How much is it safe to drink?
It used to be said that to have an alcohol problem you needed to drink more than your doctor. Perhaps that’s not such bad guidance, if recent evidence from Health Statistics Quarterly is to be believed (see National Statistics Online). Apparently doctors die less often from alcohol related causes then the general population, although this may be more to do with doctors changing their drinking habits.
In a week that has seen the UK Government attack the drinking habits of middle class residents of leafy suburbs near London, this is news indeed. Apparently the decision taken back in 1987 to recommend maximum weekly alcohol intakes for men (21 units) and women (14) was based on back of the envelope guesses (at least according to The Times Newspaper) and not based on hard evidence.
More confusing is that one unit in the UK equals 125ml at 8% ABV (alcohol by volume) or 8 grams of ethanol, but in the US one unit equals 14G of ethanol, and in France 12G! American advice states an upper weekly limit of 14 units (men) and 7 units (women). Evidence from Mukamal’s team at Harvard suggests a maximum benefit from 14 drinks per week, at least if you are aged 65 and over in Boston Massachusetts (see my Wine Diet review). So may be 14x14G per week is the answer, at least for men, although some countries (e.g. Canada) make no distinction between male and female in these matters.
The great Oxford epidemiologist Sir Richard Doll studied 12,000 middle-aged, male UK doctors and reported in 1993 that the lowest mortality rates, lower even than for teetotallers, were among those drinking between 20 and 30 (UK) units of alcohol each week. Indeed, the level of drinking needed to produce the same risk of death as a total abstainer was 63 units a week, or roughly a bottle of wine per day.
The World Health Organisation (WHO) had a go at advice in 2000, with its International Guide for Monitoring Alcohol Consumption and Related Harm. Here various risk options were laid out, from low, via medium and high, to chronic alcohol-related harm. Low risk for men was less than 35 units per week, and for women less than 17.5 i.e. half the amount, presumably related to a perceived metabolic sex difference.
So what to advise? As Sir Richard was my Regius Professor, died at the age of 92, and was one of the first to link smoking and lung cancer, he ought to have my vote. But as my local liver specialist colleague, Dr Chris Record told The Times today, “what we do know is the more you drink, the greater the risk. The trouble is we all have different genes. Some people can drink considerably more than [the limits] and they won’t get into trouble.” I think I’ll stick to my 20-30 units, at least for the present. And my female friends can go up to 17.5 units per week, unless they wish to upset the WHO by going for a touch more.
I am grateful for Andrew Norfolk’s article in The Times Newspaper of October 20, 2007 for flagging up this issue.
It used to be said that to have an alcohol problem you needed to drink more than your doctor. Perhaps that’s not such bad guidance, if recent evidence from Health Statistics Quarterly is to be believed (see National Statistics Online). Apparently doctors die less often from alcohol related causes then the general population, although this may be more to do with doctors changing their drinking habits.
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Are current guidelines on drink limits 'useless'?
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More confusing is that one unit in the UK equals 125ml at 8% ABV (alcohol by volume) or 8 grams of ethanol, but in the US one unit equals 14G of ethanol, and in France 12G! American advice states an upper weekly limit of 14 units (men) and 7 units (women). Evidence from Mukamal’s team at Harvard suggests a maximum benefit from 14 drinks per week, at least if you are aged 65 and over in Boston Massachusetts (see my Wine Diet review). So may be 14x14G per week is the answer, at least for men, although some countries (e.g. Canada) make no distinction between male and female in these matters.
The great Oxford epidemiologist Sir Richard Doll studied 12,000 middle-aged, male UK doctors and reported in 1993 that the lowest mortality rates, lower even than for teetotallers, were among those drinking between 20 and 30 (UK) units of alcohol each week. Indeed, the level of drinking needed to produce the same risk of death as a total abstainer was 63 units a week, or roughly a bottle of wine per day.
The World Health Organisation (WHO) had a go at advice in 2000, with its International Guide for Monitoring Alcohol Consumption and Related Harm. Here various risk options were laid out, from low, via medium and high, to chronic alcohol-related harm. Low risk for men was less than 35 units per week, and for women less than 17.5 i.e. half the amount, presumably related to a perceived metabolic sex difference.
So what to advise? As Sir Richard was my Regius Professor, died at the age of 92, and was one of the first to link smoking and lung cancer, he ought to have my vote. But as my local liver specialist colleague, Dr Chris Record told The Times today, “what we do know is the more you drink, the greater the risk. The trouble is we all have different genes. Some people can drink considerably more than [the limits] and they won’t get into trouble.” I think I’ll stick to my 20-30 units, at least for the present. And my female friends can go up to 17.5 units per week, unless they wish to upset the WHO by going for a touch more.
I am grateful for Andrew Norfolk’s article in The Times Newspaper of October 20, 2007 for flagging up this issue.