August 23, 2018

expert reaction to systematic analysis of the health impacts of alcohol

Researchers, publishing in The Lancet, looked at the health impact of consuming alcohol through a systematic analysis of worldwide studies.

Dr Tony Rao, Visiting Researcher at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London, said:

“The relationship between alcohol consumption and health is complex but the study has successfully overcome many of the problems in interpreting this relationship that were present in previous studies. We can now be more confident that there is no safe limit for alcohol when considering overall health risks.

“The finding of a 7 percent higher risk of developing any of the 23 alcohol-related disorders for people drinking an average of 17.5 units of alcohol per week compared with non-drinkers now challenges current U.K. guidance for lower risk drinking, which recommends no more than 14 units per week. This may well be an underestimate in people aged 50 and over, as the study did not include mental disorders such as alcohol related dementia.”

Prof David Spiegelhalter, Winton Professor for the Public Understanding of Risk at the University of Cambridge, said:

“According to data provided by the authors but not published in the paper, to suffer one extra alcohol-related health problem, around 1,600 people would need to drink two drinks totalling 20g (2.5 units) of alcohol a day for a year.  This is equivalent to around 32 standard 70cl bottles of gin over a year, so a total of 50,000 bottles of gin among these 1,600 people is associated with one extra health problem. This indicates a very low level of harm in moderate drinkers, and suggests UK guidelines of an average of 16g a day (2 units) are very low-risk indeed.

“Given the pleasure presumably associated with moderate drinking, claiming there is no ‘safe’ level does not seem an argument for abstention. There is no safe level of driving, but government do not recommend that people avoid driving.  Come to think of it, there is no safe level of living, but nobody would recommend abstention.”

Prof Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said:

“While there may be a slight benefit to heart and circulatory health from modest drinking, many studies have shown that the overall health risks of drinking alcohol outweigh any benefits.

“This study confirms that drinking more than the recommended limits of alcohol increases your risk of suffering from heart and circulatory conditions, particularly hypertension and stroke, which are major contributors to death rates worldwide. If more of us stuck to the UK drinking guidelines, we would take a big step in the right direction to reduce the scale of deaths caused by alcohol.”

* ‘Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016’ by the GBD 2016 Alcohol Collaborators was published in The Lancet on Thursday 23 August 2018.

Declared interests

Dr Tony Rao: “No conflict of interest to declare other than receiving a fee for speaking on alcohol misuse in older people at a Pharma sponsored educational event, but which did not contain any reference to the drug manufactured by that company.”