Small amounts of alcohol ‘might bring health benefits to the over 40s’

If you are 40 or older without underlying health conditions, however, the research found that small amounts of alcohol might reduce the risk of cardiovascular disease, stroke and diabetes.

This is the first study to report alcohol risk by geographical region, age, sex, and year. It suggests that global alcohol consumption recommendations should be based on age and location, with the strictest guidelines targeted toward males between ages 15-39, who are at the greatest risk of harmful alcohol consumption worldwide.

The research also indicates that adults aged 40 and older without underlying health conditions may see some benefits from small alcohol consumption (between one and two standard drinks per day), including a reduced risk in cardiovascular disease, stroke, and diabetes.

Using estimates of alcohol use in 204 countries, researchers calculated that 1.34 billion people consumed harmful amounts in 2020. In every region, the largest segment of the population drinking unsafe amounts of alcohol were males aged 15-39 and for this age group, drinking alcohol does not provide any health benefits and presents many health risks, with 60% of alcohol-related injuries occurring among people in this age group, including motor vehicle accidents, suicides, and homicides.

“Our message is simple: young people should not drink, but older people may benefit from drinking small amounts. While it may not be realistic to think young adults will abstain from drinking, we do think it’s important to communicate the latest evidence so that everyone can make informed decisions about their health,”​ said senior author Dr Emmanuela Gakidou, Professor of Health Metrics Sciences at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine.

The authors called for alcohol consumption guidelines to be revised to emphasise consumption levels by age, stressing that the level of alcohol consumption recommended by many existing guidelines is too high for young people in all regions. They also called for policies targeting males under age 40, who are most likely to use alcohol harmfully.

Writing in a linked Comment, Robyn Burton and Nick Sheron of King’s College London (who were not involved in the study) said: “Across most geographical regions in this latest 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 years across all geographical regions. This is lower than the level estimated for older adults, due to a shift in alcohol-related disease burden towards cardiovascular disease and cancers. This highlights the need to consider existing rates of disease in a population when trying to determine the total harm posed by alcohol.”​

The findings contradict a previous estimate published in The Lancet, which stressed that any alcohol use, regardless of amount, leads to health loss across populations.

Gakidou said this was down to the novel method of weighting relative risk curves according to levels of underlying disease, alongside the calculation of more disaggregated estimates by sex, age, and geographical region. “The causes that contribute to all-cause mortality vary across groups, and this changes the proportional risk of alcohol on mortality,” she explained.

Reference

THE LANCET: Alcohol consumption carries significant health risks and no benefits for young people; some older adults may benefit from drinking a small amount of alcohol​

FUNDER

Bill and Melinda Gates Foundation

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00847-9/fulltext