Does Drinking Within Low-Risk Guidelines Prevent Harm? Implications for High-Income Countries Using the International Model of Alcohol Harms and Policies
Research in Context
In Canada low risk guidelines to reduce risk from alcohol harm suggest no more than 10 units of alcohol for women per week and no more than 15 units for men.
However this study found these guidelines do not protect people from harm. In British Colombia a significant portion of alcohol-caused death and disability was experienced by those consuming within these guidelines. For example, more than 50% of cancer deaths resulting from alcohol use occurred in people consuming moderately. Further, 38% of all alcohol-attributable deaths were experienced by people consuming below the weekly limits or among former alcohol users.
Sherk and colleagues state that some national guidelines published by government may be too high.
When it comes to alcohol use, less is better,” said Dr. Adam Sherk, author of the study from Canadian Institute for Substance Use Research, University of VictoriaDr. Adam Sherk, Canadian Institute for Substance Use Research, University of Victoria
Many countries propose low-risk [drinking] guidelines for alcohol use (LRDGs) to mitigate alcohol-related harms. North American LRDGs are high by international standards. This study applied the International Model of Alcohol Harms and Policies (InterMAHP) to quantify the alcohol-caused harms experienced by those consuming within and above these guidelines. The study customized a recent Global Burden of Disease (GBD) analysis to inform guidelines in high-income countries.
Record-level death and hospital stay data for Canada were accessed. Alcohol exposure data were from the Canadian Substance Use Exposure Database. InterMAHP was used to estimate alcohol-attributable deaths and hospital stays experienced by people consuming within LRDGs, people consuming above LRDGs, and former alcohol users. GBD relative risk functions were acquired and weighted by the distribution of Canadian mortality.
More men (18%) than women (7%) consumed above weekly guidelines. Adherence to guidelines did not eliminate alcohol-caused harm: those consuming within guidelines nonetheless experienced 140 more deaths and 3,663 more hospital stays than if they had chosen to abstain from alcohol. A weighted relative risk analysis found that, for both women and men, the risk was lowest at a consumption level of 10 g per day. For all levels of consumption, men were found to experience a higher weighted relative risk than women.
Consumers following weekly LRDGs are not insulated from harm. Greater than 50% of alcohol-caused cancer deaths are experienced by those consuming within weekly limits. Findings suggest that guidelines of around one unit per day may be appropriate for high-income countries.