The World Health Organization published a statement in The Lancet Public Health in April 2023 that "there is no safe amount that does not affect health"'.[2]
The World Heart Federation (recognized by the World Health Organization as its leading NGO partner) (2022) recommends against any alcohol intake for optimal heart health.[3][4]
The 2023 Nordic Nutrition Recommendations state "Since no safe limit for alcohol consumption can be provided, the recommendation in NNR2023 is that everyone should avoid drinking alcohol."[5]
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.
"Not drinking has benefits, such as better health, and better sleep."[11]
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".[11]
At least two alcohol-free days every week. 30 g for men, 20 g for women To reduce long-term health risks[21] 50 g for men, 40 g for women On any single occasion, to reduce risk of injury.[21]
Also suggests a maximum of no more than twice this on any one occasion.[23]
Sweden
"Not possible to specify a limit for risk-free alcohol consumption."[24]
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.[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][27] most guidelines state that no safe amount of alcohol consumption has been established and recommend that pregnant women abstain entirely from alcohol.[28][29] 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.
Australia: Total abstinence during pregnancy and if planning a pregnancy[30][31]
Canada: "Don't drink if you are pregnant or planning to become pregnant."[32]
"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."[40] "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."[41] "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."[42]
Hong Kong: "Avoid alcohol and alcoholic drinks."[43]
Iceland: Total abstinence advised because no safe consumption level exists.
New Zealand: Abstinence recommended, especially in the first month of breastfeeding so that sound breastfeeding patterns can be established.[35]
United Kingdom: Total abstinence advised by some, such as the Royal College of Midwives; others advise to limit alcohol to occasional use in small amounts not exceeding the recommended maximums for non-breastfeeding woman as this is known to cause harm, and that daily or binge drinking be avoided.[41]
Countries have different recommendations concerning the administration of alcohol to minors by adults.
United Kingdom: Children aged under 15 should never be given alcohol, even in small quantities. Children aged 15–17 should not be given alcohol on more than one day a week – and then only under supervision from carers or parents.[44][45][46]
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.[47]
USA: The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines the term "binge drinking" as a pattern of drinking that brings a person's blood alcohol concentration (BAC) to 0.08 percent or above.[48] Whatever the numerical definition used, heavy drinking or rapid consumption over a short period of time with the intention of becoming intoxicated is often implied when the term is used colloquially, since four or five drinks consumed over the course of a whole day and as an accompaniment to meals will not have the same effects as the same amount consumed over a couple of hours on an empty stomach.[49]
Get Your Sexy Back: A recurring message of the campaign is that consuming 5 or more units of alcohol (70 g pure ethanol) at a single sitting constitutes binge drinking.[50]
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,[51] 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.[42][52][53]
Moreover, studies suggest even moderate alcohol consumption may significantly impair – neurobiologically beneficial and -demanding – exercise (possibly including the recovery and adaptation).[54][55][56][57]
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[58][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.[59] However, few studies or guidelines distinguish between or compare "moderate consumption" patterns (i.e. frequency, timing and dosage/intensity[60] 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.[61]
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.[59] 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".[62]
In 2023, the World Health Organization (WHO) stated that there is currently no conclusive evidence from studies that the potential benefits of moderate alcohol consumption for cardiovascular disease and type 2 diabetes outweigh the increased cancer risk associated with these drinking levels for individual consumers.[63]
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.[20][64] 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.[65]
^Mechanick, Jeffrey I.; Kushner, Robert F. (21 April 2016). Lifestyle Medicine: A Manual for Clinical Practice. Springer Science. p. 153. ISBN978-3-319-24687-1. 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.
^Deedwania, Prakash (12 January 2015). "Alcohol and Heart Health". American Heart Association (AHA). Archived from the original on 21 January 2016. Retrieved 4 August 2016.
^Barnes, Matthew. J.; Mündel, Toby; Stannard, Stephen. R. (1 January 2010). "Acute alcohol consumption aggravates the decline in muscle performance following strenuous eccentric exercise". Journal of Science and Medicine in Sport. 13 (1): 189–193. doi:10.1016/j.jsams.2008.12.627. ISSN1440-2440. PMID19230764.