A health ministry expert panel on had drafted guidelines for low-risk alcohol use, setting the daily doses of pure alcohol that raises risks of diseases at 40 grams or more for men and 20 grams or more for women.
The low-risk alcohol use guidelines are now subject to public consultation and are set to be adopted in March 2024. In their current shape, the Japanese guidelines fall short of international standards and latest science.

A health ministry expert panel has developed draft alcohol use guidelines.

These alcohol use guidelines would be the first ever for Japan. They come at a time where a growing number of countries and regions are taking action to address alcohol in science-based ways, as evidence has become so clear on the risks of alcohol for health from already small amounts.

What’s in the draft alcohol use guidelines?

The draft alcohol use guidelines of Japan, however, would fall short of these international standards. The current draft is setting the daily doses of pure alcohol that raises risks of diseases at 40 grams or more for men and 20 grams or more for women.

The Mainichi reports that the proposed guidelines, the first of their kind in Japan, would state that “it is important to keep alcohol intake as low as possible,” due in part to research results in recent years that already small amounts of alcohol can raise the risk of high blood pressure, several types of cancer, and other diseases and health conditions.

The draft guidelines suggest that the effect of alcohol on health varied depending on the age, gender, and other factors. They also warn that “excessive” alcohol use made people more susceptible to diseases, such as cancer and alcohol addiction.

The proposed guidelines focused on the net amount of alcohol contained in beverages. Citing World Health Organization and other reports that the less alcohol a person consumes, the lower would their risk of cancer and other diseases be, the guidelines point out that even small amounts of alcohol use could raise the danger of high blood pressure, as well as oesophageal cancer among men and breast cancer among women.

According to Mainichi reporting, the draft guidelines also highlight research findings that ingesting approximately 20 grams or more of pure alcohol per day raised the risk of developing bowel cancer.

Growing alcohol-free trend in Japan but urgent need to address alcohol burden

The alcohol use guidelines are being drafted at a time when a growing number of young people in Japan is choosing an alcohol-free life or reducing their alcohol use. Instead of alcohol products, they are opting for no- and low-alcohol beverages when going out and socializing with friends.

Even the harmful alcohol norms at the workplace are changing. Forcing employees to consume alcohol is now seen as harassment and can lead to serious consequences for employers.

These trends indicate that the role alcohol plays in Japanese society is changing and that people are becoming more aware of and cautious about alcohol harm.

Also the COVID-19 pandemic strengthened this growing trend of Japanese people going alcohol-free. Lockdown restrictions led to bars and restaurants either being closed or not allowed to serve alcohol products since alcohol drove the COVID-19 spread. Japanese television ran compelling messaging campaigns reminding people to stay healthy during the pandemic, to avoid catching the virus, or developing complications. The combined effect was that more Japanese people have realized they do not need alcohol and enjoy the benefits of an alcohol-free, healthy life.

According to data from the NLI Research Institute,

  • About 38% of Japanese men in 2017 reported being alcohol-free. This is an increase from about 30% reporting the same a decade ago in 2007.
  • About 70% of Japanese women reported being alcohol-free in 2017 – up from about 65% a decade ago.
  • Men in their 40s and women in their 30s had the largest change between 2007 and 2017 in the proportion reporting being alcohol-free.

All of this is good news for Japan, a country suffering from a pervasive alcohol norm and massive alcohol harm. While the younger generations are undoing Japan’s pervasive alcohol norms, the harm of years of pervasive alcohol norms and heavy use are still being experienced in the country.

According to the World Health Organization (WHO) in 2016 in Japan,

  • Total per capita alcohol consumption was 8 liters.
    • This is higher than the average for the WHO Western-Pacific region.
  • Per capita consumption of male alcohol users was at 19 liters – among the highest rates in the world.
  • More than 20,000 cancer deaths are attributable to alcohol in Japan.
Cancer deaths caused by alcohol in Japan
According to the World Health Organization (WHO) in 2016 in Japan alcohol caused 20,124 cancer deaths.

The rate of alcohol use disorder and addiction is declining in most developed countries. But in Japan it’s increasing.

A 2013 survey conducted by the Japanese Health Ministry stated that about 1.09 million people in Japan had alcohol use problems but only 40 to 50 thousand were receiving treatment.

Domestic violence is high among alcohol users. Japan continues to see a rise in reported cases of domestic violence, with police was taking action on a record 9,088 cases in 2018.

Alcohol is a major risk factor for suicide and Japan has one of the highest suicide rates among developed countries in 2018. 

How the draft guidelines fall short of international standards

From Canada, to the Nordic countries, the Mexico, the Latin America and the Caribbean, many countries and regions are following the latest evidence about harm caused by low-dose alcohol use and improve their alcohol use guidelines.

In October 2023, the brand new Latin America and Caribbean Code against Cancer recommended avoiding alcohol to people and advised governments to use alcohol taxation, other alcohol policy best buys, and alcohol warning labels to prevent cancer.

In June 2023, the latest edition of the Nordic Nutrition Recommendations stressed the absence of a safe lower limit for alcohol use, aligning with a growing body of scientific evidence. These guidelines address alcohol not only from a health harm perspective but also from an environmental harm perspective that alcohol causes.

In May 2023, the new and improved Dietary Guidelines for the Mexican population provided 10 recommendations for a health and environmentally friendly approach to nutrition. One of them is for people in Mexico to “avoid alcohol consumption for the well-being of our physical and mental health and of our families.”

And Canada’s updated and improved low-risk alcohol use guidelines are deeply rooted in world-class science about alcohol harm and they now recommend to people a maximum of two alcoholic drinks per week. Already small amount of alcohol can be damaging to health.

Science is evolving, and the recommendations about alcohol use need to change.

Research shows that no amount or kind of alcohol is good for human health. It doesn’t matter what kind of alcohol it is – wine, beer, cider or spirits.

Drinking alcohol, even a small amount, is damaging to everyone, regardless of age, sex, gender, ethnicity, tolerance for alcohol or lifestyle.

Drinking alcohol has negative consequences. The more alcohol a person drinks per week, the more the consequences add up.

People should not start to use alcohol or increase their alcohol use for health benefits. Any reduction in alcohol use is beneficial. This applies even for those who are unable or unwilling to reduce their risk to low or moderate levels. In fact, those consuming high levels of alcohol have even more to gain by reducing their consumption by as much they are able.

These are four examples that illustrate that the daily doses of 40 grams pure alcohol for men and daily doses of 20 grams of pure alcohol for women above which health risks are supposed to occur are not in line with latest science and international standards.

Next steps

The Mainichi reports that the health ministry will finalize the guidelines by the end of March 2024 – after a period of public consultation. This gives people, communities, civil society, and public health experts that chance to present latest evidence and help the government improve their draft alcohol use guidelines.

The country clearly needs an evidence-informed approach to alcohol harm. And especially the younger generation seems to be ahead of the government in recognizing the risks and harm caused by alcohol.

Source Website: Mainichi