for elderly women)[17]
  • Netherlands: 2 (@9.9g = 19.8g)
  • Portugal 18.5g[21]
  • Spain: 2 (@10g = 20g) Also suggests a maximum of no more than twice this on any one occasion.[21]
  • Sweden: 20g
  • Switzerland: 2 (@10–12g = 20–24g)[22]

Therefore, these countries recommend limits for women in the range 12–30g per day.

Daily/weekly maximum drinksEdit

These countries recommend a weekly limit, but your intake on a particular day may be higher than one-seventh of the weekly amount.

  • Australia: 4/day; 14/week (@10g = 40g/day, 140g/week). Recommends one or two alcohol-free days per week.[23]
  • Canada: 2/day; 9/week (@13.6g = 27.2g/day, 122.4g/week)[2][24]
  • Hong Kong: 2–3/day; 14/week (glass of wine or a pint of beer)
  • New Zealand: 2/day; 14/week (@10g = 20g/day, 140g)[19]
  • UK: 2–3/day; 14/week (@8g = 16–24g/day, 112g/week)
  • USA: 3/day; 7/week (@14g = 42g/day, 98g/week)[22]

Therefore, these countries recommend limits for women in the range 16–42g per day and 98–140g per week.

Weekly maximum drinksEdit

  • Denmark 168g[21]
  • Finland: 10 units (@11g = 110g/week)[21]
  • Ireland: 14 units (@10g = 140g/week)

Pregnant women Edit

Drinking in pregnancy is the cause of Fetal alcohol syndrome (BE: foetal alcohol syndrome), especially in the first eight to twelve weeks of pregnancy. Therefore, advice for pregnant women is different to that for those who are not. As there may be some weeks between conception and confirmation of pregnancy, most countries recommend that women trying to become pregnant should follow the guidelines for pregnant women.

  • Australia: Consider abstinence but if choosing to drink, then limit intake to less than 7 standard drinks, and, on any one day, no more than 2 standard drinks (spread over at least two hours).([1], p16) (Australian standard drink = 10 grams or 13 millilitres of alcohol.)
  • Canada: "Don't drink if you are pregnant or planning to become pregnant."[2]
  • France: Total abstinence[22]
  • Iceland: Advise that pregnant women abstain from alcohol during pregnancy because no safe consumption level exists.[22]
  • Israel: Total abstinence[22]
  • The Netherlands: Abstinence[22]
  • Norway: Abstinence[22]
  • New Zealand: "There is no known safe level of alcohol consumption at any stage during pregnancy. Therefore, the Ministry recommends that, to be on the safe side, it is best that women avoid drinking alcohol at all during pregnancy."[25]
  • UK: Until 25 May 2007, the advice was to avoid more than 1–2 units once or twice a week (unit = 8 grams or 10 millilitres of alcohol). The advice was changed to total abstinence.[26][27][28]
  • US: Total abstinence during pregnancy and while planning to become pregnant[22]

Breastfeeding women Edit

"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."[29] "Alcohol clears from a mother's milk at the rate of around one unit [8g] every two hours. So try to avoid alcohol before breastfeeding, or plan ahead and express milk if you know you'll be drinking."[30] "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."[1]

  • Australia: "Women who are breastfeeding are advised not to exceed the levels of drinking recommended during pregnancy, and may consider not drinking at all."[1]
  • Iceland: Advise that women abstain from alcohol during breast feeding because no safe consumption level exists.
  • New Zealand: "The guidelines recommend women do not drink alcohol, smoke, or use non-prescription drugs unless prescribed during pregnancy and breastfeeding, as these can all affect the growth and development of the baby."[25]
  • United Kingdom: "The occasional drink - one to two units [8–16g] no more than once or twice a week - probably won't do any harm. Any more than this isn't good, as it can make the baby so sleepy that it won't take enough milk."[30]

See also Edit

References Edit

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 Australian Alcohol Guidelines: Health Risks and Benefits
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 Centre for Addiction and Mental Health / Centre de toxicomanie et de santé mentale Low-Risk Drinking Guidelines
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Alcohol Advisory Council of New Zealand (ALAC) Low Risk Drinking
  4. Baum-Baicker, C. The psychological benefits of moderate alcohol consumption: a review of the literature. Drug and Alcohol Dependence, 15, 1985. Kushner, M., et al. The effects of alcohol consumption on laboratory-induced panic and state anxiety. Archives of General Psychiatry, 1996, 53, 264-270. Lipton, R. I. The effect of moderate alcohol use on the relationship between stress and depression. American Journal of Public Health, 1994, 84(12), 1913-1917
  5. Ron Weathermon, Pharm.D., and David W. Crabb, M.D. Alcohol and Medication Interactions Alcohol Research & Health Vol. 23, No. 1, 1999 pp40–54
  6. Prevention Source BC Alcohol and Drug Interactions Winter 2000
  7. Ruitenberg, A., et al. Alcohol consumption and risk of dementia: the Rotterdam Study. Lancet, 2002, 359(9303), 281-286; Holbrook TL, Barrett-Connor E A prospective study of alcohol consumption and bone mineral density. British Medical Journal, 1993 Jun 5, 306(6891):1506-9
  8. Cupples, L., et al. Effects of smoking, alcohol and APO genotype on Alzheimer disease: the MIRAGE study. Alzheimer Report, 2000, 3, 105-114
  9. Espeland, M., et al. Association between alcohol intake and domain-specific cognitive function in older women. Neuroepidemiology, 2006, 1(27), 1-12; Rodgers, B., et al. Non-linear relationships between cognitive function and alcohol consumption in young, middle-aged and older adults: The PATH Through Life Project. Addiction, 2005, 100(9), 1280-1290; Anstey, K. J., et al. Lower cognitive test scores observed in alcohol are associated with demographic, personality, and biological factors: The PATH Through Life Project. Addiction, 2005, 100(9), 1291-1301; Stampfer, M.J., et al. Effects of moderate alcohol consumption on cognitive function in women. New England Journal of Medicine, 2005, 352, 245-253; Mulkamal, K.J., et al. Prospective study of alcohol consumption and risk of dementia in older adults. Journal of the American Medical Association, 2003 (March 19), 289, 1405-1413; Dufouil, C., et al. Sex differences in the association between alcohol consumption and cognitive performance. American Journal of Epidemiology, 1997, 146(5), 405-412; Eckardt MJ, File SE, Gessa GL, Grant KA, Guerri C, Hoffman PL, Kalant H, Koob GF, Li TK, Tabakoff B. Effects of moderate alcohol consumption on the central nervous system. Alcoholism: Clinical and Experimental Research, 1998, 22(5), 998-1040; Galanis, C., et al. A longitudinal study of drinking and cognitive performance in elderly Japanese American men: the Honolulu-Asia Aging Study. American Journal of Public Health, 2000, 90(8), 14-38
  10. Obisesan T.O., et al. Moderate wine consumption is associated with decreased odds of developing age-related macular degeneration in NHANES-1. J Am Geriatr Soc 1998;46:1–7; Ritter LL, Klein R, Klein BE, et al. Alcohol use and age-related maculopathy in the Beaver Dam Eye Study. American Journal of Ophthalmology, 1995, 120,190–6
  11. Maskarinec, G., et al. Alcohol intake, body weight, and mortality in a multiethnic prospective cohort. Epidemiology, 1998, 9(6), 654-661; Gaziano, J.M. et al., Light-to-moderate alcohol consumption and mortality in the Physicians' Health Study enrollment cohort. Journal of the American College of Cardiology, 35(1), 2000, 96-105; Farchi, G., et al. Alcohol and survival in the Italian rural cohorts of the Seven Countries Study. International Journal of Epidemiology, 2000, 29, 667-671; Highlights of the NIAAA position paper on moderate alcohol consumption. Press release from the journal, Alcoholism: Clinical & Experimental Research, 6-14-04; McCallum, J., et al. The Dubbo Study of the Health of the Elderly 1988-2002: An Epidemiological Study of Hospitaol and Residential Care. Sydney, NSW, Australia: The Australian Health Policy Institute, 2003
  12. Gorini, G; E Stagnaro, V Fontana, L Miligi, V Ramazzotti, D Amadori, S Rodella, R Tumino, P Crosignani, C Vindigni, A Fontana, P Vineis, and A Seniori Costantini. Alcohol consumption and risk of Hodgkin's lymphoma and multiple myeloma: a multicentre case–control study. Annals of Oncology, 2007,18 (1), 143-148
  13. Lee, J. E. et al. Alcohol intake and renal cell cancer in a pooled analysis of 12 prospective studies. Journal of the National Cancer Institute, 2007, 99, 811-822; Rashidkhani, B., Åkesson, A., Lindblad, P, and Wolk, A. Alcohol consumption and risk of renal cell carcinoma: A prospective study of Swedish women. International Journal of Cancer, 2005 (December 10), 117(5), 848–853; Alexander S. Parker, James R. Cerhan, Charles F. Lynch, Abby G. Ershow and Kenneth P. Cantor Gender, Alcohol Consumption, and Renal Cell Carcinoma. American Journal of Epidemiology 155(5), 455-462
  14. Morton, L., et al. Alcohol consumption and risk of non-Hodgkin lymphoma: A pooled analysis Lancet Oncology, June 8, 2005
  15. PRODIGY Knowledge (Department of Health) Alcohol and Sensible Drinking
  16. 16.0 16.1 16.2 Key Facts and Issues International Center for Alcohol Policies (ICAP)
  17. 17.0 17.1 17.2 17.3 17.4 Worldwide Recommendations on Alcohol Consumption
  18. Department of Health and Ageing The Australian Standard Drink
  19. 19.0 19.1 19.2 Alcohol Advisory Council of New Zealand (ALAC) What's in a Standard Drink
  20. New Zealand Food Safety Authority (NZFSA) / Te Pou Oranga Kai O Aotearoa What's on a Food Label? Alcoholic Beverages and Foods
  21. 21.0 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 Drinking and You Drinking guidelines - units of alcohol
  22. 22.0 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 ICAP International Drinking Guidelines
  23. 23.0 23.1 Department of Health and Ageing Australian Alcohol Guidelines in Summary
  24. 24.0 24.1 Low-Risk Drinking Guidelines (LRDG) (goes live September 2006)
  25. 25.0 25.1 New Zealand Ministry of Health Manatū Hauora Ministry releases revised food and nutrition guidelines for pregnancy and breastfeeding
  26. Department of Health Updated alcohol advice for pregnant women
  27. BBC 'No alcohol in pregnancy' advised 25 May 2007
  28. Rosemary Bennett Zero – the new alcohol limit in pregnancy The Times 25 May 2007
  29. Alcohol and pregnancy
  30. 30.0 30.1 Is it advisable to drink while you're pregnant?

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