No
safe level of alcohol, new study concludes
Three million deaths
in 2016 were attributed to alcohol, which carries 'massive health risks,'
according to paper
University of
Washington School of Medicine
A new scientific study concludes there is no safe level of drinking alcohol.
The study, published
today in the international medical journal The Lancet, shows that
in 2016, nearly 3 million deaths globally were attributed to alcohol use,
including 12 percent of deaths in males between the ages of 15 and 49.
"The health risks
associated with alcohol are massive," said Dr. Emmanuela Gakidou of the
Institute for Health Metrics and Evaluation at the University of Washington and
the senior author of the study.
"Our findings are consistent with other recent research, which found clear and convincing correlations between drinking and premature death, cancer, and cardiovascular problems. Zero alcohol consumption minimizes the overall risk of health loss." Gakidou is a professor of health metrics sciences at the UW School of Medicine, and of global health at the UW School of Public Health.
"Our findings are consistent with other recent research, which found clear and convincing correlations between drinking and premature death, cancer, and cardiovascular problems. Zero alcohol consumption minimizes the overall risk of health loss." Gakidou is a professor of health metrics sciences at the UW School of Medicine, and of global health at the UW School of Public Health.
The study does not
distinguish between beer, wine, and liquor due to a lack of evidence when
estimating the disease burden, Gakidou said. However, researchers used data on
all alcohol-related deaths generally and related health outcomes to determine
their conclusions.
Alcohol use patterns vary widely by country and by sex, the average consumption per drinker, and the attributable disease burden. Globally, more than 2 billion people were current drinkers in 2016; 63% were male.
"Average
consumption" refers to a standard drink, defined in the study as 10 grams
of pure alcohol, consumed by a person daily, about the equivalent of:
- A small glass of red wine (100 ml or 3.4 fluid ounces) at 13% alcohol by volume;
- A can or bottle of beer (375 ml or 12 fluid ounces) at 3.5% alcohol by volume; or
- A shot of whiskey or other spirits (30 ml or 1.0 fluid ounces) at 40% alcohol by volume.
"Standard
drinks" are different by country. For example, in the United Kingdom a
standard drink is 8 grams of alcohol, whereas in Australia, the United States,
and Japan, it is 10 grams, 14 grams, and 20 grams, respectively.
The study, part of the
annual Global Burden of Disease, assesses alcohol-related health outcomes and
patterns between 1990 and 2016 for 195 countries and territories and by age and
sex.
It provides findings
on prevalence of current drinking, prevalence of abstention, alcohol
consumption among current drinkers, and deaths and overall poor health
attributable to alcohol for 23 health outcomes, such as communicable and non-communicable
diseases and injuries, including:
- Cardiovascular diseases: atrial fibrillation and flutter, hemorrhagic stroke, ischemic stroke, hypertensive heart disease, ischemic heart disease, and alcoholic cardiomyopathy;
- Cancers: breast, colorectal, liver, esophageal, larynx, lip and oral cavity, and nasal;
- Other non-communicable diseases: cirrhosis of the liver due to alcohol use, diabetes, epilepsy, pancreatitis, and alcohol use disorders;
- Communicable diseases: lower respiratory infections and tuberculosis;
- Intentional injuries: interpersonal violence and self-harm;
- Unintentional injuries: exposure to mechanical forces; poisonings; fire, heat, and hot substances; drowning; and other unintentional injuries; and
- Transportation-related injuries.
"We now understand
that alcohol is one of the major causes of death in the world today,"
said Lancet Editor Richard Horton. "We need to act now.
We need to act urgently to prevent these millions of deaths. And we can."
This study used 694
data sources on individual and population-level alcohol consumption, along with
592 prospective and retrospective studies on the risk of alcohol use. More than
500 GBD collaborators, such as researchers, academics, and others from more
than 40 nations contributed to the study, according to Max Griswold, senior
researcher and lead author.
"With the largest
collected evidence base to date, our study makes the relationship between
health and alcohol clear -- drinking causes substantial health loss, in myriad
ways, all over the world," Griswold said.
In 2016, eight of the
leading 10 countries with lowest death rates attributable to alcohol use among
15- to 49-year-olds were in the Middle East: Kuwait, Iran, Palestine, Libya,
Saudi Arabia, Yemen, Jordan, and Syria. The other two were Maldives and
Singapore.
Conversely, seven of
the leading 10 countries with highest death rates were in the Baltic, Eastern
European, or Central Asian regions, specifically Russia, Ukraine, Lithuania,
Belarus, Mongolia, Latvia, and Kazakhstan. The other three were Lesotho,
Burundi, and Central African Republic.
Health officials in
those nations, Gakidou said, would be well served by examining the study's
findings to inform their policies and programs to improve the health and
well-being of their constituents.
"There is a
compelling and urgent need to overhaul policies to encourage either lowering
people's levels of alcohol consumption or abstaining entirely," she said.
"The myth that one or two drinks a day are good for you is just that -- a
myth. This study shatters that myth."
ALCOHOL-ATTRIBUTABLE
DEATH RATES (PER 100,000 PEOPLE), 15-49 YEARS, BOTH SEXES, 2016
Highest rates:
- Lesotho: 145.3
- Russia: 118.4
- Central African Republic: 108.8
- Ukraine: 92.2
- Burundi: 81.1
- Lithuania: 76.1
- Belarus: 71.2
- Mongolia: 67.6
- Latvia: 65.5
- Kazakhstan: 62.2
Lowest rates:
- Kuwait: 0.3
- Iran: 0.4
- Palestine: 0.4
- Libya: 0.7
- Saudi Arabia: 0.7
- Yemen: 0.9
- Jordan: 1.3
- Maldives: 1.4
- Singapore: 1.6
- Syria: 1.7
PREVALENCE (%) OF
CURRENT DRINKERS, ALL AGES, 2016
MALES
Highest prevalence:
- Denmark: 97.1
- Norway: 94.3
- Argentina: 94.3
- Germany: 94.3
- Poland: 93.8
- France: 93.1
- South Korea: 91.3
- Switzerland: 91.2
- Greece: 90.8
- Iceland: 90.3
Lowest prevalence:
- Pakistan: 0.9
- Bangladesh: 1.0
- Egypt: 1.1
- Mali: 2.5
- Morocco: 3.0
- Senegal: 3.2
- Mauritania: 3.2
- Syria: 5.0
- Indonesia: 7.2
- Palestine: 7.9
FEMALES
- Highest prevalence:
- Denmark: 95.3
- Norway: 91.4
- Germany: 90.0
- Argentina: 89.9
- New Zealand: 88.5
- Switzerland: 88.4
- Slovakia: 87.2
- France: 86.9
- Sweden: 86.1
- Iceland: 84.8
Lowest prevalence:
- Bangladesh: 0.3
- Morocco: 1.1
- Pakistan: 1.5
- Egypt: 1.5
- Nepal: 1.5
- Syria: 1.6
- Bhutan: 1.9
- Myanmar: 2.3
- Tunisia: 2.3
- Senegal: 2.6
POPULATION AVERAGE OF
STANDARD DRINKS DAILY, ALL AGES, 2016
MALES
Greatest number of
drinks:
- Romania: 8.2
- Portugal: 7.3
- Luxembourg: 7.3
- Lithuania: 7.0
- Ukraine: 7.0
- Bosnia and Herzegovina: 6.5
- Belarus: 6.0
- Estonia: 6.0
- Spain: 5.8
- Hungary: 5.5
Lowest numbest of
drinks:
- Pakistan: 0.0008
- Iran: 0.004
- Kuwait: 0.02
- Comoros: 0.02
- Libya: 0.02
- Bangladesh: 0.03
- Palestine: 0.04
- Mauritania: 0.05
- Yemen: 0.05
- Saudi Arabia: 0.05
FEMALES
Highest number of
drinks:
- Ukraine: 4.2
- Andorra: 3.4
- Luxembourg: 3.4
- Belarus: 3.4
- Sweden: 3.2
- Denmark: 3.2
- Ireland: 3.1
- United Kingdom: 3.0
- Germany: 2.9
- Switzerland: 2.8
Lowest number of
drinks:
- Iran: 0.0003
- Kuwait: 0.01
- Mauritania: 0.02
- Libya: 0.02
- Pakistan: 0.03
- Timor-Leste: 0.04
- Palestine: 0.04
- Yemen: 0.04
- Tunisia: 0.04
- Syria: 0.05
Journal Reference:
GBD 2016 Alcohol
Collaborators. Alcohol use and burden for 195 countries and
territories, 1990–2016: a systematic analysis for the Global Burden of Disease
Study 2016. The Lancet, 2018; DOI: 10.1016/S0140-6736(18)31310-2