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This article summarizes the recommended maximum intake (or 'safe limits') of alcohol as recommended by the health agencies of various governments. These recommendations are varied, reflecting scientific uncertainty. The recommendations are distinct from legal restrictions that may apply in those countries.

Caveats

The guidelines are general guidelines applying to a 'typical' person. 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 (60 kg for men, 50 kg for women)[3]
  • People with a relative who has, or has had, a problem with alcohol. First-degree relatives are parents and siblings; second-degree relatives are grandparents, uncles, aunts, and 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., for men an average of no more than 4 standard drinks a day. For women, an average of no more than 2 standard drinks a day.]
  • 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."[4] 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."[5]
  • 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 Guideline 1" [i.e., for men an average of no more than 4 standard drinks a day. For women, an average of no more than 2 standard drinks a day]
  • Young adults (aged about 18–25 years) ([1], p6 & p14)are "urged not to drink beyond the levels set in Guideline 1" [i.e., for men an average of no more than 2 standard drinks a day. For women, an average of no more than 2 standard drinks a day].
  • 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]
  • People who have a family history of cancer or other risk factors for cancer[2] (see Alcohol and cancer for details of how alcohol affects the risk of various cancers)
  • 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)[2][3]
  • 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]
  • taking sleeping pills or tranquillisers, anti-depressants or narcotics[3]
  • responsible for the safety of others at work or at home[2]

Units and standard drinks

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

  • Austria: 6g[6]
  • United Kingdom: A Unit of alcohol 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).[7][8]
  • Iceland: 9.5g[9]
  • Netherlands: A standard drink is 9.9g.[8]
  • Australia[10], Ireland, Italy, New Zealand[9][11], Poland, Spain: A standard drink is 10g / 12.7 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[8][12]
  • Finland: A standard drink is 11g.[13]
  • 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 / 0.6 fluid ounces of pure alcohol.[13]
  • Hungary: 17g[9]
  • Japan: A standard drink is 19.75g / 25 millilitres of alcohol.
  • Hong Kong: 1 unit is roughly a glass of wine, a can of beer or half a pint of beer[citation needed]

Men

The standard drink size is given in brackets.

Daily maximum drinks (no weekly limits recommended)

  • Australia: 2/day; 14/week (@10g = 20g/day, 140g/week)[14][15] (New guidelines were adopted on 6 March 2009.[16])
  • Austria: 24g
  • Czech Republic: 24g
  • Italy: 40g (30g for the elderly)[9]
  • Japan: 1–2 (@19.75g = 19.75–39.5g)
  • Netherlands: 3 (@9.9g = 29.7g)
  • Portugal: 37g[13]
  • Spain: 3 (@10g = 30g) Also suggests a maximum of no more than twice this on any one occasion.[13]
  • Sweden: 20g
  • Switzerland:2 (@10–12g = 20–24g)[17]

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

Daily/weekly maximum drinks

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

  • Canada: 2/day; 14/week (@13.6g = 27.2g/day, 190g/week)[2][18]
  • 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)[11]
  • UK: 3–4/day; 21/week (@8g = 24–32g day, 168g/week)
  • USA: 1-2 units/day (14–28g/day), not to exceed 14 units/week (196g/week)[17]

Therefore, these countries recommend limits for men in the range 27.2–32g per day and 168–210g per week.

Weekly maximum drinks

  • Denmark: 252g[13]
  • Finland: 15 units (@11g = 165g/week)[13]
  • Ireland: 21 units (@10g = 210g/week)

Women who are neither pregnant nor breastfeeding

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)

  • Australia: 2/day; 14/week (@10g = 20g/day, 140g/week)[14][15] (New guidelines were adopted on 6 March 2009.[16])
  • Austria: 16g
  • Czech Republic: 16g
  • Italy: 30g (25g for elderly women)[9]
  • Netherlands: 2 (@9.9g = 19.8g)
  • Portugal: 18.5g[13]
  • Spain: 2 (@10g = 20g) Also suggests a maximum of no more than twice this on any one occasion.[13]
  • Sweden: 20g
  • Switzerland: 2 (@10–12g = 20–24g)[17]

Therefore, these countries recommend limits for women in the range 16–30g per day.

Daily/weekly maximum drinks

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

  • Canada: 2/day; 9/week (@13.6g = 27.2g/day, 122.4g/week)[2][18]
  • 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/week)[11]
  • UK: 2–3/day; 14/week (@8g = 16–24g/day, 112g/week)
  • USA: 1/day; 7/week (@14g = 14g/day, 98g/week)[17]

Therefore, these countries recommend limits for women in the range 14–27.2g per day and 98–140g per week.

Weekly maximum drinks

  • Denmark 168g[13]
  • Finland: 10 units (@11g = 110g/week)[13]
  • Ireland: 14 units (@10g = 140g/week)

Pregnant women

Excessive 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 from those who are not. It is not known where there is a safe minimum amount of alcohol consumption, although low levels of drinking are not known to be harmful.[19][20] 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: Total abstinence during pregnancy and if planning a pregnancy[14][15] (New guidelines were adopted on 6 March 2009).[16]
  • Canada: "Don't drink if you are pregnant or planning to become pregnant."[2]
  • France: Total abstinence[17]
  • Iceland: Advise that pregnant women abstain from alcohol during pregnancy because no safe consumption level exists.[17]
  • Israel: Total abstinence[17]
  • The Netherlands: Abstinence[17]
  • Norway: Abstinence[17]
  • 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."[21]
  • UK: Avoid alcohol for first 3 months of pregnancy.[22][23][20][24] NICE guidelines issued in March 2007 state, "If you are pregnant or planning to become pregnant, you should try to avoid alcohol completely in the first 3 months of pregnancy because there may be an increased risk of miscarriage. If you choose to drink while you are pregnant, you should drink no more than 1 or 2 UK units of alcohol once or twice a week. There is uncertainty about how much alcohol is safe to drink in pregnancy, but at this low level there is no evidence of any harm to the unborn baby. You should not get drunk or binge drink (drinking more than 7.5 UK units of alcohol on a single occasion) while you are pregnant because this can harm your unborn baby."[19]
  • US: Total abstinence during pregnancy and while planning to become pregnant[25]

In short, all countries listed above, with the exception of the UK, recommend that pregnant women abstain from alcohol consumption.

Breastfeeding women

"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."[26] "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."[27] "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: Total abstinence[14][15] (New guidelines were adopted on 6 March 2009.[16]
  • 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."[21]
  • 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."[27]

Minors

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.[28][29][30]

See also

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 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. Ron Weathermon, Pharm.D., and David W. Crabb, M.D. Alcohol and Medication Interactions Alcohol Research & Health Vol. 23, No. 1, 1999 pp40–54
  5. Prevention Source BC Alcohol and Drug Interactions Winter 2000
  6. ICAP What Is a “Standard Drink”? September 1998
  7. PRODIGY Knowledge (Department of Health) Alcohol and Sensible Drinking
  8. 8.0 8.1 8.2 Key Facts and Issues International Center for Alcohol Policies (ICAP)
  9. 9.0 9.1 9.2 9.3 9.4 Worldwide Recommendations on Alcohol Consumption
  10. Department of Health and Ageing The Australian Standard Drink
  11. 11.0 11.1 11.2 Alcohol Advisory Council of New Zealand (ALAC) What's in a Standard Drink
  12. New Zealand Food Safety Authority (NZFSA) / Te Pou Oranga Kai O Aotearoa What's on a Food Label? Alcoholic Beverages and Foods
  13. 13.0 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 Drinking and You Drinking guidelines - units of alcohol
  14. 14.0 14.1 14.2 14.3 National Health and Medical Research Council 2009 Australian Guidelines to Reduce Health Risks from Drinking Alcohol
  15. 15.0 15.1 15.2 15.3 National Health and Medical Research Council 2009 Australian Guidelines to Reduce Health Risks from Drinking Alcohol: Frequently Asked Questions
  16. 16.0 16.1 16.2 16.3 New alcohol guidelines say reduce drinking to reduce risk
  17. 17.0 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 ICAP International Drinking Guidelines
  18. 18.0 18.1 Low-Risk Drinking Guidelines (LRDG) (goes live September 2006)
  19. 19.0 19.1 NICE, Routine antenatal care for healthy pregnant women March 2007
  20. 20.0 20.1 BBC 'No alcohol in pregnancy' advised 25 May 2007
  21. 21.0 21.1 New Zealand Ministry of Health Manatū Hauora Ministry releases revised food and nutrition guidelines for pregnancy and breastfeeding
  22. Department of Health Alcohol Advice
  23. NHS Alcohol and pregnancy
  24. Rosemary Bennett Zero – the new alcohol limit in pregnancy The Times 25 May 2007
  25. 'USDA, Dietary Guidelines for Americans 2005, Chapter 9: Alcoholic Beverages
  26. Alcohol and pregnancy
  27. 27.0 27.1 Alcohol and breastfeeding
  28. Consultation on children, young people and alcohol
  29. Parents back alcohol free childhood 17 December 2009
  30. BBC 'No alcohol' urged for under-15s 29 January 2009

External links

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